Date Requested: February 14, 2019
Time Requested: 01:12 PM
Agency: Health and Human Resources, WV Department of
CBD Number: Version: Bill Number: Resolution Number:
3135 Introduced SB609
CBD Subject: Health



Sources of Revenue:

Other Fund Federal

Legislation creates:

Fiscal Note Summary

Effect this measure will have on costs and revenues of state government.

    The purpose of this bill is to create a pilot program within the Department of Health and Human Resources to implement smart health cards for individuals receiving Medicaid healthcare benefits. The smart health card pilot program would (1) promote interoperability of electronic medical record systems between public and private providers, and the Department; (2) increase the quality of care received by Medicaid recipients, and reduce waste, fraud, and abuse within the Medicaid program; (3) reduce unnecessary and redundant medical procedures, including diagnostic testing, and prevent prescription drug abuse by improving real-time availability of electronic medical records and reports from disparate healthcare systems; (4) reduce administrative burdens and improve payment system efficiency for health care providers accepting payments from the Medicaid program; (5) expand patient ownership of, and access to, his or her individual medical records in a personal cloud-based portal; and (6) improve security protections against identity theft and other unlawful uses of personal health information.
    The known estimated costs for this pilot project for FY 2020 and upon implementation are $11,250,000 and $11,000,000, respectively. The estimated costs do not include other significant costs between the Bureau for Medical Services and other vendors; it is not possible to forecast these estimates.

Fiscal Note Detail

Effect of Proposal Fiscal Year
Fiscal Year
(Upon Full
1. Estmated Total Cost 0 11,250,000 11,000,000
Personal Services 0 0 0
Current Expenses 0 11,250,000 11,000,000
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 0 0
2. Estimated Total Revenues 0 0 0

Explanation of above estimates (including long-range effect):

    The FY2020 known estimated costs for this pilot project is $11,250,000; $10,000,000 annually for Digital Imaging and Communications in Medicine (DICOM) solution, BRIM cybersecurity insurance is $1,000,000, and one-time setup data interface between Medicaid Management Information System (MMIS) and DICOM solution of $250,000. The on-going cost upon implementation of this pilot project is $11,000,000.
    The DICOM cost is strictly after a vendor has been procured to receive the initial data required to load onto a Medicaid member’s card and the installation of a card reader and software for a healthcare provider and client. The estimated cost is approximately $100 per person; the pilot project for 100,000 Medicaid recipients over the age of 55. This also includes the ongoing support for any technical issues or how to use the cards either with a healthcare provider or Medicaid member.
    The cyber security insurance ($1,000,000) is to insure any breaches occurring with the loss of data would be covered by the Board of Risk Insurance Management (BRIM).


    The timeframe for which this legislation to be implemented is not realistic; the proposed legislation states that it is to be implemented on July 1, 2019. The estimate only includes known costs for a select population of 100,000 people over the age of 55. Medicaid does not have a total population of at least 100,000 people 55 and older, therefore it is not possible to pull this sample size from this age group.

    Person submitting Fiscal Note: Bill J. Crouch
    Email Address: