Section 181-40-003 - ELIGIBILITYProviders and clients must meet statutory requirements and the following requirements:
003.01CLIENT. Eligibility criteria for the screening and diagnostic programs are as follows: (A) SCREENING. To participate in the screening an individual must submit a complete enrollment form and meet the following: (i) Be a woman between the ages of 21 - 74 years old;(ii) Have an income at or below 225% of the Federal Poverty Guidelines as of the effective date of the enrollment date; and(iii) Not have health coverage that would pay for preventive services.(B) DIAGNOSTIC. To participate in the Diagnostic Program, an individual must submit a complete enrollment form and meet the following:(i) Have an abnormal screening result within the last six months; and(ii) Be 18 -74 years of age for breast cancer diagnostics; or(iii) Be 21 -74 years of age, for cervical cancer diagnostics; and(iv) Have an income at or below 225% of the Federal Poverty Guideline as of the effective date of the enrollment date; and(v) Not have private, Medicare, or Medicaid insurance coverage that provides complete coverage for allowable program services.003.02PROVIDER. To participate as a provider in the Nebraska Breast and Cervical Cancer Program, a provider must meet the requirements in Neb. Rev. Stat. § 71-7010 and the following: (A) Service providers must be licensed by the Department, or hold equivalent credentials in another state, and perform services in compliance with requirements set out in 42 United States Code (U.S.C,) §300m as of the effective date of this chapter;(B) Submit a complete enrollment form;(C) Meet the standards set out in enrollment form;(D) Submit invoices and follow billing and payment procedures as set out in 181 Nebraska Administrative Code (NAC) 004; and(E) Accept payment made through the program as payment in full and not bill clients for Services covered by the program for which they were eligible at the time of service.181 Neb. Admin. Code, ch. 40, § 003
Amended effective 6/14/2022