FISCAL NOTE
Date Requested: January 14, 2023
Time Requested: 01:51 PM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1431 |
Introduced |
HB2111 |
|
|---|
| CBD Subject: |
|
|---|
|
FUND(S):
PEIA Basic Insurance Fund
Sources of Revenue:
Special Fund
Legislation creates:
Increases Existing Expenses
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to provide easier access to contraceptives and sterilization services. PEIA provides coverage for 12-month contraceptives, obtained at one time, after the insured has completed an initial supply prescription. Contraceptives are covered by the Plan at full cost. There are currently no plan excluded contraceptives where there is not already a covered therapeutic equivalent at no cost.
If this bill passes, PEIA would be required to cover contraceptives at an initial 12 months’ prescription. PEIA’s pharmacy benefit manager reports that 25% of contraceptives filled have not been refilled beyond the initial prescription. Using the reported average plan cost per contraceptive of $63 for a 90-day supply, and PEIA’s waste exposure of 7,500 scripts, PEIA would pay an additional $1,400,000 annually for those initial 12 months’ supply scripts that do not get refilled.
PEIA covers sterilization procedures without requiring prior authorization. Female sterilization procedures are covered at 100%, but male sterilization procedures are not covered at the same level. If this bill passes PEIA would pay an additional $75,000 annually for vasectomies to be covered at the same level.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2023
Increase/Decrease
(use"-") |
2024
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
0 |
1,475,000 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
1,475,000 |
| 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):
Wasted cost is the additional 9 months of prescription the Plan would pay in excess of a 90 day initial supply.
Memorandum
Person submitting Fiscal Note: April Taylor
Email Address: april.a.taylor@wv.gov