Texas 2017 - 85th Regular

Texas House Bill HB3954 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 3954
	1	+	By: Gonzales of Williamson, Wilson H.B. No. 3954
	2	+	(Senate Sponsor - Schwertner)
	3	+	(In the Senate - Received from the House May 1, 2017;
	4	+	May 5, 2017, read first time and referred to Committee on Health &
	5	+	Human Services; May 16, 2017, reported favorably by the following
	6	+	vote: Yeas 8, Nays 0, 1 present not voting; May 16, 2017, sent to
	7	+	printer.)
	8	+	Click here to see the committee vote
2	9
3	10
	11	+	A BILL TO BE ENTITLED
4	12		AN ACT
5	13		relating to the creation and operations of health care provider
6	14		participation programs in certain counties.
7	15		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	16		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
9	17		amended by adding Chapter 292B to read as follows:
10	18		CHAPTER 292B. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
11	19		CERTAIN COUNTIES BORDERING COUNTY CONTAINING STATE CAPITAL
12	20		SUBCHAPTER A. GENERAL PROVISIONS
13	21		Sec. 292B.001. DEFINITIONS. In this chapter:
14	22		(1) "Institutional health care provider" means a
15	23		nonpublic hospital that provides inpatient hospital services.
16	24		(2) "Paying hospital" means an institutional health
17	25		care provider required to make a mandatory payment under this
18	26		chapter.
19	27		(3) "Program" means the county health care provider
20	28		participation program authorized by this chapter.
21	29		Sec. 292B.002. APPLICABILITY. This chapter applies only to
22	30		a county that:
23	31		(1) is not served by a hospital district or a public
24	32		hospital;
25	33		(2) has a population of more than 400,000; and
26	34		(3) is adjacent to the county containing the state
27	35		capital.
28	36		Sec. 292B.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
29	37		PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
30	38		provider participation program authorizes a county to collect a
31	39		mandatory payment from each institutional health care provider
32	40		located in the county to be deposited in a local provider
33	41		participation fund established by the county. Money in the fund may
34	42		be used by the county to fund certain intergovernmental transfers
35	43		and indigent care programs as provided by this chapter.
36	44		(b) The commissioners court may adopt an order authorizing a
37	45		county to participate in the program, subject to the limitations
38	46		provided by this chapter.
39	47		SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
40	48		Sec. 292B.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
41	49		PAYMENT. The commissioners court of a county may require a
42	50		mandatory payment authorized under this chapter by an institutional
43	51		health care provider in the county only in the manner provided by
44	52		this chapter.
45	53		Sec. 292B.052. MAJORITY VOTE REQUIRED. The commissioners
46	54		court of a county may not authorize the county to collect a
47	55		mandatory payment authorized under this chapter without an
48	56		affirmative vote of a majority of the members of the commissioners
49	57		court.
50	58		Sec. 292B.053. RULES AND PROCEDURES. After the
51	59		commissioners court of a county has voted to require a mandatory
52	60		payment authorized under this chapter, the commissioners court may
53	61		adopt rules relating to the administration of the mandatory
54	62		payment.
55	63		Sec. 292B.054. INSTITUTIONAL HEALTH CARE PROVIDER
56	64		REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
57	65		county that collects a mandatory payment authorized under this
58	66		chapter shall require each institutional health care provider to
59	67		submit to the county a copy of any financial and utilization data
60	68		required by and reported to the Department of State Health Services
61	69		under Sections 311.032 and 311.033 and any rules adopted by the
62	70		executive commissioner of the Health and Human Services Commission
63	71		to implement those sections.
64	72		(b) The commissioners court of a county that collects a
65	73		mandatory payment authorized under this chapter may inspect the
66	74		records of an institutional health care provider to the extent
67	75		necessary to ensure compliance with the requirements of Subsection
68	76		(a).
69	77		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
70	78		Sec. 292B.101. HEARING. (a) Each year, the commissioners
71	79		court of a county that collects a mandatory payment authorized
72	80		under this chapter shall hold a public hearing on the amounts of any
73	81		mandatory payments that the commissioners court intends to require
74	82		during the year.
