85R7658 LED-F
By: Hinojosa S.B. No. 1130
A BILL TO BE ENTITLED
AN ACT
relating to the creation and administration of a reinvestment
allowance for certain long-term care facilities.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 242, Health and Safety Code, is amended
by adding Subchapter P to read as follows:
SUBCHAPTER P. REINVESTMENT ALLOWANCE
Sec. 242.701. DEFINITION. In this subchapter, "gross
receipts" means the gross inpatient revenue received by a facility
from services provided to facility residents. Gross receipts
exclude revenue from nonresident care, including beauty and barber
services, vending facilities, interest, charitable contributions,
the sale of meals, and outpatient services.
Sec. 242.702. REINVESTMENT ALLOWANCE; COMPUTATION. (a)
The commission shall impose a reinvestment allowance on each
facility licensed under this chapter. The reinvestment allowance
is:
(1) the product of the amount established under
Subsection (b) multiplied by the number of a facility's
non-Medicare patient days calculated under Section 242.703;
(2) payable monthly; and
(3) in addition to other amounts imposed under this
chapter.
(b) The executive commissioner shall establish for each
non-Medicare patient day an amount for use in calculating the
reinvestment allowance sufficient to produce annual revenues from
all facilities not to exceed the maximum amount that may be assessed
within the indirect guarantee threshold provided under 42 C.F.R.
Section 433.68(f)(3)(i).
(c) The commission shall determine the amount described by
Subsection (b) using non-Medicare patient days and gross receipts:
(1) reported to the commission; and
(2) covering a period of at least six months.
(d) A facility may not list the reinvestment allowance as a
separate charge on a resident's billing statement or otherwise
directly or indirectly attempt to charge the reinvestment allowance
to a resident.
Sec. 242.703. PATIENT DAYS. For each calendar day, a
facility shall determine the number of non-Medicare patient days by
adding:
(1) the number of non-Medicare residents occupying a
bed in the facility immediately before midnight of that day plus the
number of residents admitted that day, less the number of residents
discharged that day, except a resident is included in the count
under this subdivision if:
(A) the resident is admitted and discharged on
the same day; or
(B) the resident is discharged that day because
of the resident's death; and
(2) the number of beds that are on hold that day and
that have been placed on hold for a period not to exceed three
consecutive calendar days during which a resident is:
(A) in the hospital; or
(B) on therapeutic home leave.
Sec. 242.704. COLLECTION AND REPORTING. (a) The
commission shall collect the reinvestment allowance.
(b) Not later than the 25th day after the last day of a
month, each facility shall:
(1) file with the commission a report stating the
total non-Medicare resident days for the month; and
(2) pay the reinvestment allowance.
Sec. 242.705. RULES; ADMINISTRATIVE PENALTY. (a) The
executive commissioner shall adopt rules to administer this
subchapter, including rules related to imposing and collecting the
reinvestment allowance.
(b) Notwithstanding Section 242.066, an administrative
penalty assessed under that section for a violation of this
subchapter may not exceed the greater of:
(1) one-half of the amount of the facility's
outstanding reinvestment allowance; or
(2) $20,000.
Sec. 242.706. NURSING FACILITY REINVESTMENT ALLOWANCE
TRUST FUND. (a) The nursing facility reinvestment allowance trust
fund is established as a trust fund to be held by the comptroller
outside of the state treasury and administered by the commission as
trustee. Interest and income from the assets of the trust fund
shall be credited to and deposited in the trust fund. The commission
may use money in the fund only as provided by Section 242.707.
(b) The commission shall remit the reinvestment allowance
collected under this subchapter and federal matching funds received
by this state to the comptroller for deposit in the trust fund.
Sec. 242.707. REIMBURSEMENT OF FACILITIES. (a) The
commission may use money in the nursing facility reinvestment
allowance trust fund, including any federal matching funds, only
for the following purposes:
(1) reimbursing the federal share of the reinvestment
allowance as a pass-through in the rate;
(2) increasing reimbursement rates paid under the
state Medicaid program to facilities; and
(3) with any money remaining after funding
Subdivisions (1) and (2), providing direct care staff programs
related to quality incentives and quality metrics.
(b) The commission shall devise a formula by which amounts
received under this subchapter increase the reimbursement rates
paid to facilities under the state Medicaid program.
(c) Money in the nursing facility reinvestment allowance
trust fund may not be used 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).
Sec. 242.708. INVALIDITY; FEDERAL FUNDS. If any provision
of or procedure under this subchapter is held invalid by a final
court order that is not subject to appeal, or if the commission
determines that the imposition of the reinvestment allowance and
the expenditure of amounts collected as prescribed by this
subchapter will not entitle the state to receive federal matching
funds under the Medicaid program, the commission shall:
(1) stop collection of the reinvestment allowance; and
(2) not later than the 30th day after the date
collection is stopped, return to each facility, in proportion to
the total amount paid by the facility, any money deposited to the
credit of the nursing facility reinvestment allowance trust fund
but not spent.
Sec. 242.709. AUTHORITY TO ACCOMPLISH PURPOSES OF
SUBCHAPTER. The executive commissioner by rule may adopt a
definition, a method of computation, or a rate that differs from
those expressly provided by or expressly authorized by this
subchapter to the extent the difference is necessary to accomplish
the purposes of this subchapter.
Sec. 242.710. EXPIRATION. This subchapter expires August
31, 2021.
SECTION 2. (a) As soon as practicable after the effective
date of this Act, the executive commissioner of the Health and Human
Services Commission shall:
(1) adopt the rules necessary to implement Subchapter
P, Chapter 242, Health and Safety Code, as added by this Act; and
(2) notwithstanding Section 242.702, Health and
Safety Code, as added by this Act, establish the amount of the
initial reinvestment allowance imposed under Subchapter P, Chapter
242, Health and Safety Code, as added by this Act, based on
available revenue and patient day information.
(b) The amount of the initial reinvestment allowance
established under Subsection (a) of this section remains in effect
until the Health and Human Services Commission obtains the
information necessary to set the amount of the reinvestment
allowance under Section 242.702, Health and Safety Code, as added
by this Act.
SECTION 3. If before implementing any provision of 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 4. Notwithstanding any other law, a reinvestment
allowance may not be imposed under Section 242.702, Health and
Safety Code, as added by this Act, or collected under Section
242.704, Health and Safety Code, as added by this Act, until:
(1) an amendment to the state Medicaid plan that
increases the rates paid to long-term care facilities licensed
under Chapter 242, Health and Safety Code, for providing services
under the state Medicaid program is approved by the Centers for
Medicare and Medicaid Services or another applicable federal
government agency; and
(2) long-term care facilities licensed under Chapter
242, Health and Safety Code, have been compensated retroactively at
the increased rate for services provided under the state Medicaid
program for the period beginning with the effective date of this
Act.
SECTION 5. The Health and Human Services Commission shall
discontinue the reinvestment allowance imposed under Subchapter P,
Chapter 242, Health and Safety Code, as added by this Act, if the
commission reduces Medicaid reimbursement rates, including rates
that increased due to funds from the nursing facility reinvestment
allowance trust fund or federal matching funds, below the rates in
effect on September 1, 2017.
SECTION 6. 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.