Or. Admin. Code § 333-010-0115

Current through Register Vol. 63, No. 11, November 1, 2024

Section 333-010-0115 - Client Enrollment

(1)

(a) Clients are determined eligible on a self-declared basis, when they submit a completed and signed ScreenWise BCC enrollment form at the clinic site at the time of service.

(b) Prior to enrolling a client in ScreenWise BCC, providers with access to the Medicaid Management Information System (MMIS) shall check MMIS to verify that applicant is not currently receiving Medicaid. Clients enrolled in Medicaid are ineligible for ScreenWise BCC.

(2) Eligibility is effective for one year unless a client justifiably needs to begin a second breast or cervical cycle, as defined in the program manual, before the end of one year. Justifications include:

(a) The presence of new signs or symptoms; or

(b) The necessity of short-term follow-up, as defined in the program manual.

(3) If breast or cervical services are justifiably initiated again before the end of one year, then eligibility will automatically extend through the end of that cycle, even if the cycle lasts into a new year.

(4) ScreenWise BCC providers must keep a signed enrollment form on file at the clinic for a minimum of four years. Clients enrolled into the program who are found ineligible will be disenrolled.

Or. Admin. Code § 333-010-0115

PH 9-2008, f. & cert. ef. 6-16-08; PH 1-2012, f. & cert. ef. 1-17-12; PH 28-2014, f. & cert. ef. 10-10-14; PH 11-2016, f. & cert. ef. 4/1/2016

Stat. Auth.: ORS 413.042

Stats. Implemented: ORS 413.042