 |
D.C. Municipal Regulations (Last Updated: September 13, 2017) |
 |
Title 29. PUBLIC WELFARE |
|
Chapter 29-43. MEDICAID BREAST AND CERVICAL CANCER TREATMENT PROGRAM |
Section 29-4302. PROGRAM SERVICES
-
4302.1Each provider shall provide comprehensive breast or cervical cancer treatment, evaluation and management services, consisting of, but not limited to surgery, breast reconstructive surgery, radiation and chemotherapy subject to the conditions set forth in these rules.
4302.2Treatment shall not include investigational or experimental therapy or surgery.
4302.3Breast reconstructive surgery may be provided if, in the opinion of the patient's surgeon, reconstructive surgery is necessary to correct disfigurement caused by the removal of a breast or breasts.
4302.4Each provider shall establish an initial care plan within fifteen (15) days after a patient is determined to need treatment. The care plan shall include the following:
(a)Diagnosis;
(b)Description of diagnostic services necessary to treat and monitor the condition or disease;
(c)Staging of the cancer, condition or disease;
(d)Planned course of treatment, evaluation and management;
(e)Prognosis; and
(f)Expected duration of the entire course of treatment.
4302.5The care plan shall be updated every three (3) months for each patient who is determined to need treatment and shall include all items set forth in section 4302.4.
4302.6Each provider shall forward the initial care plan to Project WISH within twenty (20) days after each patient is determined to need treatment. The updated care plan shall be forwarded to Project WISH within twenty (20) days of the establishment of each updated care plan.
4302.7When a provider determines that a patient no longer needs treatment, the provider shall document the evaluation indicating that treatment has been terminated and forward the evaluation to Project WISH within fifteen (15) days.
4302.8Each provider shall notify Project WISH immediately, in writing, of a patient's refusal to follow-through with the recommended treatment, evaluation or management plan.