FISCAL NOTE
Date Requested: February 12, 2025
Time Requested: 09:37 PM |
| Agency: |
Human Services, WV Department of |
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| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1528 |
Introduced |
SB116 |
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| CBD Subject: |
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FUND(S):
'0483 - Bureau For Medical Services -Medical Services Administration; 0484 - Bureau For Medical Services - Policy and Programming; 8722 - Cons Federal Funds Div Human Resources Gen Admin Fd
Sources of Revenue:
Other Fund General and Federal
Legislation creates:
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to increase the coverage limit and to require the Bureau for Medical Services to require its Medicaid managed care organizations to provide education to Medicaid enrollees regarding the availability of benefits provided in this section beginning on July 1, 2025, and to require reporting.
The Department estimates the fiscal impact related to this legislation to be $8,710,625 (state = $2,256,437/federal = $6,454,188).
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2025
Increase/Decrease
(use"-") |
2026
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
8,710,625 |
8,710,625 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
8,710,625 |
8,710,625 |
| 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):
1. Increasing dental coverage limit - The additional cost of increasing the Medicaid adult dental coverage limit from $2,000 biannually (or about $1,000 annually) to $2,000/year is approximately $8.7 million. The following steps describe how the cost was evaluatedt:
• We first estimated the average per member per month (PMPM) claim cost differential for dental benefits with a coverage limit of $1,000/year compared to dental benefits with a coverage limit of $2,000/year using Milliman’s Dental Rating Model calibrated to the population of interest. The average PMPM claim cost under the higher limit is 24.8% higher than the PMPM claim cost under the lower limit.
• The State Fiscal Year (SFY 2024) total Medicaid MCOs adult dental spend was $35.3 million.
• The cost impact is the expected 24.8% increase applied to the $35.3M SFY 2024 spend: [$0.248 * $35.3M] = $8.7M (state = $2,251,125/federal = $6,448,875). *Used blended FMAP of 74.125%.
2. Dental rate survey - The financial impact of requiring BMS to conduct a survey of dental rates based on a study including neighboring states only (Ohio, Pennsylvania, Maryland, Virginia, and Kentucky) is a total cost of $9,625 (state = $4,812/federal = $4,813). *Used administrative FMAP of 50%.
3. Direct MCO to provide educational materials and file an electronic report - Immaterial.
4. Annual electronic report with the number of Medicaid enrollees - We estimate the cost of this report to be $1,000 or 5 hours at $200 per hour. Total cost = $1,000 (state = $500/federal = $500). *Used administrative FMAP of 50%.
Total estimated cost $8,700,000 + $9,625 + $1,000 = $8,710,625.
Memorandum
The financial impact above of amending the current coverage limit assumes no cost sharing.
Person submitting Fiscal Note: Alex J. Mayer
Email Address: osafiscalnotes@wv.gov