Texas 2017 - 85th Regular

Texas Senate Bill SB1130 Compare Versions

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

Old	New	Differences
1	1	85R7658 LED-F
2	2	By: Hinojosa S.B. No. 1130
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the creation and administration of a reinvestment
8	8	allowance for certain long-term care facilities.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Chapter 242, Health and Safety Code, is amended
11	11	by adding Subchapter P to read as follows:
12	12	SUBCHAPTER P. REINVESTMENT ALLOWANCE
13	13	Sec. 242.701. DEFINITION. In this subchapter, "gross
14	14	receipts" means the gross inpatient revenue received by a facility
15	15	from services provided to facility residents. Gross receipts
16	16	exclude revenue from nonresident care, including beauty and barber
17	17	services, vending facilities, interest, charitable contributions,
18	18	the sale of meals, and outpatient services.
19	19	Sec. 242.702. REINVESTMENT ALLOWANCE; COMPUTATION. (a)
20	20	The commission shall impose a reinvestment allowance on each
21	21	facility licensed under this chapter. The reinvestment allowance
22	22	is:
23	23	(1) the product of the amount established under
24	24	Subsection (b) multiplied by the number of a facility's
25	25	non-Medicare patient days calculated under Section 242.703;
26	26	(2) payable monthly; and
27	27	(3) in addition to other amounts imposed under this
28	28	chapter.
29	29	(b) The executive commissioner shall establish for each
30	30	non-Medicare patient day an amount for use in calculating the
31	31	reinvestment allowance sufficient to produce annual revenues from
32	32	all facilities not to exceed the maximum amount that may be assessed
33	33	within the indirect guarantee threshold provided under 42 C.F.R.
34	34	Section 433.68(f)(3)(i).
35	35	(c) The commission shall determine the amount described by
36	36	Subsection (b) using non-Medicare patient days and gross receipts:
37	37	(1) reported to the commission; and
38	38	(2) covering a period of at least six months.
39	39	(d) A facility may not list the reinvestment allowance as a
40	40	separate charge on a resident's billing statement or otherwise
41	41	directly or indirectly attempt to charge the reinvestment allowance
42	42	to a resident.
43	43	Sec. 242.703. PATIENT DAYS. For each calendar day, a
44	44	facility shall determine the number of non-Medicare patient days by
45	45	adding:
46	46	(1) the number of non-Medicare residents occupying a
47	47	bed in the facility immediately before midnight of that day plus the
48	48	number of residents admitted that day, less the number of residents
49	49	discharged that day, except a resident is included in the count
50	50	under this subdivision if:
51	51	(A) the resident is admitted and discharged on
52	52	the same day; or
53	53	(B) the resident is discharged that day because
54	54	of the resident's death; and
55	55	(2) the number of beds that are on hold that day and
56	56	that have been placed on hold for a period not to exceed three
57	57	consecutive calendar days during which a resident is:
58	58	(A) in the hospital; or
59	59	(B) on therapeutic home leave.
60	60	Sec. 242.704. COLLECTION AND REPORTING. (a) The
61	61	commission shall collect the reinvestment allowance.
62	62	(b) Not later than the 25th day after the last day of a
63	63	month, each facility shall:
64	64	(1) file with the commission a report stating the
65	65	total non-Medicare resident days for the month; and
66	66	(2) pay the reinvestment allowance.
67	67	Sec. 242.705. RULES; ADMINISTRATIVE PENALTY. (a) The
68	68	executive commissioner shall adopt rules to administer this
69	69	subchapter, including rules related to imposing and collecting the
70	70	reinvestment allowance.
71	71	(b) Notwithstanding Section 242.066, an administrative
72	72	penalty assessed under that section for a violation of this
73	73	subchapter may not exceed the greater of:
74	74	(1) one-half of the amount of the facility's
75	75	outstanding reinvestment allowance; or
76	76	(2) $20,000.
77	77	Sec. 242.706. NURSING FACILITY REINVESTMENT ALLOWANCE
78	78	TRUST FUND. (a) The nursing facility reinvestment allowance trust
79	79	fund is established as a trust fund to be held by the comptroller
80	80	outside of the state treasury and administered by the commission as
81	81	trustee. Interest and income from the assets of the trust fund
82	82	shall be credited to and deposited in the trust fund. The commission
83	83	may use money in the fund only as provided by Section 242.707.
84	84	(b) The commission shall remit the reinvestment allowance
85	85	collected under this subchapter and federal matching funds received
86	86	by this state to the comptroller for deposit in the trust fund.
87	87	Sec. 242.707. REIMBURSEMENT OF FACILITIES. (a) The
88	88	commission may use money in the nursing facility reinvestment
89	89	allowance trust fund, including any federal matching funds, only
90	90	for the following purposes:
91	91	(1) reimbursing the federal share of the reinvestment
92	92	allowance as a pass-through in the rate;
93	93	(2) increasing reimbursement rates paid under the
94	94	state Medicaid program to facilities; and
