Michigan Colorectal Cancer
Early Detection Program (MCRCEDP)
Michigan Department of Health and
Table of Contents
Contact Information: Michigan Department of Health and Human Services 3
MCRCEDP Program Requirements
Eligibility Requirements – Quick Reference Sheet
Eligibility Requirements – Detailed Document
Eligibility U.S. Citizenship
Minimum Program Requirements
CDC Service Quality Indicators
MCC Clinical Protocol for the Early Detection of Colorectal Cancer (CRC)
Conscious Sedation Policy (Propofol)
Inadequate Bowel Preparation Guidelines
Policy for Retention of Client Records
Risk Assessment Script Templates
OC Light FIT Kits
MDHHS Fecal Immunochemical Test (FIT) Instructions – English
MDHHS Agreement for Program Participation – formerly Informed Consent Form
Referral to Healthy Michigan Plan or the Health Insurance Marketplace
Michigan Tobacco Quit Line Referral Form
FIT Intake Form
Colonoscopy Intake Form
Secured Application User Agreement Access Form – MBCIS Application
MCRCEDP Provider Documents
Fax Template - Forms Tracking
Provider Claim Submission and Reimbursement
Quick Reference Sheet: Billable Codes
MCRCEDP Flowsheets, and Resources
FIT Screening Flow Chart
Colonoscopy Flow Chart (Diagnostic/Surveillance/Screening)
FIT Supply Request Form
FIT Kit Ordering Process & Expiring FIT Kits
Provider Colorectal Cancer (CRC) Resources
Client Colorectal Cancer (CRC) Resources
Annual Budget Instructions 60
MDHHS Contact Information
Michigan Department of Health and Human Services
109 W Michigan Avenue
Washington Square Bldg.
Cancer Section – 5th Floor
Lansing, MI 48933
Fax: (517) 335-8752
Dr. Nickell M. Dixon
Sharde’ Burton, BS, MPH
Cancer Policy & System Change
Susan Harris, PhD
MI Public Hlth Institute
2390 Woodlake Drive
Okemos, MI 48864
Robin L. Roberts
Svcs Coordination Unit Manger
Kanika S. Lewis, MPH, MSW, RN
Public Health Consultant
(517) 763-0290 – Fax
Lay Patient Navigator,
Billing & Reimbursement
MBCIS Technical Assistance
(517) 763-0290 – Fax
Colorectal Cancer Screening Program Eligibility
Quick Reference Sheet
The Michigan Colorectal Cancer Early Detection Program (MCRCEDP) provides colorectal cancer (CRC) screening
services in limited areas to eligible men and women:
• Ages 50-64
• Low income (≤ 250% of the Federal Poverty Level)
• Who have no symptoms
• Who are underinsured and uninsured:
• Colonoscopy for average and increased-risk clients
• Fecal Immunochemical Test (FIT), optional for average risk clients
o Insured/underinsured clients may be eligible for the MCRCEDP if they have high out- of-pocket
costs for a colonoscopy.
o Clients who are not currently insured by the Healthy Michigan Plan are eligible for the MCRCEDP.
Average Risk Clients will be screened by colonoscopy or optional FIT, an at-home collection of stool.
• Clients with a positive FIT found through the MCRCEDP will be referred for a diagnostic colonoscopy.
• Average risk clients with positive (+) FIT results obtained from outside the program, may be eligible for
o Contact an agency for additional details as these enrollments will need to be approved by
Increased Risk Clients will be screened by colonoscopy.
High Risk Clients are Not Eligible for the MCRCEDP. This includes men and women with:
• Significant ongoing gastrointestinal symptoms.
• Genetic, clinical or family history that places them at high risk for CRC.
