85R11244 MEW-F
By: Seliger S.B. No. 2117
A BILL TO BE ENTITLED
AN ACT
relating to the creation and operations of a health care provider
participation program by the City of Amarillo Hospital District.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 1001, Special District Local Laws Code,
is amended by adding Subchapter J to read as follows:
SUBCHAPTER J. HEALTH CARE PROVIDER PARTICIPATION PROGRAM
Sec. 1001.451. PURPOSE. The purpose of this subchapter is
to authorize the district to administer a health care provider
participation program to provide additional compensation to
hospitals in the district by collecting mandatory payments from
each hospital in the district to be used to provide the nonfederal
share of a Medicaid supplemental payment program and for other
purposes as authorized under this subchapter.
Sec. 1001.452. DEFINITIONS. In this subchapter:
(1) "Institutional health care provider" means a
nonpublic hospital that provides inpatient hospital services.
(2) "Paying hospital" means an institutional health
care provider required to make a mandatory payment under this
subchapter.
(3) "Program" means the health care provider
participation program authorized by this subchapter.
Sec. 1001.453. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
PARTICIPATION IN PROGRAM. The board may authorize the district to
participate in a health care provider participation program on the
affirmative vote of a majority of the board, subject to the
provisions of this subchapter.
Sec. 1001.454. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
PAYMENT. The board may require a mandatory payment authorized
under this subchapter by an institutional health care provider in
the district only in the manner provided by this subchapter.
Sec. 1001.455. RULES AND PROCEDURES. The board may adopt
rules relating to the administration of the health care provider
participation program, including collection of the mandatory
payments, expenditures, audits, and any other administrative
aspects of the program.
Sec. 1001.456. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING. If the board authorizes the district to participate in a
health care provider participation program under this subchapter,
the board shall require each institutional health care provider to
submit to the district a copy of any financial and utilization data
required by and reported to the Department of State Health Services
under Sections 311.032 and 311.033, Health and Safety Code, and any
rules adopted by the executive commissioner of the Health and Human
Services Commission to implement those sections.
Sec. 1001.457. HEARING. (a) In each year that the board
authorizes a health care provider participation program under this
subchapter, the board shall hold a public hearing on the amounts of
any mandatory payments that the board intends to require during the
year and how the revenue derived from those payments is to be spent.
(b) Not later than the fifth day before the date of the
hearing required under Subsection (a), the board shall publish
notice of the hearing in a newspaper of general circulation in the
district and provide written notice of the hearing to the chief
operating officer of each institutional health care provider in the
district.
Sec. 1001.458. LOCAL PROVIDER PARTICIPATION FUND;
DEPOSITORY. (a) If the board collects a mandatory payment
authorized under this subchapter, the board shall create a local
provider participation fund in one or more banks designated by the
district as a depository for public funds.
(b) The board may withdraw or use money in the fund only for
a purpose authorized under this subchapter.
(c) All funds collected under this subchapter shall be
secured in the manner provided by this subchapter for securing
other public funds of the district.
Sec. 1001.459. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY.
(a) The local provider participation fund established under
Section 1001.458 consists of:
(1) all mandatory payments authorized under this
chapter and received by the district;
(2) money received from the Health and Human Services
Commission as a refund of an intergovernmental transfer from the
district to the state as the nonfederal share of Medicaid
supplemental payment program payments, provided that the
intergovernmental transfer does not receive a federal matching
payment; and
(3) the earnings of the fund.
(b) Money deposited to the local provider participation
fund may be used only to:
(1) fund intergovernmental transfers from the
district to the state to provide the nonfederal share of a Medicaid
supplemental payment program authorized under the state Medicaid
plan including through the Medicaid managed care program, the Texas
Healthcare Transformation and Quality Improvement Program waiver
issued under Section 1115 of the federal Social Security Act (42
U.S.C. Section 1315), or a successor waiver program authorizing
similar Medicaid supplemental payment programs;
(2) pay costs associated with indigent care provided
by institutional health care providers in the district;
(3) pay the administrative expenses of the district in
administering the program, including collateralization of
deposits;
(4) refund a portion of a mandatory payment collected
in error from a paying hospital; and
(5) refund to paying hospitals a proportionate share
of the money that the district:
(A) receives from the Health and Human Services
Commission that is not used to fund the nonfederal share of Medicaid
supplemental payment program payments; or
(B) determines cannot be used to fund the
nonfederal share of Medicaid supplemental payment program
payments.
