Texas 2019 - 86th Regular

Texas House Bill HB4077 Compare Versions

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

Old	New	Differences
1	1	86R13354 JCG-D
2	2	By: Price H.B. No. 4077
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to rural hospitals and similar facilities; requiring a
8	8	license; authorizing fees.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Chapter 531, Government Code, is amended by
11	11	adding Subchapter G to read as follows:
12	12	SUBCHAPTER G. RURAL HOSPITALS
13	13	Sec. 531.201. STRATEGIC PLAN; REPORT. (a) The commission
14	14	shall develop and implement a strategic plan to ensure that the
15	15	citizens of this state residing in rural areas have access to
16	16	hospital services.
17	17	(b) The strategic plan must include:
18	18	(1) a proposal for using at least one of the following
19	19	methods to ensure access to hospital services in the rural areas of
20	20	this state:
21	21	(A) an enhanced cost reimbursement methodology
22	22	for the payment of rural hospitals participating in the Medicaid
23	23	managed care program in conjunction with a supplemental payment
24	24	program for rural hospitals to cover costs incurred in providing
25	25	services to recipients;
26	26	(B) a hospital rate enhancement program that
27	27	applies only to rural hospitals;
28	28	(C) a reduction of punitive actions under the
29	29	Medicaid program that require reimbursement for Medicaid payments
30	30	made to the provider, if the provider is a rural hospital, a
31	31	reduction of the frequency of payment reductions under the Medicaid
32	32	program made to rural hospitals, and an enhancement of payments
33	33	made under merit-based programs or similar programs for rural
34	34	hospitals;
35	35	(D) a reduction of state regulatory-related
36	36	costs related to the commission's review of rural hospitals; or
37	37	(E) in accordance with rules adopted by the
38	38	Centers for Medicare and Medicaid Services, the establishment of a
39	39	minimum fee schedule that applies to payments made by managed care
40	40	organizations to rural hospitals; and
41	41	(2) target dates for achieving goals related to the
42	42	proposal described by Subdivision (1).
43	43	(c) Not later than January 1, 2020, the commission shall
44	44	submit the strategic plan developed under Subsection (b) to the
45	45	Legislative Budget Board for comment and review. The commission
46	46	may not begin implementation of the proposal contained in the
47	47	strategic plan until the strategic plan is approved by the
48	48	Legislative Budget Board.
49	49	(d) Not later than November 1 of each even-numbered year,
50	50	the commission shall submit a report regarding the commission's
51	51	development and implementation of the strategic plan described by
52	52	Subsection (b) to:
53	53	(1) the legislature;
54	54	(2) the governor; and
55	55	(3) the Legislative Budget Board.
56	56	Sec. 531.202. ADVISORY COMMITTEE ON RURAL HOSPITALS. (a)
57	57	The commission shall establish the Rural Hospital Advisory
58	58	Committee, either as another advisory committee or as a
59	59	subcommittee of the Hospital Payment Advisory Committee, to advise
60	60	the commission on issues relating specifically to rural hospitals.
61	61	(b) The Rural Hospital Advisory Committee is composed of
62	62	interested persons appointed by the executive commissioner.
63	63	Section 2110.002 does not apply to the advisory committee.
64	64	(c) A member of the advisory committee serves without
65	65	compensation.
66	66	Sec. 531.203. COLLABORATION WITH OFFICE OF RURAL AFFAIRS.
67	67	The commission shall collaborate with the Office of Rural Affairs
68	68	to ensure that this state is pursuing to the fullest extent possible
69	69	federal grants, funding opportunities, and support programs
70	70	available to rural hospitals as administered by the Health
71	71	Resources and Services Administration and the Office of Minority
72	72	Health in the United States Department of Health and Human
73	73	Services.
74	74	SECTION 2. Subchapter A, Chapter 533, Government Code, is
75	75	amended by adding Section 533.0041 to read as follows:
76	76	Sec. 533.0041. REIMBURSEMENT METHODOLOGY FOR RURAL
77	77	HOSPITALS. To the extent allowed by federal law and
78	78	notwithstanding any state law, the executive commissioner shall by
79	79	rule adopt a reimbursement methodology for the payment of rural
80	80	hospitals participating in the Medicaid managed care program that
81	81	ensures the rural hospitals are reimbursed on an individual basis
82	82	that allows the rural hospitals to fully recover allowable costs
83	83	incurred in providing services to recipients. In adopting rules
84	84	under this section, the executive commissioner:
85	85	(1) may adopt a methodology that requires:
86	86	(A) the commission to directly reimburse rural
87	87	hospitals for allowable costs; or
88	88	(B) a managed care organization to reimburse
89	89	rural hospitals; and
90	90	(2) shall define "allowable costs" and "rural
91	91	hospital" for purposes of this section.
92	92	SECTION 3. Chapter 241, Health and Safety Code, is amended
93	93	by adding Subchapter K to read as follows:
94	94	SUBCHAPTER K. LIMITED SERVICES RURAL HOSPITAL
95	95	Sec. 241.301. DEFINITION. In this subchapter, "limited
96	96	services rural hospital" means a general or special hospital that
97	97	is or was licensed under this chapter and that:
98	98	(1) is:
99	99	(A) located in a rural area, as defined by:
100	100	(i) commission rule; or
101	101	(ii) 42 U.S.C. Section 1395ww(d)(2)(D); or
102	102	(B) designated by the Centers for Medicare and
103	103	Medicaid Services as a critical access hospital, rural referral
104	104	center, or sole community hospital; and
105	105	(2) otherwise meets the requirements to be designated
106	106	as a limited services rural hospital or a similarly designated
107	107	hospital under federal law.
108	108	Sec. 241.302. LICENSE REQUIRED; FEES. (a) A person may not
109	109	establish, conduct, or maintain a limited services rural hospital
110	110	unless:
111	111	(1) the United States Congress passes a bill creating
112	112	a payment program specifically for limited services rural hospitals
113	113	or similarly designated hospitals that becomes law; and
114	114	(2) the commission issues a license to the person to
115	115	establish, conduct, or maintain a limited services rural hospital
116	116	under this subchapter.
117	117	(b) If the United States Congress enacts a bill described by
118	118	Subsection (a)(1) that becomes law, the commission shall adopt
119	119	rules:
120	120	(1) establishing minimum standards for the
121	121	facilities; and
122	122	(2) implementing this section.
123	123	(c) The standards adopted under Subsection (b) must be at
124	124	least as stringent as the standards established in the law
125	125	described by Subsection (a) for eligibility to qualify for a
126	126	payment program established by the law.
127	127	(d) An applicant for a license under this section must:
128	128	(1) submit an application for the license to the
129	129	commission in a form and manner prescribed by the commission; and
130	130	(2) pay any required fee.
131	131	(e) The commission shall issue a license to act as a limited
132	132	services rural hospital under this subchapter if the applicant
133	133	complies with the rules and standards adopted under this section.
134	134	(f) The commission by order may waive or modify the
135	135	requirement of a particular provision of this chapter or a standard
136	136	adopted under this section if the commission determines that the
137	137	waiver or modification will facilitate the creation or operation of
138	138	the facility and that the waiver or modification is in the best
139	139	interests of the individuals served or to be served by the facility.
140	140	Sections 241.026(d) and (e) apply to a waiver or modification under
141	141	this section for a limited services rural hospital in the same
142	142	manner as the subsections apply to a waiver or modification for a
143	143	hospital.
144	144	(g) A provision of this chapter related to the enforcement
145	145	authority of the commission applies to a limited services rural
146	146	hospital.
147	147	SECTION 4. This Act takes effect September 1, 2019.