5160:1-5-03 Medicaid: medicaid buy-in for workers with disabilities (MBIWD).  

  • Text Box: ACTION: Final Text Box: DATE: 03/13/2015 10:16 AM

     

     

     

    TO BE RESCINDED

     

    5160:1-5-03                 Breast and cervical cancer project (BCCP) medicaid: eligibility requirements.

     

     

    An individual must meet all of the following criteria to be eligible for BCCP medicaid:

     

    (A)  The Ohio department of health (ODH) or its designated local agencies or subgrantees must determine the individual eligible for the ODH breast and cervical cancer project (BCCP).

     

    (B)   The individual must be screened for breast or cervical cancer under the centers for disease control and prevention's (CDC) national breast and cervical cancer early detection program (NBCCEDP).

     

    (1)   An individual is not required to obtain screening for both breast and cervical cancer as a condition of eligibility for participation in the NBCCEDCP.

     

    (2)   Individuals screened for breast or cervical cancer under the CDC NBCCEDP in a state other than Ohio must be determined eligible for the ODH BCCP and must utilize the ODH BCCP case management services and Ohio 's BCCP medicaid application process as outlined in rule 5101:1-41-05 of the Administrative Code.

     

    (C)   The CDC NBCCEDP funded screening must indicate to a treating health professional that the individual needs treatment for breast or cervical cancer, pre-cancerous conditions, or early stage cancer).

     

    (D)      The individual must be uninsured as defined in rule 5101:1-41-02 of the Administrative Code.

     

    (E)     The individual must not meet the eligibility criteria of any other category of medicaid.

     

    (1)       The ODJFS shall screen, as described in rule 5101:1-41-05 of the Administrative Code, all BCCP medicaid applicants for potential eligibility in other categories of medicaid.

     

    (2)   While there are no income or resource limitations for BCCP medicaid, ODJFS may require BCCP medicaid applicants to provide information regarding income and/or resources to screen the applicant for potential eligibility in other categories of medicaid.

     

     

     

     

    (F)   The individual must be under sixty-five years of age.

    (G)    The individual must meet all other general nonfinancial and nonresource eligibility requirements applicable to medicaid applicants (e.g.., citizenship/immigration status, Ohio residency, etc.) as delineated in Chapters 5101:1-38, 5101:1-39, and 5101:1-40 of the Administrative Code

    (1)        Individuals not meeting citizenship or immigration status eligibility requirements may be eligible for coverage for an emergency medical condition as described in rule 5101:1-30-80 of the Administrative Code.

    Effective:

     

    03/23/2015

    Five Year Review (FYR) Dates:

     

    12/12/2014

     

    CERTIFIED ELECTRONICALLY

     

     

    Certification

     

     

     

    03/13/2015

     

     

    Date

     

     

     

    Promulgated Under:

     

    111.15

     

    Statutory Authority:

    5111.0110

     

    Rule Amplifies:

    Prior Effective Dates:

    5111.0110

    None

     

Document Information

Effective Date:
3/23/2015
File Date:
2015-03-13
Last Day in Effect:
2015-03-23
Five Year Review:
Yes
Rule File:
5160$1-5-03_FF_R_RU_20150313_1016.pdf
Related Chapter/Rule NO.: (1)
Ill. Adm. Code 5160:1-5-03. Medicaid: medicaid buy-in for workers with disabilities (MBIWD)