Texas 2017 - 85th Regular

Texas House Bill HB3398 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 3398
	1	+	By: Darby (Senate Sponsor - Perry) H.B. No. 3398
	2	+	(In the Senate - Received from the House May 1, 2017;
	3	+	May 4, 2017, read first time and referred to Committee on
	4	+	Agriculture, Water, & Rural Affairs; May 17, 2017, reported
	5	+	favorably by the following vote: Yeas 7, Nays 0; May 17, 2017, sent
	6	+	to printer.)
2	7
3	8
	9	+	A BILL TO BE ENTITLED
4	10		AN ACT
5	11		relating to the creation and operations of health care provider
6	12		participation programs in certain counties.
7	13		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	14		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
9	15		amended by adding Chapter 293A to read as follows:
10	16		CHAPTER 293A. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
11	17		CERTAIN COUNTIES INCLUDING PORTION OF CONCHO RIVER
12	18		SUBCHAPTER A. GENERAL PROVISIONS
13	19		Sec. 293A.001. DEFINITIONS. In this chapter:
14	20		(1) "Institutional health care provider" means a
15	21		nonpublic hospital that provides inpatient hospital services.
16	22		(2) "Paying hospital" means an institutional health
17	23		care provider required to make a mandatory payment under this
18	24		chapter.
19	25		(3) "Program" means a county health care provider
20	26		participation program authorized by this chapter.
21	27		Sec. 293A.002. APPLICABILITY. This chapter applies only to
22	28		a county that:
23	29		(1) is not served by a hospital district or a public
24	30		hospital;
25	31		(2) has a population of more than 100,000; and
26	32		(3) includes a portion of the Concho River.
27	33		Sec. 293A.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
28	34		PROGRAM. (a) A county health care provider participation program
29	35		authorizes a county to collect a mandatory payment from each
30	36		institutional health care provider located in the county to be
31	37		deposited in a local provider participation fund established by the
32	38		county. Money in the fund may be used by the county to fund certain
33	39		intergovernmental transfers and indigent care programs as provided
34	40		by this chapter.
35	41		(b) The commissioners court of a county may adopt an order
36	42		authorizing the county to participate in the program, subject to
37	43		the limitations provided by this chapter.
38	44		SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
39	45		Sec. 293A.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
40	46		PAYMENT. The commissioners court of a county may require a
41	47		mandatory payment authorized under this chapter by an institutional
42	48		health care provider in the county only in the manner provided by
43	49		this chapter.
44	50		Sec. 293A.052. MAJORITY VOTE REQUIRED. The commissioners
45	51		court of a county may not authorize the county to collect a
46	52		mandatory payment authorized under this chapter without an
47	53		affirmative vote of a majority of the members of the commissioners
48	54		court.
49	55		Sec. 293A.053. RULES AND PROCEDURES. After the
50	56		commissioners court of a county has voted to require a mandatory
51	57		payment authorized under this chapter, the commissioners court may
52	58		adopt rules relating to the administration of the mandatory
53	59		payment.
54	60		Sec. 293A.054. INSTITUTIONAL HEALTH CARE PROVIDER
55	61		REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
56	62		county that collects a mandatory payment authorized under this
57	63		chapter shall require each institutional health care provider
58	64		located in the county to submit to the county a copy of any
59	65		financial and utilization data required by and reported to the
60	66		Department of State Health Services under Sections 311.032 and
61	67		311.033 and any rules adopted by the executive commissioner of the
62	68		Health and Human Services Commission to implement those sections.
63	69		(b) The commissioners court of a county that collects a
64	70		mandatory payment authorized under this chapter may inspect the
65	71		records of an institutional health care provider to the extent
66	72		necessary to ensure compliance with the requirements of Subsection
67	73		(a).
68	74		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
69	75		Sec. 293A.101. HEARING. (a) Each year, the commissioners
70	76		court of a county that collects a mandatory payment authorized
71	77		under this chapter shall hold a public hearing on the amounts of any
72	78		mandatory payments that the commissioners court intends to require
73	79		during the year.
74	80		(b) Not later than the fifth day before the date of the
75	81		hearing required under Subsection (a), the commissioners court of
76	82		the county shall publish notice of the hearing in a newspaper of
77	83		general circulation in the county.
