COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 3004-03
Bill No.: SB 844
Subject: Boards, Commissions, Committees, Councils; Optometry; Physicians; Health Care; Health Care Professionals; Licenses - Professional
Type: Original
Date: March 11, 2004
FISCAL SUMMARY
| FUND AFFECTED | FY 2005 | FY 2006 | FY 2007 |
| Total Estimated
Net Effect on General Revenue Fund |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2005 | FY 2006 | FY 2007 |
| Total Estimated
Net Effect on Other State Funds |
$0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 4 pages.
| FUND AFFECTED | FY 2005 | FY 2006 | FY 2007 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
| FUND AFFECTED | FY 2005 | FY 2006 | FY 2007 |
| Local Government | $0 | $0 | $0 |
ASSUMPTION
Officials from the Department of Conservation (MDC) state this proposal would not appear to have fiscal impact on MDC funds.
Officials from the Department of Economic Development - Division of Professional Registration assume this proposal, in its present form, will require no additional appropriation.
Officials from the Department of Insurance and the Department of Social Services - Division of Medical Services state this proposal will have no fiscal impact on their respective agencies.
Officials from the Department of Transportation stated this proposal pertains to eye care providers only and does not apply to the Highway and Patrol Medical Plan; therefore, there is no fiscal impact to the Missouri Highway and Transportation Commission or the Department of Transportation.
Officials from the Office of Attorney General (AGO) assume that because this provision would require the Board of Healing Arts and Board of Optometry to promulgate rules and enforce provisions against licensees, the AGO would be required to assist in the rule-making process and licensing matters. The AGO assumes that any potential costs arising from this proposal can be absorbed with existing resources.
ASSUMPTION (continued)
Officials from the Secretary of State's Office (SOS) assumed the rules, regulations and forms issued by the Board of Healing Arts and the Board of Optometry could require as many as 8 pages in the Code of State Regulations. For any given rule, roughly half again as many pages are published in the Missouri Register as in the Code because cost statements, fiscal notes and the like are not repeated in the Code. These costs are estimated. The estimated cost of a page in the Missouri Register is $23. The estimated cost of a page in the Code of State Regulations is $27. The actual costs could be more or less the SOS's estimated cost of $492 for FY 2005. The impact of this legislation in future years is unknown and depends upon the frequency and length of rules, filed, amended, rescinded or withdrawn.
Oversight assumes the SOS could absorb the costs of printing and distributing regulations related to this proposal. If multiple bills pass which require the printing and distribution of regulations at substantial costs, the SOS could request funding through the appropriation process. Any decisions to raise fees to defray costs would likely be made in subsequent fiscal years.
According to officials from the Missouri Consolidated Health Care Plan, this proposal may require plans to enter into new contracts for co-management arrangements. This cost is anticipated to be minimal if the charges between providers are split rather than increased. If a member opts for this arrangement and both providers are in the network, no significant fiscal impact is anticipated.
| FISCAL IMPACT - State Government | FY 2005
(10 Mo.) |
FY 2006 | FY 2007 |
| $0 | $0 | $0 |
| FISCAL IMPACT - Local Government | FY 2005
(10 Mo.) |
FY 2006 | FY 2007 |
| $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 authorizes the practice of surgical co-management under certain conditions relating to the informed consent of patients and the burden of having operating surgeons responsible for
preoperative and postoperative care. Co-managing eye care providers are prohibited from receiving a percentage of the global surgical fee that exceeds the relative value of their
services provided. Patients are required to sign forms indicating they understand the financial arrangements between eye care providers, the provider's license status and qualifications, their right to receive care from other providers, and their right to accept or decline participation in the co-management arrangement.
Nothing in the proposal requires participation of any eye care provider co-management arrangements and nothing will limit tort liability of eye care providers in regard to patient care.
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
Office of Attorney General
Department of Economic Development
Division of Professional Registration
Department of Transportation
Department of Public Safety
Missouri Highway Patrol
Missouri Consolidated Health Care Plan
Department of Insurance
Department of Conservation
Office of Secretary of State
Administrative Rules Division
Department of Social Services
Division of Medical Services
Mickey Wilson, CPA
Director
March 11, 2004