By: Coleman (Senate Sponsor - Hinojosa) H.B. No. 3793
(In the Senate - Received from the House May 13, 2013;
May 13, 2013, read first time and referred to Committee on
Intergovernmental Relations; May 17, 2013, reported adversely,
with favorable Committee Substitute by the following vote: Yeas 4,
Nays 0; May 17, 2013, sent to printer.)
COMMITTEE SUBSTITUTE FOR H.B. No. 3793 By: Hinojosa
A BILL TO BE ENTITLED
AN ACT
relating to powers, duties, and services of entities serving
counties.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Chapter 288, Health and Safety
Code, is amended to read as follows:
CHAPTER 288. HEALTH CARE FUNDING DISTRICTS IN CERTAIN COUNTIES
LOCATED ON TEXAS-MEXICO BORDER [THAT ARE ADJACENT TO COUNTIES WITH
POPULATION OF 50,000 OR MORE]
SECTION 2. Sections 288.001(2) and (3), Health and Safety
Code, are amended to read as follows:
(2) "District" means a county health care funding
district created under [by] this chapter.
(3) "Paying hospital [District taxpayer]" means an
institutional health care provider required to make a mandatory
payment [a person or entity who has paid a tax imposed] under this
chapter.
SECTION 3. Section 288.002, Health and Safety Code, is
amended to read as follows:
Sec. 288.002. CREATION OF DISTRICT. A district may be [is]
created by order of the commissioners court of [in] each county
located on the Texas-Mexico border that has a population of:
(1) 500,000 or more and is adjacent to two or more
counties each of which has a population of 50,000 or more;
(2) 350,000 or more and is adjacent to a county
described by Subdivision (1); or
(3) less than 300,000 and contains one or more
municipalities with a population of 200,000 or more.
SECTION 4. Subchapter A, Chapter 288, Health and Safety
Code, is amended by adding Sections 288.0031 and 288.0032 to read as
follows:
Sec. 288.0031. DISSOLUTION. A district created under this
chapter may be dissolved in the manner provided for the dissolution
of a hospital district under Subchapter E, Chapter 286.
Sec. 288.0032. EXPIRATION OF CHAPTER; DISTRIBUTION OF FUNDS
ON EXPIRATION. (a) A district created under this chapter is
abolished and this chapter expires on December 31, 2016.
(b) The commissioners court of a county in which a district
is created shall refund to each paying hospital the proportionate
share of any money remaining in the local provider participation
fund created by the district under Section 288.155 at the time the
district is abolished.
SECTION 5. The heading to Section 288.051, Health and
Safety Code, is amended to read as follows:
Sec. 288.051. COMMISSION; DISTRICT GOVERNANCE
[APPOINTMENT].
SECTION 6. Section 288.051, Health and Safety Code, is
amended by amending Subsection (a) and adding Subsections (c) and
(d) to read as follows:
(a) Each district created under Section 288.002 is governed
by a commission consisting of the commissioners court of the county
in which the district is created [of five members appointed as
provided by this section].
(c) Service on the commission by a county commissioner or
county judge is an additional duty of that person's office.
(d) A district is a component of county government and is
not a separate political subdivision of this state.
SECTION 7. Section 288.101, Health and Safety Code, is
amended to read as follows:
Sec. 288.101. LIMITATION ON [TAXING] AUTHORITY TO REQUIRE
MANDATORY PAYMENT. Each district may require a mandatory payment
[impose taxes] only in the manner provided by this chapter.
SECTION 8. Section 288.102, Health and Safety Code, is
amended to read as follows:
Sec. 288.102. MAJORITY VOTE REQUIRED. (a) A district may
not require [impose] any mandatory payment [tax] authorized by this
chapter, spend any money, including for the administrative expenses
of the district, or conduct any other business of the commission
without an affirmative vote of a majority of the members of the
commission.
(b) Before requiring a mandatory payment [imposing a tax]
under this chapter in any one year, the commission must obtain the
affirmative vote required by Subsection (a).
SECTION 9. Section 288.104(a), Health and Safety Code, is
amended to read as follows:
(a) The commission may adopt rules governing the operation
of the district, including rules relating to the administration of
a mandatory payment [tax] authorized by this chapter.
SECTION 10. Section 288.151, Health and Safety Code, is
amended to read as follows:
Sec. 288.151. HEARING [BUDGET]. (a) Each year, the
commission of a district shall hold a public hearing on [prepare a
budget for the following fiscal year that includes:
[(1) proposed expenditures and disbursements;
[(2) estimated receipts and collections; and
[(3)] the [rates and] amounts of any mandatory
payments [taxes] that the commission intends to require [impose]
during the year and how the revenue derived from those payments is
to be spent.
