FISCAL NOTE
FUND(S):
Sources of Revenue:
Other Fund NA
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 Department of Health and Human Resources to annually review and adjust rates it pays to care providers to be comparable, on a percentage basis, to rates paid to hospitals.
Although the cost impact is estimated to be considerable, it is not possible to calculate a definitive cost impact based on the information provided (See "Memorandum" section below).
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2009
Increase/Decrease
(use"-") |
2010
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
0 |
0 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
0 |
| Repairs and Alterations |
0 |
0 |
0 |
| Assets |
0 |
0 |
0 |
| Other |
0 |
0 |
0 |
| 2. Estimated Total Revenues |
0 |
0 |
0 |
Explanation of above estimates (including long-range effect):
Memorandum
The legislation makes this requirement applicable to “care providers”, however it does not define what that term means or the specific provider groups intended to be impacted. Hospitals are not adjusted annually on a percentage basis, and the adjustments that are made do not lend themselves to calculating an overall percentage increase (i.e. rates applicable to various codes may be adjusted up or down depending on the methodology used, and these would have to be combined to arrive at an overall rate however not all hospitals bill/use all codes or provide all services). Rates for a variety of provider types are adjusted on various timetables using a variety of methods, such as cost (based on an annual or semi-annual cost report) or annual indexes and adjustments such as DRG’s or RBRVS. Hospitals are not necessarily comparable to all provider types, and there are variances in the cost experience among these different provider types.
The Department's Bureau for Children and Families (BCF) is required to pay for medical services for children and adults in their caseload that do not have Medicaid coverage. These costs are paid with 100% state general revenue funds. BCF pays an amount based on the current Medicaid rate for the service provided so any fluctuation in these rates would financially impact BCF.
The Department's Bureau for Public Health (BPH) pays for services based upon flat fees or the Medicaid rate, any fluctuation in these rates would financially impact BPH.
Person submitting Fiscal Note: Martha Yeager Walker
Email Address: dhhrbudgetoffice@wv.gov