State Legislation Relating to the Breast and Cervical Cancer Prevention and Treatment Act of 2000 National Conference of State Legislatures July 2002

In order to preserve the historical data from the Devolution Initiative, the W.K. Kellogg Foundation Devolution Team, have captured the key content from grantee publications as of March 2004. In this process, we have attempted to accurately capture the context, but in some cases, links may be broken and images may not display properly. If you have questions about this publication or if you want to see if there have been any updates to the document, we suggest you contact the organization directly. State Legislation Relating to the Breast and Cervical Cancer Prevention and Treatment Act of 2000 National Conference of State Legislatures July 2002 STATE ACTIVITY (note: 2002 activity highlighted in italics) On March 27, 2001, Idaho became the first state to enact authorizing legislation adopting the new Medicaid option to expand eligibility to uninsured women screened for breast or cervical cancer through the Center's for Disease Control and Prevention's (CDC) screening program and found to need treatment. As of July 2002, Alabama, Alaska, Arizona, Colorado, Connecticut, Delaware, Florida, Hawaii, Indiana, Illinois, Iowa, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New York, North Dakota, Oklahoma, Oregon, Texas, Vermont, Virginia, Washington, West Virginia and Wisconsin also enacted legislation relating to the new Medicaid option. To date, a total of 42 states have introduced more than 100 bills relating to the new treatment option in the 2001 and 2002 sessions. States electing the new Medicaid option must amend their state Medicaid plans by submitting revisions to the Health Care Financing Administration (now called the Center for Medicare and Medicaid Services). For some states, an amendment to the state plan is the only requirement to participate in the new option, however, most states must also enact authorizing legislation. To date, Health and Human Service's Secretary Tommy G. Thompson approved 42 states' proposals to amend their state Medicaid plans to expand coverage to uninsured women diagnosed with breast or cervical cancer: Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, 1

Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, Wisconsin, West Virginia and Wyoming. BACKGROUND On October 24th, 2000, President William Clinton signed into law the Breast and Cervical Cancer Prevention and Treatment Act of 2000 (Public Law 106-354 (PDF-115K)*). This Act gives states the option to provide medical assistance through Medicaid to eligible women who were screened for and found to have breast or cervical cancer, including precancerous conditions, through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). On January 15, 2002, President Bush signed the Native American Breast and Cervical Cancer Treatment Technical Amendment Act of 2001 (Public Law No. 107-121). This bill amends title XIX of the Social Security Act to clarify that Indian women with breast or cervical cancer who are eligible for health services provided under a medical care program of the Indian Health Service or of a tribal organization are included in the optional Medicaid eligibility category of breast or cervical cancer patients added by the Breast and Cervical Cancer Prevention and Treatment Act of 2002. NBCCEDP, which is administered by the Centers for Disease Control and Prevention (CDC), provides free breast and cervical cancer screening and follow-up diagnostic services to women in need, such as those who are uninsured or have low incomes. In 2000, CDC began its 10th year of this landmark program, supporting early detection programs in all 50 states, 6 U.S. territories, the District of Columbia, and 12 American Indian and Alaska Native organizations. Health Care Financing Administration (HCFA) (now called the Centers for Medicare and Medicaid Services), which administers the Medicaid program, and CDC care continue to develop guidance on how to adopt the new Medicaid option. On January 4, 2001, HCFA released a memo to state health officials. The memo, HCFA Guidance on Implementing PL 106-354 contains a form required to revise Medicaid plans to accept the new Medicaid option. HCFA launched a new comprehensive webpage at http://www.hcfa.gov/medicaid/bccpt/default.htm devoted to answering questions and providing guidance on the implementation of the breast and cervical cancer treatment option. Below is a chart that summarizes all state bills introduced relating to the Breast and Cervical Cancer Prevention and Treatment Act of 2000. This includes all pending and enacted authorizing legislation 2

as well as appropriations. For more information about the Breast and Cervical Cancer Prevention and Treatment ACT of 2000, please visit the CDC's webpage at http://www.cdc.gov/cancer/nbccedp/law106-354.htm#about or HCFA's webpage at http://www.hcfa.gov/medicaid/bccpt/default.htm. Also, the National Breast Cancer Coalition, an advocacy organization, created a 50-state scorecard on state activity related to the act. First Letter of State: A C D F H I K L M N O P R T V W Bill Number Author Date Introduced Latest Status Requirements Alabama H 624 Alabama S 434 Boyd 3/13/01 Substituted by SB 434 5/3/01 Bedford 3/15/01 ENACTED 5/10/01 Provides Medicaid eligibility to certain women who have been screened for breast and cervical cancer through the CDC National Breast and Cervical Cancer Early Detection Program and who need treatment. Alaska S 234, Senate Rules 1/16/02 To Senate Amends laws to address S 304 Committe, Committees on continued eligibility for Davis Finance and Health, current recipients and Education and other regulations. Social Services 1/16/02 Alaska H 322 House rules To House Committee Committees on Finance and Health, 3

