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Medicaid Special Coverage Conditions

Breast and Cervical Cancer, Tuberculosis, and Sickle Cell Disease are grouped together in this section (Special Coverage Conditions) because they are disease specific.

Breast and Cervical Cancer and Tuberculosis are optional Medicaid eligibility groups defined by disease. However, Sickle Cell Disease is an optional coverage benefit under Medicaid and not a Medicaid eligibility group.

The Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) gives states the option to provide medical assistance through Medicaid to eligible women who were screened through the Center for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program and need treatment for breast or cervical cancer.

The Omnibus Budget Reconciliation Act of 1993 (OBRA ’93), amended the Social Security Act to allow states, at their option, to extend Medicaid eligibility to low-income individuals infected with TB, while limiting eligible individuals to coverage of TB related services.

The American Jobs Creation Act amended the Social Security Act to provide a new optional benefit in the Medicaid program and to make available federal matching funds for education and outreach to Medicaid eligible adults and children with SCD.

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