Fiscal impact reports (FIRs) are prepared by the Legislative Finance Committee (LFC) for standing finance
committees of the NM Legislature. The LFC does not assume responsibility for the accuracy of these reports
if they are used for other purposes.
Current FIRs (in HTML & Adobe PDF formats) are a vailable on the NM Legislative Website (legis.state.nm.us).
Adobe PDF versions include all attachments, whereas HTML versions may not. Previously issued FIRs and
attachments may be obtained from the LFC in Suite 101 of the State Capitol Building North.
F I S C A L I M P A C T R E P O R T
SPONSOR Campos
ORIGINAL DATE
LAST UPDATED
2/21/07
HB
SHORT TITLE Oriental Medicine Medicaid Reimbursement
SB 966
ANALYST Weber
ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT (dollars in thousands)
FY07
FY08
FY09 3 Year
Total Cost
Recurring
or Non-Rec
Fund
Affected
Total
$1,769.1 $1,769.1 $3,538.2 Recurring General
$2,030.9 $2,030.9 $4,061.8 Recurring Federal
Medicaid
(Parenthesis ( ) Indicate Expenditure Decreases)
SOURCES OF INFORMATION
LFC Files
Responses Received From
Human Services Department (HSD)
SUMMARY
Synopsis of Bill
Senate Bill 966 requires the Human Services Department Medical Assistance Division to by rule
provide medical assistance, including the services of licensed doctors of oriental medicine,
licensed chiropractic physicians and licensed dental hygienists in collaborating practice, to
persons eligible for public assistance programs under the federal act.
FISCAL IMPLICATIONS
No appropriation is included to accomplish the intent of the bill but HSD indicates there would
be a requirement of $1.8 million form the general fund.
HSD indicates that including chiropractors and doctors of oriental medicine in Medicaid’s
eligible providers and health care benefits, would create a need for approximately $3.1 million to
support these new providers and services. Most of the Medicaid services provided by a
chiropractor would be eligible for federal match funds. However, acupuncture costs could only
be paid out of state general fund.
The cost estimates are based on the assumption that (1) approximately 2% of all Medicaid
recipients (both fee-for-service and managed care) would use twelve (12) visits to a chiropractor
pg_0002
Senate Bill 966 – Page
2
OR doctor of oriental medicine
on an annual basis; and (2) federal funding would not be
available for 25% of the services – primarily those provided by doctors of oriental medicine.
The total estimated expenditure is estimated to be $3.8 million ($1,769.1 from the state General
Fund and $2,030.9 from federal Medicaid leveraged funds.) The funds would have to be
recurring.
Medicaid currently reimburses licensed dental hygienists. Therefore, there would be no fiscal
impact for inclusion of these services.
The Medicaid Management Information System would require changes to accommodate a new
provider type and specialty, and new procedure codes. These changes would be completed using
existing resources
.
SIGNIFICANT ISSUES
HSD also adds that Medicaid does not currently reimburse for services provided by licensed
chiropractors except for paying the co-insurance and deductible following Medicare payment.
States do have the option under federal law to cover chiropractic spinal manipulation in their
Medicaid programs.
Medicaid does not currently reimburse for services provided by licensed doctors of oriental
medicine. Generally, a state Medicaid program is not allowed to cover acupuncture with federal
matching funds. The federally government is still studying acupuncture to determine if it should
be added to the list of services that Medicaid can opt to cover. Therefore, acupuncture costs
could only be paid out of state General Fund.
MW/mt