75	83		(b) Not later than the fifth day before the date of the
76	84		hearing required under Subsection (a), the commissioners court of
77	85		the county shall publish notice of the hearing in a newspaper of
78	86		general circulation in the county.
79	87		(c) A representative of a paying hospital is entitled to
80	88		appear at the public hearing and to be heard regarding any matter
81	89		related to the mandatory payments authorized under this chapter.
82	90		Sec. 292B.102. DEPOSITORY. (a) The commissioners court of
83	91		each county that collects a mandatory payment authorized under this
84	92		chapter by resolution shall designate one or more banks located in
85	93		the county as the depository for mandatory payments received by the
86	94		county.
87	95		(b) All income received by a county under this chapter,
88	96		including the revenue from mandatory payments remaining after
89	97		discounts and fees for assessing and collecting the payments are
90	98		deducted, shall be deposited with the county depository in the
91	99		county's local provider participation fund and may be withdrawn
92	100		only as provided by this chapter.
93	101		(c) All funds under this chapter shall be secured in the
94	102		manner provided for securing county funds.
95	103		Sec. 292B.103. LOCAL PROVIDER PARTICIPATION FUND;
96	104		AUTHORIZED USES OF MONEY. (a) Each county that collects a
97	105		mandatory payment authorized under this chapter shall create a
98	106		local provider participation fund.
99	107		(b) The local provider participation fund of a county
100	108		consists of:
101	109		(1) all revenue received by the county attributable to
102	110		mandatory payments authorized under this chapter, including any
103	111		penalties and interest attributable to delinquent payments;
104	112		(2) money received from the Health and Human Services
105	113		Commission as a refund of an intergovernmental transfer from the
106	114		county to the state for the purpose of providing the nonfederal
107	115		share of Medicaid supplemental payment program payments, provided
108	116		that the intergovernmental transfer does not receive a federal
109	117		matching payment; and
110	118		(3) the earnings of the fund.
111	119		(c) Money deposited to the local provider participation
112	120		fund may be used only to:
113	121		(1) fund intergovernmental transfers from the county
114	122		to the state to provide:
115	123		(A) the nonfederal share of a Medicaid
116	124		supplemental payment program authorized under the state Medicaid
117	125		plan, the Texas Healthcare Transformation and Quality Improvement
118	126		Program waiver issued under Section 1115 of the federal Social
119	127		Security Act (42 U.S.C. Section 1315), or a successor waiver
120	128		program authorizing similar Medicaid supplemental payment
121	129		programs; or
122	130		(B) payments to Medicaid managed care
123	131		organizations that are dedicated for payment to hospitals;
124	132		(2) subsidize indigent programs;
125	133		(3) pay the administrative expenses of the county
126	134		solely for activities under this chapter;
127	135		(4) refund a portion of a mandatory payment collected
128	136		in error from a paying hospital; and
129	137		(5) refund to paying hospitals the proportionate share
130	138		of money received by the county that is not used to fund the
131	139		nonfederal share of Medicaid supplemental payment program
132	140		payments.
133	141		(d) Money in the local provider participation fund may not
134	142		be commingled with other county funds.
135	143		(e) An intergovernmental transfer of funds described by
136	144		Subsection (c)(1) and any funds received by the county as a result
137	145		of an intergovernmental transfer described by that subsection may
138	146		not be used by the county or any other entity to expand Medicaid
139	147		eligibility under the Patient Protection and Affordable Care Act
140	148		(Pub. L. No. 111-148) as amended by the Health Care and Education
141	149		Reconciliation Act of 2010 (Pub. L. No. 111-152).
142	150		SUBCHAPTER D. MANDATORY PAYMENTS
143	151		Sec. 292B.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
144	152		NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
145	153		commissioners court of a county that collects a mandatory payment
146	154		authorized under this chapter may require an annual mandatory
147	155		payment to be assessed on the net patient revenue of each
148	156		institutional health care provider located in the county. The
149	157		commissioners court may provide for the mandatory payment to be
150	158		assessed quarterly. In the first year in which the mandatory
151	159		payment is required, the mandatory payment is assessed on the net
152	160		patient revenue of an institutional health care provider as
153	161		determined by the data reported to the Department of State Health
154	162		Services under Sections 311.032 and 311.033 in the fiscal year
155	163		ending in 2015 or, if the institutional health care provider did not
156	164		report any data under those sections in that fiscal year, as
157	165		determined by the institutional health care provider's Medicare
158	166		cost report submitted for the 2015 fiscal year or for the closest
159	167		subsequent fiscal year for which the provider submitted the
160	168		Medicare cost report. The county shall update the amount of the
161	169		mandatory payment on an annual basis.
