FISCAL NOTE
Date Requested: February 09, 2022
Time Requested: 02:49 PM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 2567 |
Introduced |
SB607 |
|
|---|
| CBD Subject: |
Health |
|---|
|
FUND(S):
PEIA Basic Insurance Fund
Sources of Revenue:
Special Fund
Legislation creates:
Creates New Expense
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to require that provider reimbursement schedules under West Virginia Public Employees Insurance be no lower than the reimbursement provided for the same services under Medicare. Healthcare reimbursement describes the payment that a hospital, healthcare provider, diagnostic facility, or other healthcare providers receive for providing a medical service. PEIA consulted on a study of reimbursement levels and concluded that it reimburses in aggregate at 97% of Medicare currently. PEIA presently reimburses higher than Medicare for outpatient hospital and professional physician services, lower for inpatient hospital services and equal to Medicare for other services. Assuming a 3% increase in claims expense, PEIA would incur an estimated increase of $2,467,295 for the remaining 4 months of plan year 2022, and $7,401,885 for plan year 2023 respectively.
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 |
2,467,295 |
7,401,885 |
9,869,180 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
2,467,295 |
7,401,885 |
9,869,180 |
| 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 consulted on a study of reimbursement levels and concluded that it reimburses in aggregate at 97% of Medicare currently. Assuming a 3% increase in claims expense.
Memorandum
PEIA presently reimburses higher than Medicare for outpatient hospital and professional physician services, lower for inpatient hospital services and equal to Medicare for other services
Person submitting Fiscal Note: April Taylor
Email Address: april.a.taylor@wv.gov