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.
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
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
Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services
Honorable Jane Nelson, Chair, Senate Committee on Health & Human Services
John S. O'Brien, Director, Legislative Budget Board
John S. O'Brien, Director, Legislative Budget Board
SB531 by Patrick, Dan (Relating to the billing coordination system for claims submitted for payment from the Medicaid program.), As Introduced
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.
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.
General Revenue-Related Funds, Five-Year Impact: 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)
2010 ($1,007,875)
2011 ($532,250)
2012 ($240,000)
2013 ($240,000)
2014 ($240,000)
All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 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 Year Probable (Cost) fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 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)
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.
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.
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
529 Health and Human Services Commission, 539 Aging and Disability Services, Department of
LBB Staff: JOB, CL, PP, MB
JOB, CL, PP, MB