Texas 2019 - 86th Regular

Texas House Bill HB3896 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		By: Martinez Fischer H.B. No. 3896
2		-	Substitute the following for H.B. No. 3896:
3		-	By: Cole C.S.H.B. No. 3896
4	2
5	3
6	4		A BILL TO BE ENTITLED
7	5		AN ACT
8	6		relating to the creation and operations of a health care provider
9	7		participation program by the Bexar County Hospital District.
10	8		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	9		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
12	10		amended by adding Chapter 298F to read as follows:
13	11		CHAPTER 298F. BEXAR COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
14	12		PARTICIPATION PROGRAM
15	13		SUBCHAPTER A. GENERAL PROVISIONS
16	14		Sec. 298F.001. DEFINITIONS. In this chapter:
17	15		(1) "Board" means the board of hospital managers of
18	16		the district.
19	17		(2) "District" means the Bexar County Hospital
20	18		District.
21	19		(3) "Institutional health care provider" means a
22	20		nonpublic hospital located in the district that provides inpatient
23	21		hospital services.
24	22		(4) "Paying provider" means an institutional health
25	23		care provider required to make a mandatory payment under this
26	24		chapter.
27	25		(5) "Program" means the health care provider
28	26		participation program authorized by this chapter.
29	27		Sec. 298F.002. APPLICABILITY. This chapter applies only to
30	28		the Bexar County Hospital District.
31	29		Sec. 298F.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
32	30		PARTICIPATION IN PROGRAM. The board may authorize the district to
33	31		participate in a health care provider participation program on the
34	32		affirmative vote of a majority of the board, subject to the
35	33		provisions of this chapter.
36	34		Sec. 298F.004. EXPIRATION. (a) Subject to Section
37	35		298F.153(d), the authority of the district to administer and
38	36		operate a program under this chapter expires December 31, 2023.
39	37		(b) This chapter expires December 31, 2023.
40	38		SUBCHAPTER B. POWERS AND DUTIES OF BOARD
41	39		Sec. 298F.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
42	40		PAYMENT. The board may require a mandatory payment authorized
43	41		under this chapter by an institutional health care provider in the
44	42		district only in the manner provided by this chapter.
45	43		Sec. 298F.052. RULES AND PROCEDURES. The board may adopt
46	44		rules relating to the administration of the program, including
47	45		collection of the mandatory payments, expenditures, audits, and any
48	46		other administrative aspects of the program.
49	47		Sec. 298F.053. INSTITUTIONAL HEALTH CARE PROVIDER
50	48		REPORTING. If the board authorizes the district to participate in a
51	49		program under this chapter, the board shall require each
52	50		institutional health care provider to submit to the district a copy
53	51		of any financial and utilization data reported in the provider's
54	52		Medicare cost report submitted for the previous fiscal year or for
55	53		the closest subsequent fiscal year for which the provider submitted
56	54		the Medicare cost report.
57	55		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
58	56		Sec. 298F.101. HEARING. (a) In each year that the board
59	57		authorizes a program under this chapter, the board shall hold a
60	58		public hearing on the amounts of any mandatory payments that the
61	59		board intends to require during the year and how the revenue derived
62	60		from those payments is to be spent.
63	61		(b) Not later than the fifth day before the date of the
64	62		hearing required under Subsection (a), the board shall publish
65	63		notice of the hearing in a newspaper of general circulation in the
66	64		district and provide written notice of the hearing to each paying
67	65		provider in the district.
68	66		(c) A representative of a paying provider is entitled to
69	67		appear at the public hearing and be heard regarding any matter
70	68		related to the mandatory payments authorized under this chapter.
71	69		Sec. 298F.102. DEPOSITORY. (a) If the board requires a
72	70		mandatory payment authorized under this chapter, the board shall
73	71		designate one or more banks as a depository for the district's local
74	72		provider participation fund.
75	73		(b) All funds collected under this chapter shall be secured
76	74		in the manner provided for securing other district funds.
