Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 181 - SPECIAL HEALTH PROGRAMS
Chapter 40 - NEBRASKA BREAST AND CERVICAL CANCER PROGRAM
Section 181-40-003 - ELIGIBILITY
Universal Citation: 181 NE Admin Rules and Regs ch 40 ยง 003
Current through September 17, 2024
Providers and clients must meet statutory requirements and the following requirements:
003.01 CLIENT. 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.
003.02 PROVIDER. 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.
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