Presumptive Eligibility Providers for MA-BC (Archive)

Providers who participate in the Sage Screening Program may choose to register with DHS to become presumptive eligibility providers for Medical Assistance for Breast and Cervical Cancer (MA-BC). These health care providers have signed agreements (see DHS-4786) with DHS to conduct presumptive eligibility determinations for women who are screened through the program and who need treatment for breast or cervical cancer or a precancerous condition.

Authorized providers will approve presumptive MA-BC eligibility for a minimum of 30 days from the application date for Minnesota women who meet all of the following:

l  Have been screened through the Sage Screening Program and need treatment for breast or cervical cancer, including precancerous conditions and early stage cancer.

l  Completed one of the following Sage Screening Program forms:

n  Enrollment form.

n  Return Visit form.

n  Colposcopy Program form

Note:  These Minnesota Department of Health forms, which were included with Bulletin #02-21-07, Medical Assistance Coverage for Women Screened by the Minnesota Breast and Cervical Cancer Control Program, do not have DHS form numbers.

l  Are under age 65.

l  Have no health coverage.

Top of Page

The following is a list of providers who are currently authorized by DHS to grant presumptive eligibility for MA-BC. If you receive an application from a provider who is not on the list, follow your agency's procedures to submit a policy question to HealthQuest.

Presumptive Eligibility Providers

City

Affiliated Medical Center
Mary Sondrol

Willmar

Allina Medical Clinic
Mary Olmscheid

Buffalo

Austin Medical Center
Susan Schmeling

Austin

Bloomington Public Health
Patricia A. Heil, Karen Stanley, Janet Watchman

Bloomington

CommonHealth Clinic
Joan F. Oien, Mary Sandgren

Stillwater

Family Tree Clinic
Amy Gilbert, Barbara Peterson

St. Paul

Hennepin County Medical Center
Mary E. Peterson

HCMC Family Medical Centers
Beth Johnson

Minneapolis

Lake Superior Community Health Center
Christine Sandal

Duluth

Lakewood Clinic/Greater Staples Hospital
Julie Goff

Staples

Madelia Parkview Clinic
Audrey J. Weldlin

Madelia

Meritcare
Rita A. Cowie

Pelican Rapids

Mid-Minnesota Health Clinic
Pam Siewert

St. Cloud

New Ulm Medical Center
David Jones

New Ulm

Olmsted Medical Center
Susan Baker

Rochester

Owatonna Clinic/MHS
Delores Kubicek, Cynthia Oleson, Marilyn Styndl

Owatonna

Pilot City Health Center
Angelique Brown

Minneapolis

Pipestone County Medical Center
Del Thies

Pipestone

Planned Parenthood of MN/SD
Heidi M. Olson

Alexandria

Planned Parenthood of MN/SD
Amy Shepard

Burnsville

Planned Parenthood of MN/SD
Cathy Sandmann

Mankato

Planned Parenthood of MN/SD
Kristin Goff, Amy Kabore, Patti Morrison, Michelle Rach, Kari Reinbold

Minneapolis

Planned Parenthood - Rochester
Sara Meincke, Mia Rauenhorst

Rochester

Planned Parenthood – St. Cloud
Judy Huebner

St. Cloud

Regina Medical Center/ Regina Medical Group

Hastings

St. Paul-Ramsey County Department of Public Health
Carol Ball, Norma Cheesebrow, Sheila Pelzel, Mary Sonnen

St. Paul

West Side Community Health Services
Mary C. Nesvig

St. Paul

Top of Page