N.Y. Public Health Law § 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, 2027