COMMITTEE ON LEGISLATIVE RESEARCH
OVERSIGHT DIVISION
FISCAL NOTE
L.R. No.: #4234-03
Bill No. SB 1062
Subject: Insurance - Medical; Health Care; Insurance Department
Type: Corrected
Date: February 5, 2002
# Corrected to change L.R. number
FISCAL SUMMARY
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| General Revenue | ($0 to less than $50,000) | ($0 to less than $50,000) | ($0 to less than $50,000) |
| Total Estimated
Net Effect on All State Funds |
($0 to less than $50,000) | ($0 to less than $50,000) | ($0 to less than $50,000) |
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| Federal* | $0 | $0 | $0 |
| Total Estimated
Net Effect on All Federal Funds |
$0 | $0 | $0 |
*Revenues and expenditures would be less than $100,000 and would net to $0
| FUND AFFECTED | FY 2003 | FY 2004 | FY 2005 |
| Local Government | $0 | $0 | $0 |
Numbers within parentheses: ( ) indicate costs or losses.
This fiscal note contains 4 pages.
ASSUMPTION
Official from Missouri Consolidated Health Care Plan, the Missouri Department of Conservation, the Department of Transportation, and the Department of Public Safety - Missouri State Highway Patrol assume this proposal would not fiscally impact their agency.
Officials from the Department of Social Services (DOS) assume this legislation would have a fiscal impact on the Division of Medical Services. DOS states the effect of this proposal is that if a health carrier has one of these certifications, then their network is deemed adequate. DOS has relied on the network access filing as the way to determine network adequacy for MC+ health plans to avoid duplicating requirements across departments. The Center for Medicare and Medicaid Services (CMS) has approved the Department of Insurance's network access filing as Missouri's method of monitoring adequate networks. If the CMS will not approve the method of assuring network adequacy described in this legislation, the Division of Medical Services estimates the cost of looking separately at the networks which would be exempt under this new legislation.
Officials from the Department of Insurance (INS) assume this legislation will have little impact on the number of HMO's which receive network adequacy reviews. INS states currently only one HMO has JCAHO network accreditation. INS states there are 6 HMO's in the Medicare network, but the INS assumes it would still be required to review the non-Medicare portion of an HMO business. It is unknown how many HMO's there are with NCQA accreditation. INS assumes this proposal would not fiscally impact their agency.
| FISCAL IMPACT - State Government | FY 2003
(10 Mo.) |
FY 2004 | FY 2005 |
| GENERAL REVENUE FUND | |||
| Costs - Department of Social Services | |||
| Review of network adequacy | ($0 to less than $50,000) | ($0 to less than $50,000) | ($0 to less than $50,000) |
| ESTIMATED NET EFFECT ON GENERAL REVENUE FUND | ($0 to less than $50,000) | ($0 to less than $50,000) | ($0 to less than $50,000) |
| FEDERAL FUND | |||
| Income - Department of Social Services | |||
| Medicaid reimbursements | $0 to less than $50,000 | $0 to less than $50,000 | $0 to less than $50,000 |
| Costs - Department of Social Services | |||
| Review of network adequacy | ($0 to less than $50,000) | ($0 to less than $50,000) | ($0 to less than $50,000) |
| ESTIMATED NET EFFECT ON | |||
| FEDERAL FUNDS | $0 | $0 | $0 |
| FISCAL IMPACT - Local Government | FY 2003
(10 Mo.) |
FY 2004 | FY 2005 |
| $0 | $0 | $0 |
FISCAL IMPACT - Small Business
This proposal may impact small businesses which are health carriers.
DESCRIPTION
This proposal exempts health carriers from filing access plans with the Department of Insurance, which outlines their network adequacy standards, if the health carrier is an eligible Medicare + Choice organization or has received accreditation from National Committee for Quality Assurance (NCQA) or the Joint Commission on the Accreditation of Health Organizations.
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
Missouri Consolidated Health Care Plan
Department of Insurance
Missouri Department of Conservation
Department of Public Safety -
Missouri State Highway Patrol
Mickey Wilson, CPA
Acting Director
February 5, 2002