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.
                                                                   LBD06424-01-3

        A. 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.