The Empire Plan “Centers of Excellence” Programs will continue. A travel allowance for transportation and lodging will be included as part of the Centers of Excellence Program. Effective July 1, 2008, the travel allowance for mileage will be consistent with the maximum mileage allowance permitted by the Internal Revenue Service; the meal and lodging allowance in each location will be equal to the rate provided by the Federal government to its employees in such locations. The Joint Committee on Health Benefits will work with the State and Empire Plan carriers in the ongoing oversight of this benefit.
1. The Centers of Excellence for organ and tissue transplants will be required to provide pre-transplant evaluation, hospital and physician services (inpatient and outpatient), transplant procedures, follow-up care for transplant related services, as determined by the Centers, and any other services as identified during implementation as part of an all-inclusive global rate.
Centers of Excellence for infertility shall offer enhanced benefits to include
treatment of “couples” as long as both partners are covered either as an
enrollee or dependent under the Empire Plan.
The lifetime coverage limit is
$25,000. Effective January 1, 2005 the lifetime coverage limit will increase to $50,000.
Covered services include: patient education and counseling, diagnostic
testing, ovulation induction/hormonal therapy, surgery to enhance reproductive
capability, artificial insemination and Assisted Reproductive Technology
procedures. Prior authorization may be
required for certain procedures.
Exclusions include: experimental procedures, fertility drugs dispensed
at a licensed pharmacy, medical and other charges for surrogacy, donor
services/compensation in connection with pregnancy.
January 1, 2004 , or as soon thereafter as practicable, the Empire Plan Centers of
Excellence program shall be expanded to include Centers of Excellence for
Cancer Resource Services. The Centers of Excellence for Cancer Resource
Services (CRS) program will provide direct nurse consultations, information and
assistance in locating appropriate care centers, connection with cancer experts