Texas 2009 - 81st Regular

Texas House Bill HB852 Compare Versions

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Old	New	Differences
1	1	81R9142 CLG-D
2	2	By: Smith of Tarrant H.B. No. 852
3	3	Substitute the following for H.B. No. 852:
4	4	By: Coleman C.S.H.B. No. 852
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to nonpayment of hospitals under the state Medicaid
10	10	program for certain preventable adverse conditions.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
13	13	is amended by adding Section 32.02805 to read as follows:
14	14	Sec. 32.02805. NONPAYMENT OF HOSPITALS FOR PREVENTABLE
15	15	ADVERSE CONDITIONS. (a) The department in its adoption of
16	16	reasonable rules and standards governing the determination of rates
17	17	paid for inpatient hospital services on a prospective payment basis
18	18	shall assure that a hospital may not receive additional payment
19	19	associated with any of the following preventable adverse conditions
20	20	involving a recipient of medical assistance during the recipient's
21	21	hospitalization:
22	22	(1) a foreign object retained after surgery;
23	23	(2) surgery performed on the wrong body part;
24	24	(3) surgery performed on the wrong person;
25	25	(4) the wrong surgical procedure performed on the
26	26	recipient;
27	27	(5) intravascular air embolism;
28	28	(6) blood or blood product incompatibility;
29	29	(7) a stage three or four pressure ulcer;
30	30	(8) a fall or trauma resulting in a fracture,
31	31	dislocation, intracranial injury, or crushing injury;
32	32	(9) a burn or electric shock;
33	33	(10) a catheter-associated urinary tract infection;
34	34	(11) a vascular catheter-associated infection;
35	35	(12) a manifestation of poor glycemic control,
36	36	including diabetic ketoacidosis, nonketotic hyperosmolar coma,
37	37	hypoglycemic coma, secondary diabetes with ketoacidosis, and
38	38	secondary diabetes with hyperosmolarity;
39	39	(13) a surgical site infection or mediastinitis
40	40	following a coronary artery bypass graft;
41	41	(14) a surgical site infection following certain
42	42	orthopedic procedures of the spine, neck, shoulder, or elbow;
43	43	(15) a surgical site infection following bariatric
44	44	surgery for obesity, including laparoscopic gastric bypass
45	45	surgery, gastroenterostomy, and laparoscopic gastric restrictive
46	46	surgery; and
47	47	(16) deep vein thrombosis and pulmonary embolism
48	48	following certain orthopedic procedures, including total knee
49	49	replacement or hip replacement.
50	50	(b) The executive commissioner of the Health and Human
51	51	Services Commission may adopt rules to define additional
52	52	preventable adverse conditions for which a hospital shall be denied
53	53	additional payment under this section. In adopting rules under
54	54	this subsection, the executive commissioner may consider only the
55	55	same types of health care-associated adverse conditions or events
56	56	for which the Medicare program will not provide additional payment
57	57	under a policy adopted by the Centers for Medicare and Medicaid
58	58	Services.
59	59	(c) The department's nonpayment of a hospital under this
60	60	section does not in itself create civil liability and is not subject
61	61	to discovery or admissible in any civil action against the
62	62	hospital.
63	63	(d) The Health and Human Services Commission shall compile
64	64	information regarding the denial of payment to hospitals under this
65	65	section.
66	66	(e) The Health and Human Services Commission shall make
67	67	statistical information derived from the data compiled under
68	68	Subsection (d) readily available in a user-friendly format on the
69	69	commission's website.
70	70	(f) The Health and Human Services Commission may not provide
71	71	information under Subsection (e) in a manner that identifies a
72	72	recipient of medical assistance.
73	73	SECTION 2. Not later than November 1, 2009, the executive
74	74	commissioner of the Health and Human Services Commission shall
75	75	adopt rules necessary to implement Section 32.02805, Human
76	76	Resources Code, as added by this Act.
77	77	SECTION 3. Section 32.02805, Human Resources Code, as added
78	78	by this Act, applies only to a preventable adverse condition
79	79	occurring on or after the effective date of the rules adopted by the
80	80	executive commissioner of the Health and Human Services Commission
81	81	under Section 2 of this Act.
82	82	SECTION 4. If before implementing any provision of this Act
83	83	a state agency determines that a waiver or authorization from a
84	84	federal agency is necessary for implementation of that provision,
85	85	the agency affected by the provision shall request the waiver or
86	86	authorization and may delay implementing that provision until the
87	87	waiver or authorization is granted.
88	88	SECTION 5. This Act takes effect September 1, 2009.