Texas 2017 - 85th Regular

Texas Senate Bill SB1429 Compare Versions

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

Old	New	Differences
1	1	85R12627 MEW-F
2	2	By: Perry S.B. No. 1429
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the creation and operations of health care provider
8	8	participation programs in certain counties.
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 293A to read as follows:
12	12	CHAPTER 293A. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
13	13	CERTAIN COUNTIES INCLUDING PORTION OF CONCHO RIVER
14	14	SUBCHAPTER A. GENERAL PROVISIONS
15	15	Sec. 293A.001. DEFINITIONS. In this chapter:
16	16	(1) "Institutional health care provider" means a
17	17	nonpublic hospital that provides inpatient hospital services.
18	18	(2) "Paying hospital" means an institutional health
19	19	care provider required to make a mandatory payment under this
20	20	chapter.
21	21	(3) "Program" means a county health care provider
22	22	participation program authorized by this chapter.
23	23	Sec. 293A.002. APPLICABILITY. This chapter applies only to
24	24	a county that:
25	25	(1) is not served by a hospital district or a public
26	26	hospital;
27	27	(2) has a population of more than 100,000; and
28	28	(3) includes a portion of the Concho River.
29	29	Sec. 293A.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
30	30	PROGRAM. (a) A county health care provider participation program
31	31	authorizes a county to collect a mandatory payment from each
32	32	institutional health care provider located in the county to be
33	33	deposited in a local provider participation fund established by the
34	34	county. Money in the fund may be used by the county to fund certain
35	35	intergovernmental transfers and indigent care programs as provided
36	36	by this chapter.
37	37	(b) The commissioners court of a county may adopt an order
38	38	authorizing the county to participate in the program, subject to
39	39	the limitations provided by this chapter.
40	40	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
41	41	Sec. 293A.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
42	42	PAYMENT. The commissioners court of a county may require a
43	43	mandatory payment authorized under this chapter by an institutional
44	44	health care provider in the county only in the manner provided by
45	45	this chapter.
46	46	Sec. 293A.052. MAJORITY VOTE REQUIRED. The commissioners
47	47	court of a county may not authorize the county to collect a
48	48	mandatory payment authorized under this chapter without an
49	49	affirmative vote of a majority of the members of the commissioners
50	50	court.
51	51	Sec. 293A.053. RULES AND PROCEDURES. After the
52	52	commissioners court of a county has voted to require a mandatory
53	53	payment authorized under this chapter, the commissioners court may
54	54	adopt rules relating to the administration of the mandatory
55	55	payment.
56	56	Sec. 293A.054. INSTITUTIONAL HEALTH CARE PROVIDER
57	57	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
58	58	county that collects a mandatory payment authorized under this
59	59	chapter shall require each institutional health care provider
60	60	located in the county to submit to the county a copy of any
61	61	financial and utilization data required by and reported to the
62	62	Department of State Health Services under Sections 311.032 and
63	63	311.033 and any rules adopted by the executive commissioner of the
64	64	Health and Human Services Commission to implement those sections.
65	65	(b) The commissioners court of a county that collects a
66	66	mandatory payment authorized under this chapter may inspect the
67	67	records of an institutional health care provider to the extent
68	68	necessary to ensure compliance with the requirements of Subsection
69	69	(a).
70	70	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
71	71	Sec. 293A.101. HEARING. (a) Each year, the commissioners
72	72	court of a county that collects a mandatory payment authorized
73	73	under this chapter shall hold a public hearing on the amounts of any
74	74	mandatory payments that the commissioners court intends to require
75	75	during the year.
76	76	(b) A representative of a paying hospital is entitled to
77	77	appear at the public hearing and be heard regarding any matter
78	78	related to the mandatory payments authorized under this chapter.
79	79	Sec. 293A.102. DEPOSITORY. (a) The commissioners court of
80	80	each county that collects a mandatory payment authorized under this
81	81	chapter by resolution shall designate one or more banks located in
82	82	the county as the depository for mandatory payments received by the
83	83	county.
84	84	(b) All income received by a county under this chapter,
85	85	including the revenue from mandatory payments remaining after
86	86	discounts and fees for assessing and collecting the payments are
87	87	deducted, shall be deposited with the county depository in the
88	88	county's local provider participation fund and may be withdrawn
89	89	only as provided by this chapter.
90	90	(c) All funds under this chapter shall be secured in the
91	91	manner provided for securing county funds.
92	92	Sec. 293A.103. LOCAL PROVIDER PARTICIPATION FUND;
93	93	AUTHORIZED USES OF MONEY. (a) Each county that collects a
94	94	mandatory payment authorized under this chapter shall create a
95	95	local provider participation fund.
96	96	(b) The local provider participation fund of a county
97	97	consists of:
98	98	(1) all revenue received by the county attributable to
99	99	mandatory payments authorized under this chapter, including any
100	100	penalties and interest attributable to delinquent payments;
101	101	(2) money received from the Health and Human Services
102	102	Commission as a refund of an intergovernmental transfer from the
103	103	county to the state for the purpose of providing the nonfederal
104	104	share of Medicaid supplemental payment program payments, provided
105	105	that the intergovernmental transfer does not receive a federal
106	106	matching payment; and
107	107	(3) the earnings of the fund.
108	108	(c) Money deposited to the local provider participation
109	109	fund may be used only to:
110	110	(1) fund intergovernmental transfers from the county
111	111	to the state to provide the nonfederal share of a Medicaid
112	112	supplemental payment program authorized under the state Medicaid
