LEGISLATIVE FISCAL OFFICE
Fiscal Note
Fiscal Note On: HB 172 HLS 21RS 284
Bill Text Version: ENROLLED
Opp. Chamb. Action:
Proposed Amd.:
Sub. Bill For.:
Date: June 16, 2021 10:19 AM Author: BUTLER
Dept./Agy.: LDH/Medicaid
Subject: dental care Analyst: Shawn Hotstream
MEDICAID EN +$292,352 GF EX See Note Page 1 of 1
Provides for Medicaid coverage of dental care for certain adults with developmental and intellectual disabilities
Proposed law requires the Louisiana Department of Health (LDH) to provide comprehensive dental coverage for certain
individuals with developmental disabilities. The specific population are individuals of age twenty-one or older who are
enrolled in any Medicaid waiver program for persons with developmental or intellectual disabilities. Proposed law is subject
to Centers for Medicaid and Medicare approval. In addition, LDH will not implement until the legislature has appropriated
funding for such coverage.
EXPENDITURES 2021-22 2022-23 2023-24 2024-25 2025-26 5 -YEAR TOTAL
State Gen. Fd. $292,352 $5,300,615 $5,205,541 $5,205,541 $5,205,541 $21,209,590
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other $0 $285,221 $380,295 $380,295 $380,295 $1,426,106
Federal Funds $292,352 $11,677,317 $11,677,317 $11,677,317 $11,677,317 $47,001,620
Local Funds $0 $0 $0 $0 $0 $0
Annual Total $584,704 $17,263,153 $17,263,153 $17,263,153 $17,263,153 $69,637,316
REVENUES 2021-22 2022-23 2023-24 2024-25 2025-26 5 -YEAR TOTAL
State Gen. Fd. $0 $0 $0 $0 $0 $0
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other $0 $285,221 $380,295 $380,295 $380,295 $1,426,106
Federal Funds $0 $0 $0 $0 $0 $0
Local Funds $0 $0 $0 $0 $0 $0
Annual Total $0 $285,221 $380,295 $380,295 $380,295 $1,426,106
EXPENDITURE EXPLANATION
Offering comprehensive dental services to certain populations is projected to increase Medicaid expenditures by
approximately $17 M in FY 22-23 and future fiscal years. The first year cost in the expenditure table above assumes
administrative expenses only associated with rate development and staffing. Proposed law requires Medicaid to cover
comprehensive dental care for adults with developmental disabilities that are currently enrolled in the Medicaid DD waiver
programs. Currently this population receives limited dental benefits.
1) Comprehensive dental benefit provided under managed care.
2) Assumes new benefits for approximately 10,800 individuals a month (# of eligible individuals based on a 5-year average).
3) Individuals currently in one of the 4 DD waiver programs (NOW, Supports, Children’s Choice, and ROW waivers).
3) Estimate $111 per member per month costs, based on Texas model.
4) Additional hospital costs assumed for 50% of the population (individuals requiring at least 1 service in hospital setting).
5) Year one costs (salary for 1 additional support staff and $500,000 actuarial expense for rate setting).
REVENUE EXPLANATION
Statutory Dedication revenues reflected in the revenue table above are collections of a 2.25% premium tax revenues
assuming the new coverage of dental services for adults in the DD waivers are covered under managed care.
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}
Alan M. Boxberger
13.5.2 >= $500,000 Annual Tax or Fee 6.8(G) >= $500,000 Tax or Fee Increase
Change {S & H} or a Net Fee Decrease {S} Staff Director