Breast and Cervical Cancer is a Medicaid optional eligibility category for certain groups of women who are in need of treatment for breast and cervical cancer.

This page is intended to provide materials of interest to various audiences regarding the prevention and treatment of breast and cervical cancer.  There is now a law that permits state Medicaid programs to provide medical services to certain women diagnosed with breast or cervical cancer.

The Breast and Cervical Cancer Prevention and Treatment Act of 2000

On October 24, 2000, the Breast and Cervical Cancer Prevention and Treatment Act of 2000 - Public Law 106-354 – (see Downloads below) was signed into law.  This Act, which has an effective date of October 1, 2000, gives states the option to provide medical assistance through Medicaid to eligible women who were screened through the Centers for Disease Control and Prevention's (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) (see Related Links Outside CMS below) and found to have breast or cervical cancer, including pre-cancerous conditions.

NBCCEDP, which is administered by CDC, provides free breast and cervical cancer screening and follow-up diagnostic services to women in need, such as those who are uninsured or have low incomes. In 2000, CDC began its 10th year of this landmark program, supporting early detection programs in all 50 states, 6 U.S. territories, the District of Columbia, and 12 American Indian and Alaska Native organizations.

Native American Breast and Cervical Cancer Treatment Technical Amendment Act of 2001

On January 15, 2002, Congress passed a technical amendment to the BCCPT Act. This amendment, the Native American Breast and Cervical Cancer Treatment Technical Amendment Act of 2001, extends benefits of the BCCPT Act to additional American Indian and Alaska Native women. On February 28, 2002, CMS sent a letter to State Health Officials (see Downloads below) advising them of this new provision.  The amendment is attached to the letter.

Medicaid Eligibility Requirements

In order for a woman to be eligible for Medicaid under this option, she must:

• have been screened for and found to have breast or cervical cancer, including precancerous conditions, through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP)
• be under age 65; and
• be uninsured and otherwise not eligible for Medicaid

Presumptive Eligibility Option

States may also choose the presumptive eligibility option to facilitate and expedite the eligibility process.

Presumptive eligibility is a Medicaid option that allows states to enroll women in Medicaid for a limited period of time before full Medicaid applications are filed and processed, based on a determination by a Medicaid provider of likely Medicaid eligibility.

CMS Guidance

The Center for Medicaid and State Operations (CMSO) within CMS has responsibility for the administration of the Medicaid program. On January 4, 2001, CMSO released a letter to State Health Officials which describes the Act (see Downloads below), the eligibility requirements, and what states are required to do if they choose to provide benefits to this new eligibility group.  A State Plan Amendment (SPA) form is attached to the letter for use by states. This form is prepared by the state and submitted to CMS regional office staff for approval.

Additional Guidance Information

The following links and PDF downloads below contain valuable additional guidance.  (These can be found at the end of this section under "Downloads" and "Related Links Inside CMS.")

• Technical Policy Questions and Guidance (see Downloads below).

• Model Agreement for Provisions of Breast and Cervical Cancer Screening, Prevention and Treatment Services (see Downloads below).

• State Activity Map (see Downloads below).

CMS and CDC are working together to develop further guidance which provides timely responses to important issues.  CMS and CDC will release additional guidance as needed and as it becomes available.  Comments and questions can be addressed to CMS and CDC.

1)     CMS:  E-mail to BCCPT@ cms.hhs.gov.

2)     CDC:  E-mail to cancerinfo@cdc.gov or call the Toll-Free Voice Information System at 1-888-842-6355, Option 7.

Downloads
Technical Policy Questions and Guidance [PDF - 232K] Model Agreement for Provision of Breast and Cervical Cancer Screening, Prevention and Treatment Services [pdf - 232k] CMS Letter to State Health Officials - FEB 28, 2002 [PDF - 250K] Public Law 106-354 [PDF] CMSO Letter - Breast and Cervical Cancer Prevention & Treatment Act [PDF] State Activity Map
Related Links Inside CMS
Breast Cancer Screening and Mammograms Cervical Cancer Screening
Related Links Outside CMS
American Cancer Society Agency for Healthcare Research and Quality American Public Human Services Association CDC - National Breast and Cervical Cancer Early Detection Programs Department of Health and Human Services - National Womens' Health Information Center HRSA - Bureau of Primary Health Care, Community Health Center Program National Association of State Medicaid Directors National Breast Cancer Coalition National Cancer Institute National Governors' Association

Page Last Modified: 12/13/2005 2:46:00 PM
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