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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 April 2024 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.700 26 M0330.700 BREAST AND CERVICAL CANCER PREVENTION AND

TREATMENT ACT (BCCPTA)

A. Policy The Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) of 2000 (P.L. 106-354) provides for payment of medical services, including long- term care (LTC) (see Chapter M14) for certain women and men with breast cancer or women with cervical cancer Individuals eligible for the BCCPTA program must be age 18 through 64. They must have been screened and certified as needing treatment for breast or cervical cancer (including pre-cancerous conditions) by a medical provider operating under the Center for Disease Control and Prevention's Breast and Cervical Cancer Early Detection Program (BCCEDP) and referred to LDSS for a Medicaid eligibility determination. These individuals must not have creditable health insurance coverage for treatment of breast or cervical cancer. Virginia’s BCCEDP program, Every Woman’s Life, is administered by the Virginia Department of Health. Screening locations can be found at Free Breast and Cervical Screenings - Free Breast and Cervical Screenings (virginia.gov). Information can also be obtained by calling 1-866-395-4968. Through an agreement between Virginia and the District of Columbia (D.C.), residents of northern Virginia (the cities of Alexandria, Fairfax, Falls Church, Manassas, Manassas Park and the counties of Arlington, Fairfax, Loudoun and Prince William) are allowed to be screened and diagnosed for breast or cervical cancer and pre-cancerous conditions through the DC Center for Disease Control and Prevention’s “Project Wish” program. Individuals who are screened and certified as needing treatment for breast or cervical cancer through Project Wish may be eligible for Virginia Medicaid, provided they meet the requirements of the BCCPTA covered group. These individuals will receive a Virginia BCCPTA Application Form from the DC providers and will be instructed to submit the application directly to the local department of social services in their home locality. Individuals diagnosed with cancer by a provider who is not operating under the BCCEDP are not eligible in this covered group. Every Woman’s Life is responsible for determining if an individual was diagnosed by a BCCEDP provider. Refer individuals who indicate to the local agency that they received a breast or cervical cancer diagnosis but do not provide the BCCPTA Application Form to Every Woman’s Life (see above for contact information). B. Nonfinancial Eligibility 1. Required Nonfinancial Requirements BCCPTA individuals must meet the Medicaid nonfinancial requirements in chapter M02. In addition, BCCPTA individuals must not be eligible for Medicaid under the following mandatory categorically needy covered groups: