Medicaid benefit recovery.

13LSO-0173.C2

FISCAL NOTE

The revenue and expenditure fiscal impacts on the state through the Wyoming Department of Health (WDH), Wyoming Department of Family Services (DFS), and the Wyoming Attorney General's Office (AG) are indeterminable due to the following reasons:

· Current statistics on the number of fathers and their sufficiency of income and assets on which to base recovery efforts are difficult to determine;

· Actual collections (revenue gained) would be determined based on the total number of cases and the resulting coordination between the WDH, DFS, and AG.

· The WDH's Division of Healthcare Financing currently contracts through a memorandum of understanding (MOU) with the DFS' Child Support Enforcement group to collect medical support information and medical support payments.  If this agreement can be expanded potential expenditure increases on the WDH may be lessened.

· Currently WDH collects information at the time of application on fathers who are living in the home with the mother.  Beginning in 2014 the Medicaid rules change based on the requirements of the Affordable Care Act and Medicaid eligibility determinations shall be made using the income of tax filing units.  If a pregnant women and the father of the baby are unmarried and living in the same home they may not be in the same tax filing unit and therefore the father’s income may no longer be countable to the pregnant women’s household.

· If existing child support enforcement attorneys around the state take on this additional responsibility, the impact on the AG would be negligible, amounting to a couple of additional appeals each year.  If the Medicaid program must take on the responsibility, it would mean either that Medicaid contract with an outside entity to do the legal work around the state or that the AG take on the responsibility.  If the AG must take on the responsibility it would likely require a new unit in the office with the resources to travel around the state or to otherwise appear in the courts in these actions to recoup the funds.

In addition to the notes above, as well as unanticipated factors, the administrative impact to the state is indeterminable until each agency's responsibilities are fully realized when the bill's requirements are implemented.

Prepared by:    Michael Swank, LSO                   Phone:     777-7881

(Information provided by Paul Yaksic, Wyoming Department of Family Services, 777-5474; Laura Gorny, Wyoming Attorney General's Office, 777-7840; Eric McVicker, Wyoming Department of Health, 777-8205)