FISCAL NOTE
Date Requested: January 23, 2024
Time Requested: 04:49 PM |
| Agency: |
Human Services, WV Department of |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1998 |
Introduced |
SB313 |
|
|---|
| CBD Subject: |
Health |
|---|
|
FUND(S):
0403 - DIV OF HUMAN SERVICES GENERAL ADMINISTRATION FUND; 8722 - CONS FEDERAL FUNDS DIV HUMAN SERVICES GEN ADMN FD
Sources of Revenue:
General Fund 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.
Fiscal impact for the Department, including Medicaid and CHIP, is estimated at $448,398 (state portion of $116,471). This estimate is based on an ASTHO survey that says 6% of birthing mothers receive doula care. However, there may be additional costs related to pregnancies that do not result in a live birth, but receive prenatal doula services (not included here). Additionally, there may be additional administrative expenses for doula regulating entities (not included here).
In addition, 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 |
2024
Increase/Decrease
(use"-") |
2025
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
448,398 |
448,398 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
0 |
| Repairs and Alterations |
0 |
448,398 |
448,398 |
| Assets |
0 |
0 |
0 |
| Other |
0 |
0 |
0 |
| 2. Estimated Total Revenues |
0 |
0 |
0 |
Explanation of above estimates (including long-range effect):
In SFY23, Medicaid paid for approximately 8,564 births and CHIP paid for approximately 135 births. Estimate assumes 6% of these using doula services.
A rate of $859 per member includes 8 prenatal or postpartum visits and one delivery fee. Medicaid totals = (8,564 x 6% = 514 births x $859 = $441,526.00 in total expenses). Federal shared of $326,310 and State share of $115,216 based on SFY2025 FMAP. CHIP totals = (135 x 6% = 8 births x $859 = $6,872.00 in total expenses). Federal share of $5,617 and State share of $1,255 based on SFY2025 FMAP. Total Medicaid and CHIP = $448,398.00 in total expenses (federal share of $331,927 and state shae of $116,471).
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: Cynthia A. Persily, Cabinet Secretary
Email Address: dhhrbudgetoffice@wv.gov