Texas 2019 - 86th Regular

Texas House Bill HB3459 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 3459
	1	+	By: Coleman, Rosenthal, Huberty H.B. No. 3459
	2	+	(Senate Sponsor - Miles)
	3	+	(In the Senate - Received from the House April 23, 2019;
	4	+	April 25, 2019, read first time and referred to Committee on
	5	+	Administration; May 3, 2019, reported favorably by the following
	6	+	vote: Yeas 4, Nays 0; May 3, 2019, sent to printer.)
	7	+	Click here to see the committee vote
2	8
3	9
	10	+	A BILL TO BE ENTITLED
4	11		AN ACT
5	12		relating to the creation and operations of a health care provider
6	13		participation program by the Harris County Hospital District.
7	14		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	15		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
9	16		amended by adding Chapter 299 to read as follows:
10	17		CHAPTER 299. HARRIS COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
11	18		PARTICIPATION PROGRAM
12	19		SUBCHAPTER A. GENERAL PROVISIONS
13	20		Sec. 299.001. DEFINITIONS. In this chapter:
14	21		(1) "Board" means the board of hospital managers of
15	22		the district.
16	23		(2) "District" means the Harris County Hospital
17	24		District.
18	25		(3) "Institutional health care provider" means a
19	26		nonpublic hospital located in the district that provides inpatient
20	27		hospital services.
21	28		(4) "Paying provider" means an institutional health
22	29		care provider required to make a mandatory payment under this
23	30		chapter.
24	31		(5) "Program" means the health care provider
25	32		participation program authorized by this chapter.
26	33		Sec. 299.002. APPLICABILITY. This chapter applies only to
27	34		the Harris County Hospital District.
28	35		Sec. 299.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
29	36		PARTICIPATION IN PROGRAM. The board may authorize the district to
30	37		participate in a health care provider participation program on the
31	38		affirmative vote of a majority of the board, subject to the
32	39		provisions of this chapter.
33	40		Sec. 299.004. EXPIRATION. (a) Subject to Section
34	41		299.153(d), the authority of the district to administer and operate
35	42		a program under this chapter expires December 31, 2021.
36	43		(b) This chapter expires December 31, 2021.
37	44		SUBCHAPTER B. POWERS AND DUTIES OF BOARD
38	45		Sec. 299.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
39	46		PAYMENT. The board may require a mandatory payment authorized
40	47		under this chapter by an institutional health care provider in the
41	48		district only in the manner provided by this chapter.
42	49		Sec. 299.052. RULES AND PROCEDURES. The board may adopt
43	50		rules relating to the administration of the program, including
44	51		collection of the mandatory payments, expenditures, audits, and any
45	52		other administrative aspects of the program.
46	53		Sec. 299.053. INSTITUTIONAL HEALTH CARE PROVIDER
47	54		REPORTING. If the board authorizes the district to participate in a
48	55		program under this chapter, the board shall require each
49	56		institutional health care provider to submit to the district a copy
50	57		of any financial and utilization data as reported in the provider's
51	58		Medicare cost report submitted for the previous fiscal year or for
52	59		the closest subsequent fiscal year for which the provider submitted
53	60		the Medicare cost report.
54	61		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
55	62		Sec. 299.101. HEARING. (a) In each year that the board
56	63		authorizes a program under this chapter, the board shall hold a
57	64		public hearing on the amounts of any mandatory payments that the
58	65		board intends to require during the year and how the revenue derived
59	66		from those payments is to be spent.
60	67		(b) Not later than the fifth day before the date of the
61	68		hearing required under Subsection (a), the board shall publish
62	69		notice of the hearing in a newspaper of general circulation in the
63	70		district and provide written notice of the hearing to each
64	71		institutional health care provider in the district.
65	72		(c) A representative of a paying provider is entitled to
66	73		appear at the public hearing and be heard regarding any matter
67	74		related to the mandatory payments authorized under this chapter.
68	75		Sec. 299.102. DEPOSITORY. (a) If the board requires a
69	76		mandatory payment authorized under this chapter, the board shall
70	77		designate one or more banks as a depository for the district's local
71	78		provider participation fund.
72	79		(b) All funds collected under this chapter shall be secured
73	80		in the manner provided for securing other district funds.
74	81		Sec. 299.103. LOCAL PROVIDER PARTICIPATION FUND;
75	82		AUTHORIZED USES OF MONEY. (a) If the district requires a mandatory
76	83		payment authorized under this chapter, the district shall create a
77	84		local provider participation fund.
78	85		(b) The local provider participation fund consists of:
79	86		(1) all revenue received by the district attributable
80	87		to mandatory payments authorized under this chapter;
81	88		(2) money received from the Health and Human Services
82	89		Commission as a refund of an intergovernmental transfer under the
83	90		program, provided that the intergovernmental transfer does not
84	91		receive a federal matching payment; and
85	92		(3) the earnings of the fund.