Education and Social Services 1/16/02 Alaska H 65 1/16/2001 ENACTED Adds new optional group Rules 6/25/01 of persons eligible for medical assistance who require treatment for breast or cervical cancer and whose income is at or below Alaska S 38 Rules 1/16/2001 Rereferred to Senate Committee Health, Education and Social Services 2/16/01 250% of the federal poverty level. Prohibits use of more than $175,800 of general fund for FY 2002 and $189,500 for FY 2003. Includes sunset provision to end program in 2 years. [Amendment] The Department of Health must report to the legislature on the environmental, behavioral, and genetic factors associated with onset of cancer, recommendations about actions to reduce occurrence and the costs per person for act. 4

Arizona H Huppenthal 1/8/01 ENACTED 5/4/01 Provides medical 2194 assistance beginning Amended- January 1, 2002, for Striker persons who have been 4/10/01 screened for breast and cervical cancer through the well woman healthcheck program and who needs treatment for breast or cervical cancer. Includes presumptive eligibility option. Appropriates $1.3 million for FY 2001-2 and $1.4 million for FY 2002-3. No more than 5% of monies may be spent on administrative costs. Arizona S Solomon 1/10/01 From House 1079 Amended- Striker 4/18/01 Rules: Do pass constitutional and in proper form 4/19/01 [Veto] Appropriates $15 million for programs including medicaid breast and cervical cancer Passed Senate coverage for women who 3/14/01 are screened under the DHS well women healthcheck program. Arizona H 2631 Knaperik 4/10/01 Line Item Veto by Governor 4/24/01 5

Arizona S Mitchell 1/12/2001 Held in House Provides breast and 1112 cervical treatment for Engrossed Appropriations women under 65 Senate 4/18/01 screened through 3/12/01 healthcheck program. Passed Senate, to Limits assistance to House 3/12/01 medically necessary services provided during period person requires treatment. Uses simplified eligibility form. Appropriates $1.3 million in fiscal year 2001-2002 and $1.4 million in fiscal year 2002-2003 from the state general fund for purposes of this Act. Arkansas H Bradford Introduced To House Creates the Arkansas 1898 2/21/01 Rules Health Care Trust Fund 3/2/01 through a 13% cigarette Engrossed tax. Requires that 3/2/01 6.8175% of the fund shall be disbursed to the Breast Cancer Control Fund and shall be allocated according to the recommendations of the Board of Health, with advisory input from the Breast Cancer Control Board. These monies may be used as a state match for the federal Breast and 6

Cervical Cancer Treatment Act, including treatment for those Arkansas women diagnosed with breast and cervical cancer. California AB 430 Cardenas 2/20/01 8/10/01 Implements treatment act. California AB Bates 2/23/01 In Assembly [Amended version deletes 1154 this language] Expands Amended to Appropriations: To medical services to low- delete Suspense File income, uninsured, and language 5/9/01 (Amended underinsured women with about bill no longer breast and cervical Treatment tracked in this cancer. Exercises the Act, adds document) state option under the language federal Breast and about quality Cervical Cancer improvement Prevention and Treatment and Act of 2000 (P.L. 106- incentive 354) thereby supplanting component an estimated 5.2 million to increase dollars ($5,200,000) of access state General Fund 4/16/01 appropriations and instead utilizing these moneys to fund, in part, 7

treatment services for women with advanced stage cervical cancer. California AB 890 Cedillo 2/22/01 To Assembly Health 3/12/01 Requires State Department of Health Services to expand Medi- Cal eligibility to include women who are at or below 250 percent of the federal poverty leverl who have been diagnosed with breast cancer or cervical cancer. California SB Speier 2/14/01 To Assembly Provides medical 224 assistance to persons Amended Health 6/14/01 meeting these criteria: 3/19/01 The person is a resident of California. The person has a family income at or below 250 percent of the federal poverty level. The person has no other source of health care coverage and has no other insurance coverage for breast or gynecological cancer treatment or has 8

insurance coverage that requires more than a $1,000 deductible or copayment per year for breast or gynecological cancer treatment. The person is not otherwise eligible for Medi-Cal services without a share of cost. The person has a diagnosis of breast or gynecological cancer. The person was screened by a provider or entity under the CDCprogram. Colorado S 12b Reeves 9/20/01 Senate Concurs in Amendments 10/5/01 Passed House, to Senate for Concurrence 10/5/01 Uses interest from tobacco settlement funds to pay for breast and cervical cancer treatment program. Passed Senate 10/2/01 9

