85R23645 JCG-D
By: Coleman H.B. No. 4180
Substitute the following for H.B. No. 4180:
By: Springer C.S.H.B. No. 4180
A BILL TO BE ENTITLED
AN ACT
relating to issues affecting counties and certain other
governmental entities and residents.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
amended by adding Chapter 291A to read as follows:
CHAPTER 291A. COUNTY HEALTH CARE PROVIDER PARTICIPATION
PROGRAM IN CERTAIN COUNTIES BORDERING OR INCLUDING THE SAM RAYBURN
RESERVOIR
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 291A.001. DEFINITIONS. In this chapter:
(1) "Institutional health care provider" means a
nonpublic hospital that provides inpatient hospital services.
(2) "Paying hospital" means an institutional health
care provider required to make a mandatory payment under this
chapter.
(3) "Program" means the county health care provider
participation program authorized by this chapter.
Sec. 291A.002. APPLICABILITY. This chapter applies only to
a county that:
(1) is not served by a hospital district or a public
hospital;
(2) has a population of more than 75,000; and
(3) borders or includes a portion of the Sam Rayburn
Reservoir.
Sec. 291A.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
provider participation program authorizes a county to collect a
mandatory payment from each institutional health care provider
located in the county to be deposited in a local provider
participation fund established by the county. Money in the fund may
be used by the county to fund certain intergovernmental transfers
and indigent care programs as provided by this chapter.
(b) The commissioners court of a county may adopt an order
authorizing a county to participate in the program, subject to the
limitations provided by this chapter.
SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
Sec. 291A.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
PAYMENT. The commissioners court of a county may require a
mandatory payment authorized under this chapter by an institutional
health care provider in the county only in the manner provided by
this chapter.
Sec. 291A.052. MAJORITY VOTE REQUIRED. The commissioners
court of a county may not authorize the county to collect a
mandatory payment authorized under this chapter without an
affirmative vote of a majority of the members of the commissioners
court.
Sec. 291A.053. RULES AND PROCEDURES. After the
commissioners court of a county has voted to require a mandatory
payment authorized under this chapter, the commissioners court may
adopt rules relating to the administration of the mandatory
payment.
Sec. 291A.054. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
county that collects a mandatory payment authorized under this
chapter shall require each institutional health care provider to
submit to the county a copy of any financial and utilization data
required by and reported to the Department of State Health Services
under Sections 311.032 and 311.033 and any rules adopted by the
executive commissioner of the Health and Human Services Commission
to implement those sections.
(b) The commissioners court of a county that collects a
mandatory payment authorized under this chapter may inspect the
records of an institutional health care provider to the extent
necessary to ensure compliance with the requirements of Subsection
(a).
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
Sec. 291A.101. HEARING. (a) Each year, the commissioners
court of a county that collects a mandatory payment authorized
under this chapter shall hold a public hearing on the amounts of any
mandatory payments that the commissioners court intends to require
during the year and how the revenue derived from those payments is
to be spent.
(b) Not later than the 10th day before the date of the
hearing required under Subsection (a), the commissioners court of
the county shall publish notice of the hearing in a newspaper of
general circulation in the county.
(c) A representative of a paying hospital is entitled to
appear at the time and place designated in the public notice and to
be heard regarding any matter related to the mandatory payments
authorized under this chapter.
Sec. 291A.102. DEPOSITORY. (a) The commissioners court of
each county that collects a mandatory payment authorized under this
chapter by resolution shall designate one or more banks located in
the county as the depository for mandatory payments received by the
county. A bank designated as a depository serves for two years or
until a successor is designated.
(b) All income received by a county under this chapter,
including the revenue from mandatory payments remaining after
discounts and fees for assessing and collecting the payments are
deducted, shall be deposited with the county depository in the
county's local provider participation fund and may be withdrawn
only as provided by this chapter.
(c) All funds under this chapter shall be secured in the
manner provided for securing county funds.
