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Information for Potential Providers
The New Mexico Department of Health Breast and Cervical Cancer Early Detection Program is federally funded by the Centers for Disease Control and Prevention (CDC), and received an additional $300,000 in New Mexico State General Funds in 2006-2007.
Since it was established in 1991, the BCC Program has provided comprehensive breast and cervical cancer screening and diagnostic services to more than 120,969 underserved women statewide, including:
- 197,957 clinical breast exams
- 122,277 mammograms
- 183,609 Pap tests
What do potential Providers need to know about the BCC Program?
- The target population of the BCC Program is women aged 50 and older, in accordance with congressional and federal funding priorities.
- The BCC Program is funded to serve just 15-20% of New Mexico's eligible population.
- All BCC Program women receive age-appropriate, accepted standard-of-care breast and cervical cancer screening and early detection services.
- To ensure early detection, the BCC Program places emphasis on rescreening.
- Only women who receive screening and diagnostic services through the BCC Program are potentially eligible to receive treatment through BCC Medicaid.
Why is the BCC Program so important in New Mexico?
In 2004-2005:
- 23% of New Mexican women ages 19-64 reported having no healthcare coverage compared to a rate of 18% for U.S. women.
- 24% of New Mexican women were living in poverty compared to a rate of 19% for U.S. women.
Statistics taken from the Henry Kaiser Family Foundation State Data
What Services are Covered?
- Clinical Breast Exam
- Mammogram (Age-Appropriate)
- Pap Test
- Pelvic Exam
- HPV Testing (When Necessary)
- Some Follow-up Diagnostic Procedures
- Case Management
What are the eligibility requirements for the BCC Program?
Insurance:
- Eligible women must have no health insurance or inadequate coverage (high deductibles and/or co-pays, Indian Health Service coverage only).
Note: Medicare Part B covers screening services. If a woman has Medicare Part B or Full New Mexico Medicaid, she is not eligible for this Program.
Income:
- Eligible women must have a household income at or below 250% of the federal poverty level.
Age:
- An established BCC Program woman is defined as a woman who received paid services through the Program within the last three (3) years, and continues to meet program eligibility guidelines regardless of age (three [3] years is determined from the date of the last service paid).
- A new BCC Program woman must be aged 30 years or older to enter the BCC Program.
- Prior Approvals are not required for Program women to receive cervical diagnostic services when the BCC Algorithm is followed.
- Prior Approvals are required when a diagnostic LEEP is indicated, or when cervical diagnostic services outside the BCC Algorithm are requested.
- Prior Approvals are required for breast diagnostic services for Program women under age 40.
- The BCC Program pays for screening mammograms every 2 years for women aged 40-49, and annually beginning at age 50.
What if a Program Client Needs Treatment?
If a woman is diagnosed with breast or cervical cancer or a precancerous condition through the BCC Program, she can apply for Breast and Cervical Cancer
Medicaid (Category 052) through the Program office. If she meets this category's requirements she will have access to full Medicaid services, which include the cost of cancer treatment.
If she is not eligible for this Medicaid category, there are a number of other
funds that may help cover the cost of treatment, including the Anita Salas
Memorial Fund. The BCC Case Manager will help determine what appropriate financial
resources are available.
Why Should You Become a BCC Provider?
As a BCC Provider, you will be able to offer these important services to eligible
women, and the BCC Program will reimburse you.
Call (505) 841-5860 to learn how to
become a BCC Program Provider.
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Last updated on 09/20/2007 01:46 pm.
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