DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
Prevention Services Division
Breast and Cervical Cancer Screening Program
6 CCR 1015-11
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1.1 Definitions
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(1) “Advisory Board” means the seven (7) member board appointed by the Executive Director of the
Department that shall recommend guidelines for the services of the program
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(2) "Board" means the State Board Of Health.
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(3) “Breast And Cervical Cancer Medicaid Treatment Program” means the Medicaid program
administered by the Colorado Department Of Health Care Policy And Financing to provide
medical assistance to eligible persons in accordance with the provisions of the federal "Breast
And Cervical Cancer Prevention And Treatment Act Of 2000".
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(4) “Breast And Cervical Cancer Screening Program” means the Breast And Cervical Cancer Screening
Program in the Department.
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(5) “Department" means the Department of Public Health And Environment.
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(6) "Diagnostic screening" means the use of procedures including physical examinations, radiologic
imaging, surgical techniques, and any new technologies approved by the Board for detecting
whether abnormalities of the breast and cervix are malignant or benign.
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(7) "Fund" means the Breast And Cervical Cancer Screening Fund established in Section 25-4-1503,
C.R.S.
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(8) “Guidelines for the services” means the criteria used for screening based on age, clinical findings,
patient and patient’s family history.
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(9) “Referral service” means assisting women for whom further examination or treatment is indicated in
completing the recommended, medically indicated, follow-up diagnostic, treatment and/or
rescreening procedures.
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(10) "Screening" means the conduct of physical examinations, visual inspections, or other medical tests
exclusively for the purpose of ascertaining the existence of any physiological abnormality that
might be indicative of the presence of disease. "screening" includes diagnostic screening
services.
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1.2 Program Goals And Services
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(1) Program Goals. The goal of the breast and cervical cancer screening program is to help improve
access to screening for breast and cervical cancer by providing screening where it is not
otherwise readily available for reasons of cost or distance to suitable medical facilities among
underserved women and to reduce breast and cervical cancer mortality through the promotion of
compliance with routine screening guidelines.
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(2) Program Services.
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(A) Allowable Fund Purposes. The fund shall be used by the Department for the following
purposes:
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(i) To create and develop of a breast and cervical cancer screening program,
undertaken by private contract for services or operated by the Department, that
will improve the availability of breast and cervical cancer screening and which
may include the purchase, maintenance, and staffing of a truck, a van, or any
other vehicle suitably equipped to perform breast and cervical cancer screening;
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(ii) To make such screening for breast and cervical cancer available to persons who are
at or below two hundred fifty percent of the federal poverty level and who are at
least forty years of age but less than sixty-five years of age;
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(iii) To provide such further breast and cervical cancer diagnostic screening services, as
may be indicated; or
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(iv) To create and operate a referral service for the benefit of women for whom further
examination or treatment is indicated by the breast and cervical cancer
screening.
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(B) Guidelines For Screening Services.
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(i) Screening procedures services shall be provided for persons who are at or below two
hundred fifty percent of the federal poverty level and who are at least forty years
of age but less than sixty-five years of age.
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(ii) Clinical breast exams shall be provided to all women that meet the eligibility criteria
in section 1.2(2)(b)(i).
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(iii) Pelvic exam and Papanicolaou (Pap) test shall be provided to all women that meet
the eligibility criteria in section 1.2(2)(b)(i) with a cervix according to accepted
intervals, and for women who have had a supracervical hysterectomy (women
who still have a cervix) and those post-hysterectomy for conditions related to
cervical neoplasia. If a woman is uncertain as to whether she has a cervix or
whether her hysterectomy was related to cervical neoplasia, she may receive a
pelvic exam and pap test.
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(iv) Except as provided in subparagraph (v) of this subsection, mammography will be
provided to all women who are at or below two hundred fifty percent of the
federal poverty level and who are fifty years of age but less than sixty-five years
of age.
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(v) Mammography will be provided to women who are at or below two hundred fifty
percent of the federal poverty level and who are forty years of age but less than
fifty years of age who have:
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(a) Symptoms or findings on clinical breast exam suspicious for cancer;
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(b) A personal history of breast cancer; or
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(c)
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A history of breast cancer in a premenopausal first degree relative, e.g.,
mother, sister.
(C) Guidelines For Diagnostic Procedures
(i) Diagnostic procedures shall be provided for women that meet the eligibility criteria in
section 1.2(2)(b)(i) who have an abnormal screening test result(s). Clinical
guidelines for diagnostic procedures shall be established by the Department in
consultation with the Colorado Women’s Cancer Control Initiative Medical
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Advisory Committee; and clinical experts in breast and cervical cancer diagnosis
and treatment.
(ii) Diagnostic procedures shall be provided on an outpatient basis.
(D) Referral For Treatment. Referrals for treatment shall be provided to all women that meet the
eligibility criteria in section 1.2(2)(b)(i) who are diagnosed with cancer or precancerous
moderate (CINII) or severe (CINIII) cervical dysplasia. Eligibility for the Colorado Breast
And Cervical Cancer Medicaid Treatment Program will be determined for all women
diagnosed with cancer/precancer. Those determined eligible will be presumptively
enrolled in the Colorado Breast And Cervical Cancer Medicaid Treatment Program and
directed to complete and submit a Colorado Medicaid application. Women who are not
eligible for Medicaid will be given referrals to appropriate resources for medical treatment.