Bill Summary: Requires all health benefit plans to include coverage for prosthetic devices.

ESTIMATED NET EFFECT ON GENERAL REVENUE FUND
FUND AFFECTED	FY 2009	FY 2010	FY 2011


Total Estimated Net Effect on General Revenue Fund	$0	$0	$0

ESTIMATED NET EFFECT ON OTHER STATE FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011
Insurance Dedicated	Up to $5,450	$0	$0

Total Estimated Net Effect on Other State Funds	Up to $5,450	$0	$0

ESTIMATED NET EFFECT ON FEDERAL FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011


Total Estimated Net Effect on All Federal Funds	$0	$0	$0

ESTIMATED NET EFFECT ON FULL TIME EQUIVALENT (FTE)
FUND AFFECTED	FY 2009	FY 2010	FY 2011


Total Estimated Net Effect on FTE	0	0	0

☐ Estimated Total Net Effect on All funds expected to exceed $100,000 savings or (cost).

☐ Estimated Net Effect on General Revenue Fund expected to exceed $100,000 (cost).

ESTIMATED NET EFFECT ON LOCAL FUNDS
FUND AFFECTED	FY 2009	FY 2010	FY 2011
Local Government	$0	$0	$0

Officials from the Department of Public Safety (DPS) - Director’s Office assume the proposal will have no fiscal impact on their organization.

Officials from the DPS - Missouri State Highway Patrol (MHP) defer to the Missouri Department of Transportation for response regarding the potential fiscal impact of this proposal on their organization.

Officials from the Missouri Department of Conservation (MDC) assume the proposal will not fiscally impact MDC funds.

Officials from the Missouri Department of Transportation (DOT) state currently the DOT/MHP Medical Plan provides coverage for prosthetic devices for arms, legs, and eyes, except for remote control devices or devices employing robotics or computerized prostheses. The coverage include the initial purchase, fitting, necessary adjustments and supplies, and repair and replacement if deemed medically necessary.

Based on information from Meritain health, DOT’s current claims administrator, the DOT’s/MHP’s current plan coverage meets and exceeds that allowed by Medicare’s national average payment. Therefore, the DOT assumes the proposal would have no fiscal impact on the DOT or MHP. However, the DOT was unable to determine if Medicare covers computerized prosthetic devices. It so, then the DOT/MHPO would have a fiscal impact as a result of this legislation.

Officials from the Missouri Consolidated Health Care Plan (HCP) state the HCP currently covers prosthetic equipment that meets the basic medical need as well as replacement and repair due to normal wear and tear. Therefore, this legislation does not fiscally impact the HCP.

Officials from the Department of Social Services - MO HealthNet Division (MHD) state their division is affected by this legislation because of contracts with health maintenance organizations licensed by the Department of Insurance, Financial Institutions and Professional Registration.

Currently prosthetic arms and legs are covered services under the MO HealthNet program. In

FY 07, one hundred thirty-one (131) patients received prosthetic arms and legs which cost $312,043. This is approximately equal to Missouri’s Medicare rates for prosthetic arms and legs. Therefore, the MHD assumes no fiscal impact.

Officials from the Department of Insurance, Financial Institutions and Professional Registration (DIFP) estimate approximately 109 insurers would be required to submit amendments to their policies to comply with the legislation. Policy amendments must be submitted to the department for review along with a $50 filing fee. One-time additional revenues to the Insurance Dedicated Fund are estimated to be up to $5,450.

Additional staff and expenses are not being requested with this single proposal, but if multiple proposals pass during the legislative session which require policy form reviews, the DIFP will need to request additional staff to handle the increase in workload.

This proposal may impact small businesses that provide health insurance for employees if insurance premiums increase as a result of the added coverage requirement.

This proposal requires, by January 1, 2009, all health insurance benefit plans to provide coverage for certain prosthetic devices and related services and supplies that meet minimum standards as

This legislation is not federally mandated, would not duplicate any other program and would not require additional capital improvements or rental space.

FISCAL IMPACT - State Government	FY 2009 (10 Mo.)	FY 2010	FY 2011
INSURANCE DEDICATED FUND

Income - DIFP
Form filing fees	Up to $5,450	$0	$0

ESTIMATED NET EFFECT ON INSURANCE DEDICATED FUND	Up to $5,450	$0	$0