LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE
75th Regular Session
April 17, 1997
TO: Honorable Hugo Berlanga, Chair IN RE: House Bill No. 2017
Committee on Public Health By: Maxey
House
Austin, Texas
FROM: John Keel, Director
In response to your request for a Fiscal Note on HB2017 ( Relating
to telemedicine services provided under the Medicaid and Medicare
programs.) this office has detemined the following:
Biennial Net Impact to General Revenue Funds by HB2017-As Introduced
Implementing the provisions of the bill would result in a net
negative impact of $(175,972) 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 implement Texas Performance Review (TPR) recommendation
HHS14 in "Disturbing the Peace: The Challenge of Change in
Texas Government" to have the Texas Medicaid Program reimburse
providers for telemedicine services.
The bill would require
the Health and Human Services Commission to develop and implement
a system to reimburse providers for Medicaid services delivered
through a telemedicine program. The bill would require HHSC
to review programs in other states, establish billing codes
and a fee schedule, provide for an approval process before a
provider can receive reimbursement, establish a state network
of telemedicine providers, and work with the Telecommunications
Infrastructure Fund Board to ensure that small rural hospitals
benefit from telemedicine. The bill would ensure that state-owned
health care facilities and teaching hospitals are the primary
providers in the network.
The bill would require HHSC to
work with Texas Tech University in seeking a federal waiver
from the Health Care Financing Administration which would allow
the university to receive reimbursement for telemedicine services
under the Medicare program.
Methodolgy
HHSC would add two full-time equivalent positions to work on
the network development, assist providers, and provide technical
support for the system. It is assumed that Texas Tech University
and the Telecommunications Infrastructure Fund Board would not
require additional resources to implement the provisions of
the bill.
According to the Comptroller of Public Accounts
savings achieved by providing telemedicine services could be
offset by an increase in services that otherwise would not have
been provided. The Comptroller also reports that long-term
savings would result from more timely and accurate diagnosis
and treatment.
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 (Cost) Probable (Cost) Change in Number
from General from Federal Funds of State
Revenue Fund Employees from
FY 1997
0001 0555
1998 ($74,771) ($74,771) 1.3
1998 (101,201) (101,201) 2.0
2000 (96,051) (96,051) 2.0
2001 (96,051) (96,051) 2.0
2002 (96,051) (96,051) 2.0
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 ($74,771)
1999 (101,201)
2000 (96,051)
2001 (96,051)
2002 (96,051)
No significant fiscal implication to units of local government
is anticipated.
Source: Agencies: 304 Comptroller of Public Accounts
529 Health and Human Services Commission
501 Department of Health
739 Texas Tech University Health Sciences Center
LBB Staff: JK ,BB ,AZ