COMMITTEE ON LEGISLATIVE RESEARCH

OVERSIGHT DIVISION



FISCAL NOTE



L.R. No.: 1301-01

Bill No.: SB 459

Subject: Insurance - Medical; Health Care; Insurance Dept.

Type: Original

Date: February 24, 2003




FISCAL SUMMARY



ESTIMATED NET EFFECT ON GENERAL REVENUE FUND
FUND AFFECTED FY 2004 FY 2005 FY 2006
Total Estimated

Net Effect on

General Revenue

Fund

$0 $0 $0



ESTIMATED NET EFFECT ON OTHER STATE FUNDS
FUND AFFECTED FY 2004 FY 2005 FY 2006
Total Estimated

Net Effect on Other

State Funds

$0 $0 $0



Numbers within parentheses: ( ) indicate costs or losses.

This fiscal note contains 4 pages.













ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED FY 2004 FY 2005 FY 2006
Total Estimated

Net Effect on All

Federal Funds

$0 $0 $0



ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED FY 2004 FY 2005 FY 2006
Local Government $0 $0 $0




FISCAL ANALYSIS



ASSUMPTION



Officials from the Missouri Consolidated Health Care Plan and Department of Insurance assume the proposal will not fiscally impact their organizations.



Officials from the Missouri Department of Conservation (MDC) state the proposed legislation would not appear to have a fiscal impact on 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 the proposal on the MHP.



Officials from the Department of Transportation state since this proposal pertains to health services corporations, HMOs, and managed care entities only and does not pertain to the Highway & Patrol Medical Plan, there would be no fiscal impact to the Missouri Highway Transportation Commission or the Highway & Patrol Medical Plan.



Officials from the Department of Social Services - Division of Medical Services (DMS) state the proposed legislation establishes specific criteria, which if met, would allow the director of insurance to deem a managed care plan's network adequate. The specific criteria is for a Medicare + Choice ASSUMPTION (continued)



coordinated health plan, or managed care plans accredited by the National Committee for Quality Assurance (NCQA) or the Joint Commission on the Accreditation of Health Organizations (JCAHO). The listed criterion does not apply to the managed care plans contracted with the DMS for the Medicaid program. Therefore, there is no fiscal impact to the DMS.



FISCAL IMPACT - State Government FY 2004

(10 Mo.)

FY 2005 FY 2006
$0 $0 $0





FISCAL IMPACT - Local Government FY 2004

(10 Mo.)

FY 2005 FY 2006
$0 $0 $0



FISCAL IMPACT - Small Business



No direct fiscal impact to small businesses would be expected as a result of this proposal.



DESCRIPTION



This proposal deems a managed care plan's network as adequate if the managed care plan is: (1) A Medicare + Choice coordinated care plan offered by the health carrier pursuant to a contract with the federal centers for medicare and medicaid services; (2) A managed care plan that has been accredited by National Committee for Quality Assurance (NCQA), and such accreditation is in effect at the time the access plan is filed; or (3) The managed care plan's network has been accredited by the Joint Commission on the Accreditation of Health Organizations at a level of accreditation without type I recommendations or better. If the accreditation applies only to a portion of the managed care plan's network, only the accredited portion will be deemed adequate (Section 354.603).



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

February 24, 2003