FISCAL NOTE
Date Requested: February 18, 2025
Time Requested: 08:53 AM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1507 |
Introduced |
SB28 |
|
|---|
| CBD Subject: |
Health |
|---|
|
FUND(S):
PEIA Basic Insurance
Sources of Revenue:
Special Fund
Legislation creates:
Increases Existing Expenses
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 clinical genetic testing for an inherited gene mutation and evidenced-based cancer imaging; and providing that this testing is not subject to cost-sharing. PEIA does cover a limited number of genetic tests currently. However, it is anticipated that this bill would significantly increase the volume of genetic tests covered due to a lack of medical necessity guidelines. Due to the increased utilization of testing at an approximate cost of $6,500 per panel and continued increase in the number of genetic tests available, PEIA would anticipate an increase in genetic testing costs of $6.5 million in FY 2026.
PEIA currently covers some cancer screening imaging procedures at 100%. However, there would be a cost to the plan for those that aren’t currently covered and a small increase in utilization is assumed. These assumptions result in increased costs of $1.7 million for cancer screenings to PEIA.
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 |
4,100,000 |
8,200,000 |
8,200,000 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
4,100,000 |
8,200,000 |
8,200,000 |
| 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):
Please explain increases and decreases in personal services, current expenses, repairs and alterations, assets, other costs and revenues, including assumptions and data sources and delineation between start-up and ongoing costs. Please also include a long-range schedule of costs and revenues if fiscal impact is expected to vary in future years.
Memorandum
Please identify any areas of vagueness, technical defects, reasons a bill would not have a fiscal impact, and/or any special issues not captured elsewhere on this form.
Person submitting Fiscal Note: Jason Haught
Email Address: jason.a.haught@wv.gov