LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION April 17, 2023 TO: Honorable Stephanie Klick, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB3377 by Jones, Venton (relating to HIV and AIDS tests.), Committee Report 1st House, Substituted Estimated Two-year Net Impact to General Revenue Related Funds for HB3377, Committee Report 1st House, Substituted : a negative impact of ($1,594,521) 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($678,371)2025($916,150)2026($926,375)2027($944,920)2028($956,870)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($695,672)($1,074,937)$12,976$4,3252025($965,781)($1,457,760)$37,223$12,4082026($968,338)($1,461,620)$31,472$10,4912027($980,905)($1,480,588)$26,989$8,9962028($993,565)($1,499,697)$27,521$9,174 Fiscal AnalysisThe bill would require a health care provider who takes a sample of an individual's blood as part of a medical screening for a sexually transmitted infection to submit the sample for an HIV diagnostic test unless the individual opts out of the HIV test.The bill would require a health care provider to obtain an individual's consent for an HIV diagnostic test or inform the individual that the test will be performed unless the individual opts out of the test.The bill would require a health care provider who submits an individual's blood for an HIV diagnostic test to provide information on available HIV health services and referrals to community support programs to any individuals who tests positive.The bill would require the executive commissioner of the Health and Human Services Commission (HHSC) to adopt rules considering the most recent recommendations of the Centers for Disease Control and Prevention for HIV testing of adults and adolescents.The bill would not require a health care provider to comply with requirements under the bill until January 1, 2024.The bill would not require HHSC to implement a mandatory provision in the bill until funds are appropriated in a state fiscal year or other funding is available. If HHSC does not implement a mandatory provision in the bill in a state fiscal year, the agency shall certify the costs for implementation to the Legislative Budget Board for implementation in the next state fiscal biennium.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION
April 17, 2023
TO: Honorable Stephanie Klick, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB3377 by Jones, Venton (relating to HIV and AIDS tests.), Committee Report 1st House, Substituted
TO: Honorable Stephanie Klick, Chair, House Committee on Public Health
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB3377 by Jones, Venton (relating to HIV and AIDS tests.), Committee Report 1st House, Substituted
Honorable Stephanie Klick, Chair, House Committee on Public Health
Honorable Stephanie Klick, Chair, House Committee on Public Health
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB3377 by Jones, Venton (relating to HIV and AIDS tests.), Committee Report 1st House, Substituted
HB3377 by Jones, Venton (relating to HIV and AIDS tests.), Committee Report 1st House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for HB3377, Committee Report 1st House, Substituted : a negative impact of ($1,594,521) 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 HB3377, Committee Report 1st House, Substituted : a negative impact of ($1,594,521) 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 ($678,371)
2025 ($916,150)
2026 ($926,375)
2027 ($944,920)
2028 ($956,870)
All Funds, Five-Year Impact:
2024 ($695,672) ($1,074,937) $12,976 $4,325
2025 ($965,781) ($1,457,760) $37,223 $12,408
2026 ($968,338) ($1,461,620) $31,472 $10,491
2027 ($980,905) ($1,480,588) $26,989 $8,996
2028 ($993,565) ($1,499,697) $27,521 $9,174
Fiscal Analysis
The bill would require a health care provider who takes a sample of an individual's blood as part of a medical screening for a sexually transmitted infection to submit the sample for an HIV diagnostic test unless the individual opts out of the HIV test.The bill would require a health care provider to obtain an individual's consent for an HIV diagnostic test or inform the individual that the test will be performed unless the individual opts out of the test.The bill would require a health care provider who submits an individual's blood for an HIV diagnostic test to provide information on available HIV health services and referrals to community support programs to any individuals who tests positive.The bill would require the executive commissioner of the Health and Human Services Commission (HHSC) to adopt rules considering the most recent recommendations of the Centers for Disease Control and Prevention for HIV testing of adults and adolescents.The bill would not require a health care provider to comply with requirements under the bill until January 1, 2024.The bill would not require HHSC to implement a mandatory provision in the bill until funds are appropriated in a state fiscal year or other funding is available. If HHSC does not implement a mandatory provision in the bill in a state fiscal year, the agency shall certify the costs for implementation to the Legislative Budget Board for implementation in the next state fiscal biennium.
