Date Requested:February 20, 2007
Time Requested:02:00 PM
Agency: Health and Human Resources, Department of
CBD Number: Version: Bill Number: Resolution Number:
2007R1012 Introduced SB663
CBD Subject: BACKGROUND CHECKS ON MEDICAID PROVIDER APPLICANTS
FUND(S)
0403 - Div of Human Services General Administration Fund, 8722 - Cons Federal Funds Div Human Services Gen Admn Fd
Sources of Revenue
General Fund,Other Fund Federal
Legislation creates:
Neither Program nor Fund

Fiscal Note Summary

Effect this measure will have on costs and revenues of state government.

    The purpose of this bill is to require the Bureau for Medical Services to conduct a criminal background investigation on Medicaid provider applicants and on existing Medicaid providers who have not previously undergone a criminal background investigation.
    
    The Department of Health and Human Resources (Department) estimates the fiscal impact of this bill to be $1,136,400 ($568,200 in state funds) for the first year which includes $992,400 for all currently enrolled providers and an additional $144,000 for new enrollments. Each additional year is estimated to have a cost of $144,000 ($72,000 in state funds) for new enrollments.
    
    

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2007
Increase/Decrease
(use"-")
2008
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 1,136,400 144,000
Personal Services 0 0 0
Current Expenses 0 1,136,400 144,000
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 0 0
2. Estimated Total Revenues 0 0 0
3. Explanation of above estimates (including long-range effect):
    The estimate is based on 24,810 participating providers enrolled in the Medicaid program as of December 31, 2006 and an estimated number of new enrollments of 300 per month at a cost of $40 per completed FBI background check.
    
    


Memorandum
Person submitting Fiscal Note:
Martha Yeager Walker
Email Address:
fnbudoff@wvdhhr.org
    The bill does not define "provider" and was interpreted as the responsible party who signed the provider agreement. If the intent of this legislation is to require a criminal background investigation for each provider of service, the cost estimate of this legislation would increase significantly. This bill would also require the Department to begin credentialing providers verses the current process of enrolling providers. The cost to complete a background investigation required to credential a provider is estimated at $150 per enrolled provider and would result in a total cost of $4,261,500 to comply with this legislation.
    
    Additional measures are taken during the current enrollment process to identify providers who have been excluded from participation in federal programs for fraud and abuse. The Office of Inspector General provides a database of exclusions which is searchable free of charge.