OFFICE OF FISCAL ANALYSIS

Legislative Office Building, Room 5200

Hartford, CT 06106 ↓ (860) 240-0200

http://www.cga.ct.gov/ofa

sHB-5378

AN ACT IMPLEMENTING THE RECOMMENDATIONS OF THE LEGISLATIVE PROGRAM REVIEW AND INVESTIGATIONS COMMITTEE CONCERNING MEDICAID-FUNDED EMERGENCY DEPARTMENT VISITS.

As Amended by House "A" (LCO 4884)

House Calendar No.: 139

OFA Fiscal Note

State Impact:

Municipal Impact: None

Explanation

Sections 1 and 3 through 5 require the Departments of Social Services (DSS), Mental Health and Addiction Services (DMHAS) and Children and Families (DCF), through their contract with their administrative services organizations (ASO), to provide intensive case management (ICM) services to Medicaid clients, including those with behavioral health needs, effective July 1, 2016. ICM is already being utilized in the Medicaid population. To the extent that this bill results in additional clients being served by ICM or results in an impact on the mix of services being utilized by Medicaid clients, there may be savings to the state. A 1% reduction in total annual emergency department expenditures will result in a $2.3 million savings. The ASO ICM services in the bill are targeted at all Medicaid clients who might benefit from ICM, but particularly high utilizers of emergency departments. The bill requires various reporting and assessment requirements of the ASO which are not anticipated to result in a cost to the state Medicaid program. Lastly, the bill requires DSS and DMHAS, in consultation with the Office of Policy and Management to ensure all expenditures for ICM eligible for reimbursement be submitted to the Centers for Medicare and Medicaid Services.

Section 2 does not result in a fiscal impact to the DSS. The section requires DSS to print the name and contact information of the Medicaid client's primary care physician, if one has been chosen, on a state issued Medicaid benefits card.

The bill also requires DSS to report certain information to the General Assembly. This is not anticipated to result in any fiscal impact.

House “A” moved the effective date of the first five sections of the underlying bill to July 1, 2016. This delayed the fiscal impact identified in the underlying bill. The amendment also added the provision concerning the report to the General Assembly.

The Out Years

The annualized ongoing fiscal impact identified above would continue into the future subject to inflation.