By: Williams S.B. No. 1768
A BILL TO BE ENTITLED
AN ACT
relating to recovery of uncompensated hospital care costs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Sections 241.003 and 241.025, Health and Safety
Code, are amended to read as follows:
Sec. 241.003. DEFINITIONS. In this chapter:
(1) "Advanced practice nurse" means a registered nurse
recognized as an advanced practice nurse by the Texas Board of
Nursing.
(2) "Board" means the Texas Board of Health.
(3) "Commission" means the Health and Human Services
Commission.
(4) "Commissioner" means the executive commissioner
of the Health and Human Services Commission.
(5) "Comprehensive medical rehabilitation hospital"
means a general hospital that specializes in providing
comprehensive medical rehabilitation services, including surgery
and related ancillary services.
(6)[(4)]"Department" means the Texas Department of
Health.
(7)[(5)]"General hospital" means an establishment
that:
(A) offers services, facilities, and beds for use
for more than 24 hours for two or more unrelated individuals
requiring diagnosis, treatment, or care for illness, injury,
deformity, abnormality, or pregnancy; and
(B) regularly maintains, at a minimum, clinical
laboratory services, diagnostic X-ray services, treatment
facilities including surgery or obstetrical care or both, and other
definitive medical or surgical treatment of similar extent.
(8)[(6)] "Governmental unit" means a political
subdivision of the state, including a hospital district, county, or
municipality, and any department, division, board, or other agency
of a political subdivision.
(9)[(7)] "Hospital" includes a general hospital and a
special hospital.
(10)[(8)] "Medical staff" means a physician or group
of physicians and a podiatrist or a group of podiatrists who by
action of the governing body of a hospital are privileged to work in
and use the facilities of a hospital for or in connection with the
observation, care, diagnosis, or treatment of an individual who is,
or may be, suffering from a mental or physical disease or disorder
or a physical deformity or injury.
(11)[(9)] "Pediatric and adolescent hospital" means a
general hospital that specializes in providing services to children
and adolescents, including surgery and related ancillary services.
(12)[(10)] "Person" means an individual, firm,
partnership, corporation, association, or joint stock company, and
includes a receiver, trustee, assignee, or other similar
representative of those entities.
(13)[(11)] "Physician" means a physician licensed by
the Texas State Board of Medical Examiners.
(14)[(12)] "Physician assistant" means a physician
assistant licensed by the Texas State Board of Physician Assistant
Examiners.
(15)[(13)] "Podiatrist" means a podiatrist licensed
by the Texas State Board of Podiatric Medical Examiners.
(16)[(14)] Repealed by Acts 2005, 79th Leg., Ch. 1286,
Sec. 2, eff. September 1, 2005.
(17)[(15)] "Special hospital" means an establishment
that:
(A) offers services, facilities, and beds for use
for more than 24 hours for two or more unrelated individuals who are
regularly admitted, treated, and discharged and who require
services more intensive than room, board, personal services, and
general nursing care;
(B) has clinical laboratory facilities,
diagnostic X-ray facilities, treatment facilities, or other
definitive medical treatment;
(C) has a medical staff in regular attendance;
and
(D) maintains records of the clinical work
performed for each patient.
Sec. 241.025. LICENSE FEES AND COST RECOVERY.
(a) (1) The department shall charge each hospital an annual
license fee for an initial license or a license renewal.
(2)[(b)] The board by rule shall adopt the license fees
authorized by Subsection (a) according to a schedule under which
the number of beds in the hospital determines the amount of the fee.
The licensing fee may not exceed $15 a bed. A minimum license fee
may be established. The minimum fee may not exceed $1,000.
(3)[(c)] A licensing fee adopted under this chapter must be
based on the estimated cost to and level of effort expended by the
department to conduct the activity for which the fee is imposed.
(b)(1) The commission must annually collect an amount that,
in combination with any available federal funds, is sufficient to
reimburse:
(A) the estimated cost of administering public
duties related to hospitals licensed under this chapter that are
imposed on the department or another state agency pursuant to other
law; and
(B) the estimated cost of uncompensated care,
including, but not limited to, uncompensated care provided to
noncitizen unauthorized immigrants.
(2) The commissioner by rule shall require each hospital to
report fiscal year the following information relating to noncitizen
unauthorized immigrant patients:
(A) the total cost of inpatient care and outpatient
care provided to such patients;
(B) the total number of inpatient paid cases and
outpatient paid cases;
(C) the total amount of payments received for
inpatient care and outpatient care provided to such patients; and
(D) the total amount of payments received by the
hospital for such care as a percentage of the hospital's total cost.
(d) All license fees collected shall be deposited in the
state treasury to the credit of the department to administer and
enforce this chapter. These fees are hereby appropriated to the
department.
(e) All costs recovered under subsection (c), including all
federal receipts, shall be deposited in accordance with the general
appropriations act or other state law.
(f) Notwithstanding Subsection (d) or subsection (e), to
the extent that money received from the fees collected under this
chapter exceeds the costs to the department or the commission to
conduct the activity for which the fee is imposed, the department
may use the money to administer Chapter 324 and similar laws that
require the department to provide information related to hospital
care to the public. The department may not consider the costs of
administering Chapter 324 or similar laws in adopting a fee imposed
under this section.
SECTION 2. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2011.