LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE
75th Regular Session
April 23, 1997
TO: Honorable Hugo Berlanga, Chair IN RE: House Bill No. 1939
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 nutritional feedings, nutritional
counseling services, and medical nutritional products.) this
office has detemined the following:
Biennial Net Impact to General Revenue Funds by HB1939-As Introduced
Implementing the provisions of the bill would result in a net
negative impact of $(5,262,890) 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 parenteral and enteral nutritional
feedings, medical nutritional products taken orally, restorative
feedings that are medically necessary and cost-effective, and
nutritional counseling services that are provided for medical
purposes.
Methodolgy
It is assumed that enteral products used in nursing homes are
already covered under nursing home reimbursement. Parenteral
feeding in nursing homes is reimbursed through the Department
of Health. 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 these populations based on January,
1997 data for 1998 and 1999, holding 2000-2002 populations at
the 1999 level. The estimates below use February, 1997 projections
from the Department of Health for 1998 - 2000, holding AFDC
adults constant for 2001-2002, and applying a 3% growth rate
for the Disabled and Blind population for 2001-2002.
The
Department of Health estimated that of the base eligible population,
1.5% 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 4,671 in 1998, 4,633 in 1999, 4,664 in 2000, 4,729
in 2001, and 4,797 in 2002. At costs of $1,500 per person,
total costs would be approximately $7,000,000 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.
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 ($2,641,576) ($4,365,257)
1998 (2,621,314) (4,328,087)
2000 (2,638,783) (4,356,930)
2001 (2,675,843) (4,418,121)
2002 (2,714,015) (4,481,147)
Net Impact on General Revenue Related Funds:
The probable fiscal implication to General Revenue related funds
during each of the first five years is estimated as follows:
Fiscal Year Probable Net Postive/(Negative)
General Revenue Related Funds
Funds
1998 ($2,641,576)
1999 (2,621,314)
2000 (2,638,783)
2001 (2,675,843)
2002 (2,714,015)
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
324 Department of Human Services
LBB Staff: JK ,BB ,MM