Process for the Medicaid Breast and Cervical Cancer Early Detection Program (BCCEDP) 510-05-110-05

(New 2/1/2024 ML #3802)

Following is the process when an individual has submitted a Medicaid application, and the State has a referral from the Women's Way Screening Program:

If the State has received required documentation from the Women's Way Screening Program regarding an individual, contact with the Customer Support Center is made by the State sending an email to applyforhelp@nd.gov Upon receipt of the Medicaid application, the zone office will process the Medicaid application in the usual way but will NOT authorize it. Once the zone office has processed the Medicaid application and has informed the State that the case is processed but not authorized, the State will determine if the individual is eligible for coverage under the Medicaid BCCEDP. If the State determines the individual is eligible for coverage under the Medicaid BCCEDP , applicable information is entered in SPACES under the Special Health Care Coverage question and the Detail screen. If the State determines the individual is not eligible for coverage under BCCEDP coverage, no information is entered in SPACES. After determination is made, the State will contact the zone office to continue the processing of the Medicaid application in the usual way including authorization. Immediately after the zone authorizes the case, contact with the State must be made by sending an email to medicaidcc@nd.gov and include 'Medicaid BCCEDP' in the subject line as the state must add additional verbiage to the pending notice regarding the Medicaid BCCEDP coverage determination.

Following is the process for ongoing cases with an individual who has coverage under Medicaid BCCEDP:

The zone office must contact the State by sending an email to medicaidcc@nd.gov and include 'Medicaid BCCEDP' in the subject line on a case that includes an individual who has coverage under the BCCEDP when: A review is due for Medicaid A reported change is received and is being processed by the zone office. Updating the review period(s) or The individual becomes Medicare or Medicaid eligible.

If the state acts on reported change on an individual who has coverage under the Medicaid BCCEDP which can include BCCEDP coverage closing, contact with the zone will be made through email at applyforhelp@nd.gov. When the zone office receives a review for the household that includes an individual who has coverage under the Medicaid BCCEDP, contact with the State must be made by sending an email to medicaidcc@nd.gov and include 'Medicaid BCCEDP' in the subject line as the review must be processed jointly.

Note: A detailed narrative must be entered in SPACES by the state and the zone for actions taken in the case.