Texas 2017 - 85th Regular

Texas House Bill HB4300 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 4300
	1	+	By: Koop, et al. (Senate Sponsor - Huffines) H.B. No. 4300
	2	+	(In the Senate - Received from the House April 24, 2017;
	3	+	May 1, 2017, read first time and referred to Committee on
	4	+	Intergovernmental Relations; May 2, 2017, rereferred to Committee
	5	+	on Administration; May 2, 2017, reported favorably by the
	6	+	following vote: Yeas 6, Nays 0; May 2, 2017, sent to printer.)
	7	+	Click here to see the committee vote
2	8
3	9
	10	+	A BILL TO BE ENTITLED
4	11		AN ACT
5	12		relating to the creation and operations of a health care provider
6	13		participation program by the Dallas County Hospital District.
7	14		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	15		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
9	16		amended by adding Chapter 298A to read as follows:
10	17		CHAPTER 298A. DALLAS COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
11	18		PARTICIPATION PROGRAM
12	19		SUBCHAPTER A. GENERAL PROVISIONS
13	20		Sec. 298A.001. DEFINITIONS. In this chapter:
14	21		(1) "Board" means the board of hospital managers of
15	22		the district.
16	23		(2) "District" means the Dallas County Hospital
17	24		District.
18	25		(3) "Institutional health care provider" means a
19	26		nonpublic hospital located in the district that provides inpatient
20	27		hospital services.
21	28		(4) "Paying provider" means an institutional health
22	29		care provider required to make a mandatory payment under this
23	30		chapter.
24	31		(5) "Program" means the health care provider
25	32		participation program authorized by this chapter.
26	33		Sec. 298A.002. APPLICABILITY. This chapter applies only to
27	34		the Dallas County Hospital District.
28	35		Sec. 298A.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
29	36		PARTICIPATION IN PROGRAM. The board may authorize the district to
30	37		participate in a health care provider participation program on the
31	38		affirmative vote of a majority of the board, subject to the
32	39		provisions of this chapter.
33	40		Sec. 298A.004. EXPIRATION. (a) Subject to Section
34	41		298A.153(d), the authority of the district to administer and
35	42		operate a program under this chapter expires December 31, 2019.
36	43		(b) This chapter expires December 31, 2019.
37	44		SUBCHAPTER B. POWERS AND DUTIES OF BOARD
38	45		Sec. 298A.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
39	46		PAYMENT. The board may require a mandatory payment authorized
40	47		under this chapter by an institutional health care provider in the
41	48		district only in the manner provided by this chapter.
42	49		Sec. 298A.052. RULES AND PROCEDURES. The board may adopt
43	50		rules relating to the administration of the program, including
44	51		collection of the mandatory payments, expenditures, audits, and any
45	52		other administrative aspects of the program.
46	53		Sec. 298A.053. INSTITUTIONAL HEALTH CARE PROVIDER
47	54		REPORTING. If the board authorizes the district to participate in a
48	55		program under this chapter, the board shall require each
49	56		institutional health care provider to submit to the district a copy
50	57		of any financial and utilization data required by and reported to
51	58		the Department of State Health Services under Sections 311.032 and
52	59		311.033 and any rules adopted by the executive commissioner of the
53	60		Health and Human Services Commission to implement those sections.
54	61		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
55	62		Sec. 298A.101. HEARING. (a) In each year that the board
56	63		authorizes a program under this chapter, the board shall hold a
57	64		public hearing on the amounts of any mandatory payments that the
58	65		board intends to require during the year and how the revenue derived
59	66		from those payments is to be spent.
60	67		(b) Not later than the fifth day before the date of the
61	68		hearing required under Subsection (a), the board shall publish
62	69		notice of the hearing in a newspaper of general circulation in the
63	70		district and provide written notice of the hearing to each
64	71		institutional health care provider in the district.
65	72		Sec. 298A.102. DEPOSITORY. (a) If the board requires a
66	73		mandatory payment authorized under this chapter, the board shall
67	74		designate one or more banks as a depository for the district's local
68	75		provider participation fund.
69	76		(b) All funds collected under this chapter shall be secured
70	77		in the manner provided for securing other district funds.
71	78		Sec. 298A.103. LOCAL PROVIDER PARTICIPATION FUND;
72	79		AUTHORIZED USES OF MONEY. (a) If the district requires a mandatory
73	80		payment authorized under this chapter, the district shall create a
74	81		local provider participation fund.
75	82		(b) The local provider participation fund consists of:
76	83		(1) all revenue received by the district attributable
77	84		to mandatory payments authorized under this chapter;
78	85		(2) money received from the Health and Human Services
79	86		Commission as a refund of an intergovernmental transfer under the
80	87		program, provided that the intergovernmental transfer does not
81	88		receive a federal matching payment; and
82	89		(3) the earnings of the fund.
