COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: 2140-01
Bill No.: SB 578
Subject: Health Care; Hospitals; Medicaid; Social Services Department
Type: Original
Date: March 13, 2001
FISCAL SUMMARY
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| Federal Reimbursement Allowance* | $0 | $0 | $0 |
| Total Estimated
Net Effect on All State Funds |
$0 | $0 | $0 |
*Revenues and expenditures of more than $382 million annually and would net to $0.
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| Federal | $0 | $0 | $0 |
| Total Estimated
Net Effect on All Federal Funds* |
$0 | $0 | $0 |
*Revenues and expenditures of more than $599 million annually and would net to $0.
| FUND AFFECTED | FY 2002 | FY 2003 | FY 2004 |
| Local Government | $0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 4 pages.
ASSUMPTION
Officials from the Department of Social Services - Division of Medical Services (DMS) assume this proposal would not fiscally impact their agency. DMS states that if the federal reimbursement allowance (FRA) program is not extended, additional funding would be needed to maintain the current level of services. DMS assumes the FRA program would not end before the expiration date. DMS also assumes the 85% limit would be met. DMS assumes that FY 2002 would be based on nine months and FY 2003 and FY 2004 would be based on twelve months. The federal participation rate use is 61.06%.
The Barton County Memorial Hospital, the Cass Medical Center, the Cooper County Memorial Hospital, the Excelsior Springs Medical Center, the Lincoln County Memorial Hospital, the Pemiscot Memorial Hospital, the Phelps County Regional Medical Center, the Ray County Memorial Hospital, the Samaritan Memorial Hospital, and the Ste. Genevieve County Memorial Hospital officials did not respond to our fiscal impact request.
| FISCAL IMPACT - State Government | FY 2002
(9 Mo.) |
FY 2003 | FY 2004 |
| FEDERAL REIMBURSEMENT ALLOWANCE FUND | |||
| Income - Department of Social Services | |||
| Assessment of hospitals | $286,566,737 | $382,088,983 | $382,088,983 |
| Costs - Department of Social Services | |||
| Program specific expenditures | ($286,566,737) | ($382,088,983) | ($382,088,983) |
| ESTIMATED NET EFFECT ON FEDERAL REIMBURSEMENT ALLOWANCE FUND |
$0 |
$0 |
$0 |
| FEDERAL FUNDS | |||
| Income - Department of Social Services | |||
| Medicaid match | $449,351,951 | $599,135,935 | $599,135,935 |
| Costs - Department of Social Services | |||
| Program specific expenditures | ($449,351,951) | ($599,135,935) | ($599,135,935) |
| ESTIMATED NET EFFECT ON FEDERAL FUNDS |
$0 |
$0 |
$0 |
| FISCAL IMPACT - Local Government | FY 2002
(10 Mo.) |
FY 2003 | FY 2004 |
| $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 would revise the Hospital Federal Reimbursement Allowance Program. Section 208.471, RSMo, currently requires the Department of Social Services to make payments to Medicaid provider hospitals. New language would provide that prior to June 30, 2002, the payment would be in an annual amount. Beginning July 1, 2002, Sections 208.453 through 208.480 would expire 180 days after the end of any fiscal year in which the aggregate federal reimbursement allowance on hospitals is more than eighty-five percent of the sum of direct Medicaid payments. Uninsured add-on payments and graduate medical education payments would be adjusted to comply with the percentage, unless made during the 180 day period. Direct Medicaid payments, uninsured add-on payments, and enhanced graduate medical education
payments would be specifically outlined. The Division of Medical Services may currently provide alternative reimbursement for outpatient services. New language would allow this reimbursement to include payments to clinics serving low-income, uninsured patients. Section 208.480 provides that Sections 208.453 through 208.480 would expire on September 30, 2004.
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 Social Services
NOT RESPONDING: Barton County Memorial Hospital, Cass Medical Center, Cooper County Memorial Hospital, Excelsior Springs Medical Center, Lincoln County Memorial Hospital, Pemiscot Memorial Hospital, Phelps County Regional Medical Center, Ray County Memorial Hospital, Samaritan Memorial Hospital, Ste. Genevieve County Memorial Hospital
Jeanne Jarrett, CPA
Director
March 13, 2001