STATE OF NEW YORK ________________________________________________________________________ 3089 2023-2024 Regular Sessions IN ASSEMBLY February 2, 2023 ___________ Introduced by M. of A. PHEFFER AMATO, WOERNER, D. ROSENTHAL, THIELE, FAHY -- 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. LBD06424-01-3A. 3089 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.