Date Requested:March 04, 2013
Time Requested:03:41 PM
Agency: Health and Human Resources, Department of
CBD Number: Version: Bill Number: Resolution Number:
2013R2458 Introduced SB428
CBD Subject: BILLING FOR HIV TESTING
FUND(S)
0407- Central Office General Administrative Fund, 5186 - HIV Testing Fund, 8802 Public Health Federal Fund
Sources of Revenue
General Fund,Special 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 remove the prohibition on billing persons for HIV testing or testing for sexually transmitted diseases conducted by the State Bureau for Public Health or county or local health departments. The bill allows public health agencies to charge patients or their medical insurance providers for the reasonable costs for testing. It also clarifies the procedures for testing persons accused of a sexual offense for HIV or STDs.
    The Department of Health and Human Resources through the Bureau for Public Health, Office of Laboratory Services (OLS) currently provides testing for human immunodeficiency virus (HIV) and sexually transmitted disease (STD). The current funding for these tests are from a federal grant from the Centers for Disease Control (CDC), legislative appropriation of state funds and minimal fees collected by the court and deposited into the Department's HIV Testing Fund. During fiscal year 2012 the OLS performed various tests related to the items outlined in the proposed legislation. The costs for these various tests were approximately $570,000. During the current fiscal year it is estimated that there costs will increase to approximately $572,000. Additionally, the Department is experiencing a reduction in funding from the CDC causing a reduction in the amount of funding passed through to the Local Health Departments (LHDs) for the cost of the time to administer the tests and provide counseling. During calendar year 2011 the funding from the CDC was $200,000 decreasing to $90,000 for calendar year 2012. The Department estimates the proposed legislation would have minimal fiscal impact upon the Department but, that any revenue to be derived from the billing of individuals and medical insurance providers would be retained by the LHDs that have the capability to bill, offsetting some of the reduction in federal funding.
    Although the bill removes the prohibition on billing persons, the Department currently does not have capacity to implement a patient billing system.
    

Fiscal Note Detail
Over-all effect
Effect of Proposal Fiscal Year
2013
Increase/Decrease
(use"-")
2014
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):
    During fiscal year 2012 the OLS performed various tests related to the items outlined in the proposed legislation. The costs for these various tests were approximately $570,000. During the current fiscal year it is estimated that the costs will increase to approximately $572,000. The Department estimates the proposed legislation would have minimal fiscal impact upon the Department, but that any revenue to be derived from the billing of individuals and medical insurance providers would be retained by the LHDs that have the capability to bill, offsetting some of the reduction in federal funding.
    


Memorandum
Person submitting Fiscal Note:
Rocco S. Fucillo
Email Address:
dhhrbudgetoffice@wv.gov
    The language in §16-4-19(d) indicates that "all money collected under this section shall be paid to the local health department doing the testing and the local health officer shall collect and account for such funds collected hereunder." This language would prevent the Department from retaining any fees applied to testing of STD through the Bureau for Public Health.
    Technical Flaw: Some sections of the bill say "shall", whereas other sections say "may". §16-3C-2 (b) All patients who seek an HIV test shall be responsible for paying the costs of the testing, whether they are tested by a private healthcare provider, the bureau or at the local health department. (e) Such persons may arrange to pay the costs of the HIV-related testing. (g) (3) The cost of testing and treatment may be charged to and paid by the accused. (g) (4) (iv) Bill that person for the necessary laboratory and associated costs for testing either directly or by billing the person's medical insurance provider. (g) (11) The costs of mandated testing and counseling provided under this subsection and pre and post-conviction HIV-related testing and counseling provided the victim under the direction of the bureau pursuant to this subsection shall be paid by the individual to be tested or his or her medical insurance provider if possible. §16-4-19 (c) All proper charges for such examination and treatment that may be necessary shall be paid by the individual or by that person's health insurance provider.