Texas 2017 - 85th Regular

Texas House Bill HB4330 Compare Versions

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

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1	1	85R23382 JCG-D
2	2	By: Geren H.B. No. 4330
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the creation and operations of a health care provider
8	8	participation program by the Tarrant County Hospital District.
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 298B to read as follows:
12	12	CHAPTER 298B. TARRANT COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
13	13	PARTICIPATION PROGRAM
14	14	SUBCHAPTER A. GENERAL PROVISIONS
15	15	Sec. 298B.001. DEFINITIONS. In this chapter:
16	16	(1) "Board" means the board of hospital managers of
17	17	the district.
18	18	(2) "District" means the Tarrant County Hospital
19	19	District.
20	20	(3) "Institutional health care provider" means a
21	21	nonpublic hospital located in the district that provides inpatient
22	22	hospital services.
23	23	(4) "Paying provider" means an institutional health
24	24	care provider required to make a mandatory payment under this
25	25	chapter.
26	26	(5) "Program" means the health care provider
27	27	participation program authorized by this chapter.
28	28	Sec. 298B.002. APPLICABILITY. This chapter applies only to
29	29	the Tarrant County Hospital District.
30	30	Sec. 298B.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
31	31	PARTICIPATION IN PROGRAM. The board may authorize the district to
32	32	participate in a health care provider participation program on the
33	33	affirmative vote of a majority of the board, subject to the
34	34	provisions of this chapter.
35	35	Sec. 298B.004. EXPIRATION OF AUTHORITY. (a) Subject to
36	36	Sections 298B.153(d) and 298B.154, the authority of the district to
37	37	administer and operate a program under this chapter expires
38	38	December 31, 2019.
39	39	(b) Subsection (a) does not affect the authority of the
40	40	district to require and collect a mandatory payment under Section
41	41	298B.154 after December 31, 2019, if necessary.
42	42	SUBCHAPTER B. POWERS AND DUTIES OF BOARD
43	43	Sec. 298B.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
44	44	PAYMENT. The board may require a mandatory payment authorized
45	45	under this chapter by an institutional health care provider in the
46	46	district only in the manner provided by this chapter.
47	47	Sec. 298B.052. RULES AND PROCEDURES. The board may adopt
48	48	rules relating to the administration of the program, including
49	49	collection of the mandatory payments, expenditures, audits, and any
50	50	other administrative aspects of the program.
51	51	Sec. 298B.053. INSTITUTIONAL HEALTH CARE PROVIDER
52	52	REPORTING. If the board authorizes the district to participate in a
53	53	program under this chapter, the board shall require each
54	54	institutional health care provider to submit to the district a copy
55	55	of any financial and utilization data required by and reported to
56	56	the Department of State Health Services under Sections 311.032 and
57	57	311.033 and any rules adopted by the executive commissioner of the
58	58	Health and Human Services Commission to implement those sections.
59	59	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
60	60	Sec. 298B.101. HEARING. (a) In each year that the board
61	61	authorizes a program under this chapter, the board shall hold a
62	62	public hearing on the amounts of any mandatory payments that the
63	63	board intends to require during the year and how the revenue derived
64	64	from those payments is to be spent.
65	65	(b) Not later than the fifth day before the date of the
66	66	hearing required under Subsection (a), the board shall publish
67	67	notice of the hearing in a newspaper of general circulation in the
68	68	district and provide written notice of the hearing to each
69	69	institutional health care provider in the district.
70	70	Sec. 298B.102. DEPOSITORY. (a) If the board requires a
71	71	mandatory payment authorized under this chapter, the board shall
72	72	designate one or more banks as a depository for the district's local
73	73	provider participation fund.
74	74	(b) All funds collected under this chapter shall be secured
75	75	in the manner provided for securing other district funds.
76	76	Sec. 298B.103. LOCAL PROVIDER PARTICIPATION FUND;
77	77	AUTHORIZED USES OF MONEY. (a) If the district requires a mandatory
78	78	payment authorized under this chapter, the district shall create a
79	79	local provider participation fund.
80	80	(b) The local provider participation fund consists of:
81	81	(1) all revenue received by the district attributable
82	82	to mandatory payments authorized under this chapter;
83	83	(2) money received from the Health and Human Services
84	84	Commission as a refund of an intergovernmental transfer under the
85	85	program, provided that the intergovernmental transfer does not
86	86	receive a federal matching payment; and
87	87	(3) the earnings of the fund.
