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 available 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 also 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	Jennings		DATE TYPED	2/15/2004		HB
SHORT TITLE		Indigent Outpatient Reimbursement Criteria				SB	109/aSFl#1
					ANALYST		Chabot

APPROPRIATION

Appropriation Contained		Estimated Additional Impact		Recurring or Non-Rec	Fund Affected
FY04	FY05	FY04	FY05
		NFI

(Parenthesis ( ) Indicate Expenditure Decreases)

Relates to SB 1: Increase Capacity of Primary Care Clinics

SOURCES OF INFORMATION

LFC Files

Responses Received From

Department of Health (DOH)

Human Services Department (HSD)

New Mexico Health Policy Commission (HPC)

Response Not Received From

Association of Counties

SUMMARY

Synopsis of SFl Amendment #1

Senate Floor Amendment #1 to Senate Bill 109 adds the phrase “with a life-threatening illness or disability” which would restrict reimbursement under the statute to only those cases receiving services in an outpatient setting that have a life-threatening condition.

Synopsis of Original Bill

Senate Bill 109 amends Section 27-5-4N NMSA 1978 to change the following in the definitions of a health care provider:

“(10) a licensed medical doctor or osteopathic physician, dentist, optometrist or expanded practice nurse when providing services in an outpatient setting, as determined by the board, to an indigent patient;”

Significant Issues

According to DOH, outpatient health care providers are not eligible to apply to a county to recover costs for treating indigent persons in an outpatient setting. Only emergency room services are reimbursable. This bill would substantially increase health care professionals eligible for reimbursement through county indigent funds. This bill would reduce the uncompensated care impacts by providing for a source of reimbursement. DOH is not able to assess the impact on these funds in each of the counties. However, the agency states this bill “would likely reduce the funds available to ambulance providers and ambulance services” because the funds would be used for direct care. It also assesses that emergency room care for indigents may be reduced because they could be treated in outpatient settings. Emergency room services are considerably more expensive than outpatient treatment.

ADMINISTRATIVE IMPLICATIONS

County boards will have to determine qualifying services to be reimbursed if this law is enacted and the impact it will have on the county indigent funds.

POSSIBLE QUESTIONS

1. Is there an estimate of how much emergency room services would be reduced and outpatients services increased as a result of enacting this bill?

GAC/prr:yr