162	170		(b) The amount of a mandatory payment authorized under this
163	171		chapter must be uniformly proportionate with the amount of net
164	172		patient revenue generated by each paying hospital in the county. A
165	173		mandatory payment authorized under this chapter may not hold
166	174		harmless any institutional health care provider, as required under
167	175		42 U.S.C. Section 1396b(w).
168	176		(c) The commissioners court of a county that collects a
169	177		mandatory payment authorized under this chapter shall set the
170	178		amount of the mandatory payment. The amount of the mandatory
171	179		payment required of each paying hospital may not exceed six percent
172	180		of the paying hospital's net patient revenue.
173	181		(d) Subject to the maximum amount prescribed by Subsection
174	182		(c), the commissioners court of a county that collects a mandatory
175	183		payment authorized under this chapter shall set the mandatory
176	184		payments in amounts that in the aggregate will generate sufficient
177	185		revenue to cover the administrative expenses of the county for
178	186		activities under this chapter, to fund an intergovernmental
179	187		transfer described by Section 292B.103(c)(1), and to pay for
180	188		indigent programs, except that the amount of revenue from mandatory
181	189		payments used for administrative expenses of the county for
182	190		activities under this chapter in a year may not exceed the lesser of
183	191		four percent of the total revenue generated from the mandatory
184	192		payment or $20,000.
185	193		(e) A paying hospital may not add a mandatory payment
186	194		required under this section as a surcharge to a patient.
187	195		Sec. 292B.152. ASSESSMENT AND COLLECTION OF MANDATORY
188	196		PAYMENTS. The county may collect or contract for the assessment and
189	197		collection of mandatory payments authorized under this chapter.
190	198		Sec. 292B.153. INTEREST, PENALTIES, AND DISCOUNTS.
191	199		Interest, penalties, and discounts on mandatory payments required
192	200		under this chapter are governed by the law applicable to county ad
193	201		valorem taxes.
194	202		Sec. 292B.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
195	203		PROCEDURE. (a) The purpose of this chapter is to generate revenue
196	204		by collecting from institutional health care providers a mandatory
197	205		payment to be used to provide the nonfederal share of a Medicaid
198	206		supplemental payment program.
199	207		(b) To the extent any provision or procedure under this
200	208		chapter causes a mandatory payment authorized under this chapter to
201	209		be ineligible for federal matching funds, the county may provide by
202	210		rule for an alternative provision or procedure that conforms to the
203	211		requirements of the federal Centers for Medicare and Medicaid
204	212		Services.
205	213		SECTION 2. If before implementing any provision of this Act
206	214		a state agency determines that a waiver or authorization from a
207	215		federal agency is necessary for implementation of that provision,
208	216		the agency affected by the provision shall request the waiver or
209	217		authorization and may delay implementing that provision until the
210	218		waiver or authorization is granted.
211	219		SECTION 3. This Act takes effect immediately if it receives
212	220		a vote of two-thirds of all the members elected to each house, as
213	221		provided by Section 39, Article III, Texas Constitution. If this
214	222		Act does not receive the vote necessary for immediate effect, this
215	223		Act takes effect September 1, 2017.
216		-	______________________________ ______________________________
217		-	President of the Senate Speaker of the House
218		-	I certify that H.B. No. 3954 was passed by the House on April
219		-	27, 2017, by the following vote: Yeas 141, Nays 3, 3 present, not
220		-	voting.
221		-	______________________________
222		-	Chief Clerk of the House
223		-	I certify that H.B. No. 3954 was passed by the Senate on May
224		-	19, 2017, by the following vote: Yeas 29, Nays 2.
225		-	______________________________
226		-	Secretary of the Senate
227		-	APPROVED: _____________________
228		-	Date
229		-	_____________________
230		-	Governor
	224	+	* * * * *