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LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION
May 16, 2023
TO:
Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
HB2727 by Price (Relating to the provision of home telemonitoring services under Medicaid.), As Engrossed
Estimated Two-year Net Impact to General Revenue Related Funds for HB2727, As Engrossed : a negative impact of ($2,985,378) through the biennium ending August 31, 2025.
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
2024
$0
2025
($2,985,378)
2026
($2,933,909)
2027
($3,014,627)
2028
($3,051,845)
All Funds, Five-Year Impact:
Fiscal Year
Probable (Cost) from GR Match For Medicaid 758
Probable (Cost) from Federal Funds 555
Probable Revenue Gain from General Revenue Fund 1
Probable Revenue (Loss) from Foundation School Fund 193
2024
$0
$0
$0
$0
2025
($3,074,780)
($4,588,223)
$67,051
$22,351
2026
($3,114,354)
($4,642,443)
$135,334
$45,111
2027
($3,152,012)
($4,698,579)
$103,039
$34,346
2028
($3,190,926)
($4,756,586)
$104,311
$34,770
Fiscal Analysis
The bill would amend requirements that home telemonitoring services for Medicaid reimbursement be cost-effective and clinically effective.
The bill would require a provider to provide patients experiencing a high-risk pregnancy with clinically appropriate home telemonitoring services.
The bill would add federally qualified health centers (FQHCs) and rural health clinics (RHCs) as providers.
Methodology
The Health and Human Services Commission assumes that telemonitoring services would be required for patients experiencing a high-risk pregnancy, and other conditions would only be covered if services were found to be cost-effective. Assuming a September 1, 2024, start date, the additional average monthly caseload associated with providing telemonitoring services for clients experiencing high-risk pregnancies and increasing the eligible providers is estimated to be 2,451 in fiscal year 2025, increasing in each subsequent fiscal year to 2,542 in fiscal year 2028. With an average per member per month of $260.54, the estimated cost is $7.6 million in All Funds, including $3.0 million in General Revenue, in fiscal year 2025, increasing each subsequent fiscal year to $7.9 million in All Funds, including $3.1 million in General Revenue in fiscal year 2028. This analysis assumes costs associated with providing home telemonitoring services to additional clients, and not potential costs or savings that may result from changes to home telemonitoring.
The net increases in client services payments through managed care are assumed to result in an increase to insurance premium tax revenue, estimated as 1.75 percent of the increased managed care expenditures. Revenue is adjusted for assumed timing of payments and prepayments resulting in increased collections estimated to be less than $0.1 million in fiscal year 2025, $0.2 million in fiscal year 2026, $0.1 million in fiscal year 2027, and $0.1 million in fiscal year 2028. Pursuant to Section 227.001(b), Insurance Code, 25 percent of the revenue is assumed to be deposited to the credit of the Foundation School Fund.
Technology
HHSC indicates that any costs associated with the bill could be absorbed using existing resources.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.