2022-06-20T12:17:55-05:00 2021-12-31 560574444 CHERRY BEKAERT LLP 1111 METROPOLITAN AVE STE 900 CHARLOTTE NC 28204 990 2021-01-01 201184743 PATIENT ACCESS NETWORK FOUNDATION PATI 2023479272 805 15TH STREET NW 500 WASHINGTON DC 20005 KEVIN HAGAN PRESIDENT & CEO 2023479272 2022-06-14 1 KEVIN HAGAN 999009999 AMANDA ADAMS P00748038 7043771678 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z KEVIN HAGAN 805 15TH STREET NW 500 WASHINGTON DC 20005 360829204 0 X WWW.PANFOUNDATION.ORG X 2004 DC TO HELP UNDERINSURED PEOPLE WITH LIFE-THREATENING, CHRONIC AND RARE DISEASES GET THE MEDICATIONS AND TREATMENT THEY NEED BY PAYING FOR THEIR OUT-OF-POCKET COSTS AND ADVOCATING FOR IMPROVED ACCESS AND AFFORDABILITY. 14 14 178 0 0 0 439121644 297101560 0 0 11575867 13178324 0 0 450697511 310279884 454243207 380051359 0 0 4277002 8351678 505013 540483 1501876 18069237 17829405 477094459 406772925 -26396948 -96493041 621060629 507970702 184400819 176958193 436659810 331012509 X TO HELP UNDERINSURED PEOPLE WITH LIFE-THREATENING, CHRONIC AND RARE DISEASES GET THE MEDICATIONS AND TREATMENT THEY NEED BY PAYING FOR THEIR OUT-OF-POCKET COSTS AND ADVOCATING FOR IMPROVED ACCESS AND AFFORDABILITY. 0 0 398507827 380051359 AT THE PAN FOUNDATION, WE ENVISION A NATION IN WHICH EVERYONE CAN GET ACCESS TO THE TREATMENT THEY NEED. WITH THE SUPPORT OF OUR GENEROUS DONORS AND IN COLLABORATION WITH HEALTHCARE PROVIDERS AND PHARMACIES THROUGHOUT THE U.S., PAN IS ABLE TO COVER PREMIUMS, DEDUCTIBLES, CO-PAYMENTS AND COINSURANCE FOR THOUSANDS OF UNDERINSURED PATIENTS. AS A RESULT, THESE PATIENTS ARE ABLE TO OBTAIN THE TREATMENTS THEY NEED TO BEST MANAGE THEIR CONDITIONS AND IMPROVE THEIR QUALITY OF LIFE. IN 2021, THE PAN FOUNDATION ASSISTED 160,554 PATIENTS, AND PAID OVER 888,000 CLAIMS FOR PATIENTS' OUT-OF-POCKET COSTS FOR THEIR CRITICAL MEDICATIONS. THE PAN FOUNDATION OPERATES UNDER AN ADVISORY OPINION ISSUED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, OFFICE OF THE INSPECTOR GENERAL (OIG ADVISORY OPINION 07-18). ACCORDINGLY, PAN IS COMMITTED TO OPERATING IN A FULLY COMPLIANT AND TRANSPARENT MANNER THAT MEETS OR EXCEEDS ALL RELEVANT STATUTES AND GUIDANCE FOR CHARITABLE PATIENT ASSISTANCE FOUNDATIONS. 398507827 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 43 0 1 178 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 DC X X SCOTT SCHLENOFF 2026618080 805 15TH STREET NW 500 WASHINGTON DC 20005 SUSAN RUCKER CHAIR 3.00 X X 16000 0 0 DEANNA BANKS VICE CHAIR 3.00 X X 12000 0 0 NANCY MCGEE SECRETARY 3.00 X X 12000 0 0 MIRIAM ATKINS DIRECTOR 3.00 X 12000 0 0 WENDY BULLINGTON DIRECTOR 3.00 X 