Sec. 291A.103. LOCAL PROVIDER PARTICIPATION FUND;
AUTHORIZED USES OF MONEY. (a) Each county that collects a
mandatory payment authorized under this chapter shall create a
local provider participation fund.
(b) The local provider participation fund of a county
consists of:
(1) all revenue received by the county attributable to
mandatory payments authorized under this chapter, including any
penalties and interest attributable to delinquent payments;
(2) money received from the Health and Human Services
Commission as a refund of an intergovernmental transfer from the
county to the state for the purpose of providing the nonfederal
share of Medicaid supplemental payment program payments, provided
that the intergovernmental transfer does not receive a federal
matching payment; and
(3) the earnings of the fund.
(c) Money deposited to the local provider participation
fund may be used only to:
(1) fund intergovernmental transfers from the county
to the state to provide the nonfederal share of a Medicaid
supplemental payment program authorized under the state Medicaid
plan, including through the Medicaid managed care program, under
the Texas Healthcare Transformation and Quality Improvement
Program waiver issued under Section 1115 of the federal Social
Security Act (42 U.S.C. Section 1315), or under a successor waiver
program authorizing similar Medicaid supplemental payment
programs;
(2) subsidize indigent programs;
(3) pay the administrative expenses of the county
solely for activities under this chapter;
(4) refund a portion of a mandatory payment collected
in error from a paying hospital; and
(5) refund to paying hospitals the proportionate share
of money received by the county from the Health and Human Services
Commission that is not used to fund the nonfederal share of Medicaid
supplemental payment program payments.
(d) Money in the local provider participation fund may not
be commingled with other county funds.
(e) An intergovernmental transfer of funds described by
Subsection (c)(1) and any funds received by the county as a result
of an intergovernmental transfer described by that subsection may
not be used by the county or any other entity to expand Medicaid
eligibility under the Patient Protection and Affordable Care Act
(Pub. L. No. 111-148) as amended by the Health Care and Education
Reconciliation Act of 2010 (Pub. L. No. 111-152).
SUBCHAPTER D. MANDATORY PAYMENTS
Sec. 291A.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
commissioners court of a county that collects a mandatory payment
authorized under this chapter may require an annual mandatory
payment to be assessed on the net patient revenue of each
institutional health care provider located in the county. The
commissioners court may provide for the mandatory payment to be
assessed quarterly. In the first year in which the mandatory
payment is required, the mandatory payment is assessed on the net
patient revenue of an institutional health care provider as
determined by the data reported to the Department of State Health
Services under Sections 311.032 and 311.033 in the fiscal year
ending in 2015 or, if the institutional health care provider did not
report any data under those sections in that fiscal year, as
determined by the institutional health care provider's Medicare
cost report submitted for the 2015 fiscal year or for the closest
subsequent fiscal year for which the provider submitted the
Medicare cost report. The county shall update the amount of the
mandatory payment on an annual basis.
(b) The amount of a mandatory payment authorized under this
chapter must be uniformly proportionate with the amount of net
patient revenue generated by each paying hospital in the county. A
mandatory payment authorized under this chapter may not hold
harmless any institutional health care provider, as required under
42 U.S.C. Section 1396b(w).
(c) The commissioners court of a county that collects a
mandatory payment authorized under this chapter shall set the
amount of the mandatory payment. The amount of the mandatory
payment required of each paying hospital may not exceed an amount
that, when added to the amount of the mandatory payments required
from all other paying hospitals in the county, equals an amount of
revenue that exceeds six percent of the aggregate net patient
revenue of all paying hospitals in the county.
(d) Subject to the maximum amount prescribed by Subsection
(c), the commissioners court of a county that collects a mandatory
payment authorized under this chapter shall set the mandatory
payments in amounts that in the aggregate will generate sufficient
revenue to cover the administrative expenses of the county for
activities under this chapter, to fund the nonfederal share of a
Medicaid supplemental payment program as described by Section
291A.103(c)(1), and to pay for indigent programs, except that the
amount of revenue from mandatory payments used for administrative
expenses of the county for activities under this chapter in a year
may not exceed the lesser of four percent of the total revenue
generated from the mandatory payment or $20,000.
