LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
  
                              March 21, 2001
  
  
          TO:  Honorable Patricia Gray, Chair, House Committee on Public
               Health
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB703  by Maxey (Relating to prescription drug coverage
               under the state Medicaid program.), As Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  HB703, As Introduced:  negative impact of $(91,919,313) 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                        $(45,583,449)  *
          *       2003                         (46,335,864)  *
          *       2004                         (46,999,258)  *
          *       2005                         (47,660,433)  *
          *       2006                         (48,330,626)  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
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*Fiscal        Probable             Probable         Probable Revenue    *
* Year    Savings/(Cost) from  Savings/(Cost) from   Gain/(Loss) from    *
*            GR Match for        Federal Funds -    Vendor Drug Rebates  *
*              Medicaid              Federal           (State Share)     *
*                0758                 0555                 0706          *
*  2002          $(56,968,061)        $(86,144,705)          $11,384,612 *
*  2003           (57,915,455)         (87,154,502)           11,579,591 *
*  2004           (58,744,697)         (88,365,677)           11,745,439 *
*  2005           (59,571,166)         (89,609,004)           11,910,733 *
*  2006           (60,408,907)         (90,869,287)           12,078,281 *
**************************************************************************
  
Technology Impact
  
One-time automation costs are assumed for the Department of Human
Services (DHS): 500 hours at $110 per hour.  Transaction processing
costs totaling $35,000 per year are assumed for the Department of Health
(TDH).  The federal share of administrative expenses would total 50%.
  
  
Fiscal Analysis
  
The bill would prohibit TDH from limiting the number of medications
prescribed to a recipient of prescription drug benefits under the
medical assistance program.
  
  
Methodology
  
1.  The average monthly number of recipients to receive additional
prescriptions under the Medicaid Vendor Drug program is assumed to total
248,276 in FY 2002, 251,769 in FY 2003, 255,311 in FY 2004, 258,904 in FY
2005, and 262,546 in FY 2006.  Clients would receive an additional 1.01
prescriptions per month at a cost of $47.53 per prescription per month.
It is assumed cost and utilization levels would remain constant.  The
federal share of client services would be 60.20% in FY 2002, 60.08% in FY
2004, and 60.07% in each subsequent year.

2.  Approximately 20% of the General Revenue for the Vendor Drug program
is provided through manufacturer rebates.  An increase in program costs
would in turn increase revenue (Vendor Drug Rebates).  This increase
would partially offset the costs identified above.
  
  
Local Government Impact
  
No significant fiscal implication to units of local government is
anticipated.
  
  
Source Agencies:   529   Health and Human Services Commission, 324
                   Texas Department of Human Services, 501   Texas
                   Department of Health
LBB Staff:         JK, HD, PP