Sources of Revenue:

Other Fund N/A

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 provide and finance a salary supplement for providers of Medicaid eligible services in the public schools.

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):

    The process for Medicaid billing for county boards of education changed effective July 1, 2012. The Centers for Medicare and Medicaid Services required the Department of Health and Human Resources (DHHR) to move to an annual cost settlement approach for the county boards of education. While the county boards continue to use fee-for-service billing throughout the year based on the services rendered, county employees are also required to participate in a quarterly random moment time study that determines the average percentage of time spent performing Medicaid eligible services. At the end of the year each county board of education will submit an annual cost report that includes the annual salary and fringe benefit costs, as well as other county costs for contracted services, medical supplies, student transportation, etc. The average of the quarterly random moment time study percentages is applied to the costs reported, along with the ratio of Medicaid-eligible special education students to total special educations students and the state's federal reimbursement rate to determine the actual cost to the county for providing Medicaid eligible services to students. The total from the cost report is compared against the amounts billed through fee-for-service throughout the year to determine the amount of money that the county is due from DHHR or the amount that the county owes back to the DHHR. This cost settlement is projected to occur at least six months after the end of the fiscal year.
    The proposed legislation would not work under this new Medicaid cost settlement process. The legislation calls for the counties to calculate the salary supplements based on the amounts received from Medicaid during the six month period. However, the amount received through the fee-for-service billing will not be the amount that the county board ultimately receives for providing the services.
    In addition, WVDE feels that there are possible ethical concerns with the proposed legislation. The proposed legislation would give employees who provide Medicaid eligible services an incentive to increase their fee-for-service billing because they would receive a direct benefit for the amounts billed through the proposed salary supplement.



    Person submitting Fiscal Note: Brenda Freed
    Email Address: