Texas 2017 - 85th Regular

Texas House Bill HR2597 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.R. No. 2597
	1	+	85R34092 JCG-D
	2	+	By: Lucio III H.R. No. 2597
2	3
3	4
4	5		R E S O L U T I O N
5	6		BE IT RESOLVED by the House of Representatives of the State of
6	7		Texas, 85th Legislature, Regular Session, 2017, That House Rule 13,
7	8		Section 9(a), be suspended in part as provided by House Rule 13,
8	9		Section 9(f), to enable the conference committee appointed to
9	10		resolve the differences on Senate Bill 1462 (the creation and
10	11		operation of certain local health care provider participation
11	12		programs) to consider and take action on the following matter:
12	13		House Rule 13, Section 9(a)(4), is suspended to permit the
13	14		committee to add text on a matter not included in either the house
14	15		or senate version of the bill by adding the following SECTIONS to
15	16		the bill:
16	17		SECTION 28. Subtitle D, Title 4, Health and Safety Code, is
17	18		amended by adding Chapter 298B to read as follows:
18	19		CHAPTER 298B. TARRANT COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
19	20		PARTICIPATION PROGRAM
20	21		SUBCHAPTER A. GENERAL PROVISIONS
21	22		Sec. 298B.001. DEFINITIONS. In this chapter:
22	23		(1) "Board" means the board of hospital managers of
23	24		the district.
24	25		(2) "District" means the Tarrant County Hospital
25	26		District.
26	27		(3) "Institutional health care provider" means a
27	28		nonpublic hospital located in the district that provides inpatient
28	29		hospital services.
29	30		(4) "Paying provider" means an institutional health
30	31		care provider required to make a mandatory payment under this
31	32		chapter.
32	33		(5) "Program" means the health care provider
33	34		participation program authorized by this chapter.
34	35		Sec. 298B.002. APPLICABILITY. This chapter applies only to
35	36		the Tarrant County Hospital District.
36	37		Sec. 298B.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
37	38		PARTICIPATION IN PROGRAM. The board may authorize the district to
38	39		participate in a health care provider participation program on the
39	40		affirmative vote of a majority of the board, subject to the
40	41		provisions of this chapter.
41	42		Sec. 298B.004. EXPIRATION OF AUTHORITY. (a) Subject to
42	43		Sections 298B.153(d) and 298B.154, the authority of the district to
43	44		administer and operate a program under this chapter expires
44	45		December 31, 2019.
45	46		(b) Subsection (a) does not affect the authority of the
46	47		district to require and collect a mandatory payment under Section
47	48		298B.154 after December 31, 2019, if necessary.
48	49		SUBCHAPTER B. POWERS AND DUTIES OF BOARD
49	50		Sec. 298B.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
50	51		PAYMENT. The board may require a mandatory payment authorized
51	52		under this chapter by an institutional health care provider in the
52	53		district only in the manner provided by this chapter.
53	54		Sec. 298B.052. RULES AND PROCEDURES. The board may adopt
54	55		rules relating to the administration of the program, including
55	56		collection of the mandatory payments, expenditures, audits, and any
56	57		other administrative aspects of the program.
57	58		Sec. 298B.053. INSTITUTIONAL HEALTH CARE PROVIDER
58	59		REPORTING. If the board authorizes the district to participate in a
59	60		program under this chapter, the board shall require each
60	61		institutional health care provider to submit to the district a copy
61	62		of any financial and utilization data required by and reported to
62	63		the Department of State Health Services under Sections 311.032 and
63	64		311.033 and any rules adopted by the executive commissioner of the
64	65		Health and Human Services Commission to implement those sections.
65	66		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
66	67		Sec. 298B.101. HEARING. (a) In each year that the board
67	68		authorizes a program under this chapter, the board shall hold a
68	69		public hearing on the amounts of any mandatory payments that the
69	70		board intends to require during the year and how the revenue derived
70	71		from those payments is to be spent.
71	72		(b) Not later than the fifth day before the date of the
72	73		hearing required under Subsection (a), the board shall publish
73	74		notice of the hearing in a newspaper of general circulation in the
74	75		district and provide written notice of the hearing to each
75	76		institutional health care provider in the district.
76	77		Sec. 298B.102. DEPOSITORY. (a) If the board requires a
77	78		mandatory payment authorized under this chapter, the board shall
78	79		designate one or more banks as a depository for the district's local
79	80		provider participation fund.
80	81		(b) All funds collected under this chapter shall be secured
81	82		in the manner provided for securing other district funds.
82	83		Sec. 298B.103. LOCAL PROVIDER PARTICIPATION FUND;
83	84		AUTHORIZED USES OF MONEY. (a) If the district requires a mandatory
84	85		payment authorized under this chapter, the district shall create a
85	86		local provider participation fund.
86	87		(b) The local provider participation fund consists of:
87	88		(1) all revenue received by the district attributable
88	89		to mandatory payments authorized under this chapter;
89	90		(2) money received from the Health and Human Services
90	91		Commission as a refund of an intergovernmental transfer under the
91	92		program, provided that the intergovernmental transfer does not
92	93		receive a federal matching payment; and
93	94		(3) the earnings of the fund.