Contact these agencies for MCRCEDP Enrollment
• District Health Department #10: (231) 876-3826 (Kalkaska, Crawford, Manistee, Wexford, Missaukee,
Mason, Lake, Oceana, Newaygo, Montcalm, Mecosta Counties)
• Huron County Health Department: (989) 269-3323 (Huron, Sanilac, Tuscola, Bay, Saginaw, St Clair
• Health Department of Northwest Michigan: (231) 547-7677 (Antrim, Charlevoix, Emmet, Otsego
• Grand River Gastroenterology: (616) 752-5297 (Grand Rapids/surrounding area, Kent County)
• Karmanos Cancer Institute & ACCESS Community Health Center: (313) 216-2206 or (248) 304-2301
(Macomb, Oakland & Wayne Counties)
• Integrated Health Partners: (269) 425-7135 (Calhoun County)
1 $31,225 2 $42,275
3 $53,325 4 $64,375
5 $75,425 6 $86,475
Colorectal Cancer Screening Program Eligibility
The Michigan Colorectal Cancer Early Detection Program (MCRCEDP) provides colorectal (CRC) screening
services to program eligible men and women who meet the following criteria:
• Asymptomatic, aged 50-64 years
o Average risk for CRC - screened by colonoscopy or optional at-home fecal
immunochemical test (FIT)
o Increased risk for CRC – must be screened by colonoscopy
o Positive FIT /FOBT from outside the program – Average risk clients with a positive FIT
or FOBT performed outside of MCRCEDP may be enrolled in the program on a limited
basis. Contact the Michigan Department of Health and Human Services (MDHHS) for
authorization prior to enrolling these patients in the program for a diagnostic
• Low income (< 250% of the Federal Poverty Level)
• Uninsured or underinsured:
o No health insurance: Enroll eligible clients who are not currently insured.
o Inadequate health insurance: Enroll eligible clients who have high out-of-pocket CRC
For the underinsured, call the insurance company to verify deductible or out-
of-pocket expenses. Document insurance deductible on the enrollment form.
Once CRC services are provided, the client’s insurance must be billed first with
an Explanation of Benefit demonstrating a coverage gap. CDC funds must be
used as the “funds of last resort” to pay for CRC services.
Clients enrolled in the Healthy Michigan Plan (HMP) are not eligible for
MCRCEDP screening services.
Referrals for Insurance:
• All clients
o All clients interested in obtaining health insurance through the marketplace should be
referred to a Patient Navigator at Enroll Michigan or the Health Insurance Marketplace.
o Referrals to the Marketplace must be documented on the MCRCEDP enrollment form
and in MBCIS.
Referrals to Primary Care:
• If the client has no current provider, refer him/her to a PCP as a part of the enrollment process.
People who are symptomatic and those at high risk for colorectal cancer are NOT eligible for screening
or surveillance services through the MCRCEDP. A process must be in place to refer clients who are
ineligible for the MCRDEDP for additional services and/or evaluation. People at high risk include those
1. A genetic, clinical diagnosis or family history or suspicion of familial polyposis (FAP) or hereditary
non-polyposis colorectal cancer (HNPCC/Lynch Syndrome).
2. A history of inflammatory bowel disease, ulcerative colitis or Crohn’s disease.
3. Significant gastrointestinal symptoms including, but not limited to rectal bleeding, bloody
diarrhea, blood in the stool within the past 6 months, prolonged change in bowel habits such as
diarrhea or constipation for more than two weeks that has not been clinically evaluated
4. Abdominal pain
5. Unintentional weight loss of 10% or more of starting body weight
6. Symptoms of bowel obstruction (e.g., abdominal distension, nausea, vomiting, severe
Referral of Ineligible Clients:
• This includes:
o High risk clients
o Individuals who require CRC screening, but do not meet MCRCEDP eligibility
requirements (due to age, income or other eligibility criteria)
o Individuals who may not benefit from CRC screening.
• All clients, who require screening but are not eligible for the MCRCEDP, must be referred to a
PCP for CRC screening and/or diagnostic services utilizing community resources as needed.
• All uninsured clients who are not eligible for the MCRCEDP should be referred to a Patient
Navigator to assist with enrollment in the HMP and the Health Insurance Marketplace.