95	95	(3) with any money remaining after funding
96	96	Subdivisions (1) and (2), providing direct care staff programs
97	97	related to quality incentives and quality metrics.
98	98	(b) The commission shall devise a formula by which amounts
99	99	received under this subchapter increase the reimbursement rates
100	100	paid to facilities under the state Medicaid program.
101	101	(c) Money in the nursing facility reinvestment allowance
102	102	trust fund may not be used to expand Medicaid eligibility under the
103	103	Patient Protection and Affordable Care Act (Pub. L. No. 111-148) as
104	104	amended by the Health Care and Education Reconciliation Act of 2010
105	105	(Pub. L. No. 111-152).
106	106	Sec. 242.708. INVALIDITY; FEDERAL FUNDS. If any provision
107	107	of or procedure under this subchapter is held invalid by a final
108	108	court order that is not subject to appeal, or if the commission
109	109	determines that the imposition of the reinvestment allowance and
110	110	the expenditure of amounts collected as prescribed by this
111	111	subchapter will not entitle the state to receive federal matching
112	112	funds under the Medicaid program, the commission shall:
113	113	(1) stop collection of the reinvestment allowance; and
114	114	(2) not later than the 30th day after the date
115	115	collection is stopped, return to each facility, in proportion to
116	116	the total amount paid by the facility, any money deposited to the
117	117	credit of the nursing facility reinvestment allowance trust fund
118	118	but not spent.
119	119	Sec. 242.709. AUTHORITY TO ACCOMPLISH PURPOSES OF
120	120	SUBCHAPTER. The executive commissioner by rule may adopt a
121	121	definition, a method of computation, or a rate that differs from
122	122	those expressly provided by or expressly authorized by this
123	123	subchapter to the extent the difference is necessary to accomplish
124	124	the purposes of this subchapter.
125	125	Sec. 242.710. EXPIRATION. This subchapter expires August
126	126	31, 2021.
127	127	SECTION 2. (a) As soon as practicable after the effective
128	128	date of this Act, the executive commissioner of the Health and Human
129	129	Services Commission shall:
130	130	(1) adopt the rules necessary to implement Subchapter
131	131	P, Chapter 242, Health and Safety Code, as added by this Act; and
132	132	(2) notwithstanding Section 242.702, Health and
133	133	Safety Code, as added by this Act, establish the amount of the
134	134	initial reinvestment allowance imposed under Subchapter P, Chapter
135	135	242, Health and Safety Code, as added by this Act, based on
136	136	available revenue and patient day information.
137	137	(b) The amount of the initial reinvestment allowance
138	138	established under Subsection (a) of this section remains in effect
139	139	until the Health and Human Services Commission obtains the
140	140	information necessary to set the amount of the reinvestment
141	141	allowance under Section 242.702, Health and Safety Code, as added
142	142	by this Act.
143	143	SECTION 3. If before implementing any provision of this Act
144	144	a state agency determines that a waiver or authorization from a
145	145	federal agency is necessary for implementation of that provision,
146	146	the agency affected by the provision shall request the waiver or
147	147	authorization and may delay implementing that provision until the
148	148	waiver or authorization is granted.
149	149	SECTION 4. Notwithstanding any other law, a reinvestment
150	150	allowance may not be imposed under Section 242.702, Health and
151	151	Safety Code, as added by this Act, or collected under Section
152	152	242.704, Health and Safety Code, as added by this Act, until:
153	153	(1) an amendment to the state Medicaid plan that
154	154	increases the rates paid to long-term care facilities licensed
155	155	under Chapter 242, Health and Safety Code, for providing services
156	156	under the state Medicaid program is approved by the Centers for
157	157	Medicare and Medicaid Services or another applicable federal
158	158	government agency; and
159	159	(2) long-term care facilities licensed under Chapter
160	160	242, Health and Safety Code, have been compensated retroactively at
161	161	the increased rate for services provided under the state Medicaid
162	162	program for the period beginning with the effective date of this
163	163	Act.
164	164	SECTION 5. The Health and Human Services Commission shall
165	165	discontinue the reinvestment allowance imposed under Subchapter P,
166	166	Chapter 242, Health and Safety Code, as added by this Act, if the
167	167	commission reduces Medicaid reimbursement rates, including rates
168	168	that increased due to funds from the nursing facility reinvestment
169	169	allowance trust fund or federal matching funds, below the rates in
170	170	effect on September 1, 2017.
171	171	SECTION 6. This Act takes effect immediately if it receives
172	172	a vote of two-thirds of all the members elected to each house, as
173	173	provided by Section 39, Article III, Texas Constitution. If this
174	174	Act does not receive the vote necessary for immediate effect, this
175	175	Act takes effect September 1, 2017.