12000 0 0 JOSEPH D'AVELLA DIRECTOR 3.00 X 12000 0 0 JONAS DE SOUZA DIRECTOR 3.00 X 12000 0 0 JAMES DUNLOP DIRECTOR 3.00 X 12000 0 0 MARY FINDLEY DIRECTOR 3.00 X 12000 0 0 CHRISTOPHER GRAHAM DIRECTOR 3.00 X 12000 0 0 JEFFREY KING DIRECTOR 3.00 X 8000 0 0 WINFRED PARNELL DIRECTOR 3.00 X 12000 0 0 GARY THOMAS DIRECTOR 3.00 X 10000 0 0 HOWARD WEINBERG DIRECTOR 3.00 X 12000 0 0 KEVIN HAGAN PRESIDENT & CEO FROM SEPT 40.00 X 142679 0 4709 AMY NILES EXECUTIVE VICE PRESIDENT 40.00 X 235635 0 18644 SCOTT SCHLENOFF CFO & TREASURER 40.00 X 237057 0 28162 NECHUMAH GETZ COO 40.00 X 257827 0 10482 DANIEL KLEIN FORMER PRESIDENT & CEO 40.00 X 460679 0 13426 LEENA PATEL VICE PRESIDENT OF DEVELOPMENT 40.00 X 212613 0 17396 AYESHA AZAM VICE PRESIDENT OF MEDICAL AFFAIRS 40.00 X 191064 0 12843 STUART CHERANDE FRIEDMAN SENIOR DIRECTOR OF SPECIAL PROJECTS 40.00 X 166787 0 8070 DEEPAK SHRESTHA DIRECTOR OF IT 40.00 X 159766 0 13759 RICHARD CITRENBAUM VICE PRESIDENT, PATIENT SUPPORT SERVICES 40.00 X 166338 0 18038 2396445 0 145529 20 0 1 0 CAREMETX LLC 6931 ARLINGTON ROAD SUITE 308 BETHESDA MD 20814 PATIENT SERVICES 8905050 AD HOC 1350 I ST NW SUITE 550 WASHINGTON DC 20005 PATIENT SERVICES 4419793 TRUSTMARK 62923 COLLECTION CENTER DRIVE CHICAGO IL 60693 CLAIM ADMINISTRATION 1552000 SS&C HEALTH 13804 COLLECTIONS DRIVE CHICAGO IL 60693 CLAIM ADMINISTRATION 1327149 SUMMIT BUSINESS TECHNOLOGIES 8223 CLOVERLEAF DRIVE SUITE 100 MILLERSVILLE MD 21108 IT SERVICES 975115 8 297101560 297101560 9226883 9226883 54500761 50549320 3951441 3951441 3951441 310279884 0 0 13178324 380051359 380051359 1575300 522588 1052712 5251207 3109061 1389817 752329 67448 45777 17500 4171 948195 643536 246019 58640 509528 277821 174154 57553 549832 36276 513556 247749 247749 540483 540483 616179 616179 11133105 9824375 1284082 24648 278103 29235 197082 51786 747949 226157 521732 60 401061 318083 71914 11064 97634 9770 87470 394 22391 1311 20332 748 3133976 3123056 10920 312004 312004 ALLIANCE EXPENSES 289422 289422 406772925 398507827 6763222 1501876 141398137 101414537 51791285 20760000 701822 955227 13252909 7137216 1997574 6115693 425171811 378725245 621060629 507970702 15030637 14854822 169370182 162103371 184400819 176958193 X 41456591 42596877 395203219 288415632 436659810 331012509 621060629 507970702 -96493041 -9154260 0 X 0 1 X 1 0 X 525431993 530743654 434035433 439121644 297101560 2226434284 525431993 530743654 434035433 439121644 297101560 2226434284 1665072481 561361803 5779770 8605773 13565060 9824200 9266883 47041686 2273475970 0.24690 0.29110 X 1. THE FOUNDATION'S PUBLIC SUPPORT PERCENTAGE IS AT LEAST 10%.2. THE