By: Hinojosa S.B. No. 1445
A BILL TO BE ENTITLED
AN ACT
relating to imposing an uncompensated care fee on certain hospitals
to provide state funding for the Medicaid program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 32, Human Resources Code, is amended by
adding Subchapter G to read as follows:
SUBCHAPTER G. HOSPITAL UNCOMPENSATED CARE FEE
Sec. 32.301. DEFINITIONS. In this subchapter:
(1) "Commission" means the Health and Human Services
Commission.
(2) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(3) "Gross receipts" means money paid to a hospital as
compensation for services provided to patients. The term does not
include charitable contributions to a hospital.
Sec. 32.302. UNCOMPENSATED CARE FEE REQUIRED. (a) A
uncompensated care fee is imposed on each hospital in this state
that is required to obtain a license under Chapter 241, Health and
Safety Code. The fee is:
(1) equal to the daily uncompensated care fee amount
established under Subsection (b) multiplied by the number of
patient days for a month as determined in accordance with Section
32.303; and
(2) payable monthly.
(b) The commission shall set the daily uncompensated care
fee in the amount necessary to produce annual revenues equal to an
amount that is not more than six percent of the hospital's total
annual gross receipts in this state. The amount of the daily fee:
(1) must be determined using patient days and gross
receipts reported to the commission and covering a period of at
least six months; and
(2) is subject to a prospective adjustment as
necessary.
(c) The uncompensated care fee is an allowable cost for
reimbursement under the Medicaid program.
Sec. 32.303. PATIENT DAYS. A hospital shall determine the
number of patient days for each calendar day. The number of patient
days for a calendar day is equal to the number of patients occupying
a bed at the hospital immediately before midnight of that day.
Sec. 32.304. REPORTING AND COLLECTION. (a) The commission
shall collect the uncompensated care fee.
(b) Each hospital shall:
(1) not later than the 20th day after the last day of
each month file a report with the commission stating the total
patient days for the month; and
(2) not later than the 30th day after the last day of
the month pay the uncompensated care fee.
Sec. 32.305. ALLOCATION. (a) The commission shall remit
to the comptroller the uncompensated care fees paid to the
commission under this subchapter. The comptroller shall deposit
the remittances to the credit of the hospital uncompensated care
account.
(b) The hospital uncompensated care account is an account in
the general revenue fund. Money in the account may be appropriated
only for expenditures that are allowable costs for purposes of
obtaining federal matching money under the medical assistance
program, including expenditures for increased medical assistance
reimbursements to hospitals that provide high-quality inpatient
services under the medical assistance program.
(c) The hospital uncompensated care account is exempt from
the application of Section 403.095, Government Code. Interest
earned on money in the account shall be credited to the account.
Sec. 32.306. RULES. (a) The executive commissioner shall
adopt rules for the administration of this subchapter, including
rules related to the imposition and collection of the uncompensated
care fee.
(b) The executive commissioner may not adopt rules granting
exceptions from the uncompensated care fee.
Sec. 32.307. ENFORCEMENT. A hospital that fails to pay the
uncompensated care fee is ineligible to participate as a medical
assistance provider or receive medical assistance reimbursement
for the provision of services.
SECTION 2. The executive commissioner of the Health and
Human Services Commission shall adopt rules for the administration
of Subchapter G, Chapter 32, Human Resources Code, as added by this
Act, not later than November 1, 2013. The rules must specify the
month for which the initial uncompensated care fee will be imposed
under that subchapter.
SECTION 3. If before implementing any provision of 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 4. This Act takes effect September 1, 2013.