FISCAL NOTE

Date Requested: January 10, 2019
Time Requested: 03:31 PM
Agency: Health and Human Resources, WV Department of
CBD Number: Version: Bill Number: Resolution Number:
1642 Introduced HB2224
CBD Subject: Insurance


FUND(S):

0407 - CENTRAL OFFICE GENERAL ADMINISTRATIVE FUND

Sources of Revenue:

General 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 establish insurance provisions required relating to breast cancer screenings. This proposed legislation will require the Department's WV Breast and Cervical Cancer Screening Program (WVBCCSP) to expand services to provide breast cancer screenings to West Virginia women for which costs are not already covered under state or federal funding. The federally funded Centers for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program (Public Law 101-54), which provides funding to WVBCCSP, does not currently cover one baseline screening mammogram for women who are at least 30 but less than 40 years of age as required under this bill. Additionally, there are no state appropriated funds to provide annual screening mammograms to women aged 40-49 years as required under this bill. West Virginia Code ยง16-33-7(c) established the Breast and Cervical Cancer Diagnostic and Treatment (D & T) Fund for use by WVBCCSP to cover certain breast and cervical cancer diagnostic and treatment services only. Current Code does not allow D & T funds to be used for screening services. The department estimates fiscal impact of this legislation to be $219,109 to cover the required mammograms. WVBCCSP already covers the Pap testing and HPV guidelines outlined in this proposed legislation, so there would be no additional fiscal impact for providing cervical cancer screening.



Fiscal Note Detail


Effect of Proposal Fiscal Year
2019
Increase/Decrease
(use"-")
2020
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 219,109 201,007
Personal Services 0 67,397 67,397
Current Expenses 0 151,712 133,610
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):


Estimated Personal Services for FY2020 and on going are $67,397 and includes salary ($47,082) and fringes and benefits ($20,315) for a Nurse III for case management services associated with the increase of breast cancer diagnosed patients that will be covered under this proposed legislation. Fringes include Public Employees Health Insurance Administrative fee of $50 ($50 per employee x 1 FTE); Personnel Administrative fee of $180 ($180 per FTE x 1 FTE); Social Security of $3,602 ($47,082 x .0765); Health Insurance of $9,456 ($9,456 x 1 FTE); Retirement of $4,708 ($47,082 x .10); Workers Compensation of $123 ($47,082 x .00261); and WV OPEB of $2,196 ($2,196 per FTE x 1 FTE). Estimated Current Expense for FY2020 is $151,712 and includes costs to cover baseline screening mammograms for 200 women between the ages of 30 to 39 at $33,203 (200 women x $174.75 x 95% uninsured) and annual screening mammograms for 700 women between the ages of 40 to 49 at $116,209 (700 women x $174.75 x 95% uninsured). This estimate is based on using the current Medicare rate ($174.75) for baseline and annual screening mammograms; assuming that facilities will use 3D mammograph for providing the screenings which is the current standard practice; and anticipating that all of the women currently receiving other WVBCCSP services will get baseline and annual screening mammograms. It is important to note that this bill stipulates that eligible women will receive a baseline mammogram once every ten years. If all eligible women in the 30 to 39 age group get a baseline mammogram during Year 1, which is what BCCSP anticipates will occur and what this estimate is based on, they would not be eligible for another until after they are older than 40 years of age. Additional Current Expense for FY2020 include landline telephone service at $600 ($50 per month x 12 months x 1 FTE); office supplies at $200; computer equipment and monitor at $1,000 ($1,000 x 1 FTE); and a network printer at $500. Estimated Current Expense for FY2021 and ongoing fiscal years is $133,610 and includes costs to cover baseline screening mammograms for 100 women between the ages of 30 to 39 at $16,601 (100 women x $174.75 x 95% uninsured) and annual screening mammograms for 700 women between the ages of 40 to 49 at $116,209 (700 women x $174.75 x 95% uninsured). This estimate is based on using the current Medicare rate ($174.75) for baseline and annual screening mammograms; assuming that facilities will use 3D mammograph for providing the screenings which is the current standard practice; and anticipating that there will be approximately 100 additional eligible women in Year 2 and ongoing fiscal years receiving other WVBCCSP services that will get baseline screening mammograms. It is important to note that this bill stipulates that eligible women will receive a baseline mammogram once every ten years. If all eligible 100 women in the 30 to 39 age group get a baseline mammogram during Year 2, which is what BCCSP anticipates will occur and what this estimate is based on, they would not be eligible for another until after they are older than 40 years of age. Additional Current Expense for FY2020 include landline telephone service at $600 ($50 per month x 12 months x 1 FTE); and office supplies at $200.



Memorandum


WVBCCSP does not have data for women with dense breasts as this is not collected by the federal government. WVBCCSP does not currently cover ultrasounds for women with dense breasts as it is not considered abnormal. It should be noted that while the financial cost is not known, the current Medicare reimbursement rate is $98.06 per ultrasound.



    Person submitting Fiscal Note: Bill J. Crouch
    Email Address: Bill.J.Crouch@wv.gov