FOUNDATION MAINTAINS A CONTINUOUS AND BONA FIDE PROGRAM FOR SOLICITATION OF FUNDS FROM THE GENERAL PUBLIC.3. AT 24.69% THE FOUNDATION'S PUBLIC SUPPORT PERCENTAGE FOR 2021 IS WELL ABOVE THE MINIMUM REQUIREMENT OF 10% AND NARROWLY FALLS SHORT OF THE NORMAL REQUIREMENT OF 33 1/3%.4. THE FOUNDATION NORMALLY RECEIVES SUPPORT FROM A LARGE NUMBER OF UNRELATED DONORS. DURING THE PERIOD 2017-2021, THE FOUNDATION RECEIVED SUPPORT FROM 50+ CORPORATE DONORS AND WELL OVER 1,000 INDIVIDUAL DONORS. 5. THE FOUNDATION HAS A GOVERNING BODY WHICH REPRESENTS THE BROAD INTERESTS OF THE PUBLIC. THE BOARD OF DIRECTORS INCLUDES INDIVIDUALS FROM THE ACADEMIC, NONPROFIT BUSINESS, AND MEDICAL COMMUNITIES AS WELL AS ATTORNEYS AND CPAS. 6. THE FOUNDATION'S PROGRAMS PROVIDE GREAT BENEFIT TO THE PUBLIC. SINCE INCEPTION THE FOUNDATION HAS PROVIDED OVER $4 BILLION IN MEDICAL SUPPORT ASSISTANCE TO OVER 1 MILLION INDIVIDUALS.7. THE FOUNDATION PROVIDES OTHER BENEFITS DIRECTLY TO THE PUBLIC, INCLUDING: -OFFERS FINANCIAL NAVIGATION SERVICES TO HELP ELIGIBLE PATIENTS APPLY FOR THE FEDERAL LOW-INCOME SUBSIDY PROGRAM AND REDUCE THEIR OUT-OF-POCKET MEDICARE PART D MEDICATION COSTS. EDUCATES PATIENTS ABOUT THE PROGRAM AND ELIGIBILITY REQUIREMENTS.-PROVIDES TRANSPORTATION FINANCIAL ASSISTANCE TO HELP ELIGIBLE PATIENTS GET TO AND FROM THEIR MEDICAL APPOINTMENTS AND PHARMACIES.-PROVIDES TWO MENTAL HEALTH FINANCIAL ASSISTANCE PROGRAMS TO HELP ELIGIBLE PATIENTS PAY FOR THEIR OUT-OF-POCKET MEDICATION COSTS FOR BIPOLAR DISORDER AND SCHIZOPHRENIA.-OPERATES FUNDFINDER, A DIGITAL WEBSITE AND APPLICATION THAT ALLOWS PATIENTS AND HEALTHCARE PROFESSIONALS TO RAPIDLY DETERMINE THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM ANY PATIENT ASSISTANCE FOUNDATION AND PROVIDES A DIRECTORY OF PATIENT SUPPORT ORGANIZATIONS.-OFFERS PATIENTS REFERRALS TO OTHER FINANCIAL RESOURCES WHEN THEY DO NOT QUALIFY FOR ASSISTANCE AT THE PAN FOUNDATION. -MAINTAINS A NETWORK OF ALLIANCE PARTNERSHIPS WITH NATIONAL PATIENT SUPPORT ORGANIZATIONS WHO PROVIDE DISEASE-RELATED EDUCATION AND SUPPORT TO PATIENTS AND CAREGIVERS.-EDUCATES HEALTHCARE PROFESSIONALS ON NAVIGATING PATIENT ASSISTANCE AND SAFETY NET RESOURCES TO HELP ENROLL THEIR PATIENTS IN RELEVANT ASSISTANCE PROGRAMS-OFFERS A SOCIAL DETERMINANTS OF HEALTH SCREENING TOOL FOR HEALTHCARE PROFESSIONALS TO USE WITH THEIR PATIENTS TO IDENTIFY THEIR SOCIAL DETERMINANT OF HEALTH NEEDS. -CONDUCTS RESEARCH AND POLLING ON TOPICS RELATED HEALTHCARE ACCESS AND AFFORDABILITY, INCLUDING BUT NOT LIMITED TO SOCIAL DETERMINANTS OF HEALTH, MENTAL HEALTH, MEDICATION ADHERENCE, AND OTHER ACCESS ISSUES.