(b) [The commission shall hold a public hearing on the
proposed budget.] Not later than the 10th day before the date of
the hearing, the commission shall publish at least once notice of
the hearing in a newspaper of general circulation in the county in
which the district is located.
(c) A representative of a paying hospital [Any district
taxpayer] is entitled to appear at the time and place designated in
the public notice and to be heard regarding any matter related to
the mandatory payments required by the district under this chapter
[item shown in the proposed budget].
SECTION 11. Section 288.154(b), Health and Safety Code, is
amended to read as follows:
(b) All income received by a district, including the [tax]
revenue from mandatory payments remaining after [deducting]
discounts and fees for assessing and collecting the payments are
deducted [taxes], shall be deposited with the district depository
as provided by Section 288.203 and may be withdrawn only as provided
by this chapter.
SECTION 12. Subchapter D, Chapter 288, Health and Safety
Code, is amended by adding Sections 288.155 and 288.156 to read as
follows:
Sec. 288.155. LOCAL PROVIDER PARTICIPATION FUND;
AUTHORIZED USES OF MONEY. (a) Each district shall create a local
provider participation fund.
(b) The local provider participation fund consists of:
(1) all revenue from the mandatory payment required by
this chapter, including any penalties and interest attributable to
delinquent payments;
(2) money received from the Health and Human Services
Commission as a refund of an intergovernmental transfer from the
district to the state for the purpose of providing the nonfederal
share of Medicaid supplemental payment program payments, provided
that the intergovernmental transfer does not receive a federal
matching payment; and
(3) the earnings of the fund.
(c) Money deposited to the local provider participation
fund may be used only to:
(1) fund intergovernmental transfers from the
district to the state to provide the nonfederal share of a Medicaid
supplemental payment program authorized under the state Medicaid
plan, the Texas Healthcare Transformation and Quality Improvement
Program waiver issued under Section 1115 of the federal Social
Security Act (42 U.S.C. Section 1315), or a successor waiver
program authorizing similar Medicaid supplemental payment
programs;
(2) subsidize indigent programs;
(3) pay the administrative expenses of the district;
(4) refund a portion of a mandatory payment collected
in error from a paying hospital; and
(5) refund to paying hospitals the proportionate share
of the money received by the district from the Health and Human
Services Commission that is not used to fund the nonfederal share of
Medicaid supplemental payment program payments.
(d) Money in the local provider participation fund may not
be commingled with other county funds.
(e) An intergovernmental transfer of funds described by
Subsection (c)(1) and any funds received by the district as a result
of an intergovernmental transfer described by that subdivision may
not be used by the district, the county in which the district is
located, or any other entity to expand Medicaid eligibility under
the Patient Protection and Affordable Care Act (Pub. L. No.
111-148) as amended by the Health Care and Education Reconciliation
Act of 2010 (Pub. L. No. 111-152).
Sec. 288.156. ALLOCATION OF CERTAIN FUNDS. Not later than
the 15th day after the date the district receives a payment
described by Section 288.155(c)(5), the district shall transfer to
each paying hospital an amount equal to the proportionate share of
those funds to which the hospital is entitled.
SECTION 13. The heading to Subchapter E, Chapter 288,
Health and Safety Code, is amended to read as follows:
SUBCHAPTER E. MANDATORY PAYMENTS [TAXES]
SECTION 14. Section 288.201, Health and Safety Code, is
amended to read as follows:
Sec. 288.201. MANDATORY PAYMENT BASED [TAX] ON [OUTPATIENT]
HOSPITAL NET PATIENT REVENUE [SERVICES]. (a) Except as provided by
Subsection (e), the [The] commission of a district may require
[impose] an annual mandatory payment [tax] to be assessed quarterly
on the net patient revenue of [all outpatient hospital visits to] an
institutional health care provider located in the district. In the
first year in which the mandatory payment [tax] is required
[imposed], the mandatory payment [tax] is assessed on the net
patient revenue [total number of outpatient hospital visits] of an
institutional health care provider as determined by the data
reported to the Department of State Health Services under Sections
311.032 and 311.033 in the fiscal year ending in 2010 [2003]. The
district shall update the amount of the mandatory payment [this tax
basis with the number of outpatient hospital visits reported] on a
biennial basis.
