Cancer State Aid Program (CSA)

Program Overview

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;
• Retail or private pharmacies, home health and medical supply agencies that provide prior approved - supportive services..

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.

Program Focus

CSA has three distinct funding priorities:

1. To provide payments for cancer related diagnostic testing of conditions medically evaluated to be highly suspicious for cancer;
2. 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;
3. 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:

1. Make application to CSA through a participating facility;
2. Qualify for program funding both financially and medically;
3. Be uninsured or under-insured, lacking sufficient coverage for cancer treatment;
4. Have an income at or below 300% of the Federal Poverty Guidelines (outstanding medical expenses may help an applicant to qualify);
5. Be a Georgia resident who is a U.S. citizen or resident alien (lawfully admitted to reside permanently);
6. Be accepted for cancer treatment by a physician affiliated with a participating facility, and;
7. Receive all treatments at a participating facility and have CSA prior approval for each facility that is needed.
8. Patients who are approved for funding of diagnostic testing or staging services must also be medically approved for funding of any needed treatment services.
9. Only prior approved, medically eligible cancer related services are paid directly to the facilities.

CSA Does Not

1. Accept applications for program enrollment from patients or from facilities that do not have a signed agreement with CSA;
2. Provide funding for co-payments or insurance deductibles or any other expense;
3. Enroll patients whose cancer treatments have been completed prior to submission/receipt of the application;
4. Enroll patients who need only palliative care (relief of symptoms) or follow-up;
5. Provide extended follow-up after approved diagnostic or treatment services are completed;
6. Provide funding of hospice care;
7. 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 participating facility.
8. Provide payments for private physician office visits or physician fees.
9. Pay for any medical services that are not related to cancer diagnosis or treatment.

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. Prior approved, limited medical follow-up services for currently enrolled patients may be available.

Participating Facilities

Additional Resources