Texas 2017 - 85th Regular

Texas House Bill HB3993 Compare Versions

Only one version of the bill is available at this time.

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1	1	85R7469 MEW-F
2	2	By: Hefner H.B. No. 3993
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the creation and operations of health care provider
8	8	participation programs in certain counties.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
11	11	amended by adding Chapter 299 to read as follows:
12	12	CHAPTER 299. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
13	13	CERTAIN COUNTIES BORDERING LAKE PALESTINE
14	14	SUBCHAPTER A. GENERAL PROVISIONS
15	15	Sec. 299.001. DEFINITIONS. In this chapter:
16	16	(1) "Institutional health care provider" means a
17	17	nonpublic hospital that provides inpatient hospital services.
18	18	(2) "Paying hospital" means an institutional health
19	19	care provider required to make a mandatory payment under this
20	20	chapter.
21	21	(3) "Program" means the county health care provider
22	22	participation program authorized by this chapter.
23	23	Sec. 299.002. APPLICABILITY. This chapter applies only to
24	24	a county that:
25	25	(1) is not served by a hospital district or a public
26	26	hospital;
27	27	(2) has a population of more than 200,000; and
28	28	(3) borders Lake Palestine.
29	29	Sec. 299.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
30	30	PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
31	31	provider participation program authorizes a county to collect a
32	32	mandatory payment from each institutional health care provider
33	33	located in the county to be deposited in a local provider
34	34	participation fund established by the county. Money in the fund may
35	35	be used by the county to fund certain intergovernmental transfers
36	36	and indigent care programs as provided by this chapter.
37	37	(b) The commissioners court may adopt an order authorizing a
38	38	county to participate in the program, subject to the limitations
39	39	provided by this chapter.
40	40	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
41	41	Sec. 299.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
42	42	PAYMENT. The commissioners court of a county may require a
43	43	mandatory payment authorized under this chapter by an institutional
44	44	health care provider in the county only in the manner provided by
45	45	this chapter.
46	46	Sec. 299.052. MAJORITY VOTE REQUIRED. The commissioners
47	47	court of a county may not authorize the county to collect a
48	48	mandatory payment authorized under this chapter without an
49	49	affirmative vote of a majority of the members of the commissioners
50	50	court.
51	51	Sec. 299.053. RULES AND PROCEDURES. After the
52	52	commissioners court has voted to require a mandatory payment
53	53	authorized under this chapter, the commissioners court may adopt
54	54	rules relating to the administration of the mandatory payment.
55	55	Sec. 299.054. INSTITUTIONAL HEALTH CARE PROVIDER
56	56	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
57	57	county that collects a mandatory payment authorized under this
58	58	chapter shall require each institutional health care provider to
59	59	submit to the county a copy of any financial and utilization data
60	60	required by and reported to the Department of State Health Services
61	61	under Sections 311.032 and 311.033 and any rules adopted by the
62	62	executive commissioner of the Health and Human Services Commission
63	63	to implement those sections.
64	64	(b) The commissioners court of a county that collects a
65	65	mandatory payment authorized under this chapter may inspect the
66	66	records of an institutional health care provider to the extent
67	67	necessary to ensure compliance with the requirements of Subsection
68	68	(a).
69	69	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
70	70	Sec. 299.101. HEARING. (a) Each year, the commissioners
71	71	court of a county that collects a mandatory payment authorized
72	72	under this chapter shall hold a public hearing on the amounts of any
73	73	mandatory payments that the commissioners court intends to require
74	74	during the year and how the revenue derived from those payments is
75	75	to be spent.
76	76	(b) Not later than the 10th day before the date of the
77	77	hearing required under Subsection (a), the commissioners court of
78	78	the county shall publish notice of the hearing in a newspaper of
79	79	general circulation in the county.
80	80	(c) A representative of a paying hospital is entitled to
81	81	appear at the time and place designated in the public notice and to
82	82	be heard regarding any matter related to the mandatory payments
83	83	authorized under this chapter.
84	84	Sec. 299.102. DEPOSITORY. (a) The commissioners court of
85	85	each county that collects a mandatory payment authorized under this
86	86	chapter by resolution shall designate one or more banks located in
87	87	the county as the depository for mandatory payments received by the
88	88	county. A bank designated as a depository serves for two years or
89	89	until a successor is designated.
