D Cancer Treatment Ends

 

 

Revised 06/01/2021

Policy

When a Breast and Cervical Cancer Treatment Program (BCCTP) customer’s treatment end date is reported, the BCCTP eligibility end date is determined using the following table:

When the treatment was for...

Then BCCTP eligibility ends...

A pre-cancerous cervical lesion

4 months after the cancer treatment ends.

Cervical cancer

12 months after the cancer treatment ends.

Breast cancer

12 months after the last provider visit for a treatment other than hormonal therapy; or at the end of hormonal therapy for breast cancer, whichever is later.

Because hormonal therapy is usually prescribed for up to 5 years, there is no extended BCCTP eligibility following hormonal therapy.

Metastasized cancer

As determined on a case-by-case basis by the AHCCCS Chief Medical Officer.

 

When a woman is no longer eligible for BCCTP, her eligibility is reviewed to see if she qualifies for any other AHCCCS Medical Assistance (MA) program.

 

Definitions

Term

Definition

Treatment End Date

·        Date of the last provider visit for a specific therapy for cervical cancer or a pre-cancerous cervical lesion; or

·        Date of the last provider visit for a specific therapy for breast cancer or the end of hormonal therapy, whichever is later.

 

Proof

A Treatment Status Update (BC-241) with a treatment end date as determined by the AHCCCS Complete Care (ACC) plan doctor.  The BC-241 is sent at least every six months until the treatment end date is confirmed.

 

Programs Affected

This policy applies to the Breast and Cervical Cancer Treatment Program (BCCTP).

 

Timeframes

AHCCCS uses the treatment end date to determine when BCCTP eligibility ends.  Action must be taken early enough to allow time to:

·        Determine eligibility for other MA programs, and

·        When not eligible for any other MA programs, send a letter in advance telling the customer her eligibility is ending.  See MA1501C for requirements.

See Examples - BCCTP timeframes when treatment ends

 

Legal Authority

Program

Legal Authorities

Breast and Cervical Cancer Treatment Program (BCCTP)

ARS 36-2901.05(A)(2)

AAC R9-2003(A)(1)