IM-120      12/18/07

DEPARTMENT OF SOCIAL SERVICES
FAMILY SUPPORT DIVISION
P.O. BOX 2320
JEFFERSON CITY, MISSOURI

TO:	ALL COUNTY OFFICES
FROM:	JANEL R. LUCK, DIRECTOR
SUBJECT:	CLARIFICATION OF BCCT PROGRAM MANUAL REVISION #44: 1300.000.00, 1300.005.00, 1305.025.00, 1305.025.05

DISCUSSION:

Effective immediately, the Breast and Cervical Cancer Treatment (BCCT) expansion referred to in Income Maintenance Memorandum IM-111 11/26/2007 is only for uninsured women (up to 65 years of age) who have been diagnosed with breast and/or cervical cancer while eligible for and receiving MO HealthNet benefits, except for Presumptive Eligibility for Children and Temporary MO HealthNet During Pregnancy (TEMP) programs.

All other eligibility criteria for BCCT remain the same.

Take the following actions for women who have been diagnosed with breast or cervical cancer:

• Women Receiving MO HealthNet for the Aged, Blind and Disabled (MHABD):

  Women diagnosed by a MO HealthNet provider with breast or cervical cancer and receiving MHABD spenddown based on blindness or disability are to receive BCCT, as there is no income or resource limit.

• Women Receiving Other MO HealthNet Coverage:

  Prior to discontinuing a woman's coverage under any MO HealthNet category, the exparte process must include the woman's possible eligibility under BCCT as well as all other MO HealthNet programs. Forms are being revised to include breast or cervical cancer diagnosis in the pre-closing notices.

  EXAMPLE:

  Ms. Johnston, age 21 and uninsured, is receiving MO HealthNet for Pregnant Women (MPW). She reports the birth of her child, Caleb, on January 15. A pre-closing notice is sent, stating her coverage will end on March 31 after her 60-day post-partum period. Ms. Johnston reports on March 15 that she was diagnosed by her MO HealthNet provider as having cervical cancer. The eligibility specialist takes the following steps:

  1. Registers a BCCT application for Ms. Johnston.

  2. Obtains Ms. Johnston's signature on the Medical Referral and Authorization (IM-60) form, and then sends the IM-60 along with the Certification of Need for Treatment - Breast/Cervical Cancer (BCC-2) form to Ms. Johnston's physician or gives a copy of the BCC-2 to her along with an IM-31A Request for Information requesting she have her physician complete and return the BCC-2 to verify breast or cervical cancer diagnosis and need for treatment.

  3. The BCC-2 is received by the eligibility specialist, showing a diagnosis date of March 13. The eligibility specialist approves Ms. Johnston for BCCT with an eligibility start date of April 1, as she is eligible for MPW through March 31.

• Women No Longer Receiving MO HealthNet Coverage:

  Women diagnosed by a MO HealthNet provider with breast or cervical cancer when eligible for and receiving MO HealthNet coverage (including during prior quarter eligibility), and who are no longer receiving MO HealthNet benefits, may apply and be eligible for BCCT, as long as all other eligibility conditions are met.

  EXAMPLE:

  Ms. Wilhite, age 30 and uninsured, comes into FSD on January 22, 2008, and applies for BCCT. She was diagnosed with breast cancer October 15, 2007, by her MO HealthNet provider and is still in need of treatment. She received Transitional MO HealthNet (TMH) from December 1, 2006, through November 30, 2007. The eligibility specialist follows the steps in the example above. As all other eligibility criteria are met, Ms. Wilhite is approved for BCCT with an eligibility start date of December 1, 2007.

  EXAMPLE:

  Ms. Caulfield, age 19 and uninsured, comes into FSD on January 10, 2008, and applies for BCCT. She was diagnosed with cervical cancer July 15, 2007, by her MO HealthNet provider and is still in need of treatment. Ms. Caulfield received and was eligible for MO HealthNet for Families (MHF) from June 1 through September 30, 2007, on her mother's MHF case, losing eligibility due to turning age 19 on September 30.

  The eligibility specialist follows the steps in the example above. As all other eligibility criteria are met, Ms. Caulfield is approved for BCCT with an eligibility start date of October 1, 2007.

NECESSARY ACTION:

• Effective immediately, BCCT applications must be evaluated for eligibility based on the policy in this memo.

• Review this memorandum with appropriate staff.

LH