LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 77th Regular Session March 30, 2001 TO: Honorable Patricia Gray, Chair, House Committee on Public Health FROM: John Keel, Director, Legislative Budget Board IN RE: HB101 by Maxey (Relating to medical assistance for certain persons in need of treatment for breast or cervical cancer.), Committee Report 1st House, Substituted ************************************************************************** * Estimated Two-year Net Impact to General Revenue Related Funds for * * HB101, Committee Report 1st House, Substituted: negative impact * * of $(1,107,129) through the biennium ending August 31, 2003. * * * * 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 * * 2002 $(594,878) * * 2003 (512,251) * * 2004 (512,251) * * 2005 (512,251) * * 2006 (512,251) * **************************************************** All Funds, Five-Year Impact: *************************************************************************** *Fiscal Probable Savings/(Cost) from GR Probable Savings/(Cost) from * * Year Match for Medicaid Federal Funds - Federal * * 0758 0555 * * 2002 $(594,878) $(1,540,364) * * 2003 (512,251) (1,320,491) * * 2004 (512,251) (1,320,491) * * 2005 (512,251) (1,320,491) * * 2006 (512,251) (1,320,491) * *************************************************************************** Technology Impact The bill would require the Department of Human Services (DHS) to modify existing eligibility systems to track clients gaining Medicaid eligibility under the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000. The agency estimates this would require 2,750 programming hours at a cost of $110 per hour, resulting in a one-time cost of $302,500 in FY 2002. It is assumed the federal government would provide funding at an enhanced match, or 72.14 percent. Fiscal Analysis The bill would require the Department of Health (TDH) to provide Medicaid services to a person in need of treatment for breast or cervical cancer who is eligible for that assistance under the federal Breast and Cervical Cancer Prevention and Treatment Act of 2000 for a continuous period during which the person requires treatment. The bill would also require the following changes in the Medicaid eligibility process for the population noted above: simplifying provider enrollment, adopting rules to provide for certification of presumptive eligibility, and elimination of the requirement (to the extent allowed by federal law) for a personal interview. The impact of these changes has not been estimated. Methodology 1. It is estimated 187 women would be newly diagnosed per year with a cancer type eligible for Medicaid coverage: 97 diagnosed with breast cancer and 90 diagnosed with cervical cancer. It is anticipated that treatment and Medicaid eligibility would average one year. (If clients were to retain Medicaid coverage on average for longer than one year, costs would increase.) 2. Average monthly costs would include premiums, medical transportation, and prescription drugs at a cost of (respectively) $765.11, $1.62, and $50.00. Costs and utilization are assumed to remain constant. 3. It is assumed the federal government would provide funding at an enhanced match, totaling 72.14 percent in FY 2002, and 72.05 percent in each subsequent year. State General Revenue would provide the remaining percentage of funding. Local Government Impact No fiscal implication to units of local government is anticipated. Source Agencies: 324 Texas Department of Human Services, 501 Texas Department of Health LBB Staff: JK, HD, PP