COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 0147-01
Bill No.: SB 154
Subject: Health Care; Insurance - Medical; Insurance Dept.
Type: Original
Date: January 22, 2003
FISCAL SUMMARY
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Total Estimated
Net Effect on General Revenue Fund |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Insurance Dedicated | $0 to $1,000 | $0 | $0 |
| Total Estimated
Net Effect on All State Funds |
$0 to $1,000 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 4 pages.
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Local Government | $0 | $0 | $0 |
ASSUMPTION
Officials from the Department of Conservation assume the proposal will have no fiscal impact on their organization.
Officials from the Missouri Consolidated Health Care Plan assume the proposal will not fiscally impact their organization since its third-party administrator does not change the formulary mid-year. The formulary is reviewed once a year with any changes or deletions occurring at January 1 of each year.
Officials from the Department of Social Services - Division of Medical Services (DMS) state there is no impact to the DMS assuming Medicaid managed care plans can continue to prior authorize medications on the drug formulary as they currently are able to do. DMS also assumes that the DMS can increase the co-pays for the 1115 waiver premium group as allowed under Section 208.640.
Officials from the Department of Public Safety - Missouri Highway Patrol (MHP) defer to the Department of Transportation for response regarding the fiscal impact of this proposal on the MHP.
ASSUMPTION (continued)
Officials from the Department of Transportation state currently the Highway and Patrol Medical Plan does not fall within the definition of health carrier as defined in 376.150, RSMo, and the Medical Plan's pharmacy benefit does not include a restricted drug formulary. Assuming that the Medical Plan would make no benefit coverage changes mid-year, there would be no fiscal impact to the Missouri Highway Transportation Commission or the Highway & Patrol Medical Plan.
Officials from the Department of Insurance (INS) state additional staff and expenses are not being requested with this single proposal, but if multiple proposals pass during the legislative session which require policy form amendments and reviews, INS will need to request additional staff to handle the increase in workload.
Insurers and HMOs would be required to amend their policies to comply with legislation if their current policies contain language which conflict with the mandates of this bill. Policy amendments must be submitted to the department along with a $50 filing fee. The INS estimates that the number of health carriers who would need to modify their policies would be small and a range of $0 to $1,000 in revenue is projected. Filing fees are deposited to the Insurance Dedicated Fund.
The proposed legislation will result in an increase in Total State Revenue.
| FISCAL IMPACT - State Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| INSURANCE DEDICATED FUND | |||
| Income - Department of Insurance | |||
| Policy Form Filing Fees | $0 to $1,000 | $0 | $0 |
| ESTIMATED NET EFFECT ON INSURANCE DEDICATED FUND |
$0 to $1,000 |
$0 |
$0 |
| FISCAL IMPACT - Local Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| $0 | $0 | $0 |
FISCAL IMPACT - Small Business
Small health maintenance organizations (HMOs) could be affected by this proposal.
DESCRIPTION
Health carriers, as defined in section 376.1350 would not be allowed to change drug formularies except at the beginning of each policy's anniversary date. New prescription drugs may be added to the health carrier's formulary during such a period. Health carriers would not be able to increase an enrollee's co-payment, co-insurance or other out-of pocket expense for formulary drugs except at the beginning of each policy's annual anniversary date.
This legislation is not federally mandated, would not duplicate any other program and would not require additional capital improvements or rental space.
SOURCES OF INFORMATION
Department of Transportation
Department of Social Services
Department of Public Safety - Missouri Highway Patrol
Missouri Consolidated Health Care Plan
Department of Insurance
Missouri Department of Conservation
Mickey Wilson, CPA
Director
January 22, 2003