The bill would require a health care provider to obtain an individual's consent for an HIV diagnostic test or inform the individual that the test will be performed unless the individual opts out of the test.
The bill would require a health care provider who submits an individual's blood for an HIV diagnostic test to provide information on available HIV health services and referrals to community support programs to any individuals who tests positive.
The bill would require the executive commissioner of the Health and Human Services Commission (HHSC) to adopt rules considering the most recent recommendations of the Centers for Disease Control and Prevention for HIV testing of adults and adolescents.
The bill would not require a health care provider to comply with requirements under the bill until January 1, 2024.The bill would not require HHSC to implement a mandatory provision in the bill until funds are appropriated in a state fiscal year or other funding is available. If HHSC does not implement a mandatory provision in the bill in a state fiscal year, the agency shall certify the costs for implementation to the Legislative Budget Board for implementation in the next state fiscal biennium.
The bill would not require a health care provider to comply with requirements under the bill until January 1, 2024.
The bill would not require HHSC to implement a mandatory provision in the bill until funds are appropriated in a state fiscal year or other funding is available. If HHSC does not implement a mandatory provision in the bill in a state fiscal year, the agency shall certify the costs for implementation to the Legislative Budget Board for implementation in the next state fiscal biennium.
Methodology
According to HHSC, HIV testing is already covered in Medicaid and Healthy Texas Women services (HTW), but providers are not required to conduct the testing. Texas Medicaid, HTW, and the Centers for Disease Control and Prevention already allow an opt-out process for HIV testing if general informed consent for testing is already obtained. To implement the bill, HHSC Medicaid and CHIP Services (MCS) would be required to amend Texas Administrative Code (TAC) rules. MCS may need to amend Medicaid medical policies, provider handbooks, and Managed Care Organizations (MCOs) contracts to require MCOs to educate providers and ensure they comply with the new requirements.HHSC assumes increased service utilization and claims due to the requirement that providers must order diagnostic tests for HIV during a medical screening for sexually transmitted infections. Based on HHSC's assumptions, the client services related costs for HIV Testing is estimated to be $0.7 million in General Revenue ($1.8 million in All Funds) in fiscal year 2024 and $1.0 million in General Revenue ($2.4 million in All Funds) in fiscal year 2025. The lower amount in fiscal year 2024 is based on a January 1, 2024 implementation date. The estimate considers caseload growth trends, costs per HIV test, opt out rate reviews, and number of new test estimates. The agency assumes a Federal Medical Assistance Percentage (FMAP) for the Medicaid program of 60.13 percent for fiscal year 2024 and 60.15 for fiscal year 2025.HHSC estimates that additional premium tax revenue would be less than $0.1 million in fiscal year 2024 and in fiscal year 2025.According to the Department of State Health Services, any costs associated with the bill could be absorbed using existing resources.
HHSC assumes increased service utilization and claims due to the requirement that providers must order diagnostic tests for HIV during a medical screening for sexually transmitted infections. Based on HHSC's assumptions, the client services related costs for HIV Testing is estimated to be $0.7 million in General Revenue ($1.8 million in All Funds) in fiscal year 2024 and $1.0 million in General Revenue ($2.4 million in All Funds) in fiscal year 2025. The lower amount in fiscal year 2024 is based on a January 1, 2024 implementation date. The estimate considers caseload growth trends, costs per HIV test, opt out rate reviews, and number of new test estimates. The agency assumes a Federal Medical Assistance Percentage (FMAP) for the Medicaid program of 60.13 percent for fiscal year 2024 and 60.15 for fiscal year 2025.
HHSC estimates that additional premium tax revenue would be less than $0.1 million in fiscal year 2024 and in fiscal year 2025.
According to the Department of State Health Services, 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.
Source Agencies: b > td > 327 Employees Retirement System, 454 Department of Insurance, 503 Texas Medical Board, 529 Health and Human Services Commission, 537 State Health Services, Department of, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration
327 Employees Retirement System, 454 Department of Insurance, 503 Texas Medical Board, 529 Health and Human Services Commission, 537 State Health Services, Department of, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration
LBB Staff: b > td > JMc, NPe, ER, APA, NV
JMc, NPe, ER, APA, NV