94	95		(c) Money deposited to the local provider participation
95	96		fund of the district may be used only to:
96	97		(1) fund intergovernmental transfers from the
97	98		district to the state to provide the nonfederal share of Medicaid
98	99		payments for:
99	100		(A) uncompensated care payments to nonpublic
100	101		hospitals affiliated with the district, if those payments are
101	102		authorized under the Texas Healthcare Transformation and Quality
102	103		Improvement Program waiver issued under Section 1115 of the federal
103	104		Social Security Act (42 U.S.C. Section 1315);
104	105		(B) uniform rate enhancements for nonpublic
105	106		hospitals in the Medicaid managed care service area in which the
106	107		district is located;
107	108		(C) payments available under another waiver
108	109		program authorizing payments that are substantially similar to
109	110		Medicaid payments to nonpublic hospitals described by Paragraph (A)
110	111		or (B); or
111	112		(D) any reimbursement to nonpublic hospitals for
112	113		which federal matching funds are available;
113	114		(2) subject to Section 298B.151(d), pay the
114	115		administrative expenses of the district in administering the
115	116		program, including collateralization of deposits;
116	117		(3) refund a mandatory payment collected in error from
117	118		a paying provider;
118	119		(4) refund to paying providers a proportionate share
119	120		of the money that the district:
120	121		(A) receives from the Health and Human Services
121	122		Commission that is not used to fund the nonfederal share of Medicaid
122	123		supplemental payment program payments; or
123	124		(B) determines cannot be used to fund the
124	125		nonfederal share of Medicaid supplemental payment program
125	126		payments;
126	127		(5) transfer funds to the Health and Human Services
127	128		Commission if the district is legally required to transfer the
128	129		funds to address a disallowance of federal matching funds with
129	130		respect to programs for which the district made intergovernmental
130	131		transfers described by Subdivision (1); and
131	132		(6) reimburse the district if the district is required
132	133		by the rules governing the uniform rate enhancement program
133	134		described by Subdivision (1)(B) to incur an expense or forego
134	135		Medicaid reimbursements from the state because the balance of the
135	136		local provider participation fund is not sufficient to fund that
136	137		rate enhancement program.
137	138		(d) Money in the local provider participation fund may not
138	139		be commingled with other district funds.
139	140		(e) Notwithstanding any other provision of this chapter,
140	141		with respect to an intergovernmental transfer of funds described by
141	142		Subsection (c)(1) made by the district, any funds received by the
142	143		state, district, or other entity as a result of that transfer may
143	144		not be used by the state, district, or any other entity to:
144	145		(1) expand Medicaid eligibility under the Patient
145	146		Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
146	147		by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
147	148		No. 111-152); or
148	149		(2) fund the nonfederal share of payments to nonpublic
149	150		hospitals available through the Medicaid disproportionate share
150	151		hospital program or the delivery system reform incentive payment
151	152		program.
152	153		SUBCHAPTER D. MANDATORY PAYMENTS
153	154		Sec. 298B.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
154	155		NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if
155	156		the board authorizes a health care provider participation program
156	157		under this chapter, the board may require an annual mandatory
157	158		payment to be assessed on the net patient revenue of each
158	159		institutional health care provider located in the district. The
159	160		board may provide for the mandatory payment to be assessed
160	161		quarterly. In the first year in which the mandatory payment is
161	162		required, the mandatory payment is assessed on the net patient
162	163		revenue of an institutional health care provider as determined by
163	164		the data reported to the Department of State Health Services under
164	165		Sections 311.032 and 311.033 in the most recent fiscal year for
165	166		which that data was reported. If the institutional health care
166	167		provider did not report any data under those sections, the
167	168		provider's net patient revenue is the amount of that revenue as
168	169		contained in the provider's Medicare cost report submitted for the
169	170		previous fiscal year or for the closest subsequent fiscal year for
170	171		which the provider submitted the Medicare cost report. If the
171	172		mandatory payment is required, the district shall update the amount
172	173		of the mandatory payment on an annual basis.
173	174		(b) The amount of a mandatory payment authorized under this
174	175		chapter must be uniformly proportionate with the amount of net
175	176		patient revenue generated by each paying provider in the district
176	177		as permitted under federal law. A health care provider
177	178		participation program authorized under this chapter may not hold
178	179		harmless any institutional health care provider, as required under
179	180		42 U.S.C. Section 1396b(w).
180	181		(c) If the board requires a mandatory payment authorized
181	182		under this chapter, the board shall set the amount of the mandatory
182	183		payment, subject to the limitations of this chapter. The aggregate
183	184		amount of the mandatory payments required of all paying providers
184	185		in the district may not exceed six percent of the aggregate net
185	186		patient revenue from hospital services provided by all paying
186	187		providers in the district.
187	188		(d) Subject to Subsection (c), if the board requires a
188	189		mandatory payment authorized under this chapter, the board shall
189	190		set the mandatory payments in amounts that in the aggregate will
190	191		generate sufficient revenue to cover the administrative expenses of
191	192		the district for activities under this chapter and to fund an
192	193		intergovernmental transfer described by Section 298B.103(c)(1).