(c) Money in the local provider participation fund may not
be commingled with other district funds.
(d) An intergovernmental transfer of funds described by
Subsection (b)(1) and any funds received by the district as a result
of an intergovernmental transfer described by that subsection may
not be used by the district or any other entity 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. 1001.460. MANDATORY PAYMENTS. (a) Except as provided
by Subsection (e), if the board authorizes a health care provider
participation program under this subchapter, the board shall
require an annual mandatory payment to be assessed on the net
patient revenue of each institutional health care provider located
in the district. The board shall provide that the mandatory payment
is to be collected at least annually, but not more often than
quarterly. In the first year in which the mandatory payment is
required, the mandatory payment is assessed on the net patient
revenue of an institutional health care provider as determined by
the data reported to the Department of State Health Services under
Sections 311.032 and 311.033, Health and Safety Code, in the most
recent fiscal year for which that data was reported. If the
institutional health care provider did not report any data under
those sections, the provider's net patient revenue is the amount of
that revenue as contained in the provider's Medicare cost report
submitted for the previous fiscal year or for the closest
subsequent fiscal year for which the provider submitted the
Medicare cost report. The district shall update the amount of the
mandatory payment on an annual basis.
(b) The amount of a mandatory payment authorized under this
subchapter must be a uniform percentage of the amount of net patient
revenue generated by each paying hospital in the district. A
mandatory payment authorized under this subchapter may not hold
harmless any institutional health care provider, as required under
42 U.S.C. Section 1396b(w).
(c) The aggregate amount of the mandatory payments required
of all paying hospitals in the district may not exceed six percent
of the aggregate net patient revenue of all paying hospitals in the
district.
(d) Subject to the maximum amount prescribed by Subsection
(c), the board shall set the mandatory payments in amounts that in
the aggregate will generate sufficient revenue to cover the
administrative expenses of the district for activities under this
subchapter, fund an intergovernmental transfer described by
Section 1001.459(b)(1), or make other payments authorized under
this subchapter. The amount of revenue from mandatory payments
that may be used for administrative expenses by the district in a
year may not exceed $25,000, plus the cost of collateralization of
deposits. If the board demonstrates to the paying hospitals that
the costs of administering the health care provider participation
program under this subchapter, excluding those costs associated
with the collateralization of deposits, exceed $25,000 in any year,
on consent of all of the paying hospitals, the district may use
additional revenue from mandatory payments received under this
subchapter to compensate the district for its administrative
expenses. A paying hospital may not unreasonably withhold consent
to compensate the district for administrative expenses.
(e) A paying hospital may not add a mandatory payment
required under this section as a surcharge to a patient or insurer.
(f) A mandatory payment under this subchapter is not a tax
for purposes of Section 5(a), Article IX, Texas Constitution, or
this chapter.
Sec. 1001.461. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. The district may collect or contract for the assessment
and collection of mandatory payments authorized under this
subchapter.
Sec. 1001.462. CORRECTION OF INVALID PROVISION OR
PROCEDURE. To the extent any provision or procedure under this
subchapter causes a mandatory payment authorized under this
subchapter to be ineligible for federal matching funds, the board
may provide by rule for an alternative provision or procedure that
conforms to the requirements of the federal Centers for Medicare
and Medicaid Services. A rule adopted under this section may not
create, impose, or materially expand the legal or financial
liability or responsibility of the district or an institutional
health care provider in the district beyond the provisions of this
subchapter. This section does not require the board to adopt a rule.
SECTION 2. 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 3. 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.