90	90	(b) All income received by a county under this chapter,
91	91	including the revenue from mandatory payments remaining after
92	92	discounts and fees for assessing and collecting the payments are
93	93	deducted, shall be deposited with the county depository in the
94	94	county's local provider participation fund and may be withdrawn
95	95	only as provided by this chapter.
96	96	(c) All funds under this chapter shall be secured in the
97	97	manner provided for securing county funds.
98	98	Sec. 299.103. LOCAL PROVIDER PARTICIPATION FUND;
99	99	AUTHORIZED USES OF MONEY. (a) Each county that collects a
100	100	mandatory payment authorized under this chapter shall create a
101	101	local provider participation fund.
102	102	(b) The local provider participation fund of a county
103	103	consists of:
104	104	(1) all revenue received by the county attributable to
105	105	mandatory payments authorized under this chapter, including any
106	106	penalties and interest attributable to delinquent payments;
107	107	(2) money received from the Health and Human Services
108	108	Commission as a refund of an intergovernmental transfer from the
109	109	county to the state for the purpose of providing the nonfederal
110	110	share of Medicaid supplemental payment program payments, provided
111	111	that the intergovernmental transfer does not receive a federal
112	112	matching payment; and
113	113	(3) the earnings of the fund.
114	114	(c) Money deposited to the local provider participation
115	115	fund may be used only to:
116	116	(1) fund intergovernmental transfers from the county
117	117	to the state to provide:
118	118	(A) the nonfederal share of a Medicaid
119	119	supplemental payment program authorized under the state Medicaid
120	120	plan, the Texas Healthcare Transformation and Quality Improvement
121	121	Program waiver issued under Section 1115 of the federal Social
122	122	Security Act (42 U.S.C. Section 1315), or a successor waiver
123	123	program authorizing similar Medicaid supplemental payment
124	124	programs; or
125	125	(B) payments to Medicaid managed care
126	126	organizations that are dedicated for payment to hospitals;
127	127	(2) subsidize indigent programs;
128	128	(3) pay the administrative expenses of the county
129	129	solely for activities under this chapter;
130	130	(4) refund a portion of a mandatory payment collected
131	131	in error from a paying hospital; and
132	132	(5) refund to paying hospitals the proportionate share
133	133	of money received by the county from the Health and Human Services
134	134	Commission that is not used to fund the nonfederal share of Medicaid
135	135	supplemental payment program payments.
136	136	(d) Money in the local provider participation fund may not
137	137	be commingled with other county funds.
138	138	(e) An intergovernmental transfer of funds described by
139	139	Subsection (c)(1) and any funds received by the county as a result
140	140	of an intergovernmental transfer described by that subsection may
141	141	not be used by the county or any other entity to expand Medicaid
142	142	eligibility under the Patient Protection and Affordable Care Act
143	143	(Pub. L. No. 111-148) as amended by the Health Care and Education
144	144	Reconciliation Act of 2010 (Pub. L. No. 111-152).
145	145	SUBCHAPTER D. MANDATORY PAYMENTS
146	146	Sec. 299.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
147	147	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
148	148	commissioners court of a county that collects a mandatory payment
149	149	authorized under this chapter may require an annual mandatory
150	150	payment to be assessed on the net patient revenue of each
151	151	institutional health care provider located in the county. The
152	152	commissioners court may provide for the mandatory payment to be
153	153	assessed quarterly. In the first year in which the mandatory
154	154	payment is required, the mandatory payment is assessed on the net
155	155	patient revenue of an institutional health care provider as
156	156	determined by the data reported to the Department of State Health
157	157	Services under Sections 311.032 and 311.033 in the fiscal year
158	158	ending in 2015 or, if the institutional health care provider did not
159	159	report any data under those sections in that fiscal year, as
160	160	determined by the institutional health care provider's Medicare
161	161	cost report submitted for the 2015 fiscal year or for the closest
162	162	subsequent fiscal year for which the provider submitted the
163	163	Medicare cost report. The county shall update the amount of the
164	164	mandatory payment on an annual basis.