86	93		(c) Money deposited to the local provider participation
87	94		fund of the district may be used only to:
88	95		(1) fund intergovernmental transfers from the
89	96		district to the state to provide the nonfederal share of Medicaid
90	97		payments for:
91	98		(A) uncompensated care payments to nonpublic
92	99		hospitals, if those payments are authorized under the Texas
93	100		Healthcare Transformation and Quality Improvement Program waiver
94	101		issued under Section 1115 of the federal Social Security Act (42
95	102		U.S.C. Section 1315);
96	103		(B) uniform rate enhancements for nonpublic
97	104		hospitals in the Medicaid managed care service area in which the
98	105		district is located;
99	106		(C) payments available under another waiver
100	107		program authorizing payments that are substantially similar to
101	108		Medicaid payments to nonpublic hospitals described by Paragraph (A)
102	109		or (B); or
103	110		(D) any reimbursement to nonpublic hospitals for
104	111		which federal matching funds are available;
105	112		(2) subject to Section 299.151(d), pay the
106	113		administrative expenses of the district in administering the
107	114		program, including collateralization of deposits;
108	115		(3) refund a mandatory payment collected in error from
109	116		a paying provider;
110	117		(4) refund to paying providers a proportionate share
111	118		of the money attributable to mandatory payments collected under
112	119		this chapter that the district:
113	120		(A) receives from the Health and Human Services
114	121		Commission that is not used to fund the nonfederal share of Medicaid
115	122		supplemental payment program payments; or
116	123		(B) determines cannot be used to fund the
117	124		nonfederal share of Medicaid supplemental payment program
118	125		payments; and
119	126		(5) transfer funds to the Health and Human Services
120	127		Commission if the district is legally required to transfer the
121	128		funds to address a disallowance of federal matching funds with
122	129		respect to programs for which the district made intergovernmental
123	130		transfers described by Subdivision (1).
124	131		(d) Money in the local provider participation fund may not
125	132		be commingled with other district funds.
126	133		(e) Notwithstanding any other provision of this chapter,
127	134		with respect to an intergovernmental transfer of funds described by
128	135		Subsection (c)(1) made by the district, any funds received by the
129	136		state, district, or other entity as a result of the transfer may not
130	137		be used by the state, district, or any other entity to:
131	138		(1) expand Medicaid eligibility under the Patient
132	139		Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
133	140		by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
134	141		No. 111-152); or
135	142		(2) fund the nonfederal share of payments to nonpublic
136	143		hospitals available through the Medicaid disproportionate share
137	144		hospital program or the delivery system reform incentive payment
138	145		program.
139	146		SUBCHAPTER D. MANDATORY PAYMENTS
140	147		Sec. 299.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
141	148		NET PATIENT REVENUE. (a) If the board authorizes a health care
142	149		provider participation program under this chapter, the board may
143	150		require a mandatory payment to be assessed, either annually or
144	151		periodically throughout the year at the discretion of the board, on
145	152		the net patient revenue of each institutional health care provider
146	153		located in the district. The board shall provide an institutional
147	154		health care provider written notice of each assessment under this
148	155		subsection, and the provider has 30 calendar days following the
149	156		date of receipt of the notice to pay the assessment. In the first
150	157		year in which the mandatory payment is required, the mandatory
151	158		payment is assessed on the net patient revenue of an institutional
152	159		health care provider, as determined by the provider's Medicare cost
153	160		report submitted for the previous fiscal year or for the closest
154	161		subsequent fiscal year for which the provider submitted the
155	162		Medicare cost report. If the mandatory payment is required, the
156	163		district shall update the amount of the mandatory payment on an
157	164		annual basis and may update the amount on a more frequent basis.
158	165		(b) The amount of a mandatory payment authorized under this
159	166		chapter must be uniformly proportionate with the amount of net
160	167		patient revenue generated by each paying provider in the district
161	168		as permitted under federal law. A health care provider
162	169		participation program authorized under this chapter may not hold
163	170		harmless any institutional health care provider, as required under
164	171		42 U.S.C. Section 1396b(w).
165	172		(c) If the board requires a mandatory payment authorized
166	173		under this chapter, the board shall set the amount of the mandatory
167	174		payment, subject to the limitations of this chapter. The aggregate
168	175		amount of the mandatory payments required of all paying providers
169	176		in the district may not exceed four percent of the aggregate net
170	177		patient revenue from hospital services provided by all paying
171	178		providers in the district.
172	179		(d) Subject to Subsection (c), if the board requires a
173	180		mandatory payment authorized under this chapter, the board shall
174	181		set the mandatory payments in amounts that in the aggregate will
175	182		generate sufficient revenue to cover the administrative expenses of
176	183		the district for activities under this chapter and to fund an
177	184		intergovernmental transfer described by Section 299.103(c)(1).
