Texas 2017 - 85th Regular

Texas Senate Bill SB1578 Compare Versions

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

Old	New	Differences
1	1	85R8162 JCG-F
2	2	By: Nichols S.B. No. 1578
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 291A to read as follows:
12	12	CHAPTER 291A. COUNTY HEALTH CARE PROVIDER PARTICIPATION
13	13	PROGRAM IN CERTAIN COUNTIES BORDERING OR INCLUDING THE SAM RAYBURN
14	14	RESERVOIR
15	15	SUBCHAPTER A. GENERAL PROVISIONS
16	16	Sec. 291A.001. DEFINITIONS. In this chapter:
17	17	(1) "Institutional health care provider" means a
18	18	nonpublic hospital that provides inpatient hospital services.
19	19	(2) "Paying hospital" means an institutional health
20	20	care provider required to make a mandatory payment under this
21	21	chapter.
22	22	(3) "Program" means the county health care provider
23	23	participation program authorized by this chapter.
24	24	Sec. 291A.002. APPLICABILITY. This chapter applies only to
25	25	a county that:
26	26	(1) is not served by a hospital district or a public
27	27	hospital;
28	28	(2) has a population of more than 75,000; and
29	29	(3) borders or includes a portion of the Sam Rayburn
30	30	Reservoir.
31	31	Sec. 291A.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
32	32	PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
33	33	provider participation program authorizes a county to collect a
34	34	mandatory payment from each institutional health care provider
35	35	located in the county to be deposited in a local provider
36	36	participation fund established by the county. Money in the fund may
37	37	be used by the county to fund certain intergovernmental transfers
38	38	and indigent care programs as provided by this chapter.
39	39	(b) The commissioners court may adopt an order authorizing a
40	40	county to participate in the program, subject to the limitations
41	41	provided by this chapter.
42	42	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
43	43	Sec. 291A.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
44	44	PAYMENT. The commissioners court of a county may require a
45	45	mandatory payment authorized under this chapter by an institutional
46	46	health care provider in the county only in the manner provided by
47	47	this chapter.
48	48	Sec. 291A.052. MAJORITY VOTE REQUIRED. The commissioners
49	49	court of a county may not authorize the county to collect a
50	50	mandatory payment authorized under this chapter without an
51	51	affirmative vote of a majority of the members of the commissioners
52	52	court.
53	53	Sec. 291A.053. RULES AND PROCEDURES. After the
54	54	commissioners court has voted to require a mandatory payment
55	55	authorized under this chapter, the commissioners court may adopt
56	56	rules relating to the administration of the mandatory payment.
57	57	Sec. 291A.054. INSTITUTIONAL HEALTH CARE PROVIDER
58	58	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
59	59	county that collects a mandatory payment authorized under this
60	60	chapter shall require each institutional health care provider to
61	61	submit to the county a copy of any financial and utilization data
62	62	required by and reported to the Department of State Health Services
63	63	under Sections 311.032 and 311.033 and any rules adopted by the
64	64	executive commissioner of the Health and Human Services Commission
65	65	to implement those sections.
66	66	(b) The commissioners court of a county that collects a
67	67	mandatory payment authorized under this chapter may inspect the
68	68	records of an institutional health care provider to the extent
69	69	necessary to ensure compliance with the requirements of Subsection
70	70	(a).
71	71	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
72	72	Sec. 291A.101. HEARING. (a) Each year, the commissioners
73	73	court of a county that collects a mandatory payment authorized
74	74	under this chapter shall hold a public hearing on the amounts of any
75	75	mandatory payments that the commissioners court intends to require
76	76	during the year and how the revenue derived from those payments is
77	77	to be spent.
78	78	(b) Not later than the 10th day before the date of the
79	79	hearing required under Subsection (a), the commissioners court of
80	80	the county shall publish notice of the hearing in a newspaper of
81	81	general circulation in the county.
