LEGISLATIVE BUDGET BOARD
Austin, Texas
 
FISCAL NOTE, 81ST LEGISLATIVE REGULAR SESSION
 
March 2, 2009

TO:
Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services
 
FROM:
John S. O'Brien, Director, Legislative Budget Board
 
IN RE:
SB531 by Patrick, Dan (Relating to the billing coordination system for claims submitted for payment from the Medicaid program.), As Introduced



Estimated Two-year Net Impact to General Revenue Related Funds for SB531, As Introduced: a negative impact of ($1,540,125) through the biennium ending August 31, 2011.

The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.



Fiscal Year Probable Net Positive/(Negative) Impact to General Revenue Related Funds
2010 ($1,007,875)
2011 ($532,250)
2012 ($240,000)
2013 ($240,000)
2014 ($240,000)




Fiscal Year Probable (Cost) from
GR Match For Medicaid
758 		Probable (Cost) from
Federal Funds
555
2010 ($1,007,875) ($2,572,625)
2011 ($532,250) ($1,145,750)
2012 ($240,000) ($720,000)
2013 ($240,000) ($720,000)
2014 ($240,000) ($720,000)

Fiscal Analysis

The bill would amend Section 531.02413, Government Code, to require the Health and Human Services Commission (HHSC) to expand the Medicaid Billing Coordination System (BCS), if cost effective and feasible, and to process claims for all other health care services provided through the Medicaid program in the manner claims for acute care services are currently processed by the system. 

HHSC assumes that the language referring to processing claims would exclude services provided under managed care, since managed care payments to providers are not processed through the TMHP acute care claims system.   A Medicaid BCS is already in place for other types of service delivery, including fee-for-service, primary care case management (PCCM), and pharmacy claims.  Therefore, HHSC assumes no significant fiscal impact.

The cost to the Department of Aging and Disability Services (DADS) would include contracted services required to migrate certain programs to the current TMHP long-term care claims system and to enable it to perform billing coordination services on long-term care claims.  It is anticipated saving may accrue from the use of BCS on long-term care claims, and due to no longer needing the current payment systems being used for certain programs; however, DADS did not provide an estimate.


Methodology

DADS assumes that the Home and Community-based Services and Texas Home Living waiver programs would migrate to the TMHP claims system, at a cost of $1.1 million in FY 2010.  All other long-term care Medicaid programs are currently processed by TMHP.  Professional services would be required at TMHP at a cost of $1,068,000 in fiscal year 2010 and $267,000 in fiscal year 2011, for 8900 contract hours.  Annual operational costs are estimated to be $960,000 per year. 

Other information technology costs, including contracted programming hours, TMHP hardware, Data Center Services hardware/software, and internal costs at DADS are assumed to be $452,500 in fiscal year 2010 and $451,000 in fiscal year 2011.  No continuing hardware or technology costs are assumed in fiscal years 2012-2014.  It is assumed approximately 72% of costs would be Federally-funded.


Local Government Impact

No fiscal implication to units of local government is anticipated.


Source Agencies:
529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
LBB Staff:
JOB, CL, PP, MB