STATE OF MARYLAND



STATE OF MARYLAND

DHMH

Maryland Department of Health and Mental Hygiene

201 W. Preston Street • Baltimore, Maryland 21201

Martin O’Malley, Governor – Anthony G. Brown, Lt. Governor – John M. Colmers, Secretary

Cigarette Restitution Fund Program (CRFP) Phone: 410-767-7117 – Fax: 410-333-5100

Director: Carlessia A. Hussein, R.N., Dr. P.H. crf.state.md.us - Room 500

Family Health Administration

Russell W. Moy, M.D., M.P.H., Director – Joan H. Salim, Deputy Director

CCSC HO# 09-48

MEMORANDUM

Date: December 23, 2009

To: Health Officers

CRF-CPEST Cancer Coordinators

SAHC CRF Coordinators

From: Diane Dwyer, MD, Medical Director

Center for Cancer Surveillance and Control

Re: Payment for Complications Resulting from Cancer Treatment Services Provided by the Cigarette Restitution Fund Program (CRFP)

____________________________________________________________________________

We were asked by a Cigarette Restitution Funded program if it is acceptable to use CRFP funds to pay for medication for erectile dysfunction, where erectile dysfunction occurred as a side effect from prostate cancer treatment in the CRFP. We obtained legal counsel regarding this question.

According to our legal counsel’s analysis, the law does not provide clear guidance on whether treatment for erectile dysfunction or other side effects of cancer treatment should be covered by CRFP awarded funds. The legal counsel analysis identified related Maryland Regulations that provide some guidance in addressing this issue. These regulations pertain to the financial eligibility criteria for uninsured individuals to receive cancer treatment services under the CRFP. COMAR 10.14.06.02. Under these regulations, “cancer treatment service” is defined as a medical service or medical supply or medical equipment provided to treat cancer and “treat medical complications resulting from cancer screening or treatment.” COMAR 10.14.06.02B (5)(b).

Because new or worsening erectile dysfunction resulting from prostate cancer treatment may be a “medical complication,” then CRFP funds may be used to pay for medication for erectile dysfunction treatment. Similarly, urinary or fecal incontinence may results from treatment for prostate or colorectal cancer, respectively, and CRFP funds may be used for incontinence services, supplies, or equipment.

We recommend that programs address treatment of and payment for anticipated or known complications in your treatment plan for the patient. You may then discuss with the patient and the Medical Case Manager(s) the limits and duration of your CRFP coverage for the treatment of the cancer and the potential complications of treatment.

If you have any questions, please contact Barbara Andrews at (410) 767-5123 or me at (410- 767-5088.

(E-mailed to Health Officers and CRF/Colorectal Cancer Coordinators)

cc: Carlessia Hussein, Dr.PH

Arlee Gist

Diane Dwyer, MD

Russell Moy, MD, MPH

Joan Salim

Donna Gugel

Toll Free 1-877-4MD-DHMH • TTY for Disabled - Maryland Relay Service 1-800-735-2258

Web Site: dhmh.state.md.us

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