178	185		The annual amount of revenue from mandatory payments used for
179	186		administrative expenses by the district for activities under this
180	187		chapter is $600,000, plus the cost of collateralization of
181	188		deposits, regardless of actual expenses.
182	189		(e) A paying provider may not add a mandatory payment
183	190		required under this section as a surcharge to a patient.
184	191		(f) A mandatory payment assessed under this chapter is not a
185	192		tax for hospital purposes for purposes of Section 4, Article IX,
186	193		Texas Constitution, or Section 281.045.
187	194		Sec. 299.152. ASSESSMENT AND COLLECTION OF MANDATORY
188	195		PAYMENTS. (a) The district may designate an official of the
189	196		district or contract with another person to assess and collect the
190	197		mandatory payments authorized under this chapter.
191	198		(b) The person charged by the district with the assessment
192	199		and collection of mandatory payments shall charge and deduct from
193	200		the mandatory payments collected for the district a collection fee
194	201		in an amount not to exceed the person's usual and customary charges
195	202		for like services.
196	203		(c) If the person charged with the assessment and collection
197	204		of mandatory payments is an official of the district, any revenue
198	205		from a collection fee charged under Subsection (b) shall be
199	206		deposited in the district general fund and, if appropriate, shall
200	207		be reported as fees of the district.
201	208		Sec. 299.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
202	209		PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this chapter
203	210		is to authorize the district to establish a program to enable the
204	211		district to collect mandatory payments from institutional health
205	212		care providers to fund the nonfederal share of a Medicaid
206	213		supplemental payment program or the Medicaid managed care rate
207	214		enhancements for nonpublic hospitals to support the provision of
208	215		health care by institutional health care providers to district
209	216		residents in need of health care.
210	217		(b) This chapter does not authorize the district to collect
211	218		mandatory payments for the purpose of raising general revenue or
212	219		any amount in excess of the amount reasonably necessary to:
213	220		(1) fund the nonfederal share of a Medicaid
214	221		supplemental payment program or Medicaid managed care rate
215	222		enhancements for nonpublic hospitals; and
216	223		(2) cover the administrative expenses of the district
217	224		associated with activities under this chapter and other uses of the
218	225		fund described by Section 299.103(c).
219	226		(c) To the extent any provision or procedure under this
220	227		chapter causes a mandatory payment authorized under this chapter to
221	228		be ineligible for federal matching funds, the board may provide by
222	229		rule for an alternative provision or procedure that conforms to the
223	230		requirements of the federal Centers for Medicare and Medicaid
224	231		Services. A rule adopted under this section may not create, impose,
225	232		or materially expand the legal or financial liability or
226	233		responsibility of the district or an institutional health care
227	234		provider in the district beyond the provisions of this chapter.
228	235		This section does not require the board to adopt a rule.
229	236		(d) The district may only assess and collect a mandatory
230	237		payment authorized under this chapter if a waiver program, uniform
231	238		rate enhancement, or reimbursement described by Section
232	239		299.103(c)(1) is available to the district.
233	240		SECTION 2. As soon as practicable after the expiration of
234	241		the authority of the Harris County Hospital District to administer
235	242		and operate a health care provider participation program under
236	243		Chapter 299, Health and Safety Code, as added by this Act, the board
237	244		of hospital managers of the Harris County Hospital District shall
238	245		transfer to each institutional health care provider in the district
239	246		that provider's proportionate share of any remaining funds in any
240	247		local provider participation fund created by the district under
241	248		Section 299.103, Health and Safety Code, as added by this Act.
242	249		SECTION 3. If before implementing any provision of this Act
243	250		a state agency determines that a waiver or authorization from a
244	251		federal agency is necessary for implementation of that provision,
245	252		the agency affected by the provision shall request the waiver or
246	253		authorization and may delay implementing that provision until the
247	254		waiver or authorization is granted.
248	255		SECTION 4. This Act takes effect immediately if it receives
249	256		a vote of two-thirds of all the members elected to each house, as
250	257		provided by Section 39, Article III, Texas Constitution. If this
251	258		Act does not receive the vote necessary for immediate effect, this
252	259		Act takes effect September 1, 2019.
253		-	______________________________ ______________________________
254		-	President of the Senate Speaker of the House
255		-	I certify that H.B. No. 3459 was passed by the House on April
256		-	17, 2019, by the following vote: Yeas 122, Nays 17, 2 present, not
257		-	voting.
258		-	______________________________
259		-	Chief Clerk of the House
260		-	I certify that H.B. No. 3459 was passed by the Senate on May
261		-	10, 2019, by the following vote: Yeas 31, Nays 0.
262		-	______________________________
263		-	Secretary of the Senate
264		-	APPROVED: _____________________
265		-	Date
266		-	_____________________
267		-	Governor
	260	+	* * * * *