(b) The amount of a mandatory payment required under this
chapter must be uniformly proportionate with the amount of net
patient revenue generated by each paying hospital. [A tax imposed
under this section must be imposed uniformly on each institutional
health care provider of outpatient hospital services located in the
district.] A mandatory payment required [tax imposed] under this
section [also] may not hold harmless any institutional health care
provider [of outpatient hospital services], as required under 42
U.S.C. Section 1396b(w).
(c) The commission of a district shall set the amount [rate]
of the mandatory payment required [tax imposed] under this section.
The amount of the mandatory payment required of each paying
hospital [rate] may not exceed an amount that, when added to the
amount of the mandatory payments required from all other paying
hospitals in the district, equals an amount of revenue that exceeds
six percent of the aggregate net patient revenue of all paying
hospitals in the district [$100 for each outpatient hospital
visit].
(d) Subject to the maximum amount [tax rate] prescribed by
Subsection (c), the commission shall set the mandatory payments in
amounts [rate of the tax at a rate] that in the aggregate will
generate sufficient revenue to cover the administrative expenses of
the district, to fund the nonfederal share of a Medicaid
supplemental payment program, and to pay for indigent programs,
except that the amount of [tax] revenue from mandatory payments
used for administrative expenses of the district in a year may not
exceed the lesser of four percent of the total revenue generated
from the mandatory payment [tax] or $20,000.
(e) An institutional health care provider may not add a
mandatory payment required [tax imposed] under this section as a
surcharge to a patient.
SECTION 15. Section 288.202, Health and Safety Code, is
amended to read as follows:
Sec. 288.202. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS [TAXES]. (a) Except as provided by Subsection (b), the
county tax assessor-collector shall collect a mandatory payment
required [tax imposed] under this subchapter [unless the commission
employs a tax assessor and collector for the district]. The county
tax assessor-collector shall charge and deduct from mandatory
payments [taxes] collected for the district a fee for collecting
the mandatory payment [tax] in an amount determined by the
commission, not to exceed the county tax assessor-collector's usual
and customary charges [for the collection of similar taxes].
(b) If determined by the commission to be appropriate, the
commission may contract for the assessment and collection of
mandatory payments [taxes] in the manner provided by Title 1, Tax
Code, for the assessment and collection of ad valorem taxes.
(c) Revenue from a fee charged by a county tax
assessor-collector for collecting the mandatory payment [tax]
shall be deposited in the county general fund and, if appropriate,
shall be reported as fees of the county tax assessor-collector.
SECTION 16. Section 288.203, Health and Safety Code, is
amended to read as follows:
Sec. 288.203. DEPOSIT [USE] OF [TAX] REVENUE FROM MANDATORY
PAYMENTS. Revenue [generated by a district] from the mandatory
payment required by [a tax imposed under] this chapter shall be
deposited in the district's local provider participation fund
[subchapter may be used only to:
[(1) provide the nonfederal share of a Medicaid
supplemental payment program;
[(2) subsidize indigent programs; and
[(3) pay administrative expenses of the district].
SECTION 17. Section 288.204, Health and Safety Code, is
amended to read as follows:
Sec. 288.204. INTEREST, PENALTIES, AND DISCOUNTS.
Interest, penalties, and discounts on mandatory payments required
[taxes imposed] under this subchapter are governed by the law
applicable to county ad valorem taxes.
SECTION 18. Section 288.205, Health and Safety Code, is
amended to read as follows:
Sec. 288.205. PURPOSE; CORRECTION OF INVALID PROVISION OR
PROCEDURE. (a) The purpose of this chapter is to generate revenue
from a mandatory payment required [tax imposed] by the district to
provide the nonfederal share of a Medicaid supplemental payment
program.
(b) To the extent any provision or procedure under this
chapter causes a mandatory payment [tax] under this chapter to be
ineligible for federal matching funds, the district may provide by
rule for an alternative provision or procedure that conforms to the
requirements of the federal Centers for Medicare and Medicaid
Services.
SECTION 19. Sections 288.003, 288.004, 288.051(b),
288.052, 288.053, 288.054, 288.055, 288.056, 288.057, 288.058,
288.103, 288.104(b), 288.105, 288.107, 288.153, and 288.206,
Health and Safety Code, are repealed.
SECTION 20. If before implementing any provision of Chapter
288, Health and Safety Code, as amended by this Act, a state agency
determines that a waiver or authorization from a federal agency is
necessary for implementation of that provision, the agency affected
by the provision shall request the waiver or authorization and may
delay implementing that provision until the waiver or authorization
is granted.
SECTION 21. 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, 2013.
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