78	84		(c) A representative of a paying hospital is entitled to
79	85		appear at the public hearing and be heard regarding any matter
80	86		related to the mandatory payments authorized under this chapter.
81	87		Sec. 293A.102. DEPOSITORY. (a) The commissioners court of
82	88		each county that collects a mandatory payment authorized under this
83	89		chapter by resolution shall designate one or more banks located in
84	90		the county as the depository for mandatory payments received by the
85	91		county.
86	92		(b) All income received by a county under this chapter,
87	93		including the revenue from mandatory payments remaining after
88	94		discounts and fees for assessing and collecting the payments are
89	95		deducted, shall be deposited with the county depository in the
90	96		county's local provider participation fund and may be withdrawn
91	97		only as provided by this chapter.
92	98		(c) All funds under this chapter shall be secured in the
93	99		manner provided for securing county funds.
94	100		Sec. 293A.103. LOCAL PROVIDER PARTICIPATION FUND;
95	101		AUTHORIZED USES OF MONEY. (a) Each county that collects a
96	102		mandatory payment authorized under this chapter shall create a
97	103		local provider participation fund.
98	104		(b) The local provider participation fund of a county
99	105		consists of:
100	106		(1) all revenue received by the county attributable to
101	107		mandatory payments authorized under this chapter, including any
102	108		penalties and interest attributable to delinquent payments;
103	109		(2) money received from the Health and Human Services
104	110		Commission as a refund of an intergovernmental transfer from the
105	111		county to the state for the purpose of providing the nonfederal
106	112		share of Medicaid supplemental payment program payments, provided
107	113		that the intergovernmental transfer does not receive a federal
108	114		matching payment; and
109	115		(3) the earnings of the fund.
110	116		(c) Money deposited to the local provider participation
111	117		fund may be used only to:
112	118		(1) fund intergovernmental transfers from the county
113	119		to the state to provide:
114	120		(A) the nonfederal share of a Medicaid
115	121		supplemental payment program authorized under the state Medicaid
116	122		plan, the Texas Healthcare Transformation and Quality Improvement
117	123		Program waiver issued under Section 1115 of the federal Social
118	124		Security Act (42 U.S.C. Section 1315), or a successor waiver
119	125		program authorizing similar Medicaid supplemental payment
120	126		programs; or
121	127		(B) payments to Medicaid managed care
122	128		organizations that are dedicated for payment to hospitals;
123	129		(2) subsidize indigent programs;
124	130		(3) pay the administrative expenses of the county
125	131		solely for activities under this chapter;
126	132		(4) refund a portion of a mandatory payment collected
127	133		in error from a paying hospital; and
128	134		(5) refund to paying hospitals the proportionate share
129	135		of money received by the county that is not used to fund the
130	136		nonfederal share of Medicaid supplemental payment program
131	137		payments.
132	138		(d) Money in the local provider participation fund may not
133	139		be commingled with other county funds.
134	140		(e) An intergovernmental transfer of funds described by
135	141		Subsection (c)(1) and any funds received by the county as a result
136	142		of an intergovernmental transfer described by that subsection may
137	143		not be used by the county or any other entity to expand Medicaid
138	144		eligibility under the Patient Protection and Affordable Care Act
139	145		(Pub. L. No. 111-148) as amended by the Health Care and Education
140	146		Reconciliation Act of 2010 (Pub. L. No. 111-152).
141	147		SUBCHAPTER D. MANDATORY PAYMENTS
142	148		Sec. 293A.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
143	149		NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
144	150		commissioners court of a county that collects a mandatory payment
145	151		authorized under this chapter may require an annual mandatory
146	152		payment to be assessed on the net patient revenue of each
147	153		institutional health care provider located in the county. The
148	154		commissioners court may provide for the mandatory payment to be
149	155		assessed quarterly. In the first year in which the mandatory
150	156		payment is required, the mandatory payment is assessed on the net
151	157		patient revenue of an institutional health care provider as
152	158		determined by the data reported to the Department of State Health
153	159		Services under Sections 311.032 and 311.033 in the fiscal year
154	160		ending in 2015 or, if the institutional health care provider did not
155	161		report any data under those sections in that fiscal year, as
156	162		determined by the institutional health care provider's Medicare
157	163		cost report submitted for the 2015 fiscal year or for the closest
158	164		subsequent fiscal year for which the provider submitted the
159	165		Medicare cost report. The county shall update the amount of the
160	166		mandatory payment on an annual basis.
