2693.4 Eligibility Period

Eligibility continues as long as the person is receiving treatment for breast or cervical cancer. The case manager is responsible for monitoring ongoing treatment with the individual’s physician or other medical provider(s) and notifying the eligibility worker when the course of treatment ends.

Cooperation with the review requirements of 9310 is required. Individuals in this group will be mailed a Targeted Review form. Twelve month review periods shall be established for this group. The KC-1400 Notice of Review – Medical Assistance – BCC Program is used for the redetermination. Ongoing cancer treatment must be verified at review. The review form informs the beneficiary of the review and the requirement regarding ongoing cancer treatment. The beneficiary is responsible for obtaining verification of ongoing cancer treatment from the treating physician. The Statement of Continuing Cancer Treatment Medical Assistance - BCC Program is used to obtain information regarding treatment and care. Because the determination of ongoing cancer treatment is made by evaluating information on the form, the physician may submit additional information if necessary. The KDHE-DHCF Nurse/Program Manager for the BCC program makes the determination of ongoing cancer treatment.

Eligibility ends no later than the month following the month any of these requirements cease to be met, including reaching age 65, obtaining creditable coverage or the cessation of treatment. Eligibility may be established in another category if requirements are met. A new application will generally be required for this determination.

A BCC recipient who reports a pregnancy is continuously eligible per KFMAM 2300.