77	75		Sec. 298F.103. LOCAL PROVIDER PARTICIPATION FUND;
78	76		AUTHORIZED USES OF MONEY. (a) If the district requires a mandatory
79	77		payment authorized under this chapter, the district shall create a
80	78		local provider participation fund.
81	79		(b) The local provider participation fund consists of:
82	80		(1) all revenue received by the district attributable
83	81		to mandatory payments authorized under this chapter;
84	82		(2) money received from the Health and Human Services
85	83		Commission as a refund of an intergovernmental transfer under the
86	84		program, provided that the intergovernmental transfer does not
87	85		receive a federal matching payment; and
88	86		(3) the earnings of the fund.
89	87		(c) Money deposited to the local provider participation
90	88		fund of the district may be used only to:
91	89		(1) fund intergovernmental transfers from the
92	90		district to the state to provide the nonfederal share of Medicaid
93	91		payments for:
94		-	(A) payments to nonpublic hospitals, if those
95		-	payments are authorized under the Texas Healthcare Transformation
96		-	and Quality Improvement Program waiver issued under Section 1115 of
97		-	the federal Social Security Act (42 U.S.C. Section 1315);
98		-	(B) uniform rate enhancements for nonpublic
	92	+	(A) uncompensated care payments to nonpublic
	93	+	hospitals, if those payments are authorized under the Texas
	94	+	Healthcare Transformation and Quality Improvement Program waiver
	95	+	issued under Section 1115 of the federal Social Security Act (42
	96	+	U.S.C. Section 1315);
	97	+	(B) payments to nonpublic hospitals available
	98	+	through the delivery system reform incentive payment program;
	99	+	(C) uniform rate enhancements for nonpublic
99	100		hospitals in the Medicaid managed care service area in which the
100	101		district is located;
101		-	(C) payments available under another waiver
102		-	program authorizing ~~Medicaid~~ payments to ~~nonpublic hospitals or any~~
103		-	payments to ~~Medicaid managed care organizations for the benefit of~~
104		-	~~nonpublic hospitals~~; or
105		-	(D) any reimbursement to nonpublic hospitals for
	102	+	(D) payments available under another waiver
	103	+	program authorizing payments that are substantially similar to
	104	+	Medicaid payments to nonpublic hospitals described by Paragraph
	105	+	(A), (B), or (C); or
	106	+	(E) any reimbursement to nonpublic hospitals for
106	107		which federal matching funds are available;
107	108		(2) subject to Section 298F.151(d), pay the
108	109		administrative expenses of the district in administering the
109	110		program, including collateralization of deposits;
110	111		(3) refund a mandatory payment collected in error from
111	112		a paying provider;
112	113		(4) refund to paying providers a proportionate share
113	114		of the money that the district:
114	115		(A) receives from the Health and Human Services
115	116		Commission that is not used to fund the nonfederal share of Medicaid
116	117		supplemental payment program payments; or
117	118		(B) determines cannot be used to fund the
118	119		nonfederal share of Medicaid supplemental payment program
119	120		payments; and
120	121		(5) transfer funds to the Health and Human Services
121	122		Commission if the district is legally required to transfer the
122	123		funds to address a disallowance of federal matching funds with
123	124		respect to programs for which the district made intergovernmental
124	125		transfers described by Subdivision (1).
125	126		(d) Money in the local provider participation fund may not
126	127		be commingled with other district funds.
127	128		(e) Notwithstanding any other provision of this chapter,
128	129		with respect to an intergovernmental transfer of funds described by
129	130		Subsection (c)(1) made by the district, any funds received by the
130	131		state, district, or other entity as a result of that transfer may
131		-	not be used by the state, district, or any other entity to:
132		-	(1) expand Medicaid eligibility under the Patient
133		-	Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
134		-	by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
135		-	No. 111-152); or
136		-	(2) fund the nonfederal share of payments to nonpublic
137		-	hospitals available through the Medicaid disproportionate share
138		-	hospital payment program.
