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Aged, Blind and Disabled Manual Section: Categories of Eligibility Policy Manual Number: 115.005 Chapter: Breast or Cervical Cancer

Legal Authority: 1902(a)(10)(A)(ii)(XVIII) of the Social Security Act; Tenn. Comp. R. & Regs. 1200- 13-20 1. Overview The Center for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides funding to all 50 states, the District of Columbia, 5 U.S. territories, and 11 American Indian/Alaska Native tribes or tribal organizations to provide low- income individuals with screening, diagnostic and referral services for breast and cervical cancer. The Department of Health (DOH) Tennessee Breast and Cervical Cancer Screening Program (TBCCSP) provides these screening services to individuals at DOH local offices throughout the state. The TBCCSP provides clinical breast exams, mammograms and Pap tests and other needed cervical services for eligible individuals, free of charge. In order to receive these services free of charge, an individual must be: a. Under a certain income level based on family size; and b. Uninsured, or insured by a health policy that does not cover these screening tests. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 allows states to offer individuals in the NBCCEDP access to treatment through the Medicaid program. In Tennessee, eligible individuals receive Medicaid benefits in the Breast or Cervical Cancer (BCC) Category of Eligibility (COE). The CDC and the Centers for Medicare and Medicaid Services (CMS) provide matching funds to the program, equal to the state’s Medicaid Federal Medical Assistance Payment (FMAP). 2. Policy Statement TennCare Medicaid benefits are available to individuals who receive breast or cervical cancer diagnoses, including for precancerous conditions, through the TBCCSP. Eligible individuals must require ongoing treatment for the cancer, meet all non-financial and financial eligibility requirements, and not be eligible in any other TennCare Medicaid or TennCare Standard COE. Individuals diagnosed with breast or cervical cancer by the DOH may receive presumptive eligibility for the TennCare Medicaid program, if they are otherwise eligible. Presumptive eligibility provides coverage through the end of the month after the eligibility determination is made.