Re-establishes the adult cystic fibrosis assistance program to reimburse the cost of providing health care or health insurance to eligible individuals who have cystic fibrosis.
STATE OF NEW YORK
________________________________________________________________________
5432
2021-2022 Regular Sessions
IN ASSEMBLY
February 16, 2021
___________
Introduced by M. of A. PHEFFER AMATO -- read once and referred to the
Committee on Health
AN ACT to amend the public health law, in relation to the adult cystic
fibrosis assistance program
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The public health law is amended by adding a new article
2 27-g to read as follows:
3 ARTICLE 27-G
4 ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
5 Section 2795. Adult cystic fibrosis assistance program.
6 § 2795. Adult cystic fibrosis assistance program. 1. The commissioner
7 shall establish a program to reimburse the cost of providing health care
8 or health insurance to eligible individuals who have cystic fibrosis.
9 2. To be a fully eligible individual for whom health care will be
10 provided under this section, such individual:
11 (a) shall be at least twenty-one years old;
12 (b) shall have been diagnosed as having cystic fibrosis;
13 (c) shall have resided in the state for a minimum of twelve continuous
14 months immediately prior to application for services under this section;
15 (d) shall not be eligible for medical benefits under any group or
16 individual health insurance policy; and
17 (e) shall not be eligible for medical assistance pursuant to title
18 eleven of article five of the social services law solely due to earned
19 income.
20 3. To be a partially eligible individual for whom health care will be
21 provided under this section, such individual shall meet all the criteria
22 of a fully eligible individual except that a partially eligible individ-
23 ual shall be an individual who is eligible for medical benefits under
24 any group or individual health insurance policy but which does not cover
25 all services necessary for the care and treatment of cystic fibrosis.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD08811-01-1
A. 5432 2
1 4. The commissioner shall require each fully eligible individual, upon
2 determination of eligibility, to make application to a private health
3 insurance provider as prescribed by the commissioner for an individual
4 health insurance policy. If and when such policy is granted, the commis-
5 sioner shall approve payment for the associated premium.
6 5. The commissioner shall authorize payment for services related to
7 the care and treatment of cystic fibrosis not otherwise covered by a
8 health insurance policy. Providers of such services shall be reimbursed
9 at the same rate and claims for payment shall be made as if such indi-
10 vidual was eligible for benefits pursuant to title eleven of article
11 five of the social services law.
12 6. All eligible individuals shall be required to contribute seven
13 percent of their net annual income toward the cost of care and/or the
14 cost of the annual health insurance premium.
15 7. The commissioner shall, in consultation with the commissioner of
16 social services, promulgate rules and regulations necessary to implement
17 the provisions of this article.
18 § 2. This act shall take effect immediately.
