COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 1286-01
Bill No.: Perfected SB 407
Subject: Health Care; Health Care Professionals; Insurance - Medical; Medical Procedures and Personnel.
Type: Original
Date: April 1, 2003
FISCAL SUMMARY
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| General Revenue | (Unknown) | (Unknown) | (Unknown) |
| Total Estimated
Net Effect on General Revenue Fund |
(Unknown) | (Unknown) | (Unknown) |
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Insurance Dedicated | $8,000 | $0 | $0 |
| Other State Funds | (Unknown) | (Unknown) | (Unknown) |
| Total Estimated
Net Effect on Other State Funds |
(Unknown) | (Unknown) | (Unknown) |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 5 pages.
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Federal Funds | (Unknown) | (Unknown) | (Unknown) |
| Total Estimated
Net Effect on All Federal Funds |
(Unknown) | (Unknown) | (Unknown) |
| FUND AFFECTED | FY 2004 | FY 2005 | FY 2006 |
| Local Government | (Unknown) | (Unknown) | (Unknown) |
ASSUMPTION
Officials from the Department of Social Services assume the proposal will not fiscally impact their organization.
Officials from the Missouri Department of Conservation (MDC) state the proposal does not appear to affect MDC funds.
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.
Officials from the Department of Transportation state because the language removed by this legislation does not mandate any additional benefit coverage, there will be no fiscal impact to the Highway & Patrol Medical Plan.
Officials from the Department of Insurance (INS) state the INS estimates 160 insurers and HMOs would submit amendments to their policies as a result of this proposal. Policy amendments must be
ASSUMPTION (continued)
submitted to the INS for review along with a $50 filing fee. One-time additional revenues to the Insurance Dedicated Fund are estimated to be $8,000.
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 review, the INS will need to request additional staff to handle the increase in the workload.
Officials from the Missouri Consolidated Health Care Plan (HCP) state many insurers believe that requiring the medical plan to cover clinical trials for cancer and other life threatening conditions could result in an increase in the plan's financial risk. Since the treatments may vary and only a few providers would be able to administer the treatments, the cost has the potential to become significant. To reduce this risk, the plan may transfer these additional costs to the members through an increase of premium.
In contrast, some current research suggests that the cost of clinical trials may not significantly differ from that for standard cancer treatment. One study observed a clinical trial cost difference, as compared to standard cancer treatment, ranging from -10% to 23%. However, some of these studies only focused on Phase II and Phase III trials.
Forecasting the consequential financial impact of mandatory coverage of phase III and IV cancer trials is extremely difficult and, therefore, unknown.
This proposal will result in an increase in Total State Revenue.
| FISCAL IMPACT - State Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| GENERAL REVENUE | |||
| Costs - Missouri Consolidated Health Care Plan | |||
| Increase in contributions | (Unknown) | (Unknown) | (Unknown) |
| ESTIMATED NET EFFECT ON GENERAL REVENUE |
(Unknown) |
(Unknown) |
(Unknown) |
| FISCAL IMPACT - State Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| INSURANCE DEDICATED FUND | |||
| Income - Department of Insurance | |||
| Form filing fees | $8,000 | $0 | $0 |
| ESTIMATED NET EFFECT ON INSURANCE DEDICATED FUND | $8,000 | $0 | $0 |
| OTHER FUNDS | |||
| Costs - Missouri Consolidated Health Care Plan | |||
| Increase in contributions | (Unknown) | (Unknown) | (Unknown) |
| ESTIMATED NET EFFECT ON OTHER FUNDS |
(Unknown) |
(Unknown) |
(Unknown) |
| FEDERAL FUNDS | |||
| Costs - Missouri Consolidated Health Care Plan | |||
| Increase in contributions | (Unknown) | (Unknown) | (Unknown) |
| ESTIMATED NET EFFECT ON FEDERAL FUNDS |
(Unknown) |
(Unknown) |
(Unknown) |
| FISCAL IMPACT - Local Government | FY 2004
(10 Mo.) |
FY 2005 | FY 2006 |
| ALL POLITICAL SUBDIVISIONS | |||
| Costs - All Political Subdivisions | |||
| Increase in contributions | (Unknown) | (Unknown) | (Unknown) |
| ESTIMATED NET EFFECT ON ALL POLITICAL SUBDIVISIONS |
(Unknown) |
(Unknown) |
(Unknown) |
FISCAL IMPACT - Small Business
The proposal could result in an increase in small business insurance premium costs.
DESCRIPTION
This proposal requires health insurance policies to provide coverage for routine patient costs incurred for FDA- approved drugs and devices, regardless of whether the drugs and devices were approved for use in treating the patient's particular condition.
Entities seeking coverage for clinical trials do not have to post electronically whether the trial is for the treatment of cancer or other life-threatening disease.
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
April 1, 2003