S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5432
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             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:

   Section 1. The public health law is amended by adding  a  new  article
 27-g to read as follows:
                               ARTICLE 27-G
                 ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM
 SECTION 2795. ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM.
   §  2795. ADULT CYSTIC FIBROSIS ASSISTANCE PROGRAM. 1. THE COMMISSIONER
 SHALL ESTABLISH A PROGRAM TO REIMBURSE THE COST OF PROVIDING HEALTH CARE
 OR HEALTH INSURANCE TO ELIGIBLE INDIVIDUALS WHO HAVE CYSTIC FIBROSIS.
   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
 INCOME.
   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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD08811-01-1

 A. 5432                             2
 
   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.
   § 2. This act shall take effect immediately.