FISCAL NOTE
Date Requested: January 12, 2022
Time Requested: 03:58 PM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1096 |
Introduced |
SB40 |
|
|---|
| 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 prohibit insurance coverage from requiring prior authorization (PA) for physician prescribed tests to stage cancer, including, but not limited to, computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans and positron emission tomography scans.
PEIA currently does not require prior authorization for CT scans to stage cancer. PA is required for MRI scans of the spine or breast. The estimated increased cost for these scans assuming a 10% increase in MRIs is $15,000.
In addition to the above scans, genetic testing is also recommended to stage cancer per the National Comprehensive Cancer Network. In the event genetic testing is considered exempt from PA per this bill, PEIA would incur additional costs from these procedures also. Assuming an increase of genetic testing of 75%, PEIA will incur $370,600 in additional costs. Total annual estimated increased cost is $385,600.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2022
Increase/Decrease
(use"-") |
2023
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
385,600 |
0 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
385,600 |
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 estimated increased cost for these scans assuming a 10% increase in MRIs and a 75% increase in genetic testing if PA is no longer required.
Memorandum
Person submitting Fiscal Note: April Taylor
Email Address: April.A.Taylor@wv.gov