FISCAL NOTE
Date Requested: February 21, 2021
Time Requested: 04:39 PM |
| Agency: |
Public Employees Insurance Agency (PEIA) |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1029 |
Introduced |
SB39 |
|
|---|
| CBD Subject: |
|
|---|
|
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 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. The estimated increased cost for these scans assuming a 10% increase in MRIs is $13,600.
In addition to the above scans, genetic testing is also recommended to stage cancer per the National Comprehensive Cancer Network. 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 $252,900 in additional costs. Total annual estimated increased cost is $266,500.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2021
Increase/Decrease
(use"-") |
2022
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
0 |
266,500 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
0 |
266,500 |
| 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
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