113	113	plan including through the Medicaid managed care program, under the
114	114	Texas Healthcare Transformation and Quality Improvement Program
115	115	waiver issued under Section 1115 of the federal Social Security Act
116	116	(42 U.S.C. Section 1315), or under a successor program authorizing
117	117	similar Medicaid supplemental payment programs;
118	118	(2) subsidize indigent programs;
119	119	(3) pay the administrative expenses of the county
120	120	solely for activities under this chapter;
121	121	(4) refund a portion of a mandatory payment collected
122	122	in error from a paying hospital; and
123	123	(5) refund to paying hospitals the proportionate share
124	124	of money received by the county that is not used to fund the
125	125	nonfederal share of Medicaid supplemental payment program
126	126	payments.
127	127	(d) Money in the local provider participation fund may not
128	128	be commingled with other county funds.
129	129	(e) An intergovernmental transfer of funds described by
130	130	Subsection (c)(1) and any funds received by the county as a result
131	131	of an intergovernmental transfer described by that subsection may
132	132	not be used by the county or any other entity to expand Medicaid
133	133	eligibility under the Patient Protection and Affordable Care Act
134	134	(Pub. L. No. 111-148) as amended by the Health Care and Education
135	135	Reconciliation Act of 2010 (Pub. L. No. 111-152).
136	136	SUBCHAPTER D. MANDATORY PAYMENTS
137	137	Sec. 293A.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
138	138	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
139	139	commissioners court of a county that collects a mandatory payment
140	140	authorized under this chapter may require an annual mandatory
141	141	payment to be assessed on the net patient revenue of each
142	142	institutional health care provider located in the county. The
143	143	commissioners court may provide for the mandatory payment to be
144	144	assessed quarterly. In the first year in which the mandatory
145	145	payment is required, the mandatory payment is assessed on the net
146	146	patient revenue of an institutional health care provider as
147	147	determined by the data reported to the Department of State Health
148	148	Services under Sections 311.032 and 311.033 in the fiscal year
149	149	ending in 2014 or, if the institutional health care provider did not
150	150	report any data under those sections in that fiscal year, as
151	151	determined by the institutional health care provider's Medicare
152	152	cost report submitted for the 2014 fiscal year or for the closest
153	153	subsequent fiscal year for which the provider submitted the
154	154	Medicare cost report. The county shall update the amount of the
155	155	mandatory payment on an annual basis.
156	156	(b) The amount of a mandatory payment authorized under this
157	157	chapter must be uniformly proportionate with the amount of net
158	158	patient revenue generated by each paying hospital in the county. A
159	159	mandatory payment authorized under this chapter may not hold
160	160	harmless any institutional health care provider, as required under
161	161	42 U.S.C. Section 1396b(w).
162	162	(c) The commissioners court of a county that collects a
163	163	mandatory payment authorized under this chapter shall set the
164	164	amount of the mandatory payment. The amount of the mandatory
165	165	payment required of each paying hospital may not exceed six percent
166	166	of the paying hospital's net patient revenue.
167	167	(d) Subject to the maximum amount prescribed by Subsection
168	168	(c), the commissioners court of a county that collects a mandatory
169	169	payment authorized under this chapter shall set the mandatory
170	170	payments in amounts that in the aggregate will generate sufficient
171	171	revenue to cover the administrative expenses of the county for
172	172	activities under this chapter, to fund the nonfederal share of a
173	173	Medicaid supplemental payment program as described by Section
174	174	293A.103(c)(1), and to pay for indigent programs, except that the
175	175	amount of revenue from mandatory payments used for administrative
176	176	expenses of the county for activities under this chapter in a year
177	177	may not exceed the lesser of four percent of the total revenue
178	178	generated from the mandatory payment or $20,000.
179	179	(e) A paying hospital may not add a mandatory payment
180	180	required under this section as a surcharge to a patient.
181	181	Sec. 293A.152. ASSESSMENT AND COLLECTION OF MANDATORY
182	182	PAYMENTS. The county may collect or contract for the assessment and
183	183	collection of mandatory payments authorized under this chapter.
184	184	Sec. 293A.153. INTEREST, PENALTIES, AND DISCOUNTS.
185	185	Interest, penalties, and discounts on mandatory payments required
186	186	under this chapter are governed by the law applicable to county ad
187	187	valorem taxes.
188	188	Sec. 293A.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
189	189	PROCEDURE. (a) The purpose of this chapter is to generate revenue
190	190	by collecting from institutional health care providers a mandatory
191	191	payment to be used to provide the nonfederal share of a Medicaid
192	192	supplemental payment program.
193	193	(b) To the extent any provision or procedure under this
194	194	chapter causes a mandatory payment authorized under this chapter to
195	195	be ineligible for federal matching funds, the county may provide by
196	196	rule for an alternative provision or procedure that conforms to the
197	197	requirements of the federal Centers for Medicare and Medicaid
198	198	Services.
199	199	SECTION 2. If before implementing any provision of this Act
200	200	a state agency determines that a waiver or authorization from a
201	201	federal agency is necessary for implementation of that provision,
202	202	the agency affected by the provision shall request the waiver or
203	203	authorization and may delay implementing that provision until the
204	204	waiver or authorization is granted.
205	205	SECTION 3. This Act takes effect immediately if it receives
206	206	a vote of two-thirds of all the members elected to each house, as
207	207	provided by Section 39, Article III, Texas Constitution. If this
208	208	Act does not receive the vote necessary for immediate effect, this
209	209	Act takes effect September 1, 2017.