LEGISLATIVE FISCAL OFFICE
Fiscal Note
Fiscal Note On: HB 489 HLS 24RS 939
Bill Text Version: ENGROSSED
Opp. Chamb. Action:
Proposed Amd.:
Sub. Bill For.:
Date: April 1, 2024 2:32 PM Author: HUGHES
Dept./Agy.: LDH
Subject: maternal health Analyst: Shawn Hotstream
MEDICAID EG GF EX See Note Page 1 of 1
Provides relative to Medicaid services for maternal and infant health
Proposed law provides Medicaid coverage for inpatient and outpatient coverage for maternal or infant healthcare services
when such services are used for medically accepted indication and administered any healthcare facility by any healthcare
professional appropriately licensed to provide such services. Services include, but are not limited to, 1) coverage for dietician
and nutrition consultation support at the referral of the medical provider without the requirements of a diagnosis of
gestational diabetes, 2) coverage for hospital-grade breast pumps for neonatal intensive care unit mothers, 3). coverage for
double electric breast pumps beginning at 20 weeks of gestation, and 4) funding remote patient monitoring programs for
pregnant and postpartum women, which includes the CPT codes 99453, 99454, and 99199.
EXPENDITURES 2024-25 2025-26 2026-27 2027-28 2028-29 5 -YEAR TOTAL
State Gen. Fd. INCREASE INCREASE INCREASE INCREASE INCREASE
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other $0 $0 $0 $0 $0 $0
Federal Funds INCREASE INCREASE INCREASE INCREASE INCREASE
Local Funds $0 $0 $0 $0 $0 $0
Annual Total
REVENUES 2024-25 2025-26 2026-27 2027-28 2028-29 5 -YEAR TOTAL
State Gen. Fd. $0 $0 $0 $0 $0 $0
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other INCREASE INCREASE INCREASE INCREASE INCREASE
Federal Funds $0 $0 $0 $0 $0 $0
Local Funds $0 $0 $0 $0 $0 $0
Annual Total
EXPENDITURE EXPLANATION
Providing Medicaid coverage for inpatient and outpatient maternal and infant healthcare services is anticipated to result in a
significant increase in Medicaid expenditures in FY 25 and future fiscal years. Additional services include nutrition and dietary
consulting services, and remote patient monitoring services.
As an illustrative example, providing such coverage could increase costs to the Medicaid program by approximately $8 M
annually. This estimate is based on the number of deliveries in FY 23 for Medicaid women both managed care and fee for
service (41,517). Additional assumptions are reflected below.
Dietician and Nutrition Services ($1,800,865 expenditures)
1. Cost based on 3 CPT codes, including 97802, 97803, and 97804 (medical nutrition therapy codes)
2. CPT code 97802 take-up rate of 70% of pregnancies, 2 units of utilization per pregnancy, cost from $20.08 - $24.09
3. CPT code 97803 take-up rate of 40% of pregnancies, 2 units of utilization per pregnancy, cost from $17.55 - $21.06
4. CPT code 97804 take-up rate of 3% of pregnancies, 3 units of utilization per pregnancy, cost from $8.97 - $10.77
Remote Patient Monitoring ($5,965,705 expenditures)
1. CPT based on 2 CPT codes, including 99453 and 99454 (Medical device set up and education, provider review)
2. CPT code 99453 take-up rate 30% of pregnancies, one month per beneficiary, cost from $13.03 - $15.96
3. CPT code 99454 take-up rate 30% of pregnancies, monthly billing for 15 months, cost from $30.75 - $37.00
Hospital Grade Breast Pumps
The bill also provides for the usage of hospital grade breast pumps. Information provided by LDH indicates reimbursement
for industrial grade breast pumps is currently covered under the hospital per diem; therefore, this provision of the bill has no
impact.
REVENUE EXPLANATION
Any additional payments to MCOs will result in an increase in premium tax revenues collected by LDH. LDH collects 5.5% of
total MCO premiums, which is deposited into the Medical Assistance Trust Fund (MATF).
Senate Dual Referral Rules House
x 13.5.1 >= $100,000 Annual Fiscal Cost {S & H} x 6.8(F)(1) >= $100,000 SGF Fiscal Cost {H & S}
13.5.2 >= $500,000 Annual Tax or Fee Patrice Thomas
6.8(G) >= $500,000 Tax or Fee Increase
Change {S & H} or a Net Fee Decrease {S} Deputy Fiscal Officer