Reassessment

During the review, the Form WHM Physician’s Statement of Treatment is completed for continued coverage. However, some members' coverage ends when the doctor states the member is no longer in treatment. If the doctor indicates on the WHM Physician’s Statement of Treatment form that the member is in treatment but notes that the member is being treated for follow-ups or may have another type of cancer that is not considered as coverage under the Breast and Cervical Cancer Program, a second-level review by DPH is required to determine the member’s eligibility.

DFCS must receive a written response from DPH before action can be taken. Once a decision is made, the caseworker will act upon the case based on the decision made by DPH.