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JEFFERSON CITY, Mo. – The Senate today granted final passage to Senate Bill 1359, which will open up access to life-saving cancer testing for Missourians regardless if the provider receives funding from Title XV of the Public Health Service Act. Rep. Chantelle Nickson-Clark, D-St. Louis, originally filed the provision as part of House Bill 2875, but it was later added to the Senate legislation as an amendment. The bill now awaits action by the governor.
“I am incredibly thankful that the Senate recognized the importance of this bill that provides critical testing for early detection of cancer that can be the difference between life and death,” said Nickson-Clark. “This testing is essential and the red tape of funding should not be a deterrent for Missourians in need of it. As a cancer survivor, I will always use my platform at the Capitol to advocate for patient care.”
The Centers for Disease Control and Prevention (CDC) released a report in April that said one-third of socially vulnerable women are missing recommended mammograms. The study found that health-related social needs (HRSNs) such as food insecurity and lack of reliable transportation are dominant barriers that impact a person’s access to healthcare. Breast cancer causes more than 40,000 deaths to women in the U.S. each year, according to the CDC. While breast cancer deaths have been decreasing, that isn’t the case for all groups. For example, black women and women with low incomes are more likely to die from breast cancer.
The bill specifies that persons who receive breast or cervical cancer screening services of a type within the scope of such screening services as provided by Title XV of the Public Health Service Act and who otherwise meet eligibility requirements for MO HealthNet medical assistance for treatment of breast or cervical cancer are eligible for medical assistance regardless of whether the screening service was provided by a provider who receives or uses funds under that title.
The Missouri Show-Me Healthy Women Program (SMHW) offers no-cost breast and cervical cancer screenings and diagnostic testing to uninsured or underinsured individuals between the ages of 40-64 and are at or below 250 percent of the FPL. In 2000, Congress passed the Breast and Cervical Cancer Prevention and Treatment Act (BCCPT), which expanded the impact of the program by giving states the option of offering women who are diagnosed with cancer through NBCCEDP access to treatment through Medicaid. In addition, states that opted to offer coverage under the BCCPT received an enhanced FMAP match for covered individuals. For FY2025, this enhanced FMAP in Missouri is 75.72 percent. In implementation of the program, states were given the option to adopt one of three different standards of eligibility requirements:
1. CDC title XV funds paid for all or part of the costs of the individual’s screening services.
2. The individual is screened under a state or tribal NBCCEDP in which her/his particular clinical service have not been paid for by CDC title XV funds, but the service was rendered by a provider or an entity funded at least in part by CDC title XV funds; the service was within the scope of a grant, sub-grant or contract under that program; and the CDC title XV grantee has elected to include such screening activities by that provider as screening activities pursuant to CDC title XV.
3. The individual is screened by any other provider or entity and the CDC title XV grantee has elected to include screening activities by that provider as screening activities pursuant to CDC title XV. For example, if a family planning or community health center provides breast or cervical cancer screening or diagnostic services, the NBCCEDP grantee would have the option of including the provider’s screening activities as part of overall CDC title XV activities.
Under categories two and three above, the CDC title XV grantee may determine that individuals, including both women and men, have been screened under the program even though the screening was not paid for through the CDC title XV grant. Given this guidance, states have the flexibility to define the eligibility requirements for their program; including allowing individuals, screened by a non-BCCP provider, to be eligible for treatment services through the Medicaid breast and cervical cancer treatment program.
As of 2019, in twenty states and the District of Columbia, a woman will be considered screened where NBCCEDP funds pay for all or part of the costs of her screening; in fourteen states, a woman will be eligible if her provider receives NBCCEDP funds and the services were within the scope of the NBCCEDP grant; and in sixteen states, a woman is considered eligible regardless of where she was screened as long as she meets the rest of the eligibility criteria.
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