0403 - Division of Human Services Gen Admin Fund; 8722 - Cons Federal Funds Div Human Services Gen Admin Fund

Sources of Revenue:

General Fund,Other Fund Federal

Legislation creates:

A New Program

Fiscal Note Summary

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

    The purpose of this bill is to require the Department of Health and Human Resources and Medicaid to provide dental coverage to an eligible mother for two years following the birth of her child.
    The Department estimates the cost of the proposed legislation to be a total of $1,594,517 with a state share of $443,435.

Fiscal Note Detail

Effect of Proposal Fiscal Year
Fiscal Year
(Upon Full
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 1,594,517 1,594,517
2. Estimated Total Revenues 0 0 0

Explanation of above estimates (including long-range effect):

    The fiscal projections include the following assumptions: 1.) Eligibility will be established under waiver or State Plan authority; 2.) Benefits for the eligibilty group will be limited to preventive and basic emergency dental care which exceeds the current benefit available to other eligible adult Medicaid members; 3.) Benefit will be adminstered through the existing managed care network because previous benefits for this population were administered through the plan and 4.) each eligible member would remain eligible for the entire 2 year period.
    Calculation assumes 176,580 member months annually (based on SFY 2009-2011 average enrollment of pregnant members for 12 months of coverage) at a rate of $9.03 per member per month. At the blended State FMAP for SFY 2013 of 72.19%, the Federal share would be $1,151,082 and the State share $443,435.


    Implementation of this bill would require WV DHHR to complete and submit an application for a waiver from CMS in order to enable us to provide services to persons who are not otherwise financially eligible for Medicaid services. The waiver would also be required to receive permission to provide limited services (dental coverage only) for those mothers who are not otherwise eligible for Medicaid services.
     In determining the potential costs of the implementation of this bill we have assumed that the emergent dental coverage contemplated would be the same as the current coverage provided to other adult recipients of Medicaid. It is unclear from the definition of dental services contained in the bill whether the purpose of this bill is to expand the emergent dental services available for this population.
    There appears to be a gender bias issue inherent in the wording of this bill. As an example, if the birth mother relinquished custody of the child to the father, under the wording of this bill the mother would be eligible to continue her Medicaid dental coverage. However, the father, who would have the child in his custody, would not receive similar coverage. There are a number of situations that could occur that would, under the current wording of this bill, permit the mother to continue to receive dental coverage when she was not in possession of her child.

    Person submitting Fiscal Note: Michael J. Lewis, M.D., Ph.D.
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