FISCAL NOTE
Date Requested: January 26, 2018
Time Requested: 03:24 PM |
| Agency: |
Insurance Commission |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1972 |
Introduced |
SB401 |
|
|---|
| CBD Subject: |
Insurance |
|---|
|
FUND(S):
7152, 1331
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.
If enacted, SB401 would require specified coverage in health benefit plans for outpatient and inpatient treatment for substance use disorders.
If enacted, Senate Bill 401 may increase costs to the State. The potential amount of increased cost is unknown at this time. Please see the memorandum to this fiscal note.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2018
Increase/Decrease
(use"-") |
2019
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
0 |
0 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
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):
Please explain increases and decreases in personal services, current expenses, repairs and alterations, assets, other costs and revenues, including assumptions and data sources and delineation between start-up and ongoing costs. Please also include a long-range schedule of costs and revenues if fiscal impact is expected to vary in future years.
Memorandum
Senate Bill 401, if enacted, would provide for mandatory insurance coverage for substance abuse disorders.
SB401 does not contain language limiting the insurance benefits provided under the bill to the essential health benefits (EHB) specified under section 130(b) of the Patient Protection and Affordable Care Act (PPACA).
PPACA 1311 (d)(3) provides that a state must defray the cost by direct payment to enrollees or to the Plan of any state mandated benefit in excess of the EHB.
To the extent that the health insurance benefits required by SB401 do not fall within the EHB, a potential cost to the State exists.
SB401 requires that the Insurance Commissioner develop a tool to review the medical necessity of treatments for substance abuse. It is unknown at this time what the costs of developing the evidence-based and peer reviewed clinical review tool would be.
PEIA and DHHR should be consulted regarding the fiscal impact of SB 401.
Person submitting Fiscal Note: Melinda Ashworth Kiss
Email Address: Melinda.A.Kiss@wv.gov