LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 85TH LEGISLATIVE REGULAR SESSION May 8, 2017 TO: Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE:HB2062 by Phillips (Relating to the creation and operations of health care provider participation programs in certain counties.), As Engrossed No significant fiscal implication to the State is anticipated. The bill would amend the Health and Safety Code by adding a chapter to establish a health care provider participation program for certain counties that have a population more than 100,000 and contains two municipalities, each with a population of more than 15,000, that is not served by a hospital district or public hospital, and borders the Red River.The health care provider participation program would authorize a county to collect mandatory payments from nonpublic hospitals that provides inpatient hospital services. These payments would be deposited into a local provider participation fund to fund intergovernmental transfers and subsidize indigent care programs. Intergovernmental transfers would be used by the Health and Human Services Commission (HHSC) as the nonfederal share to draw down Medicaid supplemental payments including payments to the Medicaid managed care program that are dedicated for payment to hospitals. The bill specifies that if a state agency determines that a waiver from a federal agency is necessary, the agency shall request the waiver and delay implementation until such waiver is received.The non-federal share of Texas Medicaid supplemental payments is provided largely by local public funds provided to HHSC by intergovernmental transfer. The bill's amendments do not contain any implications for state General Revenue funds. According to the Department of Health and Human Services, there would be no significant fiscal impact to the agency resulting from implementation of the bill.According to the Health and Human Services Commission, there is no significant fiscal impact to the state anticipated from this bill.This bill takes effect immediately if it receives a vote of two-thirds of all the members elected to each house. If the bill does not receive the vote necessary for immediate effect it takes effect September 1, 2017. Local Government Impact The Health and Human Services Commission assumes there is no fiscal impact to local government entities from this bill.According to Grayson County, the bill would have no significant fiscal impact on the budget of the county; however, it would provide additional funding to supplement uncompensated care for indigent individuals. Source Agencies:529 Health and Human Services Commission LBB Staff: UP, KCA, JGA, GG, GP LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 85TH LEGISLATIVE REGULAR SESSION May 8, 2017 TO: Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE:HB2062 by Phillips (Relating to the creation and operations of health care provider participation programs in certain counties.), As Engrossed TO: Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE: HB2062 by Phillips (Relating to the creation and operations of health care provider participation programs in certain counties.), As Engrossed Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services Ursula Parks, Director, Legislative Budget Board Ursula Parks, Director, Legislative Budget Board HB2062 by Phillips (Relating to the creation and operations of health care provider participation programs in certain counties.), As Engrossed HB2062 by Phillips (Relating to the creation and operations of health care provider participation programs in certain counties.), As Engrossed No significant fiscal implication to the State is anticipated. No significant fiscal implication to the State is anticipated. The bill would amend the Health and Safety Code by adding a chapter to establish a health care provider participation program for certain counties that have a population more than 100,000 and contains two municipalities, each with a population of more than 15,000, that is not served by a hospital district or public hospital, and borders the Red River.The health care provider participation program would authorize a county to collect mandatory payments from nonpublic hospitals that provides inpatient hospital services. These payments would be deposited into a local provider participation fund to fund intergovernmental transfers and subsidize indigent care programs. Intergovernmental transfers would be used by the Health and Human Services Commission (HHSC) as the nonfederal share to draw down Medicaid supplemental payments including payments to the Medicaid managed care program that are dedicated for payment to hospitals. The bill specifies that if a state agency determines that a waiver from a federal agency is necessary, the agency shall request the waiver and delay implementation until such waiver is received.The non-federal share of Texas Medicaid supplemental payments is provided largely by local public funds provided to HHSC by intergovernmental transfer. The bill's amendments do not contain any implications for state General Revenue funds. According to the Department of Health and Human Services, there would be no significant fiscal impact to the agency resulting from implementation of the bill.According to the Health and Human Services Commission, there is no significant fiscal impact to the state anticipated from this bill.This bill takes effect immediately if it receives a vote of two-thirds of all the members elected to each house. If the bill does not receive the vote necessary for immediate effect it takes effect September 1, 2017. Local Government Impact The Health and Human Services Commission assumes there is no fiscal impact to local government entities from this bill.According to Grayson County, the bill would have no significant fiscal impact on the budget of the county; however, it would provide additional funding to supplement uncompensated care for indigent individuals. Source Agencies: 529 Health and Human Services Commission 529 Health and Human Services Commission LBB Staff: UP, KCA, JGA, GG, GP UP, KCA, JGA, GG, GP