Colorado H 1024 Spradley 9/20/01 To House Appropriations 9/24/01 Creates the breast and cervical cancer prevention and treatment program from a portion of the tobacco settlement funds. Elects presumptive eligibility requirement. Colorado H 1473 Young 5/6/02 ENACTED 6/7/02 Appropriates $71,175 from cash funds exempt and federal funds to pay for mental health services for medicaid breast and cervical cancer patients. Colorado EO 1 Office of 9/10/01 ENACTED Calls for special session to governor 11/1/01 deal with treatment act. OLS2-12 Funds treatment for lowincome women with breast and cervical cancer. For the first three years, Colorado will fund its share of the program with interest earned on unspent dollars from the national tobacco settlement. The state will receive $ 2 in federal matching funds for every state dollar spend under the program. 10

Colorado S 63 Hagedorn 1/11/2001 Engrossed 4/17/01 5/9/01 From House Appropriations: Postponed Indefinitely Passed Senate, To House 4/18/01 Creates the breast and cervical cancer prevention and treatment program for women under 65 screened under CDC program and amends state medical assistance plan. Creates breast and cervical cancer treatment fund. Excepts and expends any grant or award of money from the Federal government and any moneys from nonprofit health foundations. No costs for program shall be paid from the general fund. Program shall not be implemented until Health Department certifies that there are sufficient funds from nonprofit health foundations. If funds are available the department may seek supplemental appropriations from general assembly for FY 01-02 and years thereafter. 11

Connecticut 6002a Lyons 6/30/02 ENACTED 7/1/02 Appropriates $1,673,717 to the Department of Public Health for breast and cervical cancer detection and treatment. Connecticut H 7503 Lyons 6/28/01 ENACTED 7/2/01 Provides coverage under the Medicaid program in accordance with Public Law 106-354 to women diagnosed with breast or cervical cancer. Connecticut H 2/8/01 Reissued by Commissioner of Social 6709 Human Legislative Services shall provide Services Commissioner's Medicaid coverage in Office with File no. accordance with Public 810 5/24/01 Law 106-354 to women diagnosed with breast or Passed House cervical cancer. The 5/22/01 commissioner shall seek any federal waivers or amend the state Medicaid plan as necessary in order to secure federal reimbursement for the costs of providing coverage under the Medicaid program to such women. Medicaid coverage under this section shall not be 12

dependent on the available income or assets of an applicant. Delaware S 290 Sharp 1/24/02 To Senate Finance 1/24/02 Increases Medicaid eligibility to 200 percent of poverty for breast and cervical cancer treatment. Delaware SCR 20 Sorenson 6/26/01 ADOPTED 7/1/01 Requests the department of Health and Social Services to include in the state plan for medical assistance a provision for payment of medical assistance, pursuant to the federal breast and cervical cancer treatment act of 2000. Florida H 1355 Gannon 3/19/01 In House, Laid on Table 4/10/01 From House Health Promotion: Reported with a substitute, combines HB 715 Provides medical assistance for a woman who has not attained 65 years of age, whose income is at or below 250 percent of the most recently published federal poverty level, and who has been screened for breast or cervical cancer 13

4/03/2001 by a qualified entity under the CDC breast and cervical cancer early detection program. Florida S 792 Silver 3/6/01 Substituted 4/5/01 Signed by Governor (with unrelated parts line itemed vetoed) 5/31/01 Provides medical assistance for eligible women with incomes below 200 percent of the federal poverty level and under 64, for cancer treatment pursuant to the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000, screened through the National Breast and Cervical Cancer Early Detection program. Florida S Sanderson Prefiled Enacted 5/23/01 [Original language] 1306 3/5/01 Subject to specific Introduced Chapter No. appropriation, provides 3/6/01 2001-52 for Medicaid reimbursement for breast and cervical cancer treatment for persons who are eligible for such 14