83	90		(c) Money deposited to the local provider participation
84	91		fund of the district may be used only to:
85	92		(1) fund intergovernmental transfers from the
86	93		district to the state to provide the nonfederal share of Medicaid
87	94		payments for:
88	95		(A) uncompensated care payments to nonpublic
89	96		hospitals affiliated with the district, if those payments are
90	97		authorized under the Texas Healthcare Transformation and Quality
91	98		Improvement Program waiver issued under Section 1115 of the federal
92	99		Social Security Act (42 U.S.C. Section 1315);
93	100		(B) uniform rate enhancements for nonpublic
94	101		hospitals in the Medicaid managed care service area in which the
95	102		district is located;
96	103		(C) payments available under another waiver
97	104		program authorizing payments that are substantially similar to
98	105		Medicaid payments to nonpublic hospitals described by Subdivision
99	106		(A) or (B); or
100	107		(D) any reimbursement to nonpublic hospitals for
101	108		which federal matching funds are available;
102	109		(2) subject to Section 298A.151(d), pay the
103	110		administrative expenses of the district in administering the
104	111		program, including collateralization of deposits;
105	112		(3) refund a mandatory payment collected in error from
106	113		a paying provider;
107	114		(4) refund to paying providers a proportionate share
108	115		of the money that the district:
109	116		(A) receives from the Health and Human Services
110	117		Commission that is not used to fund the nonfederal share of Medicaid
111	118		supplemental payment program payments; or
112	119		(B) determines cannot be used to fund the
113	120		nonfederal share of Medicaid supplemental payment program
114	121		payments;
115	122		(5) transfer funds to the Health and Human Services
116	123		Commission if the district is legally required to transfer the
117	124		funds to address a disallowance of federal matching funds with
118	125		respect to programs for which the district made intergovernmental
119	126		transfers described by Subdivision (1); and
120	127		(6) reimburse the district if the district is required
121	128		by the rules governing the uniform rate enhancement program
122	129		described by Subdivision (1)(B) to incur an expense or forego
123	130		Medicaid reimbursements from the state because the balance of the
124	131		local provider participation fund is not sufficient to fund that
125	132		rate enhancement program.
126	133		(d) Money in the local provider participation fund may not
127	134		be commingled with other district funds.
128	135		(e) Notwithstanding any other provision of this chapter,
129	136		with respect to an intergovernmental transfer of funds described by
130	137		Subsection (c)(1) made by the district, any funds received by the
131	138		state, district, or other entity as a result of that transfer may
132	139		not be used by the state, district, or any other entity to:
133	140		(1) expand Medicaid eligibility under the Patient
134	141		Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
135	142		by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
136	143		No. 111-152); or
137	144		(2) fund the nonfederal share of payments to nonpublic
138	145		hospitals available through the Medicaid disproportionate share
139	146		hospital program or the delivery system reform incentive payment
140	147		program.
141	148		SUBCHAPTER D. MANDATORY PAYMENTS
142	149		Sec. 298A.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
143	150		NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if
144	151		the board authorizes a health care provider participation program
145	152		under this chapter, the board may require an annual mandatory
146	153		payment to be assessed on the net patient revenue of each
147	154		institutional health care provider located in the district. The
148	155		board may provide for the mandatory payment to be assessed
149	156		quarterly. In the first year in which the mandatory payment is
150	157		required, the mandatory payment is assessed on the net patient
151	158		revenue of an institutional health care provider as determined by
152	159		the data reported to the Department of State Health Services under
153	160		Sections 311.032 and 311.033 in the most recent fiscal year for
154	161		which that data was reported. If the institutional health care
155	162		provider did not report any data under those sections, the
156	163		provider's net patient revenue is the amount of that revenue as
157	164		contained in the provider's Medicare cost report submitted for the
158	165		previous fiscal year or for the closest subsequent fiscal year for
159	166		which the provider submitted the Medicare cost report. If the
160	167		mandatory payment is required, the district shall update the amount
161	168		of the mandatory payment on an annual basis.
162	169		(b) The amount of a mandatory payment authorized under this
163	170		chapter must be uniformly proportionate with the amount of net
164	171		patient revenue generated by each paying provider in the district
165	172		as permitted under federal law. A health care provider
166	173		participation program authorized under this chapter may not hold
167	174		harmless any institutional health care provider, as required under
168	175		42 U.S.C. Section 1396b(w).
169	176		(c) If the board requires a mandatory payment authorized
170	177		under this chapter, the board shall set the amount of the mandatory
171	178		payment, subject to the limitations of this chapter. The aggregate
172	179		amount of the mandatory payments required of all paying providers
173	180		in the district may not exceed six percent of the aggregate net
174	181		patient revenue from hospital services provided by all paying
175	182		providers in the district.
176	183		(d) Subject to Subsection (c), if the board requires a
177	184		mandatory payment authorized under this chapter, the board shall
178	185		set the mandatory payments in amounts that in the aggregate will
179	186		generate sufficient revenue to cover the administrative expenses of
180	187		the district for activities under this chapter and to fund an
181	188		intergovernmental transfer described by Section 298A.103(c)(1).
