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F I S C A L I M P A C T R E P O R T

SPONSOR:	Knauer		DATE TYPED:	02/04/02		HB	HJM-66
SHORT TITLE:		Nutritionists to become Medicaid Providers				SB
					ANALYST:		Weber

APPROPRIATION

Appropriation Contained		Estimated Additional Impact		Recurring or Non-Rec	Fund Affected
FY02	FY03	FY02	FY03
			NFI

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

Human Services Department

SUMMARY

Synopsis of Bill

House Joint Memorial 66 resolves that the Human Services Department be requested to study the cost and health benefits of allowing licensed nutritionists to become independent Medicaid providers and bill for their services and to make appropriate regulatory changes to facilitate this change. In addition, the Human Services Department should report its findings and recommendations to the legislative health and human services committee at its October 2002 meeting.

Significant Issues

The memorial states that the direct cost of medical care and the indirect costs of lost productivity and early death from diabetes totaled $762,400,000 in New Mexico in 1997. Proper nutrition care to children who are at risk of developing obesity and type two diabetes nationwide could save as much as one hundred billion dollars. Nutrition professionals in New Mexico are unable to obtain independent provider status under Medicaid.

The Medicaid program currently reimburses for services, which may include nutrition services, provided by:

• Individuals licensed to practice medicine or osteopathy;
• Facilities licensed as diagnostic and treatment centers;
• Individuals licensed as Certified Nurse Practitioners by the New Mexico Board of Nursing; and
• Physician Assistants certified by the National Commission on Certification of Physician’s Assistance, Inc., and licensed by the New Mexico Board of Medical Examiners.

Within their scope of practice, each of these providers is expected to give dietary instruction to treat diabetes, obesity, kidney disease, and heart disease.

In addition, nutrition services are offered and reimbursed as a separate benefit for New Mexico Medicaid recipients who are pregnant or under 21 years of age. These services include nutritional assessment and counseling by:

• Individuals licensed to practice medicine or osteopathy and the groups they form,
• Hospitals,
• Rural health clinics,
• Federally qualified health centers (FQHC),
• Institutional physician components, and
• Public health agencies.

These providers are permitted to form contractual or employment relationships with dieticians and nutritionists.

HJM 66 would request that HSD consider allowing licensed nutritionists to bill the Medicaid program as independent practitioners. HJM 66 would also request the department to expand its coverage of nutrition services.

FISCAL IMPLICATIONS

None

MW/njw

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