FISCAL NOTE
Date Requested: February 19, 2025
Time Requested: 01:16 PM |
| Agency: |
Human Services, WV Department of |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 2919 |
Introduced |
SB292 |
|
|---|
| CBD Subject: |
Insurance |
|---|
|
FUND(S):
0484 - Bureau for Medical Services-Policy and Programming, 8722 - Cons Federal Funds Div Human Services Gen Admn 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 require doula services to be covered by Medicaid and PEIA and to increase reimbursement rates.
The Department anticipates a fiscal impact of $600,000 (state = $155,250/federal = $444,750).
Some studies have indicated that the use of a doula could result in better birth outcomes, such as fewer preterm and low birth weight infants, and reductions in cesarean sections. If this occurs, the state could realize a savings in associated costs; however, it is impossible to calculate those savings at this time.
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 |
600,000 |
600,000 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
600,000 |
600,000 |
| 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):
Projected annual cost is estimated at $600,000 at a split rate of 25.875 state and 74.125 federal (state = $155,250/federal = $444,750).
Key assumptions: number of births covered by Medicaid in SFY24: 8,000, 6% of births nationwide are attended by a doula, $1,000 flat rate for birth and delivery, plus 2 prenatal and 2 postpartum visits, $125 rate per visit for 2 additional visits (up to 4 are allowed, but assume only 2 will be used). Under these assumptions: 1) the state will reimburse $1,250 per member for doula services under Medicaid (125*2) + 1,000 = $1,250, 2) the annual fiscal impact would be $600,000 ($1,250*(6%*8,000) = $600,000.
Estimate does not account for additional administrative expenses for implementation and continued coverage as well as potential savings.
Memorandum
Other states have submitted Medicaid state plan amendments to the U.S. Centers for Medicare and Medicaid Services and received approval to allow for reimbursements for doula services. Assuming West Virginia also received approval, the federal government would likely reimburse the appropriate federal match for both Medicaid and CHIP.
Person submitting Fiscal Note: Alex J. Mayer
Email Address: osafiscalnotes@wv.gov