Texas 2009 - 81st Regular

Texas Senate Bill SB2278 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R7673 TJS-F
2	2	By: Ellis S.B. No. 2278
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to charity care provided by certain nonprofit hospitals.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 311.031(16), Health and Safety Code, is
10	10	amended to read as follows:
11	11	(16) "Unreimbursed costs" means the costs a hospital
12	12	incurs for providing individuals inpatient and outpatient services
13	13	for which the hospital does not receive reimbursement from any
14	14	source, including a third-party payor. The term does not include
15	15	payor discounts or contractual adjustments in reimbursements to
16	16	third-party payors or costs for which the hospital receives any
17	17	partial payment for the related service, [after subtracting
18	18	payments received from any source for such services] including but
19	19	not limited to the following: third-party insurance payments;
20	20	Medicare payments; Medicaid payments; Medicare education
21	21	reimbursements; payments from Tricare or the Civilian Health and
22	22	Medical Program of the Uniformed Services; state reimbursements for
23	23	education; payments from drug companies to pursue research; grant
24	24	funds for research; and disproportionate share payments. [For
25	25	purposes of this definition, the term "costs" shall be calculated
26	26	by applying the cost to charge ratios derived in accordance with
27	27	generally accepted accounting principles for hospitals to billed
28	28	charges. The calculation of the cost to charge ratios shall be
29	29	based on the most recently completed and audited prior fiscal year
30	30	of the hospital or hospital system. Prior to January 1, 1996, for
31	31	purposes of this definition, charitable contributions and grants to
32	32	a hospital, including transfers from endowment or other funds
33	33	controlled by the hospital or its nonprofit supporting entities,
34	34	shall not be subtracted from the costs of providing services for
35	35	purposes of determining unreimbursed costs. After January 1, 1996,
36	36	for purposes of this definition, charitable contributions and
37	37	grants to a hospital, including transfers from endowment or other
38	38	funds controlled by the hospital or its nonprofit supporting
39	39	entities, shall not be subtracted from the costs of providing
40	40	services for purposes of determining the unreimbursed costs of
41	41	charity care and government-sponsored indigent health care.]
42	42	SECTION 2. Section 311.033(a), Health and Safety Code, is
43	43	amended to read as follows:
44	44	(a) A hospital shall submit to the department financial and
45	45	utilization data for that hospital, including data relating to the
46	46	hospital's:
47	47	(1) total gross revenue, including:
48	48	(A) Medicare gross revenue;
49	49	(B) Medicaid gross revenue;
50	50	(C) other revenue from state programs;
51	51	(D) revenue from local government programs;
52	52	(E) local tax support;
53	53	(F) charitable contributions;
54	54	(G) other third party payments;
55	55	(H) gross inpatient revenue; [and]
56	56	(I) gross outpatient revenue;
57	57	(J) disproportionate share hospitals payment
58	58	program revenue;
59	59	(K) upper payment limit supplemental payment
60	60	program revenue;
61	61	(L) tobacco settlement proceeds; and
62	62	(M) federal grant funding, including payments
63	63	made for care for undocumented persons;
64	64	(2) total deductions from gross revenue, including:
65	65	(A) contractual allowance; and
66	66	(B) any other deductions;
67	67	(3) charity care;
68	68	(4) bad debt expense;
69	69	(5) total admissions, including:
70	70	(A) Medicare admissions;
71	71	(B) Medicaid admissions;
72	72	(C) admissions under a local government program;
73	73	(D) charity care admissions; and
74	74	(E) any other type of admission;
75	75	(6) total discharges;
76	76	(7) total patient days;
77	77	(8) average length of stay;
78	78	(9) total outpatient visits;
79	79	(10) total assets;
80	80	(11) total liabilities;
81	81	(12) estimates of unreimbursed costs of subsidized
82	82	health services reported separately in the following categories:
83	83	(A) emergency care and trauma care;
84	84	(B) neonatal intensive care;
85	85	(C) free-standing community clinics;
86	86	(D) collaborative efforts with local government
87	87	or private agencies in preventive medicine, such as immunization
88	88	programs; and
89	89	(E) other services that satisfy the definition of
90	90	"subsidized health services" contained in Section 311.031(13);
91	91	(13) donations;
92	92	(14) total cost of reimbursed and unreimbursed
93	93	research;
94	94	(15) total cost of reimbursed and unreimbursed
95	95	education separated into the following categories:
96	96	(A) education of physicians, nurses,
97	97	technicians, and other medical professionals and health care
98	98	providers;
99	99	(B) scholarships and funding to medical schools,
100	100	colleges, and universities for health professions education;
101	101	(C) education of patients concerning diseases
102	102	and home care in response to community needs;
103	103	(D) community health education through
104	104	informational programs, publications, and outreach activities in
105	105	response to community needs; and
106	106	(E) other educational services that satisfy the
107	107	definition of "education-related costs" under Section 311.031(6);
108	108	and
109	109	(16) the hospital's charge description master or
110	110	charge master.
111	111	SECTION 3. Section 311.042(2), Health and Safety Code, is
112	112	amended to read as follows:
113	113	(2) "Community benefits" means the unreimbursed cost
114	114	to a hospital of providing charity care, government-sponsored
115	115	indigent health care, donations, education, government-sponsored
116	116	program services, research, and subsidized health services.
117	117	Community benefits include programs or services to reduce
118	118	disparities by increasing the proportion of the population that has
119	119	access to health information and disease prevention and that are
120	120	described by the Community Guide to Preventive Services published
121	121	by the Centers for Disease Control and Prevention of the United
122	122	States Public Health Service. The term does not include the cost to
123	123	the hospital of paying any taxes or other governmental assessments,
124	124	uncollected fees or accounts written off as bad debt, costs
125	125	incurred as a result of partial but incomplete payment by
126	126	third-party insurance payments, Medicare payments, Medicaid
127	127	payments, or payments from Tricare or the Civilian Health and
128	128	Medical Program of the Uniformed Services.
129	129	SECTION 4. Section 311.045(b)(1), Health and Safety Code,
130	130	is amended to read as follows:
131	131	(1) A nonprofit hospital or hospital system may elect
132	132	to provide community benefits, which include charity care and
133	133	government-sponsored indigent health care, according to any of the
134	134	following standards:
135	135	(A) charity care and government-sponsored
136	136	indigent health care are provided at a level which is reasonable in
137	137	relation to the community needs, as determined through the
138	138	community needs assessment, the available resources of the hospital
139	139	or hospital system, and the tax-exempt benefits received by the
140	140	hospital or hospital system;
141	141	(B) charity care and government-sponsored
142	142	indigent health care are provided in an amount equal to at least 100
143	143	percent of the hospital's or hospital system's tax-exempt benefits,
144	144	excluding federal income tax; or
145	145	(C) charity care and community benefits are
146	146	provided in a combined amount equal to at least 10 [five] percent of
147	147	the hospital's or hospital system's net patient revenue, provided
148	148	that charity care and government-sponsored indigent health care are
149	149	provided in an amount equal to at least eight [four] percent of net
150	150	patient revenue.
151	151	SECTION 5. This Act takes effect September 1, 2009.