LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 76th Regular Session
April 28, 1999
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB1340 by Carona (Relating to the regulation of
anesthesia in certain outpatient settings.), As Engrossed
**************************************************************************
* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB1340, As Engrossed: positive impact of $92,000 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. *
**************************************************************************
General Revenue-Related Funds, Five-Year Impact:
****************************************************
* Fiscal Year Probable Net Positive/(Negative) *
* Impact to General Revenue Related *
* Funds *
* 2000 $39,000 *
* 2001 53,000 *
* 2002 53,000 *
* 2003 53,000 *
* 2004 53,000 *
****************************************************
All Funds, Five-Year Impact:
***************************************************************************
*Fiscal Probable Revenue Gain/(Loss) Probable Savings/(Cost) from *
* Year from General Revenue Fund General Revenue Fund *
* 0001 0001 *
* 2000 $72,750 $(33,750) *
* 2001 134,000 (81,000) *
* 2002 134,000 (81,000) *
* 2003 135,000 (82,000) *
* 2004 135,000 (82,000) *
***************************************************************************
Fiscal Analysis
The bill would amend the Medical Practice Act and the Nursing Practice
Act to require the Board of Medical Examiners (BME) and the Board of
Nurse Examiners (BNE) to adopt rules to regulate the provision of
anesthesia services in outpatient surgical settings that are not a part
of a licensed hospital or licensed ambulatory surgical center. The bill
would require the BME and BNE to work together to reduce conflicts
between the rules adopted by each board. The bill would also require
physicians and nurse anesthetists to comply with rules adopted on or
after August 31, 2000 so that physicians would register annually; nurse
anesthetists would register biennially; and both would pay a registration
fee. The bill would require the BME and the BNE to adopt rules
necessary to implement the provisions of the bill by January 7, 2000, and
would allow registrations to be staggered over a two year period so that
all affected physicians and nurse anesthetists would be in compliance by
September 1, 2002.
In addition, the bill would authorize the BME and the BNE to inspect
office sites, and related documents, as well as allowing physicians and
nurse anesthetists to request an inspection from their respective board
to receive an advisory opinion regarding their compliance with the
provisions of the bill. The bill would also allow the BME and BNE to
conduct requested compliance inspections and establish a fee for
providing that service.
The bill would take effect September 1, 1999.
Methodology
The BME estimates 530 physicians would be affected by the requirements of
the bill and that a $100 registration fee will be assessed to those
physicians. It is assumed that the BME would stagger and phase in
registrations over a one-year period so that all affected physicians
would be in compliance by September 1, 2001. Accordingly, the BME
anticipates generating $39,000 in fee revenues by registering 390
affected physicians in fiscal year 2000, and $53,000 in fiscal year 2001
with all 530 affected physicians registering annually. In addition, the
BME estimates that a total of $33,750 in operating and travel costs would
be realized by the state for providing compliance inspections in fiscal
year 2000, and that $45,000 would be realized in each following year.
The BME estimates conducting 54 inspections in fiscal year 2000 and 72
inspections in each subsequent year with each inspections costing
approximately $625 to cover the costs of providing the service.
The BNE estimates that 1,454 registered nurse anesthetists would be
affected by the requirements of the bill and that license renewal fees
would be increased beginning September 1, 2000 by 50 cents per renewal
to cover operating and travel costs required to conduct compliance
inspections. The BNE estimates that the increase would generate
approximately $36,000 in the first two years and $37,000 in the
following two years in accordance with the anticipated growth in the
number of licensees.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 304 Comptroller of Public Accounts
LBB Staff: JK, TP, MW