193	194		The annual amount of revenue from mandatory payments that shall be
194	195		paid for administrative expenses by the district is $150,000, plus
195	196		the cost of collateralization of deposits, regardless of actual
196	197		expenses.
197	198		(e) A paying provider may not add a mandatory payment
198	199		required under this section as a surcharge to a patient.
199	200		(f) A mandatory payment assessed under this chapter is not a
200	201		tax for hospital purposes for purposes of Section 4, Article IX,
201	202		Texas Constitution, or Section 281.045.
202	203		Sec. 298B.152. ASSESSMENT AND COLLECTION OF MANDATORY
203	204		PAYMENTS. (a) The district may designate an official of the
204	205		district or contract with another person to assess and collect the
205	206		mandatory payments authorized under this chapter.
206	207		(b) The person charged by the district with the assessment
207	208		and collection of mandatory payments shall charge and deduct from
208	209		the mandatory payments collected for the district a collection fee
209	210		in an amount not to exceed the person's usual and customary charges
210	211		for like services.
211	212		(c) If the person charged with the assessment and collection
212	213		of mandatory payments is an official of the district, any revenue
213	214		from a collection fee charged under Subsection (b) shall be
214	215		deposited in the district general fund and, if appropriate, shall
215	216		be reported as fees of the district.
216	217		Sec. 298B.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
217	218		PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this chapter
218	219		is to authorize the district to establish a program to enable the
219	220		district to collect mandatory payments from institutional health
220	221		care providers to fund the nonfederal share of a Medicaid
221	222		supplemental payment program or the Medicaid managed care rate
222	223		enhancements for nonpublic hospitals to support the provision of
223	224		health care by institutional health care providers to district
224	225		residents in need of health care.
225	226		(b) This chapter does not authorize the district to collect
226	227		mandatory payments for the purpose of raising general revenue or
227	228		any amount in excess of the amount reasonably necessary to fund the
228	229		nonfederal share of a Medicaid supplemental payment program or
229	230		Medicaid managed care rate enhancements for nonpublic hospitals and
230	231		to cover the administrative expenses of the district associated
231	232		with activities under this chapter.
232	233		(c) To the extent any provision or procedure under this
233	234		chapter causes a mandatory payment authorized under this chapter to
234	235		be ineligible for federal matching funds, the board may provide by
235	236		rule for an alternative provision or procedure that conforms to the
236	237		requirements of the federal Centers for Medicare and Medicaid
237	238		Services. A rule adopted under this section may not create, impose,
238	239		or materially expand the legal or financial liability or
239	240		responsibility of the district or an institutional health care
240	241		provider in the district beyond the provisions of this chapter.
241	242		This section does not require the board to adopt a rule.
242	243		(d) The district may only assess and collect a mandatory
243	244		payment authorized under this chapter if a waiver program, uniform
244	245		rate enhancement, or reimbursement described by Section
245	246		298B.103(c)(1) is available to the district.
246	247		Sec. 298B.154. FEDERAL DISALLOWANCE. Notwithstanding any
247	248		other provision of this chapter, if the Centers for Medicare and
248	249		Medicaid Services issues a disallowance of federal matching funds
249	250		for a purpose for which intergovernmental transfers described by
250	251		Section 298B.103(c)(1) were made and the Health and Human Services
251	252		Commission demands repayment from the district of federal funds
252	253		paid to the district for that purpose, the district may require and
253	254		collect mandatory payments from each paying provider that received
254	255		those federal funds in an amount sufficient to satisfy the
255	256		repayment demand made by the commission. The percentage limitation
256	257		prescribed by Section 298B.151(c) does not apply to a mandatory
257	258		payment required under this section.
258	259		SECTION 29. As soon as practicable after the expiration of
259	260		the authority of the Tarrant County Hospital District to administer
260	261		and operate a health care provider participation program under
261	262		Chapter 298B, Health and Safety Code, as added by this Act, the
262	263		board of hospital managers of the Tarrant County Hospital District
263	264		shall transfer to each institutional health care provider in the
264	265		district that provider's proportionate share of any remaining funds
265	266		in any local provider participation fund created by the district
266	267		under Section 298B.103, Health and Safety Code, as added by this
267	268		Act.
268	269		SECTION 30. If before implementing any provision of Chapter
269	270		298B, Health and Safety Code, as added by this Act, a state agency
270	271		determines that a waiver or authorization from a federal agency is
271	272		necessary for implementation of that provision, the agency affected
272	273		by the provision shall request the waiver or authorization and may
273	274		delay implementing that provision until the waiver or authorization
274	275		is granted.
275	276		Explanation: The added language is necessary to allow the
276	277		Tarrant County Hospital District to create and operate a health
277	278		care provider participation program in Tarrant County.
278		-	Lucio III
279		-	______________________________
280		-	Speaker of the House
281		-	I certify that H.R. No. 2597 was adopted by the House on May
282		-	28, 2017, by the following vote: Yeas 138, Nays 7, 1 present, not
283		-	voting.
284		-	______________________________
285		-	Chief Clerk of the House