The Breast and Cervical Cancer Prevention and Treatment Act of 2000 (BCCPTA – the Act) (Public Law 106-354) amends Title XIX of the Social Security Act to give States enhanced matching funds to provide Medicaid eligibility to uninsured women under age 65 who are diagnosed through the federal breast cancer screening program and in need of treatment.
The California Breast Cancer Treatment Fund (BCTF) was initially implemented by the California Health Collaborative with philanthropic funds in 1996 and continues to be administered by that 501(c)(3) organization. Through December 2000, a total of 2,566 low-income (< 200% FPL), uninsured, breast cancer patients were enrolled for 12 to 18 months of eligibility for a scope of treatment benefits including surgery, chemotherapy, and radiation therapy. Eighty-seven percent of these enrollees are women aged 40-64, demonstrating this age group to be the most likely to have no source of coverage for treatment. About 60 percent of the patients were diagnosed through State or federal screening programs, with the remainder referred by other non-government sources. The highest proportion (43%) of these enrollees are classified as Stage II, with 24.9% classified Stage I, 16.1% Stage III, and 10.5% in situ. Over 1,800 medical providers participate with case rate or fee-for-service payments scheduled at 120 percent of Medicaid rates. Patient care coordination is key to provider recruitment and patients’ navigation of the continuum of providers.
The lessons learned from the BCTF experience can inform states as they implement the Medicaid option to provide treatment to low-income, uninsured women.
Learning Objectives: 1. Describe the volume, ages, and stage of disease of low-income women likely to seek breast cancer treatment through the new Medicaid option. 2. List and discuss the major policy and operations variables that define the cost and efficacy of a breast cancer treatment program. 3. Recognize how the scope of covered benefits can be used to promote best clinical practices in breast cancer treatment.
Keywords: Breast Cancer Programs, Treatment System
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: California Health Collaborative
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employee of the California Health Collaborative. The California Breast Cancer Treatment Fund Program is enabled by grants and contracts to California Health Collaborative