Florida H 715 Lerner Prefiled 2/27/01 Introduced 3/6/01 Substituted on House floor by S 1306 4/30/01 Substituted on House floor by S 1306 In House, laid on table 4/30/01 services under the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000. The Committee Substitute specifies the eligibility and enrollment limitations. [Substituted version] Establishes the Mary Brogan Breast and Cervical Early Detection Progam. The Committee Substitute, rather than creating a new optional Medicaid service category, creates a new optional Medicaid eligibility category for women who have been screened through the program and specifies eligibility criteria. Florida S Silver 1/22/02 To Senate Amends income level to 2356 Committees on at or below 200 percent House Fiscal Appropriations, of poverty and changes H 1975 Responsibility Appropriations early detection program FRC 18 Council Subcommittee on Health and Human name to Mary Brogan, deletes language on Services, and qualified entity and Health, Aging and presumptive eligibility Long Term Care 15

1/22/02 Hawaii S 118 Chun-Oakland Introduced 1/19/01 Committee amendment adopted 2/16/01 Hawaii H 68 Thielen Introduced 1/19/2001 Committee amendment adopted 2/16/01 ENACTED 6/25/01 The 21st State Legislature Adjourned - 5/14/01 Carried Over to the 21st State Legislature. 5/03/01 Amends law to establish a breast and cervical cancer treatment program for the purpose of providing funding for uninsured and underinsured persons in the State with breast or cervical cancer, or both, and for clients participating in the department's Hawaii breast and cervical cancer control program after care program who are uninsured and unable to qualify for supplemental health care insurance. Appropriates monies out of general revenues. Idaho S 1168 2/15/01 ENACTED Provides payment for State 3/27/01 breast and cervical cancer-related treatment services for persons who are eligible for screening for these cancers under 16

the federal centers for disease control and prevention's national breast and cervical cancer early detection program, and are eligible for medical assistance pursuant to the provisions of the federal "Breast and Cervical Cancer Prevention and Treatment Act of 2000" (Pub.L. 106-354). Illinois H 25 Feigenholtz Introduced 1/10/01 Amended 2/15/01 Engrossed 3/16/01 Signed by Governor, Public Act no. 92-047 7/3/01 Provide medical assistance for treatment for persons participating in cancer screening and treatment program funded under the NBCCED Program and administered by the Department of Public Health and under the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000. Illinois S 126 Obama 2/1/2001 Rereferred too Senate Committee on Rules 3/31/01 17

Illinois H 398 Coulson 1/30/2001 To House Human Services 2/6/2001 Provides medical assistance to certain women under 65 screened and found to have breast or cervical cancer who are eligible for Medicaid pursuant to Section 1902(aa) of the Social Security Act. Indiana H Becker 1/17/01 ENACTED 5/3/01 Expands Medicaid to 1938 include women under 65 (Amended screened and found to 2/8/01 and need treatment under the 2/26/01) federal Breast and Enrolled 4/12/01 Cervical Cancer Prevention and Treatment Act of 2000. Allows presumptive eligibility for qualified women. Limits eligibility to women whose family income does not exceed 200% of the federal income poverty level for the same size family. Appropriates funds from the State general fund. Indiana H 1865 Crawford 1/17/2001 To House Ways and Means 18

1/17/2001 Iowa House 4/2/02 ENACTED Allocates $250,000 from Appropriations 5/10/02 the healthy Iowans Committee tobacco trust and the tobacco settlement trust fund to the department of human services to provide coverage under the medical assistance program to women who require treatment for breast or cervical cancer. Iowa H 517 3/6/01 To House Provides for a new Human category of optional (formerly H Resources Human Resources coverage under the File 308) 4/10/01 medical assistance program. The new optional coverage applies to certain women who require treatment for breast or cervical cancer. Women who meet the criteria specified in the bill are presumptively eligible for medical assistance coverage. Iowa H File Heaton 2/19/01 In House, becomes Provides medical assistance for women 19

308 H 517 3/6/01 screened under CDC program and needing treatment for breast and cervical cancer treatment. Iowa S 537 4/25/01 Signed by FY 2002 tobacco fund (formerly SSB Appropriations Governor distribution to include 1271) 5/29/01 treatment for women screened by CDC program and family planning and community health centers funded by Susan G. Korman foundation. Appropriates $250,000. Iowa H 726 4/19/01 Senate Concurred Requires director of public Appropriations in House health and others to Amendments conduct a study and (s3601) 5/3/01 explore efforts to identify additional federal funding Passed Senate sources and opportunities 4/30/01 to enhance medical assistance dollars for the treatment of breast and cervical cancer through the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000, Pub. L. No. 106-354. Kansas H2444 Showalter 2/7/01 To House Includes the provision of medical assistance for 20