88	88	(c) Money deposited to the local provider participation
89	89	fund of the district may be used only to:
90	90	(1) fund intergovernmental transfers from the
91	91	district to the state to provide the nonfederal share of Medicaid
92	92	payments for:
93	93	(A) uncompensated care payments to nonpublic
94	94	hospitals affiliated with the district, if those payments are
95	95	authorized under the Texas Healthcare Transformation and Quality
96	96	Improvement Program waiver issued under Section 1115 of the federal
97	97	Social Security Act (42 U.S.C. Section 1315);
98	98	(B) uniform rate enhancements for nonpublic
99	99	hospitals in the Medicaid managed care service area in which the
100	100	district is located;
101	101	(C) payments available under another waiver
102	102	program authorizing payments that are substantially similar to
103	103	Medicaid payments to nonpublic hospitals described by Paragraph (A)
104	104	or (B); or
105	105	(D) any reimbursement to nonpublic hospitals for
106	106	which federal matching funds are available;
107	107	(2) subject to Section 298B.151(d), pay the
108	108	administrative expenses of the district in administering the
109	109	program, including collateralization of deposits;
110	110	(3) refund a mandatory payment collected in error from
111	111	a paying provider;
112	112	(4) refund to paying providers a proportionate share
113	113	of the money that the district:
114	114	(A) receives from the Health and Human Services
115	115	Commission that is not used to fund the nonfederal share of Medicaid
116	116	supplemental payment program payments; or
117	117	(B) determines cannot be used to fund the
118	118	nonfederal share of Medicaid supplemental payment program
119	119	payments;
120	120	(5) transfer funds to the Health and Human Services
121	121	Commission if the district is legally required to transfer the
122	122	funds to address a disallowance of federal matching funds with
123	123	respect to programs for which the district made intergovernmental
124	124	transfers described by Subdivision (1); and
125	125	(6) reimburse the district if the district is required
126	126	by the rules governing the uniform rate enhancement program
127	127	described by Subdivision (1)(B) to incur an expense or forego
128	128	Medicaid reimbursements from the state because the balance of the
129	129	local provider participation fund is not sufficient to fund that
130	130	rate enhancement program.
131	131	(d) Money in the local provider participation fund may not
132	132	be commingled with other district funds.
133	133	(e) Notwithstanding any other provision of this chapter,
134	134	with respect to an intergovernmental transfer of funds described by
135	135	Subsection (c)(1) made by the district, any funds received by the
136	136	state, district, or other entity as a result of that transfer may
137	137	not be used by the state, district, or any other entity to:
138	138	(1) expand Medicaid eligibility under the Patient
139	139	Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
140	140	by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
141	141	No. 111-152); or
142	142	(2) fund the nonfederal share of payments to nonpublic
143	143	hospitals available through the Medicaid disproportionate share
144	144	hospital program or the delivery system reform incentive payment
145	145	program.
146	146	SUBCHAPTER D. MANDATORY PAYMENTS
147	147	Sec. 298B.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
148	148	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if
149	149	the board authorizes a health care provider participation program
150	150	under this chapter, the board may require an annual mandatory
151	151	payment to be assessed on the net patient revenue of each
152	152	institutional health care provider located in the district. The
153	153	board may provide for the mandatory payment to be assessed
154	154	quarterly. In the first year in which the mandatory payment is
155	155	required, the mandatory payment is assessed on the net patient
156	156	revenue of an institutional health care provider as determined by
157	157	the data reported to the Department of State Health Services under
158	158	Sections 311.032 and 311.033 in the most recent fiscal year for
159	159	which that data was reported. If the institutional health care
160	160	provider did not report any data under those sections, the
161	161	provider's net patient revenue is the amount of that revenue as
162	162	contained in the provider's Medicare cost report submitted for the
163	163	previous fiscal year or for the closest subsequent fiscal year for
164	164	which the provider submitted the Medicare cost report. If the
165	165	mandatory payment is required, the district shall update the amount
166	166	of the mandatory payment on an annual basis.
167	167	(b) The amount of a mandatory payment authorized under this
168	168	chapter must be uniformly proportionate with the amount of net
169	169	patient revenue generated by each paying provider in the district
170	170	as permitted under federal law. A health care provider
171	171	participation program authorized under this chapter may not hold
172	172	harmless any institutional health care provider, as required under
173	173	42 U.S.C. Section 1396b(w).
174	174	(c) If the board requires a mandatory payment authorized
175	175	under this chapter, the board shall set the amount of the mandatory
176	176	payment, subject to the limitations of this chapter. The aggregate
177	177	amount of the mandatory payments required of all paying providers
178	178	in the district may not exceed six percent of the aggregate net
179	179	patient revenue from hospital services provided by all paying
180	180	providers in the district.
181	181	(d) Subject to Subsection (c), if the board requires a
182	182	mandatory payment authorized under this chapter, the board shall
183	183	set the mandatory payments in amounts that in the aggregate will
184	184	generate sufficient revenue to cover the administrative expenses of
185	185	the district for activities under this chapter and to fund an
186	186	intergovernmental transfer described by Section 298B.103(c)(1).