	132	+	not be used by the state, district, or any other entity to expand
	133	+	Medicaid eligibility under the Patient Protection and Affordable
	134	+	Care Act (Pub. L. No. 111-148) as amended by the Health Care and
	135	+	Education Reconciliation Act of 2010 (Pub. L. No. 111-152).
139	136		SUBCHAPTER D. MANDATORY PAYMENTS
140	137		Sec. 298F.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
141	138		NET PATIENT REVENUE. (a) If the board authorizes a health care
142	139		provider participation program under this chapter, the board may
143		-	require a mandatory payment to be assessed on the net ~~patient~~
144		-	revenue of each institutional health care provider located ~~in the~~
145		-	district. The board may provide for the mandatory payment to be
146		-	assessed periodically throughout the year. The board shall ~~provide~~
147		-	an institutional health care provider written notice of ~~each~~
148		-	assessment under this subsection, and the provider has 30 ~~calendar~~
149		-	days following the date of receipt of the notice to pay the
	140	+	require an annual mandatory payment to be assessed on the net
	141	+	patient revenue of each institutional health care provider located
	142	+	in the district. The board may provide for the mandatory payment to
	143	+	be assessed periodically throughout the year. The board shall
	144	+	provide an institutional health care provider written notice of
	145	+	each assessment under this subsection, and the provider has 30
	146	+	calendar days following the date of receipt of the notice to pay the
150	147		assessment. In the first year in which the mandatory payment is
151	148		required, the mandatory payment is assessed on the net patient
152	149		revenue of an institutional health care provider, which is the
153	150		amount of that revenue as reported in the provider's Medicare cost
154	151		report submitted for the previous fiscal year or for the closest
155	152		subsequent fiscal year for which the provider submitted the
156	153		Medicare cost report. If the mandatory payment is required, the
157	154		district shall update the amount of the mandatory payment on an
158	155		annual basis.
159	156		(b) The amount of a mandatory payment authorized under this
160	157		chapter must be uniformly proportionate with the amount of net
161	158		patient revenue generated by each paying provider in the district
162	159		as permitted under federal law. A health care provider
163	160		participation program authorized under this chapter may not hold
164	161		harmless any institutional health care provider, as required under
165	162		42 U.S.C. Section 1396b(w).
166	163		(c) If the board requires a mandatory payment authorized
167	164		under this chapter, the board shall set the amount of the mandatory
168	165		payment, subject to the limitations of this chapter. The aggregate
169	166		amount of the mandatory payments required of all paying providers
170	167		in the district may not exceed six percent of the aggregate net
171	168		patient revenue from hospital services provided by all paying
172	169		providers in the district.
173	170		(d) Subject to Subsection (c), if the board requires a
174	171		mandatory payment authorized under this chapter, the board shall
175	172		set the mandatory payments in amounts that in the aggregate will
176	173		generate sufficient revenue to cover the administrative expenses of
177	174		the district for activities under this chapter and to fund an
178	175		intergovernmental transfer described by Section 298F.103(c)(1).
179	176		The annual amount of revenue from mandatory payments that shall be
180	177		paid for administrative expenses of the program by the district may
181	178		not exceed 2.5 percent of the total revenue generated from the
182	179		mandatory payments, regardless of actual expenses.
183	180		(e) A paying provider may not add a mandatory payment
184	181		required under this section as a surcharge to a patient.
185	182		(f) A mandatory payment assessed under this chapter is not a
186	183		tax for hospital purposes for purposes of Section 4, Article IX,
187	184		Texas Constitution, or Section 281.045 of this code.
188	185		Sec. 298F.152. ASSESSMENT AND COLLECTION OF MANDATORY
189	186		PAYMENTS. (a) The district may designate an official of the
190	187		district or contract with another person to assess and collect the
191	188		mandatory payments authorized under this chapter.