82	82	(c) A representative of a paying hospital is entitled to
83	83	appear at the time and place designated in the public notice and to
84	84	be heard regarding any matter related to the mandatory payments
85	85	authorized under this chapter.
86	86	Sec. 291A.102. DEPOSITORY. (a) The commissioners court of
87	87	each county that collects a mandatory payment authorized under this
88	88	chapter by resolution shall designate one or more banks located in
89	89	the county as the depository for mandatory payments received by the
90	90	county. A bank designated as a depository serves for two years or
91	91	until a successor is designated.
92	92	(b) All income received by a county under this chapter,
93	93	including the revenue from mandatory payments remaining after
94	94	discounts and fees for assessing and collecting the payments are
95	95	deducted, shall be deposited with the county depository in the
96	96	county's local provider participation fund and may be withdrawn
97	97	only as provided by this chapter.
98	98	(c) All funds under this chapter shall be secured in the
99	99	manner provided for securing county funds.
100	100	Sec. 291A.103. LOCAL PROVIDER PARTICIPATION FUND;
101	101	AUTHORIZED USES OF MONEY. (a) Each county that collects a
102	102	mandatory payment authorized under this chapter shall create a
103	103	local provider participation fund.
104	104	(b) The local provider participation fund of a county
105	105	consists of:
106	106	(1) all revenue received by the county attributable to
107	107	mandatory payments authorized under this chapter, including any
108	108	penalties and interest attributable to delinquent payments;
109	109	(2) money received from the Health and Human Services
110	110	Commission as a refund of an intergovernmental transfer from the
111	111	county to the state for the purpose of providing the nonfederal
112	112	share of Medicaid supplemental payment program payments, provided
113	113	that the intergovernmental transfer does not receive a federal
114	114	matching payment; and
115	115	(3) the earnings of the fund.
116	116	(c) Money deposited to the local provider participation
117	117	fund may be used only to:
118	118	(1) fund intergovernmental transfers from the county
119	119	to the state to provide the nonfederal share of a Medicaid
120	120	supplemental payment program authorized under the state Medicaid
121	121	plan, including through the Medicaid managed care program, under
122	122	the Texas Healthcare Transformation and Quality Improvement
123	123	Program waiver issued under Section 1115 of the federal Social
124	124	Security Act (42 U.S.C. Section 1315), or under a successor waiver
125	125	program authorizing similar Medicaid supplemental payment
126	126	programs;
127	127	(2) subsidize indigent programs;
128	128	(3) pay the administrative expenses of the county
129	129	solely for activities under this chapter;
130	130	(4) refund a portion of a mandatory payment collected
131	131	in error from a paying hospital; and
132	132	(5) refund to paying hospitals the proportionate share
133	133	of money received by the county from the Health and Human Services
134	134	Commission that is not used to fund the nonfederal share of Medicaid
135	135	supplemental payment program payments.
136	136	(d) Money in the local provider participation fund may not
137	137	be commingled with other county funds.
138	138	(e) An intergovernmental transfer of funds described by
139	139	Subsection (c)(1) and any funds received by the county as a result
140	140	of an intergovernmental transfer described by that subsection may
141	141	not be used by the county or any other entity to expand Medicaid
142	142	eligibility under the Patient Protection and Affordable Care Act
143	143	(Pub. L. No. 111-148) as amended by the Health Care and Education
144	144	Reconciliation Act of 2010 (Pub. L. No. 111-152).
