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