FISCAL NOTE

Date Requested: February 15, 2017
Time Requested: 01:21 PM
Agency: Public Employees Insurance Agency (PEIA)
CBD Number: Version: Bill Number: Resolution Number:
2408 Introduced HB2460
CBD Subject: Insurance


FUND(S):

2180

Sources of Revenue:

Special Fund

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 reimbursement and member benefits for telemedicine to be the same as similar face to face services. PEIA’s current benefit for telemedicine allows $47 of reimbursement for the first visit and $40 thereafter. The only permissible telemedicine service is primary care visits and there is a $40 member copay. With passage of this bill PEIA will be required to cover more services provided through telemedicine and pay a higher reimbursement for primary care visits with lower member copays. This will increase costs to the plan. PEIA has assumed 20% of current primary care visits will utilize telemedicine. Assuming PEIA will reimburse the additional telemedicine services required by this bill at the same rate as similar face to face services and use the same member benefit, there will be no other initial additional costs to the plan.



Fiscal Note Detail


Effect of Proposal Fiscal Year
2017
Increase/Decrease
(use"-")
2018
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 2,092,240 4,289,092
Personal Services 0 0 0
Current Expenses 0 2,092,240 4,289,092
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):


PEIA has assumed 20% of current primary care visits will utilize telemedicine (366,738*.2=73,348), $77.05 vs $40 for primary care office visit reimbursement. $40 vs $20 for telemedicine copay. 2018 Telemedicine $40 vs $20 Cost PCP Utilization Utilization Copay Difference 2018 2019 366,738 73,348 20 $1,466,952 $1,503,626 2018 $40 vs 77.05 PCP Reimb. reimbursement dif $77.05 73,348 37.05 2,717,528 $2,785,467 4,184,480 $4,289,092 January 18 Effective $2,092,240.23



Memorandum






    Person submitting Fiscal Note: jason haught
    Email Address: jason.a.haught@wv.gov