FISCAL NOTE
Date Requested: February 12, 2025
Time Requested: 10:01 PM |
| Agency: |
Human Services, WV Department of |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 1172 |
Introduced |
SB252 |
|
|---|
| CBD Subject: |
Health |
|---|
|
FUND(S):
'0484 - Bureau For Medical Services - Policy and Programming; 8722 - Cons Federal Funds Div Human Resources Gen Admin Fd
Sources of Revenue:
Other Fund General and Federal
Legislation creates:
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to require coverage and reimbursement for home blood pressure monitoring devices for certain persons diagnosed with hypertension.
The Department estimates the fiscal impact of this legislation to be $308,512 (state = $79,827/federal = $228,685).
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 |
308,512 |
308,512 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
308,512 |
308,512 |
| 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):
Projected annual costs is estimated at $308,512 (state = $79,827/federal = $228,685).
The Department assumes there are 8,000 births per year in WV Medicaid; and that 20% of births will have severe hypertension qualifying them for coverage of the home blood pressure monitoring. Please see Memorandum.
Assume one device (HCPCS A4670), one extra cuff, one set-up visit (CPT 99473), and eight monthly consults (CPT 99474) per qualifying woman. This is an added cost of about $192.82 ($10.22 + $22.76 + $12.01*8 + $63.76) per year, based on a survey of Medicaid payment rates available at: https://www.ama-assn.org/system/files/smbp-coverage-medicaid.pdf.
The final annual cost is estimated at 8,000*20%*$192.82 or $308,512 with a split rate of 25.875% State and 74.125% Federal.
Memorandum
This analysis does not consider savings from reduced readmissions or increased costs from added treatment costs resulting from monitoring.
Hypertension complicates 10–20% of pregnancies in the United States and is a significant contributor to maternal deaths worldwide, with 14% of global maternal mortality directly related to hypertension. https://pmc.ncbi.nlm.nih.gov/articles/PMC10407242/#bib0009
Remote monitoring programs have found that rates of severe hypertension occur in 12.8% to 26.2% of their participants.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7289450/
Person submitting Fiscal Note: Alex J. Mayer
Email Address: osafiscalnotes@wv.gov