Texas 2019 - 86th Regular

Texas House Bill HB3679 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~86R24089~~ JCG-F
	1	+	86R9041 JCG-F
2	2		By: Frank H.B. No. 3679
3		-	Substitute the following for H.B. No. 3679:
4		-	By: Stickland C.S.H.B. No. 3679
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to the creation and operations of health care provider
10	8		participation programs in certain counties.
11	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	10		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
13	11		amended by adding Chapter 292C to read as follows:
14	12		CHAPTER 292C. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
15	13		CERTAIN COUNTIES WITH HOSPITAL DISTRICT BORDERING OKLAHOMA
16	14		SUBCHAPTER A. GENERAL PROVISIONS
17	15		Sec. 292C.001. DEFINITIONS. In this chapter:
18	16		(1) "Institutional health care provider" means a
19	17		nonpublic hospital that provides inpatient hospital services and
20	18		that is not located within the boundaries of a hospital district.
21	19		(2) "Paying hospital" means an institutional health
22	20		care provider required to make a mandatory payment under this
23	21		chapter.
24	22		(3) "Program" means the county health care provider
25	23		participation program authorized by this chapter.
26	24		Sec. 292C.002. APPLICABILITY. This chapter applies only to
27	25		a county that:
28	26		(1) contains a hospital district that is not
29	27		countywide;
30	28		(2) has a population of more than 125,000; and
31	29		(3) borders Oklahoma.
32	30		Sec. 292C.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
33	31		PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
34	32		provider participation program authorizes a county to collect a
35	33		mandatory payment from each institutional health care provider
36	34		located in the county to be deposited in a local provider
37	35		participation fund established by the county. Money in the fund may
38	36		be used by the county to fund certain intergovernmental transfers
39	37		as provided by this chapter.
40	38		(b) The commissioners court of a county may adopt an order
41	39		authorizing the county to participate in the program, subject to
42		-	the limitations provided by this chapter.
43		-	Sec. 292C.004. EXPIRATION. The authority of a county to
44		-	administer and operate a program under this chapter expires
45		-	December 31, 2023.
	40	+	the limitations provided by this chapter, only if the commissioners
	41	+	court obtains the written consent of each institutional health care
	42	+	provider located in the county stating the provider's intent to
	43	+	participate in the program.
	44	+	Sec. 292C.004. EXPIRATION. (a) The authority of the
	45	+	district to administer and operate a program under this chapter
	46	+	expires on the earlier of:
	47	+	(1) December 31, 2025; or
	48	+	(2) at the end of the program year during which the
	49	+	district:
	50	+	(A) receives any written notice from a paying
	51	+	hospital that the hospital no longer wishes to participate in the
	52	+	program; or
	53	+	(B) does not receive the written consent of each
	54	+	paying hospital located in the county as required by Section
	55	+	292C.154.
	56	+	(b) This chapter expires December 31, 2025.
46	57		SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
47	58		Sec. 292C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
48	59		PAYMENT. The commissioners court of a county may require a
49	60		mandatory payment authorized under this chapter by an institutional
50	61		health care provider in the county only in the manner provided by
51	62		this chapter.
52	63		Sec. 292C.052. MAJORITY VOTE REQUIRED. The commissioners
53	64		court of a county may not authorize the county to collect a
54	65		mandatory payment authorized under this chapter without an
55	66		affirmative vote of a majority of the members of the commissioners
56	67		court.
57	68		Sec. 292C.053. RULES AND PROCEDURES. After the
58	69		commissioners court of a county has voted to require a mandatory
59	70		payment authorized under this chapter, the commissioners court may
60	71		adopt rules relating to the administration of the mandatory
61	72		payment.
62	73		Sec. 292C.054. INSTITUTIONAL HEALTH CARE PROVIDER
63	74		REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
64	75		county that collects a mandatory payment authorized under this
65	76		chapter shall require each institutional health care provider
66	77		located in the county to submit to the county a copy of any
67	78		financial and utilization data required by and reported to the
68	79		Department of State Health Services under Sections 311.032 and
69	80		311.033 and any rules adopted by the executive commissioner of the
70	81		Health and Human Services Commission to implement those sections.
71	82		(b) The commissioners court of a county that collects a
72	83		mandatory payment authorized under this chapter may inspect the
73	84		records of an institutional health care provider to the extent
74	85		necessary to ensure compliance with the requirements of Subsection
75	86		(a).
76	87		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
77	88		Sec. 292C.101. HEARING. (a) Each year, the commissioners
78	89		court of a county that collects a mandatory payment authorized
79	90		under this chapter shall hold a public hearing on the amounts of any
80	91		mandatory payments that the commissioners court intends to require
81	92		during the year.