161	167		(b) The amount of a mandatory payment authorized under this
162	168		chapter must be uniformly proportionate with the amount of net
163	169		patient revenue generated by each paying hospital in the county. A
164	170		mandatory payment authorized under this chapter may not hold
165	171		harmless any institutional health care provider, as required under
166	172		42 U.S.C. Section 1396b(w).
167	173		(c) The commissioners court of a county that collects a
168	174		mandatory payment authorized under this chapter shall set the
169	175		amount of the mandatory payment. The amount of the mandatory
170	176		payment required of each paying hospital may not exceed six percent
171	177		of the paying hospital's net patient revenue.
172	178		(d) Subject to the maximum amount prescribed by Subsection
173	179		(c), the commissioners court of a county that collects a mandatory
174	180		payment authorized under this chapter shall set the mandatory
175	181		payments in amounts that in the aggregate will generate sufficient
176	182		revenue to cover the administrative expenses of the county for
177	183		activities under this chapter, to fund an intergovernmental
178	184		transfer described by Section 293A.103(c)(1), and to pay for
179	185		indigent programs, except that the amount of revenue from mandatory
180	186		payments used for administrative expenses of the county for
181	187		activities under this chapter in a year may not exceed the lesser of
182	188		four percent of the total revenue generated from the mandatory
183	189		payment or $20,000.
184	190		(e) A paying hospital may not add a mandatory payment
185	191		required under this section as a surcharge to a patient.
186	192		Sec. 293A.152. ASSESSMENT AND COLLECTION OF MANDATORY
187	193		PAYMENTS. The county may collect or contract for the assessment and
188	194		collection of mandatory payments authorized under this chapter.
189	195		Sec. 293A.153. INTEREST, PENALTIES, AND DISCOUNTS.
190	196		Interest, penalties, and discounts on mandatory payments required
191	197		under this chapter are governed by the law applicable to county ad
192	198		valorem taxes.
193	199		Sec. 293A.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
194	200		PROCEDURE. (a) The purpose of this chapter is to generate revenue
195	201		by collecting from institutional health care providers a mandatory
196	202		payment to be used to provide an intergovernmental transfer
197	203		described by Section 293A.103(c)(1).
198	204		(b) To the extent any provision or procedure under this
199	205		chapter causes a mandatory payment authorized under this chapter to
200	206		be ineligible for federal matching funds, the county may provide by
201	207		rule for an alternative provision or procedure that conforms to the
202	208		requirements of the federal Centers for Medicare and Medicaid
203	209		Services.
204	210		SECTION 2. If before implementing any provision of this Act
205	211		a state agency determines that a waiver or authorization from a
206	212		federal agency is necessary for implementation of that provision,
207	213		the agency affected by the provision shall request the waiver or
208	214		authorization and may delay implementing that provision until the
209	215		waiver or authorization is granted.
210	216		SECTION 3. This Act takes effect immediately if it receives
211	217		a vote of two-thirds of all the members elected to each house, as
212	218		provided by Section 39, Article III, Texas Constitution. If this
213	219		Act does not receive the vote necessary for immediate effect, this
214	220		Act takes effect September 1, 2017.
215		-	______________________________ ______________________________
216		-	President of the Senate Speaker of the House
217		-	I certify that H.B. No. 3398 was passed by the House on April
218		-	27, 2017, by the following vote: Yeas 143, Nays 1, 3 present, not
219		-	voting.
220		-	______________________________
221		-	Chief Clerk of the House
222		-	I certify that H.B. No. 3398 was passed by the Senate on May
223		-	19, 2017, by the following vote: Yeas 30, Nays 1.
224		-	______________________________
225		-	Secretary of the Senate
226		-	APPROVED: _____________________
227		-	Date
228		-	_____________________
229		-	Governor
	221	+	* * * * *