FISCAL NOTE
Date Requested: February 07, 2018
Time Requested: 08:02 AM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 2393 |
Introduced |
SB478 |
|
|---|
| CBD Subject: |
Human Services, Insurance, State Personnel |
|---|
|
FUND(S):
PEIA
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 mandate insurance coverage for treatment of mitochondrial disease. This bill will increase PEIA costs. A primary cause of the increase is requiring coverage of over-the-counter vitamins and supplements for a disease that is difficult to diagnose. This could expose the plan to unnecessary costs caused by over utilization of unwarranted vitamin and supplement prescriptions. The allowance of over-the-counter products for mitochondrial disease could also eventually expose the plan to this same coverage for other diseases.
PEIA’s research indicates there is variance in the effectiveness of treatment from patient to patient. Each treatment must be tailored by the patient’s physician to meet the patients needs. This makes it difficult to provide an estimate of the fiscal impact.
PEIA has identified a rate of occurrence for Mitochondrial disease of one in 2,500. By applying this rate of occurrence to PEIA’s population of 216,000 members, there are an estimated 86 members. Depending on the vitamin or supplement prescribed, PEIA could expect an increase in costs to the plan of approximately $32,000. This assumption assumes per unit cost of $.30 at four units per day, and an average member cost share of fifteen percent.
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 |
32,000 |
0 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
32,000 |
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):
PEIA has identified a rate of occurrence for Mitochondrial disease of one in 2,500. By applying this rate of occurrence to PEIA’s population of 216,000 members, there are an estimated 86 members. Depending on the vitamin or supplement prescribed, PEIA could expect an increase in costs to the plan of approximately $32,000. This assumption assumes per unit cost of $.30 at four units per day, and an average member cost share of fifteen percent.
Memorandum
PEIA’s research indicates there is variance in the effectiveness of treatment from patient to patient. Each treatment must be tailored by the patient’s physician to meet the patients needs. This makes it difficult to provide an estimate of the fiscal impact.
Person submitting Fiscal Note: Jason Haught
Email Address: jason.a.haught@wv.gov