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Staff Tools | Breast and Cervical Cancer Medical Program Manual
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DHS home | SPD
Staff Tools | Breast and Cervical Cancer Medical Program Manual
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This program is for women who have a need for medical assistance based on the need for treatment for breast or cervical cancer. The Department administers the Oregon Breast and Cervical Cancer Program (BCCM) by entering into agreements with local entities (referred to in this rule as qualified entities) to provide screening services funded by the Centers for Disease Control in support of the National Breast and Cervical Cancer Early Detection Program. The qualified entities make the eligibility determination. If an individual has not been determined eligible for BCCM by a qualified entity and they do not meet the requirements for any other DHS Medicaid program, they should be denied.
DHS Health Services is responsible for ensuring that BCCM clients meet program eligibility requirements. Treat BCCM clients as presumptively eligible for Medicaid based on the determination by Health Services All BCCM cases are maintained at the Statewide Processing Center in Salem.
A woman may be eligible for medical assistance without regard to her income or resources. To be eligible, she must:
Start of presumptive eligibility. A woman is presumptively eligible for the BCCM program under this rule beginning the day a qualified entity determines, on the basis of preliminary information, that she is likely to meet the requirements above.
End of presumptive eligibility. A woman is no longer presumptively eligible for the BCCM program under this rule the earlier of:
A qualified entity that determines that a woman is presumptively eligible for the BCCM program must:
Continuing eligibility following the period of presumptive eligibility. To remain eligible for benefits, a woman determined by a qualified entity to be presumptively eligible under this rule, but who is potentially eligible for medicaid, must apply for medical assistance by not later than the last day of the month following the month during which the determination is made. The Department determines continuing eligibility of a woman found presumptively eligible under this rule. To facilitate the determination process, the Department will provide qualified entities with the necessary forms and information on how to assist such women in completing and filing the forms.
When eligibility ends. A woman found eligible for the BCCM program by the Department under this rule becomes ineligible:
Periodic Redeterminations. Redeterminations are due every 12 months. 461-115-0430
Age. The client must be under age 65. 461-120-0510
Estates. They will have a claim against their estates. 461-135-0835
Retroactive Medical. May have 90 days retroactive medical, but not to precede January 1, 2002. 461-135-0875
The BCCM Program Application (DHS 1463) is sent by an Oregon Breast and Cervical Cancer Program Coordinator to branch 5503 for her eligibility determination. They will code the case and may send an OHP 7210 to her to determine eligibility for other Medicaid programs. The OHP branch will determine, code and hold these cases.
If a woman is determined to be eligible for BCCM, she will be coded as a P2
case with a BCP case descriptor. If she is subsequently determined eligible
for another program she will be coded for that program with a BCS case descriptor.
