FISCAL NOTE



FUND(S):

0403 - Div of Human Services General Administration Fund, 0525 - Consolidated Medical Services Fund, 5156 - Hospital Services Revenue Account, 8722 - Cons Federal Funds Div Human Services Gen Admin Fd

Sources of Revenue:

General Fund,Special Fund,Other Fund Federal

Legislation creates:

Neither Program nor Fund



Fiscal Note Summary


Effect this measure will have on costs and revenues of state government.


The purpose of this bill is to require each birthing facility licensed by the Department of Health and Human Resources to perform a pulse oximetry screening for congenital birth defects on every newborn in its care, a minimum of 24 hours after birth. The requirement that the Department include the pulse oximetry screening to the tests required of birthing facilities, licensed by the Department, would not result in an increase in costs to comply with the legislation. However, there could be a fiscal impact to the Department's Bureau for Behavioral Health and Health Facilities, which operates the Welch Community Hospital, which provides birthing and newborn care services. The Department estimates these costs to be minimal. Additionally, the service mandated in the proposed legislation is currently a covered service for the Department's Medicaid eligible clients. The reimbursement for this service would be included in the inpatient hospital or facility reimbursement for the birth and therefore would not result in an increase in costs . However, if billed separately (i.e. performed during an office or clinic visit) it would not be reimbursable unless billed as the only service on that day.



Fiscal Note Detail


Effect of Proposal Fiscal Year
2012
Increase/Decrease
(use"-")
2013
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 0 0
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):






Memorandum


Screening for Critical Congenital Heart Defects (CCHD) will occur in the newborn nursery at the birthing facility at a minimum of 24 hours after birth. Implications may include a longer hospital stay if mothers and infants are currently routinely discharged before 24 hours after birth. Not all birthing hospitals may have infant pulse oximeters because of the relatively small number of births at some. Additional training for hospital staff may be required, as not all nurses in the newborn nursery are trained to use pulse oximetry. Insurance companies, Medicaid and PEIA will need to cover the cost of screening in the newborn nurseries if not already included. It is expected that pulse oximetry results will be collected using existing newborn screening data collection methods, with nominal anticipated financial impact to the Department's Office of Maternal, Child and Family Health. Follow-up will be minimal since referrals on infants will be made by pediatricians prior to discharge from the hospital. If additional follow-up needs to occur once the infant is discharged from the hospital, current newborn screening follow-up staff can meet this need.



    Person submitting Fiscal Note: Michael J. Lewis, M.D., Ph.D.
    Email Address: dhhrbudgetoffice@wv.gov