Texas 2019 - 86th Regular

Texas House Bill HB2798 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	86R26244 KFF-D
2		-	By: Klick, Deshotel, Clardy, Hinojosa, H.B. No. 2798
3		-	et al.
4		-	Substitute the following for H.B. No. 2798:
5		-	By: Clardy C.S.H.B. No. 2798
	1	+	86R6626 KFF-D
	2	+	By: Klick H.B. No. 2798
6	3
7	4
8	5		A BILL TO BE ENTITLED
9	6		AN ACT
10	7		relating to the reimbursement of certain urban teaching hospitals
11	8		for the provision of inpatient hospital care under Medicaid.
12	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	10		SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
14	11		is amended by adding Section 32.0285 to read as follows:
15	12		Sec. 32.0285. CALCULATION OF MEDICAL EDUCATION ADD-ON FOR
16	13		REIMBURSEMENT OF CERTAIN URBAN TEACHING HOSPITALS. (a) In this
17	14		section:
18	15		(1) "Base standard dollar amount" means the
19	16		standardized payment amount calculated by the commission for costs
20	17		incurred by prospectively paid hospitals in this state for
21	18		providing inpatient hospital care under Medicaid.
22	19		(2) "Children's hospital" means a hospital designated
23	20		by the Centers for Medicare and Medicaid Services as a children's
24	21		hospital.
25	22		(3) "Medical education add-on" means an adjustment to
26	23		the base standard dollar amount for an urban teaching hospital to
27	24		reflect higher patient care costs relative to nonteaching urban
28	25		hospitals.
29	26		(4) "Rural hospital" means a hospital enrolled as a
30	27		Medicaid provider that:
31	28		(A) is located in a county with a population of
32	29		not more than 60,000;
33	30		(B) is designated by the Centers for Medicare and
34	31		Medicaid Services as a critical access hospital, sole community
35	32		hospital, or rural referral center and is not located in an area
36	33		defined by the United States Office of Management and Budget as a
37	34		metropolitan statistical area; or
38	35		(C) meets all of the following criteria:
39	36		(i) has 100 or fewer beds;
40	37		(ii) is designated by the Centers for
41	38		Medicare and Medicaid Services as a critical access hospital, sole
42	39		community hospital, or rural referral center; and
43	40		(iii) is located in an area defined by the
44	41		United States Office of Management and Budget as a metropolitan
45	42		statistical area.
46	43		(5) "State-owned teaching hospital" means:
47	44		(A) The University of Texas Medical Branch at
48	45		Galveston;
49	46		(B) The University of Texas Health Science Center
50	47		at Tyler; and
51	48		(C) The University of Texas M.D. Anderson Cancer
52	49		Center.
53	50		(6) "Teaching hospital" means a hospital that incurs
54	51		indirect costs for operating graduate medical education programs
55	52		and for which the Centers for Medicare and Medicaid Services has
56	53		calculated and assigned a percentage Medicare education adjustment
57	54		factor under 42 C.F.R. Section 412.105.
58	55		(7) "Urban hospital" means a hospital that:
59	56		(A) is located in an area defined by the United
60	57		States Office of Management and Budget as a metropolitan
61	58		statistical area; and
62	59		(B) is not a rural hospital, children's hospital,
63	60		state-owned teaching hospital, or freestanding psychiatric
64	61		facility.
65	62		(b) To the extent permitted by federal law, in order to
66	63		ensure that urban teaching hospitals are accurately reimbursed for
67	64		the provision of inpatient hospital care to recipients under
68	65		Medicaid, the commission shall at least annually update the
69	66		education adjustment factor used to calculate the medical education
70	67		add-on using the most current data available, including:
71	68		(1) data related to the number of interns and
72	69		residents enrolled in a hospital's approved teaching program; and
73	70		(2) the Medicare education adjustment factor assigned
74	71		under 42 C.F.R. Section 412.105 in effect at the time the commission
75	72		makes the update.
76		-	SECTION 2. (a) In this section:
77		-	(1) "Medicaid" has the meaning assigned by Section
78		-	531.001, Government Code.
79		-	(2) "Medical education add-on," "teaching hospital,"
80		-	and "urban hospital" have the meanings assigned by Section 32.0285,
81		-	Human Resources Code, as added by this Act.
82		-	(b) As soon as practicable after the effective date of this
83		-	Act, the Health and Human Services Commission shall conduct a study
84		-	to evaluate the impacts and effectiveness of using the Medicare
85		-	education adjustment factor assigned under 42 C.F.R. Section
86		-	412.105 in effect on the effective date of this Act to calculate the
87		-	medical education add-on used to reimburse teaching hospitals for
88		-	the provision of inpatient hospital care under Medicaid. The
89		-	commission shall develop and make recommendations on alternative
90		-	factors and methodologies for calculating and annually updating the
91		-	medical education add-on that:
92		-	(1) best recognize the higher costs incurred by
93		-	teaching hospitals; and
94		-	(2) mitigate issues identified with using the Medicare
95		-	education adjustment factor without reducing reimbursements to
96		-	urban teaching hospitals that have maintained or increased the
97		-	number of interns and residents enrolled in the hospitals' approved
98		-	teaching programs.
99		-	(c) Not later than December 1, 2020, the Health and Human
100		-	Services Commission shall report its findings and recommendations
101		-	under Subsection (b) of this section to the governor, the standing
102		-	committees of the senate and house of representatives having
103		-	primary jurisdiction over matters relating to state finance and
104		-	appropriations from the state treasury, the standing committees of
105		-	the senate and house of representatives having primary jurisdiction
106		-	over Medicaid, and the Legislative Budget Board.
107		-	SECTION 3. If before implementing any provision of this Act
	73	+	SECTION 2. If before implementing any provision of this Act
108	74		a state agency determines that a waiver or authorization from a
109	75		federal agency is necessary for implementation of that provision,
110	76		the agency affected by the provision shall request the waiver or
111	77		authorization and may delay implementing that provision until the
112	78		waiver or authorization is granted.
113		-	SECTION 4. This Act takes effect immediately if it receives
	79	+	SECTION 3. This Act takes effect immediately if it receives
114	80		a vote of two-thirds of all the members elected to each house, as
115	81		provided by Section 39, Article III, Texas Constitution. If this
116	82		Act does not receive the vote necessary for immediate effect, this
117	83		Act takes effect September 1, 2019.