By: Lambert (Senate Sponsor - Buckingham) H.B. No. 1142
(In the Senate - Received from the House April 16, 2019;
April 17, 2019, read first time and referred to Committee on
Intergovernmental Relations; May 6, 2019, reported favorably by
the following vote: Yeas 7, Nays 0; May 6, 2019, sent to printer.)
Click here to see the committee vote
A BILL TO BE ENTITLED
AN ACT
relating to the creation and operations of health care provider
participation programs in certain counties.
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 293C to read as follows:
CHAPTER 293C. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
CERTAIN COUNTIES NOT BORDERING CERTAIN POPULOUS COUNTIES
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 293C.001. DEFINITIONS. In this chapter:
(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
chapter.
(3) "Program" means a county health care provider
participation program authorized by this chapter.
Sec. 293C.002. APPLICABILITY. This chapter applies only to
a county that:
(1) is not served by a hospital district or a public
hospital;
(2) has a population of more than 125,000 and less than
140,000; and
(3) is not adjacent to a county with a population of
one million or more.
Sec. 293C.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
PROGRAM. (a) A county health care provider participation program
authorizes a county to collect a mandatory payment from each
institutional health care provider located in the county to be
deposited in a local provider participation fund established by the
county. Money in the fund may be used by the county to fund certain
intergovernmental transfers and indigent care programs as provided
by this chapter.
(b) The commissioners court of a county may adopt an order
authorizing the county to participate in the program, subject to
the limitations provided by this chapter.
SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
Sec. 293C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
PAYMENT. The commissioners court of a county may require a
mandatory payment authorized under this chapter by an institutional
health care provider in the county only in the manner provided by
this chapter.
Sec. 293C.052. MAJORITY VOTE REQUIRED. The commissioners
court of a county may not authorize the county to collect a
mandatory payment authorized under this chapter without an
affirmative vote of a majority of the members of the commissioners
court.
Sec. 293C.053. RULES AND PROCEDURES. After the
commissioners court of a county has voted to require a mandatory
payment authorized under this chapter, the commissioners court may
adopt rules relating to the administration of the mandatory
payment.
Sec. 293C.054. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
county that collects a mandatory payment authorized under this
chapter shall require each institutional health care provider
located in the county to submit to the county 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.
(b) The commissioners court of a county that collects a
mandatory payment authorized under this chapter may inspect the
records of an institutional health care provider to the extent
necessary to ensure compliance with the requirements of Subsection
(a).
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
Sec. 293C.101. HEARING. (a) Each year, the commissioners
court of a county that collects a mandatory payment authorized
under this chapter shall hold a public hearing on the amounts of any
mandatory payments that the commissioners court intends to require
during the year.
(b) Not later than the fifth day before the date of the
hearing required under Subsection (a), the commissioners court of
the county shall publish notice of the hearing in a newspaper of
general circulation in the county.
(c) A representative of a paying hospital is entitled to
appear at the public hearing and be heard regarding any matter
related to the mandatory payments authorized under this chapter.
Sec. 293C.102. DEPOSITORY. (a) The commissioners court of
each county that collects a mandatory payment authorized under this
chapter by resolution shall designate one or more banks located in
the county as the depository for mandatory payments received by the
county.
(b) All income received by a county under this chapter,
including the revenue from mandatory payments remaining after
discounts and fees for assessing and collecting the payments are
deducted, shall be deposited with the county depository in the
county's local provider participation fund and may be withdrawn
only as provided by this chapter.
(c) All funds under this chapter shall be secured in the
manner provided for securing county funds.
Sec. 293C.103. LOCAL PROVIDER PARTICIPATION FUND;
AUTHORIZED USES OF MONEY. (a) Each county that collects a
mandatory payment authorized under this chapter shall create a
local provider participation fund.
(b) The local provider participation fund of a county
consists of:
(1) all revenue received by the county attributable to
mandatory payments authorized under this chapter, including any
penalties and interest attributable to delinquent payments;
(2) money received from the Health and Human Services
Commission as a refund of an intergovernmental transfer from the
county to the state for the purpose of providing 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.
(c) Money deposited to the local provider participation
fund may be used only to:
(1) fund intergovernmental transfers from the county
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) subsidize indigent programs;
(3) pay the administrative expenses of the county
solely for activities under this chapter;
(4) refund a portion of a mandatory payment collected
in error from a paying hospital; and
(5) refund to paying hospitals the proportionate share
of money received by the county that is not used to fund the
nonfederal share of Medicaid supplemental payment program
payments.
(d) Money in the local provider participation fund may not
be commingled with other county funds.
(e) An intergovernmental transfer of funds described by
Subsection (c)(1) and any funds received by the county as a result
of an intergovernmental transfer described by that subsection may
not be used by the county 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. 293C.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
commissioners court of a county that collects a mandatory payment
authorized under this chapter may require an annual mandatory
payment to be assessed on the net patient revenue of each
institutional health care provider located in the county. The
commissioners court may provide for the mandatory payment to be
assessed 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 fiscal year
ending in 2017 or, if the institutional health care provider did not
report any data under those sections in that fiscal year, as
determined by the institutional health care provider's Medicare
cost report submitted for the 2017 fiscal year or for the closest
subsequent fiscal year for which the provider submitted the
Medicare cost report. The county 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 uniformly proportionate with the amount of net
patient revenue generated by each paying hospital in the county. 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 commissioners court of a county that collects a
mandatory payment authorized under this chapter shall set the
amount of the mandatory payment. The amount of the mandatory
payment required of each paying hospital may not exceed six percent
of the hospital's net patient revenue.
(d) Subject to the maximum amount prescribed by Subsection
(c), the commissioners court of a county that collects a mandatory
payment authorized under this chapter shall set the mandatory
payments in amounts that in the aggregate will generate sufficient
revenue to cover the administrative expenses of the county for
activities under this chapter, to fund an intergovernmental
transfer described by Section 293C.103(c)(1), and to pay for
indigent programs, except that the amount of revenue from mandatory
payments used for administrative expenses of the county for
activities under this chapter in a year may not exceed the lesser of
four percent of the total revenue generated from the mandatory
payment or $20,000.
(e) A paying hospital may not add a mandatory payment
required under this section as a surcharge to a patient.
Sec. 293C.152. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. The county may collect or contract for the assessment and
collection of mandatory payments authorized under this chapter.
Sec. 293C.153. INTEREST, PENALTIES, AND DISCOUNTS.
Interest, penalties, and discounts on mandatory payments required
under this chapter are governed by the law applicable to county ad
valorem taxes.
Sec. 293C.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
PROCEDURE. (a) The purpose of this chapter is to generate revenue
by collecting from institutional health care providers a mandatory
payment to be used to provide an intergovernmental transfer
described by Section 293C.103(c)(1).
(b) 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 county may provide by
rule for an alternative provision or procedure that conforms to the
requirements of the federal Centers for Medicare and Medicaid
Services.
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, 2019.
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