TO ALLOW A PHYSICIAN OR HEALTHCARE PROVIDER TO OFFER COGNITIVE ASSESSMENTS FOR CERTAIN PATIENTS; AND TO MANDATE THAT INSURANCE POLICIES COVER ASSESSMENTS FOR COGNITIVE FUNCTION FOR CERTAIN PATIENTS.

segalco.com PURPOSE OF BILL: HB 1164 To require a physician or healthcare provider to offer cognitive assessments for certain patients; and to mandate that insurance policies cover assessments for cognitive function for certain patients. ACTUARIAL STATEMENT The Fiscal Impact Statement was prepared according to generally accepted actuarial principles and practices, in compliance with ACT 112. The Statement provides an estimate of the financial and actuarial effect of the proposed change(s) on the Plans, if possible. The Statement makes no comment or opinion with regard to the merits of the measure for which the Statement is prepared; however, any identified technical or mechanical defects have been noted. We have reviewed the input and results of our analysis for reasonableness and relied upon the data and information provided by the Plans and their Claims Processing Contractors. 3/5/2025 _________________________________________ _________________ Patrick Klein, FSA, MAAA Date Vice President, Segal 3/5/2025 _________________________________________ __________________ Matthew Kersting, FSA, MAAA Date Vice President, Segal PROJECTED COSTS Plan Design Change Estimated Cost/(Savings) Pl

AME-6577 - Potential Population for Dementia Low High Low Estimate High Estimate DescriptionPopulationEstimate Estimate PopulationPopulation %% Current Eligible Members 65 and over98,5392% 1,9715% 4,927 Current Eligible Members 60 and 6438,5692% 7715% 1,928 Unduplicated Recipient Count for those with Down Syndrome diagnosis1522% 35% 8 Unduplicated Recipient Count for those with TBI diagnosis1,8072% 3 65% 9 0 Overall Unduplicated Count for 60+, DS, and TBI Diagnosis40,5282% 8115% 2,026 Total Other Medicaid Population99,3682% 1,9875% 4,968 Estimated Population (Exc 65+) 2,798 6,995 Medicare Copay Estimated Amount$0.00$0.00 99483 CPT Rate90% of the Medicare$241.20$241.20 Total Computable$674,858$1,687,146 FMAP69.71%69.71% Federal Share$470,444$1,176,109 State Share$204,415$511,036 We estimated a graded range impact for a cognitive assessment for the above populations. All recipients excluding 65+ were estimated with 99483 CPT Code for Cognitive Assessment. We estimate a low impact of $675 thousand total computable, or $204 thousand State Share and a high impact of $1.7 Million total computable, or $511 thousand State Share. Prepared by Arkansas Department of Human Services