Appropriations 2/8/01 individuals with a diagnosis of breast cancer or cervical cancer, including but not limited to treatment and followup care and medications, with applicable incomes that do not exceed 250% of the poverty level established under the most recent poverty guidelines issued by the federal department of health and human services. Kentucky SB 56 Kerr 1/8/02 To House Health and Welfare 1/15/02 Passed Senate, To House 1/11/02 Provides Medicaid eligibility to certain women who have been screened for breast and cervical cancer through the CDC National Breast and Cervical Cancer Early Detection Program and who need treatment. Raises the income eligibility limit to 250 percent of the federal poverty line. Allocates $600,000 in state funds over the next two years. Kentucky BR Scorsone 1/8/02 To Senate Expands Medicaid 21

448, S 3 BR 1061, H 211, H 41, Health and Welfare- -reported favorably 3/27/02 eligibility to implement Federal Breast and Cervical Cancer Prevention and Treatment Act of 2000. Marzian Burch Passed House, To Senate 3/15/02 Louisiana H 1 LeBlanc 3/26/01 Signed by Governor 6/22/01 Appropriates $700,000 in funds for payments to private providers for implementing the Medicaid eligibility option authorized by the Federal Breast and Cervical Cancer Prevention and Treatment Act of 2000 (P.L.106-354). Louisiana HCR 141 Winston 5/8/01 Adopted 6/4/01 Urges and requests DHH to participate fully in any federal grant programs beneficial to women with breast cancer. Maine H 1018 Saxl 3/5/01 Senate Accepts Ought Not to Pass report. Pursuant to Joint Rule 310. House Accepts Ought Not to Pass Resolves that, by January 1, 2002, the Department of Human Services shall amend its rules regarding reimbursement under the Medicaid program to 22

report. Pursuant to provide for Joint Rule 310. reimbursement for qualified care for breast 5/02/01 and cervical cancer. Maine H 655 Office of the 2/15/01 Signed by Requires the Department Governor Governor, Public of Human Services to Law No. 439 amend the rules 6/21/01 regarding eligibility for the Medicaid program and the state Medicaid plan to grant eligibility to women who have breast or cervical cancer diagnosed through the Maine Breast and Cervical Health Program. Provides $135,690 in FY 2001-2 and $161,631in FY 2002-3. Maine H 208 (LD 243) Lovett 1/23/2001 Passed House, placed on special appropriations table 5/23/01 Passed Senate as amended by Committee A Amendment 5/22/01 Proposes concept draft to implement the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000. 23

Massachusetts Office of the 1/23/02 To House Expands MassHealth to Governor Commmittee on provide services to new Ways and Means eligibilty category. Massachusetts 11/21/01 ENACTED LINE Provides $2,824,552 H 4800 Conference ITEM VETO funding for eligible 12/1/01 women who require Medical treatment for either breast or cervical cancer in accordance with Treatment Act of 2000 (PL 106-354.) Massachusetts 4/18/01 In House, proposed Expands MassHealth H 4100 House Ways budget amendment benefits to uninsured and Means adopted 5/1/01 women under age 65 whose financial eligibility as determined by the division does not exceed 250 per cent of the federal poverty level and who have been identified as requiring treatment for either breast or cervical cancer by the CDC breast and cervical cancer early detection program operated by the department of public health and who otherwise would not qualify for MassHealth. 24

Michigan S 1101 Gougeon 3/20/02 To House Appropriations, Passed Senate, To House 3/20/02 Appropriates funds for medical services to continue breast and cervical cancer treatment for FY 02-03. Michigan H Mortimer 2/15/01 ENACTED Establishes breast and 4254 7/23/01 cervical cancer treatment Reprint coverage for women up to 4/24/01 250% of the federal poverty level, who are under age 65, and who are not otherwise covered by insurance. Minnesota S 689 Sams 2/12/01 Rereferred to Senate Committee on Finance From Senate Health and Family Security: Do Pass 3/1/01 Medical assistance may be paid for a person who has been screened for breast or cervical cancer under the CDC program. Includes presumptive eligibility. Minnesota H 706 Goodno 2/8/01 Amended 4/4/01 Rereferred to House Health and Human Services Finance 4/4/01 25

