Breast and Cervical Cancer Prevention and Treatment Act

May 19, 2013

ACS CAN won a reversal of an adverse breast and cervical coverage decision in Tennessee. Through ACS's Health Insurance Assistance Service, ACS CAN learned that Tennessee had wrongfully denied Medicaid coverage to a woman who was eligible for the program under the Breast and Cervical Cancer Prevention and Treatment Act of 2000 (BCCPTA). The state claimed she lost her eligibility due to having an Aflac cancer-only policy. This supplemental insurance policy should not have affected her coverage, but Tennessee used that policy to claim it did not have to give her benefits. While ACS CAN did not legally represent the patient, we worked through our Judicial Advocacy Initiative to make Centers for Medicare and Medicaid Services (CMS) (the DC federal agency) aware of her case as an example of a practice that could have affected many other women in the state. At CMS's request, Tennessee performed a comprehensive review of their records and reinstated the patient's eligibility for Medicaid. In this patient's case, Medicaid may be life-saving due to her history. The ACS CAN letter leading to the reinstatement was drafted by one of our JAI volunteers. ACS CAN will continue to monitor the B&C screening and treatment programs to ensure the enforcement of all the related laws and regulations as part of our ongoing effort to improve access to care even as we fight for broader, meaningful health care reform.