0588, 2154 (Children's Operating Fund), 8838

Sources of Revenue:

General 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.

    This bill seeks to improve program integrity for the State's Medicaid and Children's Health Insurance Program by implementing waste fraud and abuse, prevention detection and recovery utilizing data verification and provider screening technology solutions, state of the art clinical code editing technology, predictive modeling and analytics technologies and implementation of fraud investigative services combining retrospective claims analysis and prospective waste, fraud or abuse detection. It provides implementation of claims audit and recovery services by utilizing a contractor selected using information from the Cooperative Purchasing Network. The Secretary of the West Virginia Department of Health and Human Resources as well as the Director of the Children's Health Insurance Program would be required to report to the legislature annually.
    WVCHIP is unable to estimate the fiscal impact of this bill for the following reasons: 1)many waste and fraud detection processes are already in place and the impact of changing current processes to new processes under this bill cannot be determined; 2) we do not know the impact of Affordable Care Act requirements and how processes outlined in this bill would overlap with those. Please refer to DHHR response for more information.

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 0 0
2. Estimated Total Revenues 0 0 0

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



    While this bill names WVCHIP, it does not appear to amend any code sections that govern WVCHIP. WVCHIP is legislated under Chapter 5 article 16b. This bill appears only to amend Medicaid code sections found in Chapter 9.

    Person submitting Fiscal Note: Stacey L. Shamblin
    Email Address: