N.Y. Public Health Law § 4371: Reimbursement of living donor expenses

§ 4371. Reimbursement of living donor expenses. 1. The living donor

support program is hereby established in the department.

2. (a) Subject to appropriations therefor, the program shall pay the

living donor expenses for living donors who are residents of the state

and make a living donation in which the ultimate recipient, either

directly or through paired donation is a resident of the state. The

commissioner through regulations shall establish eligible living donor

expenses that are eligible for reimbursement under the program which

shall include at a minimum: lost wages (including demonstrated lost

non-employment income) or the economic value of sick or vacation days

expended; travel and lodging, child care and elder care expenses; and

costs of medications and care associated with the living donation

surgery that are not covered by health insurance. The total period of

time related to lost wages or expended sick or vacation days shall not

exceed four weeks unless special circumstances are demonstrated, such as

the nature of physical labor required for the living donor's employment;

provided that the total period shall in no event exceed eight weeks. The

commissioner may, by regulation, impose reasonable limitations on: (i)

the amount of lost wages for a living donor making an income in excess

of an annual rate of one hundred twenty-five thousand dollars; or (ii)

the amount of living donor expenses above fourteen thousand dollars for

any single living donor; and may include additional living donor

expenses including reimbursement for costs of care performed by

relatives or family members of the living donor.

(b) The program shall not pay reimbursement for expenses paid or

required to be paid for by any third-party payer, including wages or

other expenses that were covered under paid medical leave by the living

donor's employer or that are covered by other sources of reimbursement

such as the federal National Living Donor Assistance Program. The

program shall be the payer of last resort with respect to any benefit

under the program.

(c) Living donor expenses shall be reimbursed as close in time as

possible to their being incurred by the donor, including by pre-payment

where practicable.

3. (a) The commissioner may contract for the administration of

reimbursement under the program. Factors such as cost to the state, ease

of use for the living donor, and ease of use for transplant center

hospitals shall be taken into consideration when awarding such contract.

(b) The commissioner shall make regulations to implement this section.

(c) This section shall be interpreted so as not to conflict with the

federal National Organ Transplant Act (42 U.S.C. 274e).