Medicaid Cancer Treatment Program: Breast, Cervical, Colorectal and Prostate Cancer (MCTP)

The Healthcare Workforce Recruitment and Retention Act expanded Medicaid eligibility to certain individuals screened and diagnosed with breast and/or cervical cancer or pre-cancerous conditions through the Cancer Services Program Partnerships (CSPP).

This coverage became effective on October 1, 2002. This option allows the State to provide Medicaid benefits to uninsured individuals, who have been screened and diagnosed by the Centers for Disease Control and Prevention (CDC) National Breast and Cervical Cancer Early Detection program and found to be in need of treatment for these types of cancer.

Chapter 176 of the Laws of 2006 expanded the Breast and Cervical Cancer Treatment Program to include treatment of colorectal and prostate cancer. Coverage for colorectal cancer treatment was implemented on April 1, 2007. The prostate cancer treatment portion of this expansion was implemented on October 1, 2007.

To be eligible for Medicaid coverage for breast and/or cervical cancer treatment, individuals must:

  • Meet the established criteria to qualify for CDC screening under the National Breast and Cervical Cancer Early Detection Program;
  • Have income that is at or below 250% Federal Poverty Level (FPL);
  • Be 18 years of age or older;
  • Not be covered under any creditable insurance;
  • Be in need treatment for breast and/or cervical cancer or a pre-cancerous condition;
  • Be ineligible for Medicaid under other eligibility groups;
  • Be a resident of New York State; and
  • Be a U.S. citizen or an alien with satisfactory immigration status.

While the Federal program for breast and/or cervical cancer is limited to females under the age of 65, New York State also covers any males or individuals over 65 years of age under a State-funded program.

To be eligible for Medicaid coverage for colorectal and/or prostate cancer treatment, individuals must:

  • Be screened and/or diagnosed through a CSPP partnership or CSPP provider;
  • Be under 65 years of age;
  • Have income at or below 250% Federal Poverty Level (FPL);
  • Not be covered under any creditable insurance;
  • Need treatment for colorectal and/or prostate cancer or pre-cancerous condition;
  • Be ineligible for Medicaid under other eligibility groups;
  • Be a resident of New York State; and
  • Be a U.S. citizen or an alien with satisfactory immigration status.

Enrollment:

Unlike most Medicaid programs, where enrollment occurs at the local department of social services, the point of entry for this program is the Cancer Services Program Partnerships, who are the qualified designated entities that assist individuals in completing the MCTP enrollment process. Enrollments for MCTP are processed centrally by State staff in the Office of Health Insurance Programs (OHIP). Individuals who are determined eligible will receive Medicaid coverage for as long as they need cancer treatment.

If you think this program will benefit you or someone you know, you should contact your local CSPP.

This program offers help, hope, and health care to individuals diagnosed with breast, cervical, colorectal or prostate cancer. Individuals can now gain access to life saving treatment and services they need to overcome cancer under New York State Medicaid.

Check the Department of Health website at:

http://www.nyhealth.gov/nysdoh/cancer/center/cancerhome.htm or
Public Health Program List or
Call The Cancer Services Program at 1-866-442-2262.

For additional information call the Medicaid Help Line at: 1-800-541-2831; or
E-mail your questions to:canserv@health.state.ny.us
For more information see The American Cancer Society at: http://www.cancer.org
For more information see The National Cancer Institute at: http://www.nci.nih.gov/
For more information see The National Institutes of Health at:http://health.nih.gov/index.asp