182	189		The annual amount of revenue from mandatory payments that shall be
183	190		paid for administrative expenses by the district is $150,000, plus
184	191		the cost of collateralization of deposits, regardless of actual
185	192		expenses.
186	193		(e) A paying provider may not add a mandatory payment
187	194		required under this section as a surcharge to a patient.
188	195		(f) A mandatory payment assessed under this chapter is not a
189	196		tax for hospital purposes for purposes of Section 4, Article IX,
190	197		Texas Constitution, or Section 281.045.
191	198		Sec. 298A.152. ASSESSMENT AND COLLECTION OF MANDATORY
192	199		PAYMENTS. (a) The district may designate an official of the
193	200		district or contract with another person to assess and collect the
194	201		mandatory payments authorized under this chapter.
195	202		(b) The person charged by the district with the assessment
196	203		and collection of mandatory payments shall charge and deduct from
197	204		the mandatory payments collected for the district a collection fee
198	205		in an amount not to exceed the person's usual and customary charges
199	206		for like services.
200	207		(c) If the person charged with the assessment and collection
201	208		of mandatory payments is an official of the district, any revenue
202	209		from a collection fee charged under Subsection (b) shall be
203	210		deposited in the district general fund and, if appropriate, shall
204	211		be reported as fees of the district.
205	212		Sec. 298A.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
206	213		PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this chapter
207	214		is to authorize the district to establish a program to enable the
208	215		district to collect mandatory payments from institutional health
209	216		care providers to fund the nonfederal share of a Medicaid
210	217		supplemental payment program or the Medicaid managed care rate
211	218		enhancements for nonpublic hospitals to support the provision of
212	219		health care by institutional health care providers to district
213	220		residents in need of health care.
214	221		(b) This chapter does not authorize the district to collect
215	222		mandatory payments for the purpose of raising general revenue or
216	223		any amount in excess of the amount reasonably necessary to fund the
217	224		nonfederal share of a Medicaid supplemental payment program or
218	225		Medicaid managed care rate enhancements for nonpublic hospitals and
219	226		to cover the administrative expenses of the district associated
220	227		with activities under this chapter.
221	228		(c) To the extent any provision or procedure under this
222	229		chapter causes a mandatory payment authorized under this chapter to
223	230		be ineligible for federal matching funds, the board may provide by
224	231		rule for an alternative provision or procedure that conforms to the
225	232		requirements of the federal Centers for Medicare and Medicaid
226	233		Services. A rule adopted under this section may not create, impose,
227	234		or materially expand the legal or financial liability or
228	235		responsibility of the district or an institutional health care
229	236		provider in the district beyond the provisions of this chapter.
230	237		This section does not require the board to adopt a rule.
231	238		(d) The district may only assess and collect a mandatory
232	239		payment authorized under this chapter if a waiver program, uniform
233	240		rate enhancement, or reimbursement described by Section
234	241		298A.103(c)(1) is available to the district.
235	242		SECTION 2. As soon as practicable after the expiration of
236	243		the authority of the Dallas County Hospital District to administer
237	244		and operate a health care provider participation program under
238	245		Chapter 298A, Health and Safety Code, as added by this Act, the
239	246		board of hospital managers of the Dallas County Hospital District
240	247		shall transfer to each institutional health care provider in the
241	248		district that provider's proportionate share of any remaining funds
242	249		in any local provider participation fund created by the district
243	250		under Section 298A.103, Health and Safety Code, as added by this
244	251		Act.
245	252		SECTION 3. If before implementing any provision of this Act
246	253		a state agency determines that a waiver or authorization from a
247	254		federal agency is necessary for implementation of that provision,
248	255		the agency affected by the provision shall request the waiver or
249	256		authorization and may delay implementing that provision until the
250	257		waiver or authorization is granted.
251	258		SECTION 4. This Act takes effect immediately if it receives
252	259		a vote of two-thirds of all the members elected to each house, as
253	260		provided by Section 39, Article III, Texas Constitution. If this
254	261		Act does not receive the vote necessary for immediate effect, this
255	262		Act takes effect September 1, 2017.
256		-	______________________________ ______________________________
257		-	President of the Senate Speaker of the House
258		-	I certify that H.B. No. 4300 was passed by the House on April
259		-	20, 2017, by the following vote: Yeas 142, Nays 2, 2 present, not
260		-	voting.
261		-	______________________________
262		-	Chief Clerk of the House
263		-	I certify that H.B. No. 4300 was passed by the Senate on May
264		-	4, 2017, by the following vote: Yeas 31, Nays 0.
265		-	______________________________
266		-	Secretary of the Senate
267		-	APPROVED: _____________________
268		-	Date
269		-	_____________________
270		-	Governor
	263	+	* * * * *