| 1 | 1 | | 81R26671 KLA-D |
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| 2 | 2 | | By: Rose H.B. No. 4158 |
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| 3 | 3 | | Substitute the following for H.B. No. 4158: |
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| 4 | 4 | | By: Rose C.S.H.B. No. 4158 |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to reimbursement rates for nursing home services provided |
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| 10 | 10 | | to Medicaid recipients. |
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| 11 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 12 | 12 | | SECTION 1. Section 32.028, Human Resources Code, is amended |
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| 13 | 13 | | by amending Subsection (n) and adding Subsection (q) to read as |
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| 14 | 14 | | follows: |
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| 15 | 15 | | (n) The executive commissioner of the Health and Human |
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| 16 | 16 | | Services Commission [commission] shall ensure that rules governing |
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| 17 | 17 | | the determination of rates paid for nursing home services provide |
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| 18 | 18 | | for the reporting of all revenue received and costs incurred, |
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| 19 | 19 | | without regard to whether a cost is an allowable cost for |
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| 20 | 20 | | reimbursement under the medical assistance program, except: |
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| 21 | 21 | | (1) as provided by Subsection (h); and |
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| 22 | 22 | | (2) a penalty imposed under this chapter or Chapter |
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| 23 | 23 | | 242, Health and Safety Code. |
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| 24 | 24 | | (q) The Health and Human Services Commission shall |
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| 25 | 25 | | periodically conduct an analysis of the base rates paid for nursing |
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| 26 | 26 | | home services provided under the medical assistance program to |
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| 27 | 27 | | enable the executive commissioner of the commission to |
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| 28 | 28 | | appropriately set future rates. In conducting the analysis, the |
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| 29 | 29 | | commission may consider any factors the commission considers |
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| 30 | 30 | | relevant, including: |
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| 31 | 31 | | (1) the costs incurred by nursing homes to provide |
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| 32 | 32 | | services to recipients of medical assistance; |
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| 33 | 33 | | (2) general and health-care specific inflation |
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| 34 | 34 | | issues; |
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| 35 | 35 | | (3) rates paid in other states for comparable |
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| 36 | 36 | | services; and |
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| 37 | 37 | | (4) incentives offered under Subsection (g) to improve |
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| 38 | 38 | | quality of care. |
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| 39 | 39 | | SECTION 2. If before implementing any provision of this Act |
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| 40 | 40 | | a state agency determines that a waiver or authorization from a |
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| 41 | 41 | | federal agency is necessary for implementation of that provision, |
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| 42 | 42 | | the agency affected by the provision shall request the waiver or |
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| 43 | 43 | | authorization and may delay implementing that provision until the |
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| 44 | 44 | | waiver or authorization is granted. |
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| 45 | 45 | | SECTION 3. This Act takes effect September 1, 2009. |
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