Cancer State Aid Program (CSA)
The Cancer State Aid Program was established in 1937 by the Georgia legislature at the request of Georgia physicians to provide cancer treatment to uninsured and under-insured, low-income Georgians. State funds are assigned to CSA by the Georgia Legislature each state fiscal year for payment of cancer related services.
CSA provides services through agreements with:
- Hospitals and free standing radiation therapy centers;
- Physician groups or medical treatment centers.
- Supportive services during treatment may be provided through retail or
private pharmacies, home health and medical supply agencies that have
agreements with CSA.
During FY12 – 381 patient applications were received, 255 patients were
enrolled, 223 received services provided through program funds. Over 3,200
claims for payment containing multiple treatment services totaling more than
$6,212,700 were reimbursed. CSA provided payments for 87% of those enrolled.
CSA has three distinct funding priorities:
- To provide payments for cancer related diagnostic testing of conditions medically evaluated to be highly suspicious for cancer;
- To provide payments for cancer staging evaluations and treatment planning for those who have a cancer diagnosis, but have not yet had a full medical workup;
- And to provide standard cancer treatment services to patients whose prognosis and planned treatments are medically eligible for program funding.
Eligibility for CSA Funding
All applicants must:
- Make application to CSA through a participating facility;
- Qualify for program funding both financially and medically;
- Be uninsured or under-insured, lacking sufficient coverage for cancer
- Have an income at or below 300% of the Federal Poverty Guidelines
(outstanding medical expenses may help an applicant to qualify);
- Be a Georgia resident who is a U.S. citizen or resident alien (lawfully
admitted to reside permanently);
- Be accepted for cancer treatment by a physician affiliated with a
participating facility, and;
- Receive all treatments at a participating facility and have CSA prior
approval for each facility that is needed.
- Patients who are approved for funding of diagnostic testing or staging
services must also be medically approved for funding of any needed treatment
- Only prior approved, medically eligible cancer related services are paid
directly to the facilities.
CSA Does Not
- Accept applications for program enrollment from patients or from
facilities that do not have a signed agreement with CSA;
- Provide funding for co-payments or insurance deductibles or any other
- Enroll patients whose cancer treatments have been completed prior to
submission/receipt of the application;
- Enroll patients who need only palliative care (relief of symptoms) or
- Extend follow-up after approved diagnostic or treatment services are
- Provide funding of hospice care;
- Provide payments to third party vendors that do not have an agreement with
CSA. This may include laboratory services and others billed separately from the
Access to the program is provided through treatment facilities that perform
financial and medical eligibility assessments for the program.
Applicants are continuously enrolled based on the availability of funds. Final
eligibility decisions and approval of funding for services are made by the
Cancer State Aid Program.
Services available to currently enrolled patients with approval for cancer
related diagnostic services or approval for funding of cancer treatment may
include physician prescribed inpatient and outpatient services at participating
hospitals, approved freestanding radiation centers and physician groups or
medical treatment centers; approved independent pharmacies, home health agencies
and medical suppliers.
Patients must make application through the participating
Cancer State Aid
facility that will provide the cancer related services. Designated staff at
participating facilities will assist the patient in completion of the
application and will submit the application to CSA on their behalf. Enrolled
patients must first have CSA approval to receive care from each needed facility
for services to be eligible for program payment. All program payments are based
upon current available funds.
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