Okla. Admin. Code § 317:35-21-1

Current through Vol. 42, No. 4, November 1, 2024

Section 317:35-21-1 - Oklahoma Cares Breast and Cervical Cancer Treatment (BCC) program

(a) The Breast and Cervical Cancer Prevention and Treatment Act of 2000 (BCCPTA) allows states to provide Medicaid to uninsured women under age sixty-five (65) who are in need of treatment for breast and/or cervical cancer. A medical eligibility evaluation is performed through the Centers for Disease Control(CDC) and Prevention's National Breast and Cervical Cancer Early Detection Program (NBCCEDP). If the evaluation determines the woman is in need of treatment for breast and/or cervical cancer, including pre-cancerous conditions and early stage, recurrent or metastatic cancer the case is forwarded to Oklahoma Health Care Authority (OHCA) for final medical eligibility determination.

(b) To receive Breast and Cervical Cancer (BCC) Treatment services, the woman must meet all of the following conditions.

(1) The woman must have been screened for BCC under the CDC Breast and Cervical Cancer Early Detection Program [see Oklahoma Administrative Code (OAC) 317:35-21-3] established under Title XV of the Public Health Service Act, and upon screening examination found to be in need of treatment, including an abnormal finding that is potentially indicative of a cancerous or precancerous condition or found to have an early stage, recurrent or metastatic cancer of the breast or cervix. (see OAC 317:35-21-5) .

(2) The woman must:

(A) not have creditable insurance coverage that covers the treatment of breast or cervical cancer (see OAC 317:35-21-4) ,

(B) not be eligible for any other categorically needy SoonerCare eligibility group,

(C) be under sixty-five (65) years of age,

(D) be a US citizen or qualified alien (see OAC 317:35-5-25 for citizenship/alien status and identity verification requirements),

(E) be a resident of Oklahoma,

(F) declare her Social Security number,

(G) assign her rights to Third Party Liability if she has insurance that is not creditable, and

(H) declare her household income for the purpose of determining eligibility for services under the SoonerCare program.

Okla. Admin. Code § 317:35-21-1

Added at 22 Ok Reg 409, eff 1-1-05 (emergency); Added at 22 Ok Reg 2528, eff 7-11-05; Amended at 24 Ok Reg 2116, eff 6-25-07; Amended at 28 Ok Reg 1546, eff 6-25-11

Amended by Oklahoma Register, Volume 36, Issue 21, July 15, 2019, eff. 9/1/2019