192	189		(b) The person charged by the district with the assessment
193	190		and collection of mandatory payments shall charge and deduct from
194	191		the mandatory payments collected for the district a collection fee
195	192		in an amount not to exceed the person's usual and customary charges
196	193		for like services.
197	194		(c) If the person charged with the assessment and collection
198	195		of mandatory payments is an official of the district, any revenue
199	196		from a collection fee charged under Subsection (b) shall be
200	197		deposited in the district general fund and, if appropriate, shall
201	198		be reported as fees of the district.
202	199		Sec. 298F.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
203		-	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
204		-	~~chapter~~ is to authorize the district to establish a program to
205		-	~~enable the~~ district to collect mandatory payments from
206		-	~~institutional health~~ care providers to fund the nonfederal share of
207		-	~~a Medicaid~~ supplemental payment program or the Medicaid managed
208		-	~~care rate~~ enhancements for nonpublic hospitals to support the
209		-	~~provision of~~ health care by institutional health care providers to
210		-	~~district~~ residents in need of health care.
	200	+	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this chapter
	201	+	is to authorize the district to establish a program to enable the
	202	+	district to collect mandatory payments from institutional health
	203	+	care providers to fund the nonfederal share of a Medicaid
	204	+	supplemental payment program or the Medicaid managed care rate
	205	+	enhancements for nonpublic hospitals to support the provision of
	206	+	health care by institutional health care providers to district
	207	+	residents in need of health care.
211	208		(b) This chapter does not authorize the district to collect
212	209		mandatory payments for the purpose of raising general revenue or
213	210		any amount in excess of the amount reasonably necessary to fund the
214	211		nonfederal share of a Medicaid supplemental payment program or
215	212		Medicaid managed care rate enhancements for nonpublic hospitals and
216	213		to cover the administrative expenses of the district associated
217	214		with activities under this chapter and other amounts for which the
218	215		fund may be used as described by Section 298F.103(c).
219	216		(c) To the extent any provision or procedure under this
220	217		chapter causes a mandatory payment authorized under this chapter to
221	218		be ineligible for federal matching funds, the board may provide by
222	219		rule for an alternative provision or procedure that conforms to the
223	220		requirements of the federal Centers for Medicare and Medicaid
224	221		Services. A rule adopted under this section may not create, impose,
225	222		or materially expand the legal or financial liability or
226	223		responsibility of the district or an institutional health care
227	224		provider in the district beyond the provisions of this chapter.
228	225		This section does not require the board to adopt a rule.
229	226		(d) The district may only assess and collect a mandatory
230	227		payment authorized under this chapter if a waiver program, uniform
231	228		rate enhancement, or reimbursement described by Section
232	229		298F.103(c)(1) is available to the district.
233	230		SECTION 2. As soon as practicable after the expiration of
234	231		the authority of the Bexar County Hospital District to administer
235	232		and operate a health care provider participation program under
236	233		Chapter 298F, Health and Safety Code, as added by this Act, the
237	234		board of hospital managers of the Bexar County Hospital District
238	235		shall transfer to each institutional health care provider in the
239	236		district that provider's proportionate share of any remaining funds
240	237		in any local provider participation fund created by the district
241	238		under Section 298F.103, Health and Safety Code, as added by this
242	239		Act.
243	240		SECTION 3. If before implementing any provision of this Act
244	241		a state agency determines that a waiver or authorization from a
245	242		federal agency is necessary for implementation of that provision,
246	243		the agency affected by the provision shall request the waiver or
247	244		authorization and may delay implementing that provision until the
248	245		waiver or authorization is granted.
249	246		SECTION 4. This Act takes effect immediately if it receives
250	247		a vote of two-thirds of all the members elected to each house, as
251	248		provided by Section 39, Article III, Texas Constitution. If this
252	249		Act does not receive the vote necessary for immediate effect, this
253	250		Act takes effect September 1, 2019.