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. Subtitle D, Title 4, Health and Safety Code, is
amended by adding Chapter 295A to read as follows:
CHAPTER 295A. CITY OF AMARILLO HOSPITAL DISTRICT HEALTH CARE
PROVIDER PARTICIPATION PROGRAM
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 295A.001. PURPOSE. The purpose of this chapter 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 chapter.
Sec. 295A.002. DEFINITIONS. In this chapter:
(1) "Board" means the board of hospital managers of
the district.
(2) "District" means the City of Amarillo Hospital
District.
(3) "Institutional health care provider" means a
nonpublic hospital that provides inpatient hospital services.
(4) "Paying hospital" means an institutional health
care provider required to make a mandatory payment under this
chapter.
(5) "Program" means the health care provider
participation program authorized by this chapter.
Sec. 295A.003. APPLICABILITY. This chapter applies only to
the City of Amarillo Hospital District.
Sec. 295A.004. 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 chapter.
SUBCHAPTER B. POWERS AND DUTIES OF BOARD
Sec. 295A.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
PAYMENT. The board may require a mandatory payment authorized
under this chapter by an institutional health care provider in the
district only in the manner provided by this chapter.
Sec. 295A.052. 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. 295A.053. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING. If the board authorizes the district to participate in a
health care provider participation program under this chapter, 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 and any rules adopted by the
executive commissioner of the Health and Human Services Commission
to implement those sections.
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
Sec. 295A.101. HEARING. (a) In each year that the board
authorizes a health care provider participation program under this
chapter, 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. 295A.102. LOCAL PROVIDER PARTICIPATION FUND;
DEPOSITORY. (a) If the board collects a mandatory payment
authorized under this chapter, 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 chapter.
(c) All funds collected under this chapter shall be secured
in the manner provided by Chapter 1001, Special District Local Laws
Code, for securing other public funds of the district.
Sec. 295A.103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY.
(a) The local provider participation fund established under
Section 295A.102 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:
(A) the nonfederal share of a Medicaid
supplemental payment program authorized under the state Medicaid
plan, 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; or
(B) payments to Medicaid managed care
organizations that are dedicated for payment to hospitals;
(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).
SUBCHAPTER D. MANDATORY PAYMENTS
Sec. 295A.151. MANDATORY PAYMENTS. (a) Except as provided
by Subsection (e), if the board authorizes a health care provider
participation program under this chapter, 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 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
chapter 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 chapter 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
chapter, fund an intergovernmental transfer described by Section
295A.103(b)(1), or make other payments authorized under this
chapter. 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 chapter, 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
chapter 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 chapter is not a tax for
purposes of Section 5(a), Article IX, Texas Constitution, or
Chapter 1001, Special District Local Laws Code.
Sec. 295A.152. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. The district may collect or contract for the assessment
and collection of mandatory payments authorized under this chapter.
Sec. 295A.153. CORRECTION OF INVALID PROVISION OR
PROCEDURE. To the extent any provision or procedure under this
chapter causes a mandatory payment authorized under this chapter 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 chapter.
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.