LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
200 W. Washington St., Suite 301
Indianapolis, IN 46204
(317) 233-0696
iga.in.gov
FISCAL IMPACT STATEMENT
LS 6432 NOTE PREPARED: Dec 13, 2023
BILL NUMBER: HB 1054 BILL AMENDED:
SUBJECT: Screening for Scoliosis.
FIRST AUTHOR: Rep. Garcia Wilburn BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
FEDERAL
Summary of Legislation: The bill requires a health care provider who provides health care services to a
child who is at least nine years of age but less than 13 years of age to take certain actions concerning a
scoliosis screening.
Effective Date: July 1, 2024.
Explanation of State Expenditures: If scoliosis screenings increase and result in more children receiving
additional testing and treatment for scoliosis, costs to Medicaid and the state employee health plan could
increase.
Additional Information: Scoliosis is a curvature of the spine that often can be monitored throughout
childhood. Adverse effects of scoliosis vary depending on its severity and include treatment costs, cosmetic
deformity, reduced quality of life, disability, chronic back pain, social and psychological effects, functional
limitations, and pulmonary disorders.
If the curvature of the spine becomes too pronounced, it could require treatment such as a brace or cast, with
the most severe cases requiring surgery. Roughly 1% to 3% of children nationally experience a scoliosis
angle greater than 10 degrees, with 1% experiencing an angle greater than 20 degrees, and 0.4% experiencing
an angle greater than 40 degrees.
Screening tests for scoliosis are noninvasive. Visual inspection is the most common screening test. The
healthcare provider will look for asymmetry of the shoulders, shoulder blades, and hips using the forward
bend test. If scoliosis is suspected, radiography such as x-rays are used to confirm the diagnosis and to
HB 1054 1 determine the degree of curvature. The average cash price for an x-ray for scoliosis is $263; however, the
price will vary depending on location and insurance coverage. Some states screen for scoliosis in schools
where costs range from $0.06 to $194.00 per child based on whether further follow-up testing is needed.
Medicaid and the Children’s Health Insurance Program (CHIP) are jointly funded between the state and
federal governments. The state share of costs for most Medicaid medical services for FFY 2024 is 34%, 10%
for the age 19 to 64 expansion population within the Healthy Indiana Plan (HIP), and 24% for CHIP. The
state share of administrative costs is 50%. The state share of most Medicaid and CHIP expenditures is paid
from General Fund appropriations, and state dedicated funds primarily cover HIP costs.
Explanation of State Revenues:
Explanation of Local Expenditures: If additional scoliosis screenings result in more children receiving
additional testing and treatment for scoliosis, cost to local units offering health insurance could increase.
Explanation of Local Revenues:
State Agencies Affected: Family and Social Services Administration; State Personnel Department.
Local Agencies Affected: Local units offering health insurance.
Information Sources: https://pubmed.ncbi.nlm.nih.gov/10984793/;
https://www.uspreventiveservicestaskforce.org/uspstf/document/RecommendationStatementFinal/adolesc
ent-idiopathic-scoliosis-screening;
https://jamanetwork.com/journals/jama/article-abstract/2668355;
https://turquoise.health/services/x-ray-entire-spine-scoliosis-evaluation-1-view/.
Fiscal Analyst: Jasmine Noel, 317-234-1360.
HB 1054 2