(e) A paying hospital may not add a mandatory payment
required under this section as a surcharge to a patient.
Sec. 291A.152. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. The county may collect or contract for the assessment and
collection of mandatory payments authorized under this chapter.
Sec. 291A.153. INTEREST, PENALTIES, AND DISCOUNTS.
Interest, penalties, and discounts on mandatory payments required
under this chapter are governed by the law applicable to county ad
valorem taxes.
Sec. 291A.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
PROCEDURE. (a) The purpose of this chapter is to generate revenue
by collecting from institutional health care providers a mandatory
payment to be used to provide the nonfederal share of a Medicaid
supplemental payment program.
(b) To the extent any provision or procedure under this
chapter causes a mandatory payment authorized under this chapter to
be ineligible for federal matching funds, the county may provide by
rule for an alternative provision or procedure that conforms to the
requirements of the federal Centers for Medicare and Medicaid
Services.
SECTION 2. Subchapter C, Chapter 775, Health and Safety
Code, is amended by adding Section 775.0341 to read as follows:
Sec. 775.0341. APPOINTMENT OF BOARD IN CERTAIN DISTRICTS
LOCATED IN MORE THAN ONE COUNTY. (a) This section applies only to a
district that was authorized to have a board of emergency services
commissioners appointed under former Section 776.0345 and that is
located:
(1) partly in a county with a population of less than
22,000; and
(2) partly in a county with a population of more than
54,000.
(b) A five-member board of emergency services commissioners
appointed under this section serves as the district's governing
body. A commissioner serves a two-year term.
(c) The commissioners court of the smallest county in which
the district is located shall appoint two commissioners to the
board. The commissioners court of the largest county in which the
district is located shall appoint three commissioners to the board.
(d) To be eligible for appointment as an emergency services
commissioner under this section, a person must be at least 18 years
of age and reside in the district. Two commissioners must reside in
the smallest county in which the district is located, and three
commissioners must reside in the largest county in which the
district is located.
(e) On January 1 of each year, a commissioners court shall
appoint a successor for each emergency services commissioner
appointed by that commissioners court whose term has expired.
(f) The appropriate commissioners court shall fill a
vacancy on the board for the remainder of the unexpired term.
SECTION 3. Section 775.035, Health and Safety Code, is
amended by adding Subsection (j) to read as follows:
(j) This section does not apply to a district described by
Section 775.0341.
SECTION 4. Section 775.036, Health and Safety Code, is
amended by adding Subsection (a-1) to read as follows:
(a-1) Notwithstanding Subsection (a)(1), the board for a
district located wholly in a county with a population of 75,000 or
less may by resolution determine to hold the board's regular
meetings less frequently than prescribed by that subsection. The
resolution must require the board to meet either quarterly or every
other month. The board shall meet as required by the resolution.
SECTION 5. Section 81.001(b), Local Government Code, is
amended to read as follows:
(b) If present, the county judge is the presiding officer of
the commissioners court. This subsection does not apply to a
meeting held under Section 551.127, Government Code, if the county
judge is not located at the physical space made available to the
public for the meeting.
SECTION 6. (a) All governmental acts and proceedings of an
emergency services district to which former Section 776.0345,
Health and Safety Code, applied before that section was repealed
and that relate to the selection of emergency services
commissioners of the district and that were taken between January
1, 2012, and the effective date of this Act are validated, ratified,
and confirmed in all respects as if they had been taken as
authorized by law.
(b) This section does not apply to any matter that on the
effective date of this Act:
(1) is involved in litigation if the litigation
ultimately results in the matter being held invalid by a final court
judgment; or
(2) has been held invalid by a final court judgment.
SECTION 7. Section 250.006(b), Local Government Code, is
repealed.
SECTION 8. If before implementing any provision of Chapter
291A, Health and Safety Code, as added by 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 9. 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.