Minnesota S 4 6/11/01 Signed by Governor 6/29/01 Provides medical assistance for a person who has been screened for breast or cervical cancer by the Minnesota breast and cervical cancer control program and needs treatment, including diagnostic services necessary to determine the extent and proper course of treatment, for breast or cervical cancer, including precancerous conditions and early stage cancer. Includes presumptive eligibility. Mississippi Moody 1/2/02 Signed by Governor 3/25/02 Creates Mississippi Healthcare Coordinating Council to establish a comprehensive preventive health care plan; includes expanding Medicaid coverage for breast and cervical cancer screenings and treatment. Mississippi H 881 Moody 1/12/2001 Signed by Governor 4/12/01 Provides medical assistance to women under 65 who have been screened for breast and 26

cervical cancer under the CDC Prevention NBCCED Program established under Title XV of the Public Health Service Act in accordance with the requirements of that act and who need treatment for breast or cervical cancer Mississippi S 2269 Huggins 1/5/2001 DIED in Committee 2/8/01 Mississippi H 1480 Holland 1/15/2001 1/30/2001 DIED in Public Health and Welfare Provides medical assistance to women under 65 who are screened for breast and cervical cancer under the CDC breast and cervical cancer early detection program established under Title XV of the Public Health Service Act and need treatment for breast or cervical cancer. Missouri S 60 Steelman 1/3/2001 Perfected 4/3/01 From House Social Services and Medicaid and Elderly: Do Pass as Provides medical assistance to persons who have been diagnosed with breast or cervical cancer and who are eligible for 27

Substituted 5/8/01 Passed Senate 4/10/01 coverage. Such persons shall be eligible during a period of presumptive eligibility. Missouri H 762 Kreider 2/13/01 ENACTED 6/21/01 Provides medical assistance to persons who have been diagnosed with breast or cervical cancer and who are eligible for coverage pursuant to 42 U.S.C. 1396a (a)(10)(a)(ii)(xviii). Missouri S Sims 2/8/01 To House Provides medical 448 and 588 assistance for persons Perfected Children, Families who have been diagnosed 4/24/01 and Health 5/2/01 with breast or cervical cancer and who are Passed Senate eligible for coverage 4/30/01 pursuant to 42 U.S.C. 1396a (a)(10)(a)(ii)(xviii). Such persons shall be eligible during a period of presumptive eligibility. Montana D Gutsche 1/16/2001 ENACTED Provides full medical 844 4/30/2001 assistance under the Amended Montana Medicaid HB 456 2/8/01 program the individual requires treatment of breast or cervical cancer, 28

or both, or of a precancerous condition of the breast or cervix, if the individual has been screened for breast and cervical cancer under the Montana breast and cervical health program funded by the CDC program. Appropriates $129,270 in FY 2002 and $258,540 in FY 2003 of tobacco settlement funds for purpose of matching Federal Medicaid funds. Nebraska L 1095 Jensen 1/15/02 To Legislative Health and Human Services 1/16/02 Amends effective day of act. Nebraska L 677 Pederson 1/16/2001 Signed by Governor 5/25/01 Provides medical assistance for women under 65 needing treatment who screened for breast and cervical cancer under the CDC breast and cervical cancer early detection program established under title XV of the federal Public Health Service Act, 42 U.S.C. 29

Nevada A 75 Berman 2/9/01 Committee amendment adopted on Assembly floor, Ordered Engrossed 3/23/01 Requires adoption of state cancer plan and mandates administrative action necessary to provide Medicaid coverage to certain patients with breast or cervical cancer. New Jersey A Blee 2/15/01 ENACTED Provides medical 3218 7/27/01 assistance to women who have been screened for breast or cervical cancer New Jersey S 2139 Vitale To Senate Budget and Appropriations 2/26/01 under the federal CDC breast and cervical cancer early detection program and require treatment for breast or cervical cancer based upon criteria established by the commissioner. New Mexico S 1 Altamirano 1/15/02 Vetoed by Governor 3/6/02 Appropriates $1,300,000 from tobacco settlement program for breast and cervical cancer treatment for uninsured women under age 65 identified through the CDC program. New Mexico H 72 Trujillo 1/16/02 From House Consumer and Appropriates $1,600,000 for expenditure in fiscal year 2003 to provide 30

