FISCAL NOTE
Date Requested: March 09, 2021 Time Requested: 12:05 PM |
Agency: |
Public Employees Insurance Agency (PEIA) |
CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
2510 |
Introduced |
HB2634 |
|
CBD Subject: |
Health |
---|
|
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 bill provides that an insurance provider who offers an insurance product in this state, the Bureau for Medical Services, and the Public Employees Insurance Agency must provide coverage for 20 visits per event for each of the treatment modalities of physical therapy, occupational therapy, osteopathic manipulation, a chronic pain management program, and chiropractic services when ordered or prescribed by a health care practitioner. This bill will increase the claim costs of PEIA.
PEIA currently requires prior authorization for any visit in excess of twenty therapies referenced in this bill, with member paying deductible and coinsurance. The twenty-visit limit is cumulative for all therapies per event. This bill will remove the prior authorization requirement, exposing the plan to unnecessary utilization of therapies. The bill will also limit the member out of pocket costs to a copay for visits beyond twenty.
Assuming a fifteen percent increase in utilization of these therapy services, the loss of member deductible and coinsurance for visits in excess of twenty, PEIA estimates an increase in costs of $3.8 million per year.
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 |
3,800,000 |
0 |
Personal Services |
0 |
0 |
0 |
Current Expenses |
0 |
3,800,000 |
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):
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