Breast and Cervical Cancer Medical Program

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Breast and Cervical Cancer Medical Program BCCM
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Overview

• Federal Legislation
• Screening
• Treatment
• What is BCCM?
• Who is Eligible for BCCM?
• What does the BCCM Cover?
• How does the BCCM Work?

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• Breast and Cervical Cancer Mortality Prevention
  Act of 1990
• The Breast and Cervical Cancer Mortality
  Prevention Act of 1990 (Public Law 101-354)
  established the Centers for Disease Control and
  Preventions National Breast and Cervical Cancer
  Early Detection Program. The program provides
  breast and cervical cancer screening exams to
  underserved women, including those who are older,
  have low incomes, or are members of racial and
  ethnic minority groups. The program operates in
  all 50 states, the District of Columbia, 6 U.S.
  territories, and 12 American Indian/ Alaska
  Native organizations.
• Screening of Oregon women began in 1995.
• Screening and Diagnostics only.
• Treatment for diagnosed cancers is expressly
  excluded.

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• Breast and Cervical Cancer Prevention and
  Treatment Act of 2000
• Signed into law on October 24, 2000 by President
  William Clinton. This Act gives states the
  option to provide medical assistance through
  Medicaid to eligible women who were screened for
  and found to have breast or cervical cancer,
  including precancerous conditions, through the
  National Breast and Cervical Cancer Early
  Detection Program (NBCCEDP).
• Adopted by Oregon State Legislature in January
  2002 and effective 1 April 2002.

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• Oregon BCCP / BCCM
• Breast and Cervical Cancer Program (BCCP)
• Grant from the CDC
• Grants from Susan G. Komen and American Cancer
  Society
• Screening diagnostic services only
• No State General Funds
• Breast and Cervical Cancer Medical Program (BCCM)
• Medicaid waiver
• Treatment services through OHP
• 3 Fed for every 1 State
• No State General Funds

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What is the BCCM?
The BCCM is a Medicaid waiver which acts as a
conduit between the BCCP (Screening and
Diagnostic program) to the state Medicaid program
(Oregon Health Plan OHP). It allows BCCP women
diagnosed with breast or cervical cancer to
receive life-saving cancer treatment.
BCCP - Screening
BCCM is the Link between the Screening Program
and the Oregon Health Plan.
OHP - Treatment
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Basic Eligibility for the BCCM

• A woman who was enrolled in the BCCP and was
  diagnosed with breast or cervical cancer,
  including CIN II/III, is presumed eligible for
  the BCCM.
• She does not have to fill out an OHP application.
• She does not have to undergo assets testing.
• There is no wait period for eligibility
  determination.

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Who is Eligible for the BCCM?

• Women who have received a breast or cervical
  cancer screening and/or diagnostic procedure paid
  for by the BCCP and have been found to be in
  need of treatment for breast or cervical cancer
  or CIN II/III and who are
• under the age of 65 and
• legal residents of the U.S.A.
• Men are NOT eligible for the BCCM.

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What does BCCM cover?

• Women who are enrolled in BCCM are immediately
  put into the OHP-Plus Program. Effective date is
  the date that they were determined to be in need
  of treatment for breast or cervical cancer.
  This is the date that the cancer was diagnosed
  which is typically the date of their biopsy.
• Women can be retrod as far back as 90 days if
  needed.
• E.g., unpaid medical bills within the previous 90
  days.

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What does BCCM cover?

• Women are insured by OHP-Plus for ALL OHP-Plus
  covered services.
• Includes non-breast or cervical cancer services,
  such as routine doctors office visits,
  preventive health exams, injuries,
  pharmaceuticals, mental health coverage, dental
  and medical transportation.
• Call 1-800-273-0557, the OHP Patient Services
  Hotline for specific coverage information.

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What does BCCM cover?

• Provides an OHP open card vs. a managed health
  care plan. Women may use their OHP card wherever
  it is accepted.
• Women diagnosed with invasive cervical or breast
  cancer will be enrolled in OHP-Plus for one year.
• Women diagnosed with CIN II or CIN III will be
  enrolled in OHP-Plus for six months.

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What does BCCM cover?

• Children of BCCM-eligible women who are under the
  age of 19 and still residing within the household
  are eligible to apply for OHP standard.
• Women who are still in need of treatment for
  their breast or cervical cancer will continue to
  be re-enrolled in OHP-Plus until such time as
  they are NO longer in need of treatment.

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What does BCCM cover?

• At the end of the enrollment period, the women
  will be sent a letter of redetermination. This
  is a one-page form that OHP will mail to her
  toward the end of her eligibility period.
• She should take this form to her doctor and have
  him or her sign it.
• If she is still in need of treatment for her
  breast or cervical cancer, her doctor will sign
  yes, she is still in need.., sign the form and
  mail it to OHP in Salem.
• If she is no longer in need of treatment, her
  benefits are terminated.

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Redetermination Form
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What does BCCM cover?

• The annual redetermination process will continue
  for as long as she is in need of treatment for
  the breast or cervical cancer which initially
  qualified her for the program.
• There is no time limit i.e., Tamoxifen or Femara
  use
• Upon termination of OHP-Plus eligibility, she may
  apply for OHP standard and will be given
  preferential treatment because she will have had
  continuous health insurance coverage. At that
  time she must fill out the OHP standard
  application and meet all of the OHP assets
  testing.

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How does the BCCM Work?

• Upon a BCCP client being diagnosed with breast or
  cervical cancer or CIN II/III, notify the BCCP
  office at 971-673-0581 or BCCP_info_at_state.or.us.
• The BCCM Coordinator will contact you (the
  provider) and arrange to send the patient a BCCM
  application form.
• Preference is email

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BCCM Application Form Page 1
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BCCM Application Page 2
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BCCM Application Page 3
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BCCM Application Page 4
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How does the BCCM Work?

• The patient will fill out the BCCM application
  and FAX it back to the BCCP. Sending this form
  directly to OHP will delay processing.
• BCCP will log, review, approve, sign and FAX the
  BCCM application to a special unit of the OHP in
  Salem for immediate processing.
• OHP will log the application into their system
  assign a recipient ID number and begin
  processing.
• About five working days for new OHP recipient to
  be accessible in OHP system.
• About two weeks before new OHP recipient receives
  OHP card via the mail.

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How does the BCCM Work?

• Things that delay BCCM processing
• NO Social Security Number
• OHP will only process for Emergent Care
• NO Signature
• Client MUST sign
• About one month after initial BCCM application is
  filed, OHP will send a form to the recipient
  asking her to declare her U.S.A. citizenship
  status.
• No proof required, e.g., passport or birth
  certificate.
• Failure to return form will end clients
  eligibility.

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How does the BCCM Work?

• The OHP Processing Center will add the womans
  name into the DHS-OHP database. Providers can
  access this database.
• Once the BCCP woman has been put into OHP, the
  PCP should close out her BCCP cycles. She is now
  a client of OHP vs. a BCCP client.
• As a PCP, ensure that you obtain and enter the
  following information into the BCCP Web Data
  System. This is important for CDC reporting
• Date treatment started
• Stage of tumor
• Size of tumor

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Contact Us!

• Contact us
• Contact BCCP at [phone].
• You can also email us at bccp.info_at_state.or.us.

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Contact Us!

• Your participation in the Breast and Cervical
  Cancer Program helps save lives, and we thank you
  for your support.