Public Affairs: Do Pass; Rereferred to House Committee on Appropriations and Finance 1/25/02 state matching funds for breast and cervical cancer services available under the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000. New Mexico H 2 Miera 1/16/2001 ENACTED WITH LINE ITEM VETO 3/16/01 [VETOED] Appropriates $300,000 of tobacco settlement fund for the purpose of adding an optional Medicaid eligibility category for low-income women diagnosed with breast or cervical cancer per the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000. New Mexico S 33 Garcia 1/22/2001 From Senate Public Affairs: Do Pass as Amended 1/31/01 Appropriates $300,000 from tobacco settlement fund to the department of health to fund breast cancer and cervical cancer treatment for low-income women. New Mexico H 129 Beam 1/18/2001 From House Government and 31

Urban Affairs: Do Pass 2/1/01 New York s Senate Rules 1/15/02 Signed by States that persons who 6084 Committee Governor are not eligible for 1/25/02 medical assistance under A 9610 the terms of section 1902(a)(10)(a)(i) of the federal social security act are eligible for medical assistance coverage during the treatment of breast or cervical cancer. New York S 1014 Dollinger 1/16/2001 To Senate Social Services 1/16/2001 Amends the social services law, in relation to increasing medical assistance income eligibility for the treatment of breast and cervical cancer. New York A 5547 Eddington 2/26/01 To Senate Health 3/12/01 Passed Assembly, To Senate 3/12/01 Amends the public health law and the social services law, in relation to extending medical assistance to persons with breast and cervical cancer. 32

New York S Office of 1/17/2001 Amended in Senate Provides medical 1148 New York A Governor Amended 3/13/01 Finance 3/13/01 assistance to women under 65 who have been screened for breast 2000 Amended in Assembly Ways and Means 3/13/01 and/or cervical cancer under CDC Prevention NBCCED Program and need treatment for breast of cervical cancer. New York S 4465 Leibell 4/16/01 To Senate Health 4/16/01 Provides medical assistance coverage during treatment of breast or cervical cancer to persons not otherwise eligible. North Carolina S 537 Rand 3/19/01 To Senate Appropriations/Base Budget 3/19/01 Appropriates $621,315 for the 2001-2002 fiscal year and $1,215,230 for the 2002-2003 fiscal year to match Federal funds to provide full Medicaid coverage to eligible women determined to need treatment for breast cancer of cervical cancer. North Carolina H 566 Alexander 3/12/01 To House Appropriations 3/12/01 33

North Dakota H 1472 Sandvig 1/22/2001 ENACTED 4/13/01 Provides medical assistance for women screened and found to have breast or cervical cancer in accordance with the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000. Requires that the Department of Human Services establish an income eligibility limit that may not exceed 200% FPL. Appropriates $114,755 from Community Health Trust Fund and $429,365 of Federal funds for program beginning July1, 2001 to June 30, 2003. Ohio H 217 Sullivan 4/12/01 To House Finance and Appropriations 4/25/01 Directs the director of job and family services to submit to the United States secretary of health and human services an amendment to the state medicaid plan to implement the Breast and Cervical Cancer Prevention and Treatment Act of 2000. 34

Oklahoma S Dunlap 2/5/01 Signed by Creates "OK Breast and 741 governor 6/4/01 Cervical Cancer Engrossed Treatment Advisory 3/5/01 Committee." Develops treatment option under the state Medicaid program for individuals who are in need of breast or cervical cancer treatment and who have family incomes that are below 185% of the FPL. [amendment] establishes eligibility at family incomes below 150% of the FPL, establishes fee schedule that encourages self-responsibility Oregon H 3214 Patridge 3/8/01 ENACTED 8/2/01 Requires Department of Human Services to provide medical assistance to certain women in need of treatment for breast or cervical cancer. Appropriates $323,736 from the general fund and declares emergency, effective July 1, 2001. Pennsylvania Frankel 4/16/02 In House, Laid on Provides state medical assistance funds, as well 35

H 1750 Table as federal medicaid funds for eligible recipients authorized by the breast Pennsylvania S 1016 Schwartz 6/21/01 To Senate Public Health and Welfare 6/21/01 and cervical cancer mortality prevention act of 2000, for treatment for uninsured and underinsured WOMEN who have been diagnosed with breast or cervical cancer, regardless of the screening entity. Pennsylvania Tilghman 3/26/01 To Senate [Amended version deletes S 1 Rules this language] Amended and Executive Appropriates sufficient version Nominations for funds to provide medical deletes this concurrence assistance coverage in language 4/30/01 accordance with the 6/19/01 federal breast and Amended bill no cervical cancer prevention longer tracked act of 2000. Rhode Island S 121 Izzo 1/23/2001 To Senate Finance Appropriates 3% of increased cigarette tax to finance cancer treatment as state match for the National Breast and Cervical Cancer Treatment Act of 2000. 36

