FISCAL NOTE
Date Requested: March 05, 2024
Time Requested: 09:39 AM |
| Agency: |
Human Services, WV Department of |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 2410 |
Comm. Sub. Eng. |
HB4753 |
|
|---|
| CBD Subject: |
Insurance |
|---|
|
FUND(S):
0403 - DIV OF HUMAN SERVICES GENERAL ADMINISTRATION FUND; 8722 - CONS FEDERAL FUNDS DIV HUMAN SERVICES GEN ADMN FD
Sources of Revenue:
Other Fund General and Federal funds
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.
The Department estimates a fiscal impact related to this legislation of $8,731,200 ($2,278,407 state funds). The costs could likely be offset by savings (or cost avoidance) as the tests are intended to diagnose, treat, and manage diseases and conditions; facilitate the use of more effective and targeted health care treatments; and help avoid use of therapies that may be unsafe or ineffective for specific patients. However, any such savings and, thus, the net impact on Medicaid expenditures cannot be reliably estimated 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 |
8,731,200 |
8,731,200 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
8,731,200 |
8,731,200 |
| 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):
Based on a Maryland fiscal note (HB1217), should 1% of enrollees (5,138) receive one biomarker test at a cost of $1,700 per test, Medicaid expenditures increase by approximately $8,731,200 ($2,278,407 in state spend) on an annual basis. Uptake of biomarker testing could be as high as 25% of Medicaid enrollees (128,395) which would cost an estimated $218,271,500 ($56,957,948 in state spend).
Percentage of enrollees is calculated based on February 2024 enrollment of 513,581. State match is calculated based on SFY25 FMAP of 73.905%.
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: Cynthia A. Persily, Ph.D.
Email Address: DHHRbudgetoffice@wv.gov