LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
March 15, 1999
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB897 by Haggerty (Relating to medical assistance
payments for ambulance services.), As Introduced
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB897, As Introduced: negative impact of $(29,447,074) through *
* the biennium ending August 31, 2001. *
* *
* 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 Medicaid program, for ambulance services for
individuals eligible for Medicaid and Medicare, to pay the difference
between the customary rate prevailing in a community and the maximum
Medicare allowable charges for the same service.
General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $(14,723,537) *
* 2001 (14,723,537) *
* 2002 (14,723,537) *
* 2003 (14,723,537) *
* 2004 (14,723,537) *
****************************************************
All Funds, Five-Year Impact:
*****************************************************
* Fiscal Year Probable Savings/(Cost) from *
* General Revenue Fund *
* 0001 *
* 2000 $(14,723,537) *
* 2001 (14,723,537) *
* 2002 (14,723,537) *
* 2003 (14,723,537) *
* 2004 (14,723,537) *
*****************************************************
Fiscal Analysis
According to analysis by the Department of Health, the bill would define
customary rate to mean amounts billed by ambulance services in local
areas.
Methodology
The average ambulance charge in the state is assumed to be $428.88. The
average Medicaid payment per claim amount is the 20 percent share of the
Medicare maximum allowed reimbursement. The Medicare average payment per
claim is $274.80. The Medicare maximum reimbursement is the sum of
$68.30 plus $274.80 equals $343.10. The difference between the billed
amount ($428.88) and the average paid claim amount would be $85.78, paid
from general revenue. The number of ambulance trips per year is assumed
to be 171,643.
According to the Department of Health, federal matching funds would not
be available for these increased reimbursement amounts and therefore the
difference between the billed amount estimated above and the average
paid claim amount estimated above would be paid from 100 percent state
dollars.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies:
LBB Staff: JK, TP, AZ, KF