N.Y. PBH Law § 2795 — New York Code / Act PBH / Article 27-G / Section 2795
New York state adult cystic fibrosis assistance program
Status: in_force

* § 2795. New York state adult cystic fibrosis assistance program. 1.\nSubject to available appropriation for the purpose outlined in this\narticle, the department shall establish an adult cystic fibrosis\nassistance program, which shall be known as the "New York State Adult\nCystic Fibrosis Assistance Program", and which shall consist of\nadministrative support services for the provision of financial\nassistance for services such as prescription drug costs, device costs,\nmedical care services, behavioral health services, and insurance\npremiums for the treatment of cystic fibrosis disease and its\nconditions.\n  2. The commissioner shall enter into a contract for the operation and\npromotion of the adult cystic fibrosis assistance program subject to\nsuch terms and conditions as may be contained within such contract with\nan organization that has experience and expertise improving access to\nhealthcare for patients who are underinsured by dispersing financial\nassistance grants to cover costs of essential treatments and\nmedications. The contractor may subcontract as needed for the effective\nperformance of the contract. All such subcontractors and the terms of\nsuch subcontracts shall be subject to approval by the commissioner.\n  3. The duties of the contractor shall include, but not be limited to,\nthe following:\n  (a) verification of patient eligibility for financial assistance\ngrants allowable pursuant to paragraph (b) of this subdivision. To be\neligible for a financial assistance grant, a patient shall meet criteria\ndetermined by the department, which shall include but not be limited to,\nrequiring the patient:\n  (i) be a New York state resident;\n  (ii) be at least twenty-one years of age or older;\n  (iii) have a diagnosis of cystic fibrosis; and\n  (iv) have some form of primary private health insurance or Medicare\nand is not eligible for state Medicaid, and shall maintain health\ninsurance during the financial assistance award period;\n  (b) review of financial assistance grant applications submitted by\neligible patients for approval, for services including but not limited\nto prescription drug costs, device costs, medical care services,\nbehavioral health services, and medical, vision and dental insurance\npremiums, for patient treatment of cystic fibrosis;\n  (c) disbursement of grant funding for applications approved pursuant\nto paragraph (b) of this subdivision related to the care and treatment\nof cystic fibrosis not otherwise covered by a health insurance policy;\n  (d) preparation and submission of a monthly report to the department.\nSuch report shall include but not be limited to:\n  (i) new grants, which is the number of new grant recipients for\ninitial grant periods;\n  (ii) renewal grants, which is the number of renewal grant recipients\nfor renewal grant periods;\n  (iii) total active grant recipient count, which is the total number of\nactive grant recipients;\n  (iv) grant recipients by insurance type, which is the number of active\ngrant recipients sorted by insurance type;\n  (v) program expenses, which is the total amount spent sorted by\nassistance type but does not include administration fees;\n  (vi) application outcomes report, which is the number of grant\nrecipients who have become inactive, sorted by reason; and\n  (vii) allotment used, which is the total amount of copayment\nassistance provided to each grant recipient compared to what is\ncurrently used by the grant recipient.\n  * NB Repealed March 31, 2027\n