Rhode Island S 884 Graziano 3/27/01 To Senate Health Education and Welfare 3/27/01 Provides funding for breast and cervical cancer treatment for persons screened for these cancers under the CDC screening program. Rhode Island H 5892 Henseler 2/6/01 Passed House, To Senate Committee on Finance 6/26/01 Establishes a program for the treatment of breast and cervical cancer and precancerous conditions of breast and cervical cancer pursuant to federal law. Texas H 101 Maxey 1/9/2001 In House, Tabled 5/7/01 Provides medical assistance to a person in Texas S 532 Nelson 2/5/01 Engrossed 4/26/01 Signed by Governor 5/26/01 need of treatment for breast or cervical cancer who is eligible for that Assistance under the Breast and Cervical Cancer Prevention and Treatment Act of 2000. Includes presumptive eligibility option. Texas S 1156 Zaffirini 3/6/01 Vetoed by Governor 6/17/01 [language removed from amended version] Requires the department to provide medical assistance to a person in need of treatment for 37

breast or cervical cancer who is eligible for that assistance under the Breast and Cervical Cancer Prevention and Treatment Act of 2000 (Pub. L. No. 106-354) for a continuous period during which the person requires that treatment. Vermont H 485 Westman 3/21/01 Signed by Governor 6/16/01 Authorizes the department of prevention, assistance, transition, and health access to amend the rules for the Medicaid program to establish a new optional coverage category, adding coverage for women who: (1) have been screened for and found to have breast or cervical cancer, including pre-cancerous conditions, through the CDC Program;(2) are under 65; and (3) are uninsured and other wise not eligible for Medicaid. 38

Virginia H 2828 Amundson 1/19/2001 Re-referred to House Committee on Appropriations 2/1/01 Provides medical assistance, pursuant to the Breast and Cervical Cancer Prevention and Treatment Act of 2000 for certain women with breast or cervical cancer when such women have been screened for breast or cervical cancer under the CDC Breast and Cervical Cancer Early Detection Program established under Title XV of the Public Health Service Act who need treatment for breast or cervical cancer, including treatment for a precancerous condition of the breast or cervix. Virginia H 11a Hamilton 4/30/01 Senate insists on substitute with amendment 5/9/01 Passed Senate, to House for Concurrence 5/7/01 Passed House 5/4/01 Requires State Plan for Medical Assistance Services be amended to add coverage of breast and cervical cancer treatment of women diagnosed through the CDC Program (Every Woman's Life). The coverage shall be limited to theperiod of treatment for breast and cervical 39

cancer. Virginia S 1377 Ticer 1/19/2001 House accepts Governor's Recommended Amendments 4/5/01 Senate accepts Governor's Recommended Amendments 4/4/01 States that the state plan will include a provision for payment of medical assistance, pursuant to the Breast and Cervical Cancer Prevention and Treatment Act of 2000, for certain women with breast or cervical cancer when such women (i) have been screened for breast or cervical cancer under the CDC Breast and Cervical Cancer Early Detection Program. Includes presumptive eligibility. Washington H Ruderman 1/12/2001 Enacted 6/11/01 Provides medical 1058 assistance for women Re- under 65 who have been commended screened for breast and as cervical cancer under the substituted state breast and cervical from health program committee administered by the 2/6/01 department of health and 40

have been identified as needing treatment for breast or cervical cancer; and are not otherwise covered by health insurance West Virginia H 101 Kiss 4/16/01 Signed by Governor 4/27/01 Transfers $400,000 to the Breast and Cervical Cancer Diagnostic Treatment Fund From the Maternal and Child Health Clinics, Clinicians, and Medical Contracts and Fees. West Virginia H 2597 Campbell 3/1/01 3/1/01 To House Health and Human Resources and to Finance Extends Medicaid coverage to low incomewest Virginia women who have been diagnosed with breast or cervical cancer. Wisconsin S 55 ENACTED 8/30/01 Relates to implementing treatment act. Wisconsin A Joint 2/20/01 To Joint Committee Provides medical 144 on Finance, Joint assistance to women Finance diagnosed with breast or Retirement cervical cancer and is not Systems, Joint eligible for health care 41

Tax Exemptions 2/20/01 coverage under Section 49.665. The woman must be under 65 years of age and have been screened for breast or cervical cancer under a breast and cervical cancer early detection program that is authorized under a grant received under 42 USC 300k. The woman must require treatment for breast or cervical cancer. 42