145	145	SUBCHAPTER D. MANDATORY PAYMENTS
146	146	Sec. 291A.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
147	147	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
148	148	commissioners court of a county that collects a mandatory payment
149	149	authorized under this chapter may require an annual mandatory
150	150	payment to be assessed on the net patient revenue of each
151	151	institutional health care provider located in the county. The
152	152	commissioners court may provide for the mandatory payment to be
153	153	assessed quarterly. In the first year in which the mandatory
154	154	payment is required, the mandatory payment is assessed on the net
155	155	patient revenue of an institutional health care provider as
156	156	determined by the data reported to the Department of State Health
157	157	Services under Sections 311.032 and 311.033 in the fiscal year
158	158	ending in 2015 or, if the institutional health care provider did not
159	159	report any data under those sections in that fiscal year, as
160	160	determined by the institutional health care provider's Medicare
161	161	cost report submitted for the 2015 fiscal year or for the closest
162	162	subsequent fiscal year for which the provider submitted the
163	163	Medicare cost report. The county shall update the amount of the
164	164	mandatory payment on an annual basis.
165	165	(b) The amount of a mandatory payment authorized under this
166	166	chapter must be uniformly proportionate with the amount of net
167	167	patient revenue generated by each paying hospital in the county. A
168	168	mandatory payment authorized under this chapter may not hold
169	169	harmless any institutional health care provider, as required under
170	170	42 U.S.C. Section 1396b(w).
171	171	(c) The commissioners court of a county that collects a
172	172	mandatory payment authorized under this chapter shall set the
173	173	amount of the mandatory payment. The amount of the mandatory
174	174	payment required of each paying hospital may not exceed an amount
175	175	that, when added to the amount of the mandatory payments required
176	176	from all other paying hospitals in the county, equals an amount of
177	177	revenue that exceeds six percent of the aggregate net patient
178	178	revenue of all paying hospitals in the county.
179	179	(d) Subject to the maximum amount prescribed by Subsection
180	180	(c), the commissioners court of a county that collects a mandatory
181	181	payment authorized under this chapter shall set the mandatory
182	182	payments in amounts that in the aggregate will generate sufficient
183	183	revenue to cover the administrative expenses of the county for
184	184	activities under this chapter, to fund the nonfederal share of a
185	185	Medicaid supplemental payment program as described by Section
186	186	291A.103(c)(1), and to pay for indigent programs, except that the
187	187	amount of revenue from mandatory payments used for administrative
188	188	expenses of the county for activities under this chapter in a year
189	189	may not exceed the lesser of four percent of the total revenue
190	190	generated from the mandatory payment or $20,000.
191	191	(e) A paying hospital may not add a mandatory payment
192	192	required under this section as a surcharge to a patient.
193	193	Sec. 291A.152. ASSESSMENT AND COLLECTION OF MANDATORY
194	194	PAYMENTS. The county may collect or contract for the assessment and
195	195	collection of mandatory payments authorized under this chapter.
196	196	Sec. 291A.153. INTEREST, PENALTIES, AND DISCOUNTS.
197	197	Interest, penalties, and discounts on mandatory payments required
198	198	under this chapter are governed by the law applicable to county ad
199	199	valorem taxes.
200	200	Sec. 291A.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
201	201	PROCEDURE. (a) The purpose of this chapter is to generate revenue
202	202	by collecting from institutional health care providers a mandatory
203	203	payment to be used to provide the nonfederal share of a Medicaid
204	204	supplemental payment program.
205	205	(b) To the extent any provision or procedure under this
206	206	chapter causes a mandatory payment authorized under this chapter to
207	207	be ineligible for federal matching funds, the county may provide by
208	208	rule for an alternative provision or procedure that conforms to the
209	209	requirements of the federal Centers for Medicare and Medicaid
210	210	Services.
211	211	SECTION 2. If before implementing any provision of this Act
212	212	a state agency determines that a waiver or authorization from a
213	213	federal agency is necessary for implementation of that provision,
214	214	the agency affected by the provision shall request the waiver or
215	215	authorization and may delay implementing that provision until the
216	216	waiver or authorization is granted.
217	217	SECTION 3. This Act takes effect immediately if it receives
218	218	a vote of two-thirds of all the members elected to each house, as
219	219	provided by Section 39, Article III, Texas Constitution. If this
220	220	Act does not receive the vote necessary for immediate effect, this
221	221	Act takes effect September 1, 2017.