Date Requested:February 07, 2012
Time Requested:11:55 AM
Agency: Public Employees Insurance Agency (PEIA)
CBD Number: Version: Bill Number: Resolution Number:
2012R1001 Amendment HB2887
CBD Subject: MEDICAL COVERAGE FOR EOSINOPHILIC DISORDER
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 health insurance coverage for eosinophilic disorders.
    
    The Public Employees Insurance Agency covers diagnosis and treatment of eosinophilic disorders. Enteral/Parenteral feeding is currently covered when it is medically life sustaining to the patient. It is not covered as a supplement to the diet. Only total parenteral nutrition (TPN) or total nutrient admixture (TNA) when no food is given by other routes is covered. Coverage requirements for enteral nutrition supplements are contingent on the beneficiary must have a permanent functional impairment of the gastrointestinal tract, enteral nutrition supplements must be reasonable and necessary for the beneficiary and the beneficiary must require tube feeding to maintain weight and strength commensurate with their overall health status.
    
    Today‚Äôs Dietician reports that no medication can cure food allergies. The only way to prevent it is to avoid allergenic foods. Since January 2006 the Food Allergy Labeling and Consumer Protection Act requires manufacturers to identify on all product packaging ingredients derived from eight commonly allergenic foods: milk, egg, soybean, wheat, peanut, tree nut, fish and crustacean shellfish.
    
    Gastro Kids also reports, medication does not appear to be as effective as dietary changes in the treatment of eosinophilic esophagitis.
    
    Adults 160,404
    Children 60,136
    Infants (Under 18 months) 2,864
    Total Enrollment 223,404
    
    Probability of esophagitis non-infants 0.0005
    Probability of esophagitis infants 0.04
    Esophagitis non-infant duration in days 60
    Esophagitis infant duration in days 365
    Probability of e. gastritis 0.000285714
    E. gastritis duration in days 60
    
    
    Expected number of esophagitis days 48,425
    Non-infants 6,616
    Infants 41,809
    
    Expected number of e. gastritis days 3,829.78
    
    
    Cost per day of coverage 120.00
    
    Expected Esophagitis cost $ 5,811,036
    Expected E. Gastritis Cost $ 459,574
    Total Annual cost $ 6,270,610
    
    
    FY 2013 $ 6,270,000
    FY 2014 $ 6,770,000
    FY 2015 $ 7,310,000
    
    Three year total cost $20,350,000
    
    
    The total expected increase in medical health care costs trended at 8% for the next three fiscal years is anticipated to be $20,350,000.
    
    FY-2013 $6,270,000
    FY-2014 $6,770,000
    FY-2015 $7,310,000
    Total $20,350,000
    

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2012
Increase/Decrease
(use"-")
2013
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