Texas 2019 - 86th Regular

Texas House Bill HB2035 Compare Versions

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

Old	New	Differences
1	1	86R9410 KKR-F
2	2	By: Price H.B. No. 2035
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to reimbursement of rural hospitals participating in the
8	8	Medicaid managed care program.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter A, Chapter 533, Government Code, is
11	11	amended by adding Section 533.0041 to read as follows:
12	12	Sec. 533.0041. REIMBURSEMENT METHODOLOGY FOR RURAL
13	13	HOSPITALS. (a) In this section, "rural hospital" has the meaning
14	14	assigned by commission rules for purposes of Medicaid.
15	15	(b) To the extent allowed by federal law and notwithstanding
16	16	any state law, the executive commissioner shall by rule adopt a
17	17	reimbursement methodology for the payment of rural hospitals
18	18	participating in the Medicaid managed care program that ensures the
19	19	rural hospitals are reimbursed on an individual basis that allows
20	20	the rural hospitals to fully recover allowable costs incurred in
21	21	providing services to recipients. In adopting rules under this
22	22	section, the executive commissioner:
23	23	(1) may adopt a methodology that requires:
24	24	(A) the commission to directly reimburse rural
25	25	hospitals for allowable costs;
26	26	(B) a managed care organization to reimburse
27	27	rural hospitals; or
28	28	(C) both the commission and a managed care
29	29	organization to share in the total amount of reimbursement paid to
30	30	rural hospitals; and
31	31	(2) shall:
32	32	(A) define "allowable costs" for purposes of this
33	33	section; and
34	34	(B) require that the amount of reimbursement paid
35	35	to a rural hospital is subject to any applicable adjustments made by
36	36	the commission for payments to or penalties imposed on the rural
37	37	hospital that are based on a quality-based or performance-based
38	38	requirement under the Medicaid managed care program.
39	39	(c) Not later than January 1 of each even-numbered year,
40	40	the commission shall, as applicable:
41	41	(1) make an initial determination of the allowable
42	42	costs incurred by a rural hospital participating in the Medicaid
43	43	managed care program that is based on the rural hospital's cost
44	44	reports submitted to the federal Centers for Medicare and Medicaid
45	45	Services and other available information that the commission
46	46	considers relevant in determining the hospital's allowable costs;
47	47	or
48	48	(2) review and update the allowable costs previously
49	49	determined or updated under this subsection using the same criteria
50	50	required under Subdivision (1).
51	51	SECTION 2. Not later than January 1, 2020, the Health and
52	52	Human Services Commission shall determine the allowable costs
53	53	incurred by a rural hospital participating in the Medicaid managed
54	54	care program before that date as required by Section
55	55	533.0041(c)(1), Government Code, as added by this Act.
56	56	SECTION 3. If before implementing any provision of this Act
57	57	a state agency determines that a waiver or authorization from a
58	58	federal agency is necessary for implementation of that provision,
59	59	the agency affected by the provision shall request the waiver or
60	60	authorization and may delay implementing that provision until the
61	61	waiver or authorization is granted.
62	62	SECTION 4. This Act takes effect September 1, 2019.