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Committee asks department to study billing options for tuberculosis services; recommends moving $320,000 out of Medicaid line
Summary
Staff told the committee about Utah's tuberculosis funding mix and recommended moving a $320,000 general-fund item out of Medicaid into public-health prevention; the committee supported staff recommendations to study billing public-health TB services to insurance and move the line item.
Legislative staff told the Social Services Appropriations Subcommittee that Utah's tuberculosis (TB) case-management funding is a mix of federal, state and local dollars and recommended a pair of follow-ups: a study of whether local public-health TB services could be billed to insurance and a transfer of a $320,000 general-fund Medicaid line item to the public-health prevention and epidemiology line item.
Russell Franzen briefed the committee that, in 2024, Utah's 13 local health departments received about $280,000 to manage roughly 51 active TB cases and about 63 latent TB infections. Franzen said the total funding for TB programs statewide is about $1.5 million, split roughly 54% state and 46% federal. He identified a $320,000 general-fund appropriation that currently lives inside the Medicaid line item but does not qualify for Medicaid match; the $320,000 includes about $239,000 for treatment costs (drugs and home monitoring) and about $81,000 held to reserve two beds at the University of Utah pulmonary unit for isolation treatment.
Franzen and the agency recommended (1) that the department and local health departments report by Oct. 1, 2026, on the feasibility of billing public-health case-management services for TB to insurance, including implementation costs and potential revenue, and (2) that the legislature transfer the $320,000 from the Medicaid integrated public-health services line item into the public-health and prevention epidemiology line item beginning next fiscal year. Agency staff told the committee they support the recommendations.
Committee members asked about the payor mix and whether additional revenue could be obtained; staff noted many TB patients are uninsured or non'U.S. born, so billing opportunities may be limited. The committee approved the package of staff recommendations that included the TB proposals.
Why it matters: shifting a $320,000 appropriation to the public-health line item aligns the funding with the program that uses it and would improve fiscal clarity; a feasibility study would tell lawmakers whether some public-health TB services could be billed to insurance to recover federal or private funds.
