85R10100 JG-F
By: Price H.B. No. 3633
A BILL TO BE ENTITLED
AN ACT
relating to cost reporting requirements for certain facilities and
providers participating in medical assistance programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.0285 to read as follows:
Sec. 32.0285. STREAMLINED COST REPORTING AND COST
VALIDATION FOR CERTAIN PROVIDERS. (a) This section applies to a
facility providing services under the ICF-IID program, as defined
by Section 534.001, Government Code, or a home and community-based
services (HCS) waiver program provider.
(b) The executive commissioner shall develop and implement
a streamlined cost reporting system for facilities and providers to
which this section applies. The streamlined cost reporting system
must:
(1) be organized by program type; and
(2) not later than December 1 of each odd-numbered
year, require each facility and provider to submit a financial
statement detailing the applicable program's costs that complies
with generally accepted accounting principles and contains the
following cost categories:
(A) total income for each program;
(B) total costs for each program, reported by
specific expense categories to be determined by commission rule;
(C) total costs for each service unit; and
(D) average payment rates for each program.
(c) The commission shall review the financial statement
required under Subsection (b) and use the financial statement to
evaluate a facility's or provider's compliance with any obligations
or requirements for participating in an incentive program
established under Section 32.028(g).
(d) In developing and implementing the streamlined cost
reporting system, the commission shall:
(1) consult with appropriate advisory committees to
obtain recommendations for the specific expense categories to be
included in the financial statement;
(2) ensure that any recommendations or rules adopted
based on recommendations provided under Subdivision (1):
(A) reduce administrative burdens and costs on
facilities and providers; and
(B) are consistent with:
(i) economic efficiency;
(ii) available resources and capacity of
small businesses; and
(iii) allowable and unallowable program
costs under Medicaid; and
(3) ensure that the streamlined cost reporting system:
(A) is implemented in a way that eases the
administrative burden on facilities and providers;
(B) establishes the relevant cost baselines and
framework for the cost determination and rate-setting processes;
and
(C) provides current and accurate data for
legislative reporting and budgeting.
(e) Not later than January 1 of each even-numbered year, the
commission shall randomly select 10 facilities and providers whose
financial reports the commission will use to validate program costs
reported in the financial statements for the preceding state fiscal
biennium required under Subsection (b). The executive commissioner
by rule shall designate small, medium, and large classes of
providers. The facilities and providers selected under this
subsection must include three facilities or providers from the
small providers class, four facilities or providers from the medium
providers class, and three facilities or providers from the large
providers class. The commission shall notify the facilities and
providers selected under this subsection not later than 120 days
before the date validation is scheduled to begin.
(f) A facility or provider that is selected under Subsection
(e) shall:
(1) cooperate with all reasonable requests from the
commission for necessary information and data to validate program
costs;
(2) hire additional staff as necessary to ensure
accurate and timely compliance with this section and rules adopted
under this section;
(3) contract with a certified public accountant to
audit the information and data collected by the facility or
provider; and
(4) submit detailed information and data of program
costs along with the report of the audit required under Subdivision
(3) in the form and manner prescribed by the commission.
(g) The commission shall review and analyze the report of
each audit required under Subsection (f) not later than August 31 of
each even-numbered year and prepare and submit a report to the
legislature based on those audits.
SECTION 2. 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 3. Not later than November 1, 2017, the executive
commissioner of the Health and Human Services Commission shall
adopt rules necessary to implement the changes in law made by this
Act.
SECTION 4. 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, 2017.