FISCAL NOTE
Date Requested: March 05, 2024
Time Requested: 09:38 AM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 2410 |
Comm. Sub. Eng. |
HB4753 |
|
|---|
| CBD Subject: |
Insurance |
|---|
|
FUND(S):
PEIA Basic Insurance Fund
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 biomarker testing. PEIA supports the use of biomarker testing and currently includes coverage for certain biomarker testing, as evidence supports the efficacy.
Current claims data indicates PEIA pays approximately 90% of physician ordered biomarker claims received from in-network, Clinical Laboratory Improvement Amendments (CLIA) approved laboratories. This Bill will permit PEIA to continue use of the prior authorization (PA) process to assure only evidence-based bio-marker testing will be permitted. Assuming utilization and cost trend increases from experience of other states; anticipated growth in FDA approved scope; and increased administrative expense required to craft and maintain PAs, address appeals, and adjust systems, PEIA anticipates the fiscal impact from this bill to be $263,000
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 |
0 |
263,000 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
0 |
| 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