82	93		(b) Not later than the fifth day before the date of the
83	94		hearing required under Subsection (a), the commissioners court of
84	95		the county shall publish notice of the hearing in a newspaper of
85	96		general circulation in the county.
86	97		(c) A representative of a paying hospital is entitled to
87	98		appear at the time and place designated in the public notice and to
88	99		be heard regarding any matter related to the mandatory payments
89	100		authorized under this chapter.
90	101		Sec. 292C.102. DEPOSITORY. (a) The commissioners court of
91	102		each county that collects a mandatory payment authorized under this
92	103		chapter by resolution shall designate one or more banks located in
93	104		the county as the depository for mandatory payments received by the
94	105		county.
95	106		(b) All income received by a county under this chapter,
96	107		including the revenue from mandatory payments remaining after
97	108		discounts and fees for assessing and collecting the payments are
98	109		deducted, shall be deposited with the county depository in the
99	110		county's local provider participation fund and may be withdrawn
100	111		only as provided by this chapter.
101	112		(c) All funds under this chapter shall be secured in the
102	113		manner provided for securing county funds.
103	114		Sec. 292C.103. LOCAL PROVIDER PARTICIPATION FUND;
104	115		AUTHORIZED USES OF MONEY. (a) Each county that collects a
105	116		mandatory payment authorized under this chapter shall create a
106	117		local provider participation fund.
107	118		(b) The local provider participation fund of a county
108	119		consists of:
109	120		(1) all revenue received by the county attributable to
110	121		mandatory payments authorized under this chapter, including any
111	122		penalties and interest attributable to delinquent payments;
112	123		(2) money received from the Health and Human Services
113	124		Commission as a refund of an intergovernmental transfer from the
114	125		county to the state for the purpose of providing the nonfederal
115	126		share of Medicaid supplemental payment program payments, provided
116	127		that the intergovernmental transfer does not receive a federal
117	128		matching payment; and
118	129		(3) the earnings of the fund.
119	130		(c) Money deposited to the local provider participation
120	131		fund may be used only to:
121	132		(1) fund intergovernmental transfers from the county
122	133		to the state to provide:
123	134		(A) the nonfederal share of a Medicaid
124	135		supplemental payment program authorized under the state Medicaid
125	136		plan, the Texas Healthcare Transformation and Quality Improvement
126	137		Program waiver issued under Section 1115 of the federal Social
127	138		Security Act (42 U.S.C. Section 1315), or a successor waiver
128	139		program authorizing similar Medicaid supplemental payment
129	140		programs; or
130	141		(B) payments to Medicaid managed care
131	142		organizations that are dedicated for payment to hospitals;
132	143		(2) pay the administrative expenses of the county
133	144		solely for activities under this chapter;
134	145		(3) refund a portion of a mandatory payment collected
135	146		in error from a paying hospital; and
136	147		(4) refund to paying hospitals the proportionate share
137	148		of money received by the county that is not used to fund the
138	149		nonfederal share of Medicaid supplemental payment program
139	150		payments.
140	151		(d) Money deposited to the local provider participation
141	152		fund may not be used to pay for the services of a consultant or a
142	153		person required to register under Chapter 305, Government Code.
143	154		(e) Money in the local provider participation fund may not
144	155		be commingled with other county funds.
145	156		(f) An intergovernmental transfer of funds described by
146	157		Subsection (c)(1) and any funds received by the county as a result
147	158		of an intergovernmental transfer described by that subsection may
148	159		not be used by the county or any other entity to expand Medicaid
149	160		eligibility under the Patient Protection and Affordable Care Act
150	161		(Pub. L. No. 111-148) as amended by the Health Care and Education
151	162		Reconciliation Act of 2010 (Pub. L. No. 111-152).
152	163		SUBCHAPTER D. MANDATORY PAYMENTS
153	164		Sec. 292C.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
154	165		NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
155	166		commissioners court of a county that collects a mandatory payment
156	167		authorized under this chapter may require an annual mandatory
157	168		payment to be assessed on the net patient revenue of each
158	169		institutional health care provider located in the county. The
159	170		commissioners court may provide for the mandatory payment to be
160	171		assessed quarterly. In the first year in which the mandatory
161	172		payment is required, the mandatory payment is assessed on the net
162	173		patient revenue of an institutional health care provider as
163	174		determined by the data reported to the Department of State Health
164	175		Services under Sections 311.032 and 311.033 in the fiscal year
165	176		ending in 2017 or, if the institutional health care provider did not
166	177		report any data under those sections in that fiscal year, as
167	178		determined by the institutional health care provider's Medicare
168	179		cost report submitted for the 2017 fiscal year or for the closest
169	180		subsequent fiscal year for which the provider submitted the
170	181		Medicare cost report. The county shall update the amount of the
171	182		mandatory payment on an annual basis.
