LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION March 20, 2023 TO: Honorable James B. Frank, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB2641 by Johnson, Ann (Relating to Medicaid coverage and reimbursement for the provision of rapid whole genome sequencing to certain infants with acute or complex illnesses.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB2641, As Introduced : a negative impact of ($36,454,318) through the biennium ending August 31, 2025. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2024$02025($36,454,318)2026($38,143,967)2027($39,389,472)2028($41,354,402)All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 Probable Revenue Gain fromGeneral Revenue Fund1 Probable Revenue Gain fromFoundation School Fund1932024$0$02025($38,722,899)($57,782,769)$1,701,436$567,1452026($39,902,100)($59,480,465)$1,318,600$439,5332027($41,205,626)($61,423,579)$1,362,116$454,0382028($42,592,029)($63,490,235)$928,220$309,407 Fiscal AnalysisThe bill would require the Health and Human Services Commission (HHSC) to establish and provide Medicaid reimbursement for rapid whole genome sequencing.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION
March 20, 2023
TO: Honorable James B. Frank, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB2641 by Johnson, Ann (Relating to Medicaid coverage and reimbursement for the provision of rapid whole genome sequencing to certain infants with acute or complex illnesses.), As Introduced
TO: Honorable James B. Frank, Chair, House Committee on Human Services
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB2641 by Johnson, Ann (Relating to Medicaid coverage and reimbursement for the provision of rapid whole genome sequencing to certain infants with acute or complex illnesses.), As Introduced
Honorable James B. Frank, Chair, House Committee on Human Services
Honorable James B. Frank, Chair, House Committee on Human Services
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB2641 by Johnson, Ann (Relating to Medicaid coverage and reimbursement for the provision of rapid whole genome sequencing to certain infants with acute or complex illnesses.), As Introduced
HB2641 by Johnson, Ann (Relating to Medicaid coverage and reimbursement for the provision of rapid whole genome sequencing to certain infants with acute or complex illnesses.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for HB2641, As Introduced : a negative impact of ($36,454,318) through the biennium ending August 31, 2025.
Estimated Two-year Net Impact to General Revenue Related Funds for HB2641, As Introduced : a negative impact of ($36,454,318) through the biennium ending August 31, 2025.
General Revenue-Related Funds, Five- Year Impact:
2024 $0
2025 ($36,454,318)
2026 ($38,143,967)
2027 ($39,389,472)
2028 ($41,354,402)
All Funds, Five-Year Impact:
2024 $0 $0
2025 ($38,722,899) ($57,782,769) $1,701,436 $567,145
2026 ($39,902,100) ($59,480,465) $1,318,600 $439,533
2027 ($41,205,626) ($61,423,579) $1,362,116 $454,038
2028 ($42,592,029) ($63,490,235) $928,220 $309,407
Fiscal Analysis
The bill would require the Health and Human Services Commission (HHSC) to establish and provide Medicaid reimbursement for rapid whole genome sequencing.
Methodology
Assuming a start date of September 1, 2024, HHSC estimates that 7,573 clients will utilize the additional services in fiscal year 2025, increasing to 7,835 in fiscal year 2028. The estimated cost to Medicaid is $95.5 million in All Funds, including $57.8 million in General Revenue in fiscal year 2025, and increasing to $106.1 million in All Funds, including $63.5 million in General Revenue, in fiscal year 2028.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 $2.3 million in fiscal year 2025, $1.8 million in fiscal year 2026, $1.8 million in fiscal year 2027, and $1.2 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.It is assumed that costs to the HHSC associated with rulemaking and implementation of the new benefit could be absorbed within existing agency resources.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 529 Health and Human Services Commission
529 Health and Human Services Commission
LBB Staff: b > td > JMc, NPe, ER, CST, NV
JMc, NPe, ER, CST, NV