2023 New York Laws › PBH - Public Health › Article 27-G - Adult Cystic Fibrosis Assistance Program › 2795 - New York State Adult Cystic Fibrosis Assistance Program.

* §  2795. New York state adult cystic fibrosis assistance program. 1.
Subject to available appropriation for  the  purpose  outlined  in  this
article,  the  department  shall  establish  an  adult  cystic  fibrosis
assistance program, which shall be known as the "New  York  State  Adult
Cystic   Fibrosis  Assistance  Program",  and  which  shall  consist  of
administrative  support  services  for  the   provision   of   financial
assistance  for  services such as prescription drug costs, device costs,
medical  care  services,  behavioral  health  services,  and   insurance
premiums   for   the  treatment  of  cystic  fibrosis  disease  and  its
conditions.
2. The commissioner shall enter into a contract for the operation  and
promotion  of  the  adult  cystic fibrosis assistance program subject to
such terms and conditions as may be contained within such contract  with
an  organization  that  has experience and expertise improving access to
healthcare for patients who are  underinsured  by  dispersing  financial
assistance   grants   to   cover   costs  of  essential  treatments  and
medications. The contractor may subcontract as needed for the  effective
performance  of  the  contract. All such subcontractors and the terms of
such subcontracts shall be subject to approval by the commissioner.
3. The duties of the contractor shall include, but not be limited  to,
the following:
(a)  verification  of  patient  eligibility  for  financial assistance
grants allowable pursuant to paragraph (b) of this  subdivision.  To  be
eligible for a financial assistance grant, a patient shall meet criteria
determined by the department, which shall include but not be limited to,
requiring the patient:
(i) be a New York state resident;
(ii) be at least twenty-one years of age or older;
(iii) have a diagnosis of cystic fibrosis; and
(iv)  have  some  form of primary private health insurance or Medicare
and is not eligible  for  state  Medicaid,  and  shall  maintain  health
insurance during the financial assistance award period;
(b)  review  of  financial  assistance grant applications submitted by
eligible patients for approval, for services including but  not  limited
to  prescription  drug  costs,  device  costs,  medical  care  services,
behavioral health services, and medical,  vision  and  dental  insurance
premiums, for patient treatment of cystic fibrosis;
(c)  disbursement  of grant funding for applications approved pursuant
to paragraph (b) of this subdivision related to the care  and  treatment
of cystic fibrosis not otherwise covered by a health insurance policy;
(d)  preparation and submission of a monthly report to the department.
Such report shall include but not be limited to:
(i) new grants, which is  the  number  of  new  grant  recipients  for
initial grant periods;
(ii)  renewal  grants, which is the number of renewal grant recipients
for renewal grant periods;
(iii) total active grant recipient count, which is the total number of
active grant recipients;
(iv) grant recipients by insurance type, which is the number of active
grant recipients sorted by insurance type;
(v) program expenses, which  is  the  total  amount  spent  sorted  by
assistance type but does not include administration fees;
(vi)  application  outcomes  report,  which  is  the  number  of grant
recipients who have become inactive, sorted by reason; and
(vii)  allotment  used,  which  is  the  total  amount  of   copayment
assistance  provided  to  each  grant  recipient  compared  to  what  is
currently used by the grant recipient.
* NB Repealed March 31, 2025