Okla. Admin. Code § 310:566-3-3

Current through Vol. 42, No. 7, December 16, 2024

Section 310:566-3-3 - Criteria for screening services contractors

Criteria for contractors to provide services include the following:

(1) Contractors shall ensure approved services are performed by board certified radiologists, pathologists, GYN physicians, surgeons, and oncologists.

(2) Contractors agree that procedures and services provided shall not exceed the amount that would be paid under Medicare Part B rates of Title XVIII of the Social Security Act.

(3) Mammography contractors shall ensure current FDA certification and ACR accreditation; be Medicare and Medicaid approved facilities; their participating physicians/providers be Medicare and Medicaid approved providers; and their services must be delivered with personnel and equipment in accordance with the Mammography Quality Standards Act.

(4) Mammography facilities shall utilize the Breast Image Reporting and Data System (BIRADS) and follow the ACR guidelines for mammography report content.

(5) A board certified radiologist must be immediately available to determine selection of views, and readings when a diagnostic mammogram is performed.

(6) Cytology and pathology specimens obtained shall be submitted to a CLIA approved laboratory for processing. The laboratory will provide cytological reading and analysis of cervical and vaginal Pap smears by Certified/Registered Cytotechnologists. And cytology (Pap) smears will be reported using the current Bethesda classification system. The laboratory will provide board certified pathologists or experienced certified cytotechnologists to re-screen all Pap smears with specified abnormal diagnosis. The Laboratory will provide surgical pathology analyses and readings of cervical and breast biopsies.

(7) Contract physicians shall practice according to the current standards of medical care for breast and cervical cancer early detection, diagnosis and treatment.

(8) Service delivery can be provided by a variety of settings. Service delivery must include:

(A) Providing screening services for a specific geographic area.

(B) Providing a point of contact for scheduling appointments.

(C) Providing age and income eligibility screening.

(D) Providing comprehensive breast and cervical cancer screening to eligible women.

(E) Providing referral and follow-up for women with abnormal screening results.

(F) Providing required reporting system for screening and follow-up activities.

(G) Providing population based education, out-reach, and recruitment activities.

Okla. Admin. Code § 310:566-3-3

Added at 22 Ok Reg 400, eff 12-21-04 (emergency); Added at 22 Ok Reg 2409, eff 7-11-05