FISCAL NOTE
Date Requested: March 03, 2025
Time Requested: 03:53 PM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1588 |
Introduced |
HB3084 |
|
|---|
| CBD Subject: |
Health |
|---|
|
FUND(S):
PEIA Basic Insurance
Sources of Revenue:
Special Fund
Legislation creates:
Creates New Expense
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to require health benefit plans to cover medically necessary procedures resulting from cancer treatment. PEIA currently covers the majority of the procedures that would arise from cancer treatments. However, PEIA does not currently cover any dental procedures that would arise from cancer treatments.
Research indicates most head, neck and oral cancer treatments result in a broad span of dental procedures. Utilizing existing cancer patient claim data and assumptions for the average dental claims and utilization rates, PEIA projects an increased claims expense of $612,000.
This revised estimate is due to PEIA staff concerns that the original estimate assumed too low of an average cost of the dental care necessary for these treatments. The original estimate assumed the two-year average of 382.5 cases of head and neck cancer cases at an average cost of $1,300 and 70% requiring dental care. The new estimate assumes an average cost of $2,000 per case with 80% of cases requiring dental care.
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 |
0 |
612,000 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
612,000 |
| 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):
This revised estimate is due to PEIA staff concerns that the original estimate assumed too low of an average cost of the dental care necessary for these treatments. The original estimate assumed the two-year average of 382.5 cases of head and neck cancer cases at an average cost of $1,300 and 70% requiring dental care. The new estimate assumes an average cost of $2,000 per case with 80% of cases requiring dental care.
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