Medical Assistance for Women with Breast or Cervical Cancer

2.5.1.1.2 Mandatory Verifications

Mandatory verifications must be verified through an available electronic data source or by paper proof, if electronic data sources are unsuccessful or unavailable. Self-attestation alone is not acceptable for eligibility requirements with mandatory verifications.

Presumptive Eligibility Period

For presumptive eligibility for MA-BC, the following must be verified:

  • Screened by the Minnesota Department of Health Sage Screening Program or the American Indian Cancer Foundation Screen Our Circle Program

  • Need for treatment or further diagnostic services for breast or cervical cancer

A Sage Enrollment form or Screen Our Circle Enrollment form are acceptable proof of both Sage screening and the need for treatment.

A Social Security number (SSN) or verification of an SSN is not required for PE. Verification of US citizenship and immigration status is not required for PE.

On-going MA-BC Eligibility

For on-going MA-BC coverage, the following must be verified:

  • Screened by the Minnesota Department of Health Sage Screening Program or the American Indian Cancer Foundation Screen Our Circle Program

  • Need for treatment or further diagnostic services for breast or cervical cancer

A Minnesota Department of Health Sage Enrollment form or American Indian Cancer Foundation Screen Our Circle Enrollment form are acceptable proof of both Sage screening and the need for treatment.

County, tribal and state servicing agencies must retain verification documentation in accordance with the County Human Service Records Retention Schedule (DHS-6928).

Legal Citations

Minnesota Statutes, section 265B.056, subdivision 10