LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
March 15, 2001
TO: Honorable Mike Moncrief, Chair, Senate Committee on
Health & Human Services
FROM: John Keel, Director, Legislative Budget Board
IN RE: SB789 by Moncrief (Relating to the regulation and
reimbursement of telemedicine medical services.), As
Introduced
**************************************************************************
* Estimated Two-year Net Impact to General Revenue Related Funds for *
* SB789, As Introduced: negative impact of $(33,710,650) 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 $(11,091,775) *
* 2003 (22,618,875) *
* 2004 (22,969,948) *
* 2005 (23,368,358) *
* 2006 (23,773,689) *
****************************************************
All Funds, Five-Year Impact:
***************************************************************************
*Fiscal Probable Probable Probable Change in *
* Year Savings/(Cost) Savings/(Cost) Savings/(Cost) Number of State *
* from GR Match from Federal from Employees from *
* for Medicaid Funds - Federal Telecommunicat- FY 2001 *
* 0758 0555 ions *
* Infrastructure *
* Fund *
* 0345 *
* 2002 $(11,091,775) $(16,752,190) $(54,317) 3.0 *
* 2003 (22,618,875) (34,000,861) (42,317) 3.0 *
* 2004 (22,969,948) (34,538,162) (42,317) 3.0 *
* 2005 (23,368,358) (35,137,523) (42,317) 3.0 *
* 2006 (23,773,689) (35,747,296) (42,317) 3.0 *
***************************************************************************
Fiscal Analysis
The bill would amend current telemedicine statutes. Section 2 would
require the Health and Human Services Commission (HHSC) to require by
rule that all state Medicaid-operating agencies provide Medicaid
reimbursement for telemedicine services. Restrictions related to the
type of facility that may participate would be removed. The HHSC would
be responsible for monitoring and regulating the use of telemedicine
services, in consultation with the Board of Medical Examiners, and for
creating and maintaining a telemedicine medical services registry.
Section 10 would require the Telecommunications Infrastructure Fund
Board (TIFB) to establish an assistance program to provide education and
facilitate access to funds.
Methodology
Provision of Telemedicine Services to Medicaid Recipients
The following estimate relates only to services to be provided through
the Department of Health (TDH). Potentially, the bill could require
additional services be funded at the Department of Human Services (DHS)
and other agencies. If additional Medicaid-operating agencies were
affected, additional costs would result.
It is assumed 25% of the total Medicaid population served by TDH would
receive telemedicine services. The affected number of recipients per
year would total 462,452 in FY 2002, 470486 in FY 2003, 478,658 in FY
2004, and 486973 in FY 2005, and 495432 in FY 2006. Each client would
receive two telemedicine services in FY 2002 (to allow for a March 2002
implementation) and four telemedicine services per year for each
subsequent year. The per service cost would total $30. The federal
share of client services expenses would total 60.20% in FY 2002, 60.08%
in FY 2003, and 60.07% in each subsequent year.
Monitoring and Regulation of Telemedicine Providers/Services
The HHSC estimates two FTEs would be required. Annual salaries would
total 37,322 and 19,452 respectively. Fringe benefits would total 28.28%
of salary. One-time set up costs totaling $12,000 per FTE are assumed
for FY 2002. This expense would be shared equally by the federal
government and the state.
Development and Administration of an Assistance Program
It is estimated the TIFB would require one additional FTE, with an annual
salary of 32,988 per year. Fringe benefits would total 28.28% of
salary. One-time set up costs totaling $12,000 are assumed for FY 2002.
Expenses would be funded through the Telecommunication Infrastructure
Fund (345). While the bill would implement a new education and grant
program, TIFB has assumed that no increase in funding is required.
However, the agency indicates the average grant award may need to be
reduced or the number of grants may need to be reduced.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: 529 Health and Human Services Commission, 503
Texas State Board of Medical Examiners, 324 Texas
Department of Human Services, 501 Texas Department
of Health
LBB Staff: JK, HD, PP, AJ