Patient Advocate Foundation’s (PAF) Case Management program provides one-on-one assistance with a professional case manager to help qualified patients, their families and caregivers resolve financial, job-related, and healthcare access issues that may be the result of a patient’s chronic, debilitating, or life-threatening diagnosis. In order to qualify for case management assistance, the patient must have a chronic, debilitating, or life-threatening disease and must be receiving active treatment for the disease, must have received treatment for the disease within the last six (6) months, or will begin treatment for the disease in the next 60 days. PAF’s Case Management program provides assistance with resolving a broad variety of patient and caregiver concerns including: (1) access to care (e.g., assistance in obtaining prior authorization approvals; second opinions, insurance appeals; insurance plan review); (2) cost of care (e.g., co-pay assistance, premium assistance); (3) cost of living expenses (e.g., rent, utility, transportation, food/nutrition assistance programs);(4) safety net program support (e.g. SSDI, LIS, Extra Help enrollment assistance) and (5) employment-related issues (e.g., FMLA, short-term and long-term disability). PAF’s Case Management program identifies sources of assistance, including other charitable organizations and government-sponsored programs, and assists patients in enrolling in these services as appropriate.
PAF will not consider the identity of any physician, provider, supplier of items or services, donor, drug therapy, services or supplies being utilized, or the referral source when assessing whether an applicant is qualified for case management assistance through PAF’s Case Management program. Further, case management assistance is not dependent on the use of a particular drug, particular supplies, or particular provider or suppliers and patients are free to switch drug therapies, treating physicians, pharmacies, and suppliers at any time without affecting their continued eligibility for case management assistance from PAF.
Qualifying patients are provided one-on-one assistance by PAF’s Case Management program until their access to care, cost of care, cost of living, or employment-related issues are resolved. Case Management assistance is provided to the extent the Case Management program has capacity to provide assistance with no preference being given to patients from any one referral source.
Information Collection, Use, Disclosure Ownership and Sharing
Patient Advocate Foundation is committed to ensuring patient’s privacy is protected. It is the policy of Patient Advocate Foundation that patients’ individually identifiable information, including protected health information, collected from patients, or their authorized representatives, in the course of PAF providing assistance through its case management program, as well as all other foundation programs, may only be used after authorization by patients, or their representatives, as follows:
1. By PAF and its representatives to provide services and support to patients seeking assistance from and enrolled in PAF programs, including those administered by PAF as a service provider or program partner, to respond to applications for assistance, resolve issues presented by patients seeking assistance from PAF and to evaluate the effectiveness of the case management program.
2. Representatives may include PAF employees, both permanent and temporary, directors, officers, PAF legal counsel, contracted third party service provider organizations, specific contacts within organizations contracting PAF as a program administrator and specific contacts within organizations partnering with PAF to provide case management services.
3. Patients’ contact information may be used in the future to share printed and/or electronic communications from Patient Advocate Foundation and the PAF Case Management program. If the patient does not wish to receive print and/or electronic communications from PAF or Case Management, he/she may contact the program at 1-800-532-5274 and request to have his/her contact information removed from the mailing list.
4. Patients’ data may also be used in de-identified aggregated reports. This means that information patients provide to PAF may be combined with other patients’ data to prepare reports analyzing patient needs and the effectiveness of the case management program. PAF will only use de-identified patient data, i.e., patient data where all identifying data terms like the patient’s name, identifying numbers, etc. have been removed in these aggregated reports.
5. PAF is the owner of the personal information collected through PAF programs and may provide de-identified reports.
6. PAF collects information that patients voluntarily provide or that is given to us by patients’ authorized representatives and providers, including but not limited to family members, caregivers, guardians, medical providers, pharmacies, health care facilities, diagnostic laboratories, medical equipment providers, health and welfare benefit plans, insurance companies, benefit administrators and employers.
7. PAF will not sell or rent patients’ individually identifiable information, including protected health information, to anyone.
8. PAF will not share personal information with any third party outside of the organization other than as necessary to resolve issues presented by the patients, to process an application for assistance, to process a claim being made against a financial award that has been provided, to evaluate the effectiveness of the case management program, as required by a partnering organization, for PAF operations/management or as is required by law.