172	183		(b) The amount of a mandatory payment authorized under this
173	184		chapter must be uniformly proportionate with the amount of net
174	185		patient revenue generated by each paying hospital in the county. A
175	186		mandatory payment authorized under this chapter may not hold
176	187		harmless any institutional health care provider, as required under
177	188		42 U.S.C. Section 1396b(w).
178	189		(c) The commissioners court of a county that collects a
179	190		mandatory payment authorized under this chapter shall set the
180	191		amount of the mandatory payment. The amount of the mandatory
181	192		payment required of each paying hospital may not exceed six percent
182	193		of the paying hospital's net patient revenue.
183	194		(d) Subject to the maximum amount prescribed by Subsection
184	195		(c), the commissioners court of a county that collects a mandatory
185	196		payment authorized under this chapter shall set the mandatory
186	197		payments in amounts that in the aggregate will generate sufficient
187	198		revenue to cover the administrative expenses of the county for
188	199		activities under this chapter and to fund an intergovernmental
189	200		transfer described by Section 292C.103(c)(1), except that the
190	201		amount of revenue from mandatory payments used for administrative
191	202		expenses of the county for activities under this chapter in a year
192		-	may not exceed $20,000, plus the cost of collateralization of
193		-	deposits. If the county demonstrates to the paying hospitals that
194		-	the costs of administering the program under this chapter,
195		-	excluding those costs associated with the collateralization of
196		-	deposits, exceed $20,000 in any year, on consent of a majority of
197		-	the paying hospitals, the county may use additional revenue from
198		-	mandatory payments received under this chapter to compensate the
199		-	county for its administrative expenses. A paying hospital may not
200		-	unreasonably withhold consent to compensate the county for
201		-	administrative expenses.
	203	+	may not exceed eight percent of the total revenue generated from the
	204	+	mandatory payment.
202	205		(e) A paying hospital may not add a mandatory payment
203	206		required under this section as a surcharge to a patient.
204	207		Sec. 292C.152. ASSESSMENT AND COLLECTION OF MANDATORY
205	208		PAYMENTS. The county may collect or contract for the assessment and
206	209		collection of mandatory payments authorized under this chapter.
207	210		Sec. 292C.153. INTEREST, PENALTIES, AND DISCOUNTS.
208	211		Interest, penalties, and discounts on mandatory payments required
209	212		under this chapter are governed by the law applicable to county ad
210	213		valorem taxes.
211		-	Sec. 292C.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
	214	+	Sec. 292C.154. ANNUAL CONSENT OF PAYING PROVIDERS. For
	215	+	each year in which the commissioners court of a county intends to
	216	+	require a mandatory payment under the program and before the date of
	217	+	the hearing required under Section 292C.101, the commissioners
	218	+	court of the county must obtain the written consent of each paying
	219	+	hospital stating the paying hospital's intent to continue to
	220	+	participate in the program.
	221	+	Sec. 292C.155. PURPOSE; CORRECTION OF INVALID PROVISION OR
212	222		PROCEDURE. (a) The purpose of this chapter is to generate revenue
213	223		by collecting from institutional health care providers a mandatory
214	224		payment to be used to provide the nonfederal share of a Medicaid
215	225		supplemental payment program.
216	226		(b) To the extent any provision or procedure under this
217	227		chapter causes a mandatory payment authorized under this chapter to
218	228		be ineligible for federal matching funds, the county may provide by
219	229		rule for an alternative provision or procedure that conforms to the
220	230		requirements of the federal Centers for Medicare and Medicaid
221	231		Services.
222	232		SECTION 2. As soon as practicable after the expiration of
223	233		the authority of a county to administer and operate a health care
224	234		provider participation program under Chapter 292C, Health and
225	235		Safety Code, as added by this Act, the commissioners court of the
226		-	county shall transfer to the institutional health care providers in
227		-	the county a proportionate share of any remaining funds in any local
228		-	provider participation fund created by the county under Section
229		-	292C.103, Health and Safety Code, as added by this Act.
	236	+	county shall transfer to each institutional health care provider in
	237	+	the county that provider's proportionate share of any remaining
	238	+	funds in any local provider participation fund created by the
	239	+	county under Section 292C.103, Health and Safety Code, as added by
	240	+	this Act.
230	241		SECTION 3. If before implementing any provision of this Act
231	242		a state agency determines that a waiver or authorization from a
232	243		federal agency is necessary for implementation of that provision,
233	244		the agency affected by the provision shall request the waiver or
234	245		authorization and may delay implementing that provision until the
235	246		waiver or authorization is granted.
236	247		SECTION 4. This Act takes effect immediately if it receives
237	248		a vote of two-thirds of all the members elected to each house, as
238	249		provided by Section 39, Article III, Texas Constitution. If this
239	250		Act does not receive the vote necessary for immediate effect, this
240	251		Act takes effect September 1, 2019.