This article describes a large public health screening program's early experience in adding case management as a formal program component. The results demonstrate that state and tribal programs participating in the National Breast and Cervical Cancer Early Detection Program have implemented a variety of organizational models for case management of women with abnormal screening results. Programs have different approaches to staffing and reimbursement of case management services, yet most programs have implemented a "patient navigator" or "medical" model of case management service delivery. Although a number of challenges were identified, a clear and positive finding is that case managers are playing an integral role in the transition between a cancer diagnosis through the program and enrollment in Medicaid for treatment services through the National Breast and Cervical Cancer Prevention and Treatment Act of 2000.