187	187	The annual amount of revenue from mandatory payments that shall be
188	188	paid for administrative expenses by the district is $150,000, plus
189	189	the cost of collateralization of deposits, regardless of actual
190	190	expenses.
191	191	(e) A paying provider may not add a mandatory payment
192	192	required under this section as a surcharge to a patient.
193	193	(f) A mandatory payment assessed under this chapter is not a
194	194	tax for hospital purposes for purposes of Section 4, Article IX,
195	195	Texas Constitution, or Section 281.045.
196	196	Sec. 298B.152. ASSESSMENT AND COLLECTION OF MANDATORY
197	197	PAYMENTS. (a) The district may designate an official of the
198	198	district or contract with another person to assess and collect the
199	199	mandatory payments authorized under this chapter.
200	200	(b) The person charged by the district with the assessment
201	201	and collection of mandatory payments shall charge and deduct from
202	202	the mandatory payments collected for the district a collection fee
203	203	in an amount not to exceed the person's usual and customary charges
204	204	for like services.
205	205	(c) If the person charged with the assessment and collection
206	206	of mandatory payments is an official of the district, any revenue
207	207	from a collection fee charged under Subsection (b) shall be
208	208	deposited in the district general fund and, if appropriate, shall
209	209	be reported as fees of the district.
210	210	Sec. 298B.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
211	211	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this chapter
212	212	is to authorize the district to establish a program to enable the
213	213	district to collect mandatory payments from institutional health
214	214	care providers to fund the nonfederal share of a Medicaid
215	215	supplemental payment program or the Medicaid managed care rate
216	216	enhancements for nonpublic hospitals to support the provision of
217	217	health care by institutional health care providers to district
218	218	residents in need of health care.
219	219	(b) This chapter does not authorize the district to collect
220	220	mandatory payments for the purpose of raising general revenue or
221	221	any amount in excess of the amount reasonably necessary to fund the
222	222	nonfederal share of a Medicaid supplemental payment program or
223	223	Medicaid managed care rate enhancements for nonpublic hospitals and
224	224	to cover the administrative expenses of the district associated
225	225	with activities under this chapter.
226	226	(c) To the extent any provision or procedure under this
227	227	chapter causes a mandatory payment authorized under this chapter to
228	228	be ineligible for federal matching funds, the board may provide by
229	229	rule for an alternative provision or procedure that conforms to the
230	230	requirements of the federal Centers for Medicare and Medicaid
231	231	Services. A rule adopted under this section may not create, impose,
232	232	or materially expand the legal or financial liability or
233	233	responsibility of the district or an institutional health care
234	234	provider in the district beyond the provisions of this chapter.
235	235	This section does not require the board to adopt a rule.
236	236	(d) The district may only assess and collect a mandatory
237	237	payment authorized under this chapter if a waiver program, uniform
238	238	rate enhancement, or reimbursement described by Section
239	239	298B.103(c)(1) is available to the district.
240	240	Sec. 298B.154. FEDERAL DISALLOWANCE. Notwithstanding any
241	241	other provision of this chapter, if the Centers for Medicare and
242	242	Medicaid Services issues a disallowance of federal matching funds
243	243	for a purpose for which intergovernmental transfers described by
244	244	Section 298B.103(c)(1) were made and the Health and Human Services
245	245	Commission demands repayment from the district of federal funds
246	246	paid to the district for that purpose, the district may require and
247	247	collect mandatory payments from each paying provider that received
248	248	those federal funds in an amount sufficient to satisfy the
249	249	repayment demand made by the commission. The percentage limitation
250	250	prescribed by Section 298B.151(c) does not apply to a mandatory
251	251	payment required under this section.
252	252	SECTION 2. As soon as practicable after the expiration of
253	253	the authority of the Tarrant County Hospital District to administer
254	254	and operate a health care provider participation program under
255	255	Chapter 298B, Health and Safety Code, as added by this Act, the
256	256	board of hospital managers of the Tarrant County Hospital District
257	257	shall transfer to each institutional health care provider in the
258	258	district that provider's proportionate share of any remaining funds
259	259	in any local provider participation fund created by the district
260	260	under Section 298B.103, Health and Safety Code, as added by this
261	261	Act.
262	262	SECTION 3. If before implementing any provision of this Act
263	263	a state agency determines that a waiver or authorization from a
264	264	federal agency is necessary for implementation of that provision,
265	265	the agency affected by the provision shall request the waiver or
266	266	authorization and may delay implementing that provision until the
267	267	waiver or authorization is granted.
268	268	SECTION 4. This Act takes effect immediately if it receives
269	269	a vote of two-thirds of all the members elected to each house, as
270	270	provided by Section 39, Article III, Texas Constitution. If this
271	271	Act does not receive the vote necessary for immediate effect, this
272	272	Act takes effect September 1, 2017.