Date Requested:February 14, 2011
Time Requested:11:30 AM
Agency: Public Employees Insurance Agency (PEIA)
CBD Number: Version: Bill Number: Resolution Number:
Comm. Sub. Eng. HB2693
CBD Subject: INSURANCE COVERAGE FOR AUTISM SPECTRUM DISORDERS
FUND(S)
2180
Sources of Revenue
Special Fund
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 insurance coverage for autism spectrum disorders. The bill also ensures any limitation to coverage does not conflict with other applicable law.
    
    The Public Employees Insurance Agency (PEIA) presently pays for the diagnosis of autism spectrum disorder. A review of the PEIA membership demographics indicates approximately 53,000 dependent children. By using the standard level of incidents for autism spectrum disorder of .91% for PEIA dependent children it is expected that the population requiring the coverage defined in this bill to be approximately 483. The identified dependent children would require intensive services and have high utilization rates for behavior therapy and other required benefits such as drug therapy prescribed by a treating health care provider as well as occupational, physical and speech therapy visits to name a few. It is assumed that there will be a significant number if not all that utilize this benefit when it becomes available.
    
    The original legislation has been amended to cover applied behavioral analysis in an amount not to exceed $30,000 per individual for three consecutive years, then in an amount not to exceed $2,000 per month.
    
    Depending on incidence rate variable of 1 in 60 or 1 in 110 the PEIA has estimated a range of projected cost to cover autism spectrum disorder.
    
    The range of cost associated with the delivery of these benefits would be an additional cost to the program. Based upon these assumptions it is projected the annual cost to the PEIA to be as follow:
    
    FY-2012 $11,302,803.00 - $20,707,761.00
    
    FY-2013 $12,433,083.00 - $22,778,537.00
    
    FY-2014 $13,676,391.00 - $25,506,391.00
    
    Total $37,412,277.00 - $68,542,689.00
    

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2011
Increase/Decrease
(use"-")
2012
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
3. Explanation of above estimates (including long-range effect):
    


Memorandum
Person submitting Fiscal Note:
Chip Myers
Email Address:
clifford.m.myers@wv.gov