Ohio Admin. Code 5160:1-5-02.2 - Medicaid: breast and cervical cancer project (BCCP): eligibility requirements
(1) When the individual no longer
meets one or more of the eligibility criteria for BCCP medicaid described in
(2) When a finding is made that the
individual was determined eligible for Ohio department of health (ODH) BCCP
when such determination was made in error and ODH BCCP eligibility did not
(3) When a finding is made that the
individual was not screened for breast or cervical cancer under
(4) When the individual no longer
receives treatment for breast or cervical cancer, pre-cancerous conditions, or
early stage cancer. "Treatment" and "no longer receives treatment of breast or
cervical cancer" are defined in rule 5160:1-5-02.1 of the Administrative
(5) When the treatment period has
ended and ODM has not received the required renewal documents with verification
of continued need for treatment.
(a) ODM may presume that an
individual is receiving treatment for the duration of the treatment
(b) A treatment period lasting more
than twelve months from the beginning month of BCCP eligibility requires ODM to
perform a review of the individual's continuing BCCP medicaid eligibility, in
accordance with rule 5160:1-5-02.4 of the Administrative Code.
(6) When the individual obtains
creditable health coverage as defined in rule 5160:1-5-02.1 of the
(7) When the individual reaches
sixty-five years of age.
(8) When the individual meets
eligibility criteria of any other category of medicaid. If the individual is
determined eligible for any other category of medicaid, the last day of BCCP
medicaid coverage will be the last day of the month prior to the month the new
category of medicaid begins.
(9) When the individual fails to
cooperate in the eligibility determination or renewal process, including the
determination of eligibility for other categories of medicaid.
(a) To facilitate immediate access
to services for individuals who are in need of treatment for breast or cervical
cancer, BCCP medicaid coverage shall be approved for a period of time while an
eligibility determination for other categories of medicaid is
(b) If the individual fails to
cooperate in the determination of eligibility for other categories of medicaid
as required, the last day of BCCP medicaid coverage will be the last day of the
month following the month in which eligibility for BCCP medicaid coverage was
approved, in accordance with paragraph (D)(9)(a) of this rule.
Promulgated Under: 111.15
Statutory Authority: 5163.02, 5160.02
Rule Amplifies: 5160.02, 5163.02
Prior Effective Dates: 07/01/2002, 03/23/2015, 01/01/2018, 07/08/2020 (Emer.)
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