-DEVELOPS RESOURCES TO EDUCATE POLICYMAKERS AND OTHER STAKEHOLDERS ABOUT COMPLEX HEALTHCARE ACCESS AND AFFORDABILITY TOPICS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 630813 261507 369306 12622096 6875709 5746387 6115693 CO-PAYMENT ASSISTANCE OBLIGATION 162103371 162103371 X 300509445 -9154260 -9154260 309663705 616179 616179 310279884 406156746 0 406156746 616179 616179 406772925 PART X, LINE 2: THE FOUNDATION IS A NON-PROFIT, TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT BELIEVES THAT THE FOUNDATION CONTINUES TO SATISFY THE REQUIREMENTS OF A TAX EXEMPT ORGANIZATION AND IS NOT SUBJECT TO TAX. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT HAS EVALUATED THE EFFECT OF FASB GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS BY PRESCRIBING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE FOUNDATION'S POLICY IS TO RECORD A LIABILITY FOR ANY TAX POSITION TAKEN THAT IS BENEFICIAL TO THE FOUNDATION, INCLUDING ANY RELATED INTEREST AND PENALTIES, WHEN IT IS MORE LIKELY THAN NOT THE POSITION TAKEN BY MANAGEMENT WITH RESPECT TO A TRANSACTION OR CLASS OF TRANSACTIONS WILL BE OVERTURNED BY A TAXING AUTHORITY UPON EXAMINATION. X X X X X 1 THE PURSUANT GROUP 15660 N DALLAS PKWY 1000 DALLAS TX 75248 INDIVIDUAL GIVING CAMPAIGN 0 0 540483 -540483 540483 -540483 AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY SCHEDULE G, PART I, LINE 2B, COLUMN (IV): NO AMOUNT HAS BEEN REPORTED IN COLUMN (IV) BECAUSE IT IS DIFFICULT TO DETERMINE WHAT PORTION OF CONTRIBUTION REVENUE RECEIVED DURING THE YEAR WAS ATTRIBUTABLE TO THIS FUNDRAISER'S EFFORTS. 1 MEDICATION CO-PAY ASSISTANCE 160554 380051359 PART I, LINE 2: THESE FUNDS REPRESENT THE GRANTS MADE FOR THE BENEFIT OF PATIENTS. THROUGH AN APPLICATION PROCESS WHICH INCLUDES INCOME VERIFICATION AND CONFIRMATION OF MEDICAL NEED AGAINST ELIGIBILITY CRITERIA SET BY THE BOARD, PAN ENSURES THAT ALL PATIENTS WHO REQUEST OUR SERVICES MEET THE CRITERIA FOR RECEIVING A GRANT BEFORE ANY FUNDS ARE DISBURSED. THE PATIENT'S GRANT WILL PROVIDE ASSISTANCE FOR THEIR RESPONSIBILITY (DEDUCTIBLE, CO-PAYMENT, OR COINSURANCE) FOR COVERED MEDICATION SERVICES AFTER PAYMENT FROM THE PRIMARY INSURANCE OR THE AMOUNT AVAILABLE TO EACH PATIENT IS LIMITED BY A CAP SET BY THE BOARD. FUNDS ARE DISBURSED TO THE PHARMACY OR PHYSICIAN'S OFFICE WHEN POSSIBLE, SINCE WE WANT TO ENSURE THAT THE PATIENT DOES NOT NEED TO PROVIDE FUNDS OUT-OF-POCKET FOR THEIR MEDICATIONS. X X X X X X 0 1 0 0 0 0 0 0 0 DANIEL KLEIN FORMER PRESIDENT & CEO 348014 0 109744 0 2921 0 11600 0 1826 0 474105 0 0 0 NECHUMAH GETZ COO 219086 0 38423 0 318 0 9377 0 1105 0 268309 0 