FISCAL NOTE
Date Requested: March 12, 2025
Time Requested: 12:21 PM |
| Agency: |
Health, WV Department of |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 3611 |
Comm. Sub. |
SB707 |
|
|---|
| CBD Subject: |
Finance and Administration; Health |
|---|
|
FUND(S):
0426 - DEPARTMENT OF HEALTH-OMCH-WEST VIRGINIA BIRTH TO THREE; 5214 - WEST VIRGINIA BIRTH-TO-THREE FUND
Sources of Revenue:
Other Fund General and Special
Legislation creates:
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to increase payment for professional services provided in person to the West Virginia Birth-to-Three program by therapists and other professionals who are not employed by a state agency by 25 percent.
This bill increases rates for in person services. The Department estimates a fiscal impact related to this legislation of $5,634,680, of which $2,217,378 is the state share.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2025
Increase/Decrease
(use"-") |
2026
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
5,634,680 |
5,634,680 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
5,634,680 |
5,634,680 |
| 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 calculations take the current in person rates, increases them by 25% and multiplies them by the current utilization. The total cost estimate is $5,634,680, of which $2,217,378 is the state share for the Department of Health.
Memorandum
It is important to note that there is funding in the Governor’s Budget for a rate increase, both Supplemental and Improvement. The estimated annual cost is $6,445,390.90, of which $2,536,230.85 is the state portion needed. The methodology to calculate this rate increase was based on increasing provider reimbursement rates to current comparable rates paid by the Bureau for Medical Services for comparable services. If the rates were already comparable or higher, no increase was calculated. Additionally, rates are based on three setting types, services provided at the service provider (in person) location, at the home and virtually. Virtual services are provided using a secure video conferencing platform and allow for the practitioner to see the child and family and share information on screen. Services provided at the service provider location are provided in the practitioner’s facility and the family must travel to receive early intervention services. The ability to offer virtual services was implemented during the pandemic and reimbursed at the same rate as in person/home services. In the supplemental and improvement calculations, virtual rates were reduced by 15% to incentivize in person service provision to better meet the needs of the child and families. Virtual services and those provided at the service provider location are able to be offered at a lower cost than in person services but need to remain available in areas in which service provider shortages are occurring and for those services that are appropriate to be provided virtually.
Therefore, since the rate increase currently included in the Governor’s Budget exceeds the amount needed for a flat 25% increase, the fiscal impact for this legislation would be a lesser cost to the Department.
A portion of Birth to Three expenditures are billed to Medicaid (part of the Department of Human Services) for elgibile clients. It is estimated that $3,417,302 ($884,226 state/$2,533,075 federal) of the above cost would be for Medicaid eligible clients.
Person submitting Fiscal Note: Russell Crane
Email Address: osafiscalnotes@wv.gov