165	165	(b) The amount of a mandatory payment authorized under this
166	166	chapter must be uniformly proportionate with the amount of net
167	167	patient revenue generated by each paying hospital in the county. A
168	168	mandatory payment authorized under this chapter may not hold
169	169	harmless any institutional health care provider, as required under
170	170	42 U.S.C. Section 1396b(w).
171	171	(c) The commissioners court of a county that collects a
172	172	mandatory payment authorized under this chapter shall set the
173	173	amount of the mandatory payment. The amount of the mandatory
174	174	payment required of each paying hospital may not exceed an amount
175	175	that, when added to the amount of the mandatory payments required
176	176	from all other paying hospitals in the county, equals an amount of
177	177	revenue that exceeds six percent of the aggregate net patient
178	178	revenue of all paying hospitals in the county.
179	179	(d) Subject to the maximum amount prescribed by Subsection
180	180	(c), the commissioners court of a county that collects a mandatory
181	181	payment authorized under this chapter shall set the mandatory
182	182	payments in amounts that in the aggregate will generate sufficient
183	183	revenue to cover the administrative expenses of the county for
184	184	activities under this chapter, to fund an intergovernmental
185	185	transfer described by Section 299.103(c)(1), and to pay for
186	186	indigent programs, except that the amount of revenue from mandatory
187	187	payments used for administrative expenses of the county for
188	188	activities under this chapter in a year may not exceed the lesser of
189	189	four percent of the total revenue generated from the mandatory
190	190	payment or $20,000.
191	191	(e) A paying hospital may not add a mandatory payment
192	192	required under this section as a surcharge to a patient.
193	193	Sec. 299.152. ASSESSMENT AND COLLECTION OF MANDATORY
194	194	PAYMENTS. (a) Except as provided by Subsection (b), the county tax
195	195	assessor-collector shall collect the mandatory payment authorized
196	196	under this chapter. The county tax assessor-collector shall charge
197	197	and deduct from mandatory payments collected for the county a fee
198	198	for collecting the mandatory payment in an amount determined by the
199	199	commissioners court of the county, not to exceed the county tax
200	200	assessor-collector's usual and customary charges.
201	201	(b) If determined by the commissioners court to be
202	202	appropriate, the commissioners court may contract for the
203	203	assessment and collection of mandatory payments in the manner
204	204	provided by Title 1, Tax Code, for the assessment and collection of
205	205	ad valorem taxes.
206	206	(c) Revenue from a fee charged by a county tax
207	207	assessor-collector for collecting the mandatory payment shall be
208	208	deposited in the county general fund and, if appropriate, shall be
209	209	reported as fees of the county tax assessor-collector.
210	210	Sec. 299.153. INTEREST, PENALTIES, AND DISCOUNTS.
211	211	Interest, penalties, and discounts on mandatory payments required
212	212	under this chapter are governed by the law applicable to county ad
213	213	valorem taxes.
214	214	Sec. 299.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
215	215	PROCEDURE. (a) The purpose of this chapter is to generate revenue
216	216	by collecting from institutional health care providers a mandatory
217	217	payment to be used to provide the nonfederal share of a Medicaid
218	218	supplemental payment program.
219	219	(b) To the extent any provision or procedure under this
220	220	chapter causes a mandatory payment authorized under this chapter to
221	221	be ineligible for federal matching funds, the county may provide by
222	222	rule for an alternative provision or procedure that conforms to the
223	223	requirements of the federal Centers for Medicare and Medicaid
224	224	Services.
225	225	SECTION 2. If before implementing any provision of this Act
226	226	a state agency determines that a waiver or authorization from a
227	227	federal agency is necessary for implementation of that provision,
228	228	the agency affected by the provision shall request the waiver or
229	229	authorization and may delay implementing that provision until the
230	230	waiver or authorization is granted.
231	231	SECTION 3. This Act takes effect immediately if it receives
232	232	a vote of two-thirds of all the members elected to each house, as
233	233	provided by Section 39, Article III, Texas Constitution. If this
234	234	Act does not receive the vote necessary for immediate effect, this
235	235	Act takes effect September 1, 2017.