LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE
75th Regular Session
April 30, 1997
TO: Honorable Hugo Berlanga, Chair IN RE: House Bill No. 1939, Committee Report 1st House, Substituted
Committee on Public Health By: Coleman
House
Austin, Texas
FROM: John Keel, Director
In response to your request for a Fiscal Note on HB1939 ( Relating
to Medicaid coverage of certain nutrition therapy and nutrition
services.) this office has detemined the following:
Biennial Net Impact to General Revenue Funds by HB1939-Committee Report 1st House, Substituted FN Revision 1
Implementing the provisions of the bill would result in a net
negative impact of $(3,729,199) to General Revenue Related Funds
through the biennium ending August 31, 1999.
The bill would make no appropriation but could provide the legal
basis for an appropriation of funds to implement the provisions
of the bill.
Fiscal Analysis
The bill would amend Section 32.024 of the Human Resources Code,
requiring that, subject to the availability of funds appropriated
by the Legislature, the state shall provide coverage under the
state Medicaid program for enteral nutrition therapy and related
nutrition services that are ordered by a physician. The nutrition
services must be provided by a licensed dietitian.
Methodolgy
It is assumed that enteral products used in nursing homes are
already covered under nursing home reimbursement. It is assumed
that Medicaid recipients under 21 years of age would already
receive nutritional services through the program known as the
Medicaid Comprehensive Care program (CCP), and that the Aged
and Medicare-related groups are covered by Medicare for these
services.
The estimate of the base population potentially
eligible for reimbursement for these services comprises the
AFDC adult population and 70% of the Disabled and Blind population;
it is assumed that 30% of the Disabled and Blind population
is under 21 or over 65.
The Department of Health estimated
that of the base eligible population, 1.0% would utilize these
newly available Medicaid nutrition services at an estimated
annual cost of $1,500 per person. The projected total number
of individuals utilizing these services would be 3,198 in 1998,
3,179 in 1999, 3,179 in 2000, 3,179 in 2001, and 3,179 in 2002.
Costs for providing services by licensed dietitians is estimated
at $50.51 per client in 1998, and at $51.00 per client in 1999-2002.
Total costs for nutrition and dietitian services would be approximately
$4.96 million per year to all funds. The general revenue share
of that is assumed to be 37.7% in 1998 and 37.72% in 1999 -
2002. (This fiscal note is based on updated information received
from the Department of Health on 4/30/97.)
Note: In the
event that rebates are negotiated for these nutrition products,
the state may generate revenues to offset some of the general
revenue costs estimated to implement the provisions of this
bill.
The probable fiscal implications of implementing the provisions
of the bill during each of the first five years following passage
is estimated as follows:
Five Year Impact:
Fiscal Year Probable Probable
Savings/(Cost) Savings/(Cost)
from General from Federal Funds
Revenue Fund
0001 0555
1998 ($1,869,366) ($3,089,165)
1998 (1,859,833) (3,070,796)
2000 (1,859,833) (3,070,796)
2001 (1,859,833) (3,070,796)
2002 (1,859,833) (3,070,796)
Net Impact on General Revenue Related Funds:
Fiscal Year Probable Net Postive/(Negative)
General Revenue Related Funds
Funds
1998 ($1,869,366)
1999 (1,859,833)
2000 (1,859,833)
2001 (1,859,833)
2002 (1,859,833)
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: Agencies: 501 Department of Health
LBB Staff: JK ,BB ,MM