LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
April 6, 1999
TO: Honorable Elliott Naishtat, Chair, House Committee on
Human Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB3638 by Naishtat (Relating to judicial review of
certain decisions about medical assistance.), As
Introduced
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* Estimated Two-year Net Impact to General Revenue Related Funds for *
* HB3638, As Introduced: negative impact of $(791,180) 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. *
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General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $(398,090) *
* 2001 (393,090) *
* 2002 (393,090) *
* 2003 (393,090) *
* 2004 (393,090) *
****************************************************
All Funds, Five-Year Impact:
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*Fiscal Probable (Cost) to Probable (Cost) to Change in Number of *
* Year General Revenue Fund Federal Funds State Employees from *
* (Medicaid Match) (Medicaid) FY 1999 *
* 0001 0555 *
* 2000 $(398,090) $(398,090) 4.0 *
* 2001 (393,090) (393,090) 4.0 *
* 2002 (393,090) (393,090) 4.0 *
* 2003 (393,090) (393,090) 4.0 *
* 2004 (393,090) (393,090) 4.0 *
**************************************************************************
Fiscal Analysis
The bill would amend Section 2001.223 of the Government Code, add Section
2001.2231 to the Government Code, and add Section 22.0181 to the Human
Resources Code. The bill would allow for judicial review of the
granting, payment, denial, or withdrawal of medical assistance by the
Health and Human Services Commission or an agency operating part of the
medical assistance (Medicaid) program.
Methodology
Assumptions related to the Department of Human Services (DHS):
1) DHS conducted 3,200 hearings related to Medicaid eligibility and
benefits in fiscal year 1998. This number is assumed for fiscal year
2000 and each subsequent year.
2) Costs for transcription of hearings would average $150 per hearing,
resulting in an annual cost of $480,000.
3) One additional attorney would be required for every 800 hearings on
Medicaid eligibility and benefits. (The attorney would review cases,
make recommendations, and coordinate with the Attorney General's Office
on cases that are appealed to district court.) Consequently, four
additional FTE positions would be required.
4) Expenses per FTE position would include an annual salary (B-13)
totaling $41,016, annual travel totaling $4,000, annual fringe benefits
totaling 27.59 percent of salary, and one-time start-up costs totaling
$2,500.
5) Expenses would be paid equally with general revenue and matching
federal funds.
Assumptions related to the Department of Health (TDH):
1) TDH conducted 539 hearings related to Medicaid in fiscal year 1998.
This number is assumed for fiscal year 2000 and each subsequent year.
2) Costs for transcription of hearings would average $150 per hearing,
resulting in an annual cost of $80,850.
3) The additional review and coordination related to Medicaid hearings
would require less than one FTE position. It is assumed TDH could meet
this responsibility using existing resources.
4) Expenses would be paid equally with general revenue and matching
federal funds.
The Office of the Attorney General anticipates additional
responsibilities required by the bill could be absorbed by existing
staff.
Note: To the extent that district courts overturn determinations made by
state agencies (and sustained by state hearings officers), expenditures
related to client benefits would increase.
Local Government Impact
The bill would allow Medicaid applicants to appeal to district court
decisions made by state agencies that are sustained by state hearings
officers. This would serve to increase the number of cases in district
courts. The bill also provides that such appeals take precedence over
all civil cases except workers' compensation and unemployment cases.
Source Agencies:
LBB Staff: JK, TP, AZ, PP