0 0 SCOTT SCHLENOFF CFO & TREASURER 206643 0 30096 0 318 0 8689 0 19473 0 265219 0 0 0 AMY NILES EXECUTIVE VICE PRESIDENT 207131 0 27126 0 1378 0 3900 0 14744 0 254279 0 0 0 LEENA PATEL VICE PRESIDENT OF DEVELOPMENT 186034 0 26432 0 147 0 8332 0 9064 0 230009 0 0 0 AYESHA AZAM VICE PRESIDENT OF MEDICAL AFFAIRS 168747 0 22191 0 126 0 5595 0 7248 0 203907 0 0 0 RICHARD CITRENBAUM VICE PRESIDENT, PATIENT SUPPORT SERV 149760 0 16267 0 311 0 4318 0 13720 0 184376 0 0 0 STUART CHERANDE FRIEDMAN SENIOR DIRECTOR OF SPECIAL PROJECTS 145727 0 20860 0 200 0 7128 0 942 0 174857 0 0 0 DEEPAK SHRESTHA DIRECTOR OF IT 136010 0 23651 0 105 0 6543 0 7216 0 173525 0 0 0 PART I, LINE 4B SCOTT SCHLENOFF, AMY NILES, NECHUMAH GETZ, LEENA PATEL, AND AYESHA AZAM PARTICIPATED IN THE ORGANIZATION'S 457(F) PLAN EFFECTIVE JANUARY 1, 2020. THE BENEFIT PAYABLE TO EACH PARTICIPANT UNDER THE PLAN IS AN AMOUNT EQUAL TO 75% OF THE PARTICIPANT'S 2020 ANNUAL BASE SALARY. EACH PARTICIPANT WILL BECOME VESTED IN HIS OR HER BENEFIT ON DECEMBER 31, 2023, IF THE PARTICIPANT REMAINS CONTINUOUSLY EMPLOYED BY THE FOUNDATION ON A FULL-TIME BASIS THROUGH THAT DATE. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE FINANCE COMMITTEE. ALL BOARD MEMBERS RECEIVE A COPY OF THE FORM PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C AS POTENTIAL BOARD MEMBERS OR OFFICERS ARE RECRUITED THEY ARE ASKED ABOUT POSSIBLE CONFLICTS OF INTEREST. UPON JOINING PAN, AND AT LEAST ANNUALLY, MEMBERS READ AND SIGN THE CONFLICT OF INTEREST POLICY. IF ANY CONFLICTS ARE NOTED ON THE FORM, MORE INFORMATION WILL BE GATHERED AND IT WILL BE DETERMINED IF THE ISSUE IS MATERIAL. IN ADDITION, THAT MEMBER WILL ABSTAIN FROM ALL DISCUSSIONS AND VOTE ON THE MATTER. IF IT IS MATERIAL, WE INVOLVE LEGAL COUNSEL AND A DETAILED FOLLOW UP AND RESOLUTION WILL OCCUR. FORM 990, PART VI, SECTION B, LINE 15 THE INDEPENDENT BOARD DETERMINES THE COMPENSATION FOR THE PRESIDENT/CEO. THE NEW PRESIDENT/CEO STARTED IN SEPTEMBER 2021. HIS COMPENSATION WAS DETERMINED WITH THE HELP OF AN OUTSIDE CONSULTANT WHO USED DATA FROM OTHER ORGANIZATIONS' 990S. ALL OTHER EMPLOYEES SALARIES ARE DETERMINED BY THE PRESIDENT/CEO IN ACCORDANCE WITH THIRD PARTY COMPENSATION SURVEYS. THE MOST RECENT STAFF COMPENSATION STUDY WAS COMPLETED IN 2020. IN ADDITION, PERIODICALLY, THE STAFF REVIEWS FORMS 990 OF ORGANIZATIONS WITH SIMILAR MISSIONS TO HELP DETERMINE COMPENSATION. ALL DISCUSSIONS ARE DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE POSTED ON ITS WEBSITE. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY MAY BE MADE AVAILABLE UPON REQUEST ON A CASE BY CASE BASIS.