FISCAL NOTE
Date Requested: February 15, 2023
Time Requested: 08:31 AM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 3534 |
Introduced |
HB3534 |
|
|---|
| CBD Subject: |
Insurance |
|---|
|
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.
This bill prohibits an insurer from imposing a copayment or coinsurance for services rendered for occupational or physical therapies that is greater than the those imposed for primary care services. PEIA currently charges a $20 copay for therapies under twenty-visits, and a $25 copay for approved therapy over twenty-visits with members paying deductible and coinsurance. The twenty-visit limit is cumulative for all therapies per event. This bill would limit the member out of pocket costs over the twenty-visit limit to a $20 copay and prohibit the member from paying deductible and coinsurance.
The fiscal impact to PEIA is the loss of member deductible and coinsurance and a reduced copay for visits more than twenty. PEIA estimates cost exposure of $1,050,000 annually if the bill passes.
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 |
1,050,000 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
1,050,000 |
| 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):
The fiscal impact to PEIA is the loss of member deductible and coinsurance and a reduced copay for visits more than twenty.
Memorandum
Please identify any areas of vagueness, technical defects, reasons a bill would not have a fiscal impact, and/or any special issues not captured elsewhere on this form.
Person submitting Fiscal Note: April Taylor
Email Address: april.a.taylor@wv.gov