FISCAL NOTE
Date Requested: January 10, 2020 Time Requested: 03:45 PM |
Agency: |
Public Employees Insurance Agency (PEIA) |
CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
1131 |
Introduced |
SB56 |
|
CBD Subject: |
Insurance |
---|
|
FUND(S):
PEIA Basic Insurance
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.
The purpose of this bill is to prohibit insurance coverage from requiring prior authorization (PA) for physician prescribed tests to stage cancer, including, but not limited to, computerized tomography (CT) scans, magnetic resonance imaging (MRI) scans and positron emission tomography (PET) scans.
PEIA currently does not require prior authorization for CT scans to stage cancer. PA is required for MRI scans of the spine or breast, and PET scans. The estimated increased cost for these scans assuming a 10% increase in MRI’s and 20% increase in PET’s is $124,700.
In addition to the above scans, genetic testing is also recommended to stage cancer per the National Comprehensive Cancer Network (NCCN.) In the event genetic testing is considered exempt from PA per this bill, PEIA would incur additional costs from these procedures also. Assuming an increase of genetic testing of 75%, PEIA will incur $75,400 in additional costs.
Total annual estimated increased cost is $200,100.
Fiscal Note Detail
Effect of Proposal |
Fiscal Year |
2020 Increase/Decrease (use"-") |
2021 Increase/Decrease (use"-") |
Fiscal Year (Upon Full Implementation) |
1. Estmated Total Cost |
0 |
0 |
200,100 |
Personal Services |
0 |
0 |
0 |
Current Expenses |
0 |
0 |
200,100 |
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 estimated increased cost for these scans assuming a 10% increase in MRI’s and 20% increase in PET’s is $124,700.
Assuming an increase of genetic testing of 75%, PEIA will incur $75,400 in additional costs.
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: Jason Haught
Email Address: jason.a.haught@wv.gov