Presumptive Eligibility (PE) Programs

1900.020.50 Breast and Cervical Cancer Treatment (BCCT-PE)

IM#51, May 18, 2017

Section 1902 [42 U.S.C. 1396a] (a) (10) (A) (ii)(XVIII) of the Social Security Act allows states the option of providing medical assistance to uninsured women under age 65, that have been screened and need treatment for breast and cervical cancer under the Centers for Disease Control and Prevention Breast and Cervical Cancer Early Detection Program. Section 1920B [42 U.S.C. 1396r.lb] allows states to provide a period of Presumptive Eligibility. Missouri opted to provide this coverage to Missouri residents when the Breast and Cervical Cancer Treatment Act (HB 762) was signed June 21, 2001. The program began effective August 28, 2001.

The Department of Health and Senior Services (DHSS) is responsible for insuring that providers meet criteria for screening under the Breast and Cervical Cancer Treatment Act.

Eligibility requirements for BCCT-PE are found in section 1305.000.00 ELIGIBILITY CRITERIA.

Presumptive Eligibility determinations for BCCT (BCCT PE) are made by Show Me Healthy Women (SMHW) providers who have signed a SMHW Participation Agreement with the Department of Health and Senior Services (DHSS). When a SMHW provider determines a woman is eligible for PE, they will issue a BCCT Temporary MO HealthNet approval letter (BCC-1).

NOTE: Only hospitals that are SMHW providers are allowed to determine eligibility for BCCT PE.