LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION March 28, 2023 TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB989 by Huffman (Relating to health benefit plan coverage for certain biomarker testing.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for SB989, As Introduced : a negative impact of ($2,687,068) 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$02025($2,687,068)2026($2,849,433)2027($2,976,211)2028($3,161,492)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$0$02025($2,858,735)($4,420,055)$128,750$42,9172026($2,984,257)($4,607,930)$101,118$33,7062027($3,117,042)($4,811,436)$105,623$35,2082028($3,258,156)($5,027,310)$72,498$24,166 Fiscal AnalysisThe bill would require affected health benefit plans, including the state Medicaid program and the Children's Health Insurance Program (CHIP), to provide coverage for biomarker testing for the diagnosis, treatment, management, monitoring of an enrollee's disease or condition when medically and scientifically supported. LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION March 28, 2023 TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB989 by Huffman (Relating to health benefit plan coverage for certain biomarker testing.), As Introduced TO: Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: SB989 by Huffman (Relating to health benefit plan coverage for certain biomarker testing.), As Introduced Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services Jerry McGinty, Director, Legislative Budget Board Jerry McGinty, Director, Legislative Budget Board SB989 by Huffman (Relating to health benefit plan coverage for certain biomarker testing.), As Introduced SB989 by Huffman (Relating to health benefit plan coverage for certain biomarker testing.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for SB989, As Introduced : a negative impact of ($2,687,068) 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 SB989, As Introduced : a negative impact of ($2,687,068) 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 $0 2025 ($2,687,068) 2026 ($2,849,433) 2027 ($2,976,211) 2028 ($3,161,492) All Funds, Five-Year Impact: 2024 $0 $0 $0 2025 ($2,858,735) ($4,420,055) $128,750 $42,917 2026 ($2,984,257) ($4,607,930) $101,118 $33,706 2027 ($3,117,042) ($4,811,436) $105,623 $35,208 2028 ($3,258,156) ($5,027,310) $72,498 $24,166 Fiscal Analysis The bill would require affected health benefit plans, including the state Medicaid program and the Children's Health Insurance Program (CHIP), to provide coverage for biomarker testing for the diagnosis, treatment, management, monitoring of an enrollee's disease or condition when medically and scientifically supported. Methodology The bill would require HHSC to expand existing benefits for biomarker testing for Medicaid and CHIP clients. Assuming a September 1, 2024 start date, the additional average monthly Medicaid caseload associated with expanding biomarker testing covered benefits is estimated to be 7,501 in fiscal year 2025, increasing in each subsequent fiscal year to 7,774 in fiscal year 2028. The additional average monthly CHIP caseload is estimated to be 568 in fiscal year 2025, increasing in each subsequent fiscal year to 571 in fiscal year 2028. This results in an estimated cost of $7.3 million in All Funds, including $2.9 million in General Revenue, in fiscal year 2025, increasing each subsequent fiscal year to $8.3 million in All Funds, including $3.3 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 and vendor drug rebates. This results in assumed increased collections $0.2 million in fiscal year 2025, $0.1 million in fiscal year 2026, $0.1 million in fiscal year 2027, less than $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.Based on the analysis of the Employees Retirement System, Teacher Retirement System, Department of Insurance, Texas A&M University System Administrative & General Offices, and the University of Texas System Administration, duties and responsibilities associated with implementing the provisions of the bill could be accomplished by utilizing existing resources. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: b > td > 323 Teacher Retirement System, 327 Employees Retirement System, 454 Department of Insurance, 529 Health and Human Services Commission, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration 323 Teacher Retirement System, 327 Employees Retirement System, 454 Department of Insurance, 529 Health and Human Services Commission, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration LBB Staff: b > td > JMc, NPe, ER, CST, NV JMc, NPe, ER, CST, NV