S T A T E O F N E W Y O R K
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8002
I N S E N A T E
January 5, 2024
___________
Introduced by Sen. THOMAS -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
AN ACT to amend the public health law, in relation to the New York state
adult cystic fibrosis program; and to amend a chapter of the laws of
2023, amending the public health law relating to the adult cystic
fibrosis assistance program, as proposed in legislative bills numbers
S. 6521 and A. 3089, in relation to the effectiveness thereof
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 2795 of the public health law, as added by a chap-
ter of the laws of 2023, amending the public health law relating to the
adult cystic fibrosis assistance program, as proposed in legislative
bills numbers S. 6521 and A. 3089, is amended to read as follows:
§ 2795. [Adult] NEW YORK STATE ADULT cystic fibrosis assistance
program. 1. [The commissioner] SUBJECT TO AVAILABLE APPROPRIATION FOR
THE PURPOSE OUTLINED IN THIS ARTICLE, THE DEPARTMENT shall establish [a]
AN ADULT CYSTIC FIBROSIS ASSISTANCE program [to reimburse the cost of
providing health care or health insurance to eligible individuals who
have], 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. [To be a fully eligible individual for whom health care will be
provided under this section, such individual:
(a) shall be at least twenty-one years old;
(b) shall have been diagnosed as having cystic fibrosis;
(c) shall have resided in the state for a minimum of twelve continuous
months immediately prior to application for services under this section;
(d) shall not be eligible for medical benefits under any group or
individual health insurance policy; and
(e) shall not be eligible for medical assistance pursuant to title
eleven of article five of the social services law solely due to earned
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06424-02-4
S. 8002 2
income] 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 MEDICA-
TIONS. 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. [To be a partially eligible individual for whom health care will be
provided under this section, such individual shall meet all the criteria
of a fully eligible individual except that a partially eligible individ-
ual shall be an individual who is eligible for medical benefits under
any group or individual health insurance policy but which does not cover
all services necessary for the care and treatment of cystic fibrosis.
4. The commissioner shall require each fully eligible individual, upon
determination of eligibility, to make application to a private health
insurance provider as prescribed by the commissioner for an individual
health insurance policy. If and when such policy is granted, the commis-
sioner shall approve payment for the associated premium.
5. The commissioner shall authorize payment for services related to
the care and treatment of cystic fibrosis not otherwise covered by a
health insurance policy. Providers of such services shall be reimbursed
at the same rate and claims for payment shall be made as if such indi-
vidual was eligible for benefits pursuant to title eleven of article
five of the social services law.
6. All eligible individuals shall be required to contribute seven
percent of their net annual income toward the cost of care and/or the
cost of the annual health insurance premium.
7. The commissioner shall, in consultation with the commissioner of
social services, promulgate rules and regulations necessary to implement
the provisions of this article] 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 INSUR-
ANCE 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, BEHAV-
IORAL HEALTH SERVICES, AND MEDICAL, VISION AND DENTAL INSURANCE PREMI-
UMS, 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;
S. 8002 3
(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 RECIPI-
ENTS WHO HAVE BECOME INACTIVE, SORTED BY REASON; AND
(VII) ALLOTMENT USED, WHICH IS THE TOTAL AMOUNT OF COPAYMENT ASSIST-
ANCE PROVIDED TO EACH GRANT RECIPIENT COMPARED TO WHAT IS CURRENTLY USED
BY THE GRANT RECIPIENT.
§ 2. Section 2 of a chapter of the laws of 2023, amending the public
health law relating to the adult cystic fibrosis assistance program, as
proposed in legislative bills numbers S. 6521 and A. 3089, is amended to
read as follows:
§ 2. This act shall take effect immediately AND SHALL EXPIRE MARCH 31,
2024 WHEN UPON SUCH DATE THE PROVISIONS OF THIS ACT SHALL BE DEEMED
REPEALED.
§ 3. This act shall take effect immediately; provided, however, that
section one of this act shall take effect on the same date and in the
same manner as a chapter of the laws of 2023 amending the public health
law relating to the adult cystic fibrosis assistance program, as
proposed in legislative bills numbers S. 6521 and A. 3089, takes effect;
provided, further, that the amendments to section 2795 of the public
health law made by section one of this act shall not affect the repeal
of such section and shall be deemed repealed therewith.
