LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION April 3, 2023 TO: Honorable James B. Frank, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB3285 by Price (Relating to Medicaid coverage and reimbursement for the provision of certain digital therapeutics.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB3285, As Introduced : a negative impact of ($1,427,016) 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 toGeneral Revenue Related Funds2024($30,517)2025($1,396,499)2026($2,662,777)2027($2,719,177)2028($2,761,154)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($30,517)($91,553)$0$02025($1,438,101)($2,156,944)$31,202$10,4002026($2,805,378)($4,198,369)$106,951$35,6502027($2,842,724)($4,249,915)$92,660$30,8872028($2,886,521)($4,318,295)$94,025$31,342 Fiscal AnalysisThe bill would require the Health and Human Services Commission (HHSC) to establish and provide Medicaid reimbursement for certain prescription digital therapeutics (PDT). LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION April 3, 2023 TO: Honorable James B. Frank, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB3285 by Price (Relating to Medicaid coverage and reimbursement for the provision of certain digital therapeutics.), As Introduced TO: Honorable James B. Frank, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB3285 by Price (Relating to Medicaid coverage and reimbursement for the provision of certain digital therapeutics.), 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 HB3285 by Price (Relating to Medicaid coverage and reimbursement for the provision of certain digital therapeutics.), As Introduced HB3285 by Price (Relating to Medicaid coverage and reimbursement for the provision of certain digital therapeutics.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB3285, As Introduced : a negative impact of ($1,427,016) 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. Estimated Two-year Net Impact to General Revenue Related Funds for HB3285, As Introduced : a negative impact of ($1,427,016) 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. 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: 2024 ($30,517) 2025 ($1,396,499) 2026 ($2,662,777) 2027 ($2,719,177) 2028 ($2,761,154) All Funds, Five-Year Impact: 2024 ($30,517) ($91,553) $0 $0 2025 ($1,438,101) ($2,156,944) $31,202 $10,400 2026 ($2,805,378) ($4,198,369) $106,951 $35,650 2027 ($2,842,724) ($4,249,915) $92,660 $30,887 2028 ($2,886,521) ($4,318,295) $94,025 $31,342 Fiscal Analysis The bill would require the Health and Human Services Commission (HHSC) to establish and provide Medicaid reimbursement for certain prescription digital therapeutics (PDT). Methodology Assuming a September 1, 2024, start date, the number of individuals utilizing newly approved PDTs is estimated to be 2,786 in fiscal year 2025, increasing each subsequent year to 5,648 in fiscal year 2028. The estimated cost is $3.6 million in All Funds, including $1.4 million in General Revenue, in fiscal year 2025, increasing each subsequent fiscal year to $7.2 million in All Funds, including $2.9 million in General Revenue in fiscal year 2028.The net increase in client services payments through managed care is 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, $0.1 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 Technology costs are estimated to total $122,070 in All Funds in fiscal year 2024 and $29,160 in All Funds in fiscal year 2025 for system modifications to the Vendor Drug Program Fee-for-Service Pharmacy Claims System. 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