LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE
74th Regular Session
April 24, 1995
TO: Honorable Hugo Berlanga, Chair IN RE: House Bill No. 2810
Committee on Public Health By: Coleman
House of Representatives
Austin, Texas
FROM: John Keel, Director
In response to your request for a Fiscal Note on House Bill No.
2810 (Relating to Medicaid reimbursement for medical
nutritionals.) this office has determined the following:
The bill would make no appropriation but could provide the legal
basis for an appropriation of funds to implement the provisions
of the bill.
The bill would require the Department of Health to expand the
scope of benefits included in the Texas Medicaid Program. The
bill would require the department to provide reimbursement and
coverage for parental (outside the intestinal tract) and enteral
(via the intestinal tract) nutrition therapy, medical nutritional
products taken orally, restorative feedings that are medically
necessary and cost-effective, and nutritional counseling
services.
The bill would allow the department to establish a prior
authorization procedure for the medical nutritionals. The bill
would direct the department to include medical nutritionals as
prescribed by a physician which are necessary for the nutritional
management of an illness, injury, disorder, or other health
condition identified by department rule. The bill specifies that
coverage of such products under this provision "will not result
in any premium paid with respect to the comprehensive Medicaid
benefit package."
For the purposes of estimating the costs to implement the
provisions of this bill, the following assumptions were made:
* Medical nutritionals would be made available to Medicaid
eligible adults as the expanded benefit. Under current federal
and state policies, Medicaid eligible children (under age 21)
already receive this benefit through the Early, Periodic
Screening, Diagnosis and Treatment (EPSDT) program.
* Adults dually eligible for the Medicaid and Medicare
benefits are assumed to be covered by Medicare for these
services; thus, no costs in this analysis are attributed to this
population.
* The number of Medicaid adults utilizing these services
were estimated to be 5,699 in fiscal year 1996 and 11,871 each
year thereafter. It was assumed that it would take the
department six months to adopt rules to implement the provisions
of the bill and to gain federal approval through a State Medicaid
Plan amendment.
* The annual costs per client were assumed to be $988.
The probable fiscal implication of implementing the provisions of
the bill during each of the first five years following passage
is estimated as follows:
Fiscal Probable Cost Out Probable Cost Out
Year of General of Federal
Revenue as Match Medicaid Funds
For Medicaid
Services
1996 $2,122,740 $3,507,872
1997 4,470,922 7,257,626
1998 4,470,922 7,257,626
1999 4,470,922 7,257,626
2000 4,470,922 7,257,626
Similar annual fiscal implications would continue as long as the
provisions of the bill are in effect.
No fiscal implication to units of local government is
anticipated.
Source: Department of Health, Department of Human Services,
Health and Human Services Commission
LBB Staff: JK, AZ, DF