H.B. No. 4289
AN ACT
relating to the authority of certain local governments to create
and operate health care provider participation programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
amended by adding Chapter 300 to read as follows:
CHAPTER 300. HEALTH CARE PROVIDER PARTICIPATION PROGRAMS IN CERTAIN
POLITICAL SUBDIVISIONS IN THIS STATE
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 300.0001. PURPOSE. The purpose of this chapter is to
authorize a hospital district, county, or municipality in this
state to administer a health care provider participation program to
provide additional compensation to certain hospitals located in the
hospital district, county, or municipality by collecting mandatory
payments from each of those hospitals to be used to provide the
nonfederal share of a Medicaid supplemental payment program and for
other purposes as authorized under this chapter.
Sec. 300.0002. DEFINITIONS. In this chapter:
(1) "Institutional health care provider" means a
nonpublic hospital that provides inpatient hospital services.
(2) "Local government" means a hospital district,
county, or municipality to which this chapter applies.
(3) "Paying hospital" means an institutional health
care provider required to make a mandatory payment under this
chapter.
(4) "Program" means a health care provider
participation program authorized by this chapter.
Sec. 300.0003. APPLICABILITY. This chapter applies only
to:
(1) a hospital district that is not participating in a
health care provider participation program authorized by another
chapter of this subtitle; and
(2) a county or municipality that:
(A) is not participating in a health care
provider participation program authorized by another chapter of
this subtitle; and
(B) is not served by a hospital district or a
public hospital.
Sec. 300.0004. LOCAL JURISDICTION HEALTH CARE PROVIDER
PARTICIPATION PROGRAM; ORDER REQUIRED FOR PARTICIPATION. The
governing body of a local government may only adopt an order or
ordinance authorizing that local government to participate in a
health care provider participation program after an affirmative
vote of the majority of the governing body.
SUBCHAPTER B. POWERS AND DUTIES OF GOVERNING BODY
Sec. 300.0051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
PAYMENT. The governing body of a local government may require a
mandatory payment authorized under this chapter by an institutional
health care provider located in that hospital district, county, or
municipality, as applicable, only in the manner provided by this
chapter.
Sec. 300.0052. RULES AND PROCEDURES. The governing body of
a local government may adopt rules relating to the administration
of the health care provider participation program in the local
government, including collection of the mandatory payments,
expenditures, audits, and any other administrative aspects of the
program.
Sec. 300.0053. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING. If the governing body of a local government authorizes
the local government to participate in a health care provider
participation program under this chapter, the governing body shall
require each institutional health care provider to submit to the
local government a copy of any financial and utilization data
required by and reported to the Department of State Health Services
under Sections 311.032 and 311.033 and any rules adopted by the
executive commissioner of the Health and Human Services Commission
to implement those sections.
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
Sec. 300.0101. HEARING. (a) In each year that the
governing body of a local government authorizes a health care
provider participation program under this chapter, the governing
body shall hold a public hearing on the amounts of any mandatory
payments that the governing body intends to require during the year
and how the revenue derived from those payments is to be spent.
(b) Not later than the fifth day before the date of the
hearing required under Subsection (a), the governing body shall
publish notice of the hearing in a newspaper of general circulation
in the hospital district, county, or municipality, as applicable,
and provide written notice of the hearing to the chief operating
officer of each institutional health care provider located in the
hospital district, county, or municipality, as applicable.
(c) A representative of a paying hospital is entitled to
appear at the time and place designated in the public notice and to
be heard regarding any matter related to the mandatory payments
authorized under this chapter.
Sec. 300.0102. LOCAL PROVIDER PARTICIPATION FUND;
DEPOSITORY. (a) Each governing body of a local government that
collects a mandatory payment authorized under this chapter shall
create a local provider participation fund.
(b) If a governing body of a local government creates a
local provider participation fund, the governing body shall
designate one or more banks as a depository for the mandatory
payments received by the local government.
(c) The governing body of a local government may withdraw or
use money in the local provider participation fund of the local
government only for a purpose authorized under this chapter.
(d) All funds collected under this chapter shall be secured
in the manner provided for securing other funds of the local
government.
Sec. 300.0103. LOCAL PROVIDER PARTICIPATION FUND;
AUTHORIZED USES OF MONEY. (a) The local provider participation
fund established by a local government under Section 300.0102
consists of:
(1) all revenue received by the local government
attributable to mandatory payments authorized under this chapter;
(2) money received from the Health and Human Services
Commission as a refund of an intergovernmental transfer from the
local government to the state for the purpose of providing the
nonfederal share of Medicaid supplemental payment program
payments, provided that the intergovernmental transfer does not
receive a federal matching payment; and
(3) the earnings of the fund.
(b) Money deposited to the local provider participation
fund of a local government may be used only to:
(1) fund intergovernmental transfers from the local
government to the state to provide the nonfederal share of Medicaid
payments for:
(A) uncompensated care payments to nonpublic
hospitals, if those payments are authorized under the Texas
Healthcare Transformation and Quality Improvement Program waiver
issued under Section 1115 of the federal Social Security Act (42
U.S.C. Section 1315);
(B) uniform rate enhancements for nonpublic
hospitals in the Medicaid managed care service area in which the
local government is located;
(C) payments available under another waiver
program authorizing payments that are substantially similar to
Medicaid payments to nonpublic hospitals described by Paragraph (A)
or (B); or
(D) any reimbursement to nonpublic hospitals for
which federal matching funds are available;
(2) subject to Section 300.0151(d), pay the
administrative expenses of the local government in administering
the program, including collateralization of deposits;
(3) refund all or a portion of a mandatory payment
collected in error from a paying hospital;
(4) refund to paying hospitals a proportionate share
of the money that the local government:
(A) receives from the Health and Human Services
Commission that is not used to fund the nonfederal share of Medicaid
supplemental payment program payments; or
(B) determines cannot be used to fund the
nonfederal share of Medicaid supplemental payment program
payments;
(5) transfer funds to the Health and Human Services
Commission if the local government is required by law to transfer
the funds to address a disallowance of federal matching funds with
respect to payments, rate enhancements, and reimbursements for
which the local government made intergovernmental transfers
described by Subdivision (1); and
(6) reimburse the local government if the local
government is required by the rules governing the uniform rate
enhancement program described by Subdivision (1)(B) to incur an
expense or forego Medicaid reimbursements from the state because
the balance of the local provider participation fund is not
sufficient to fund that rate enhancement program.
(c) Money in the local provider participation fund of a
local government may not be commingled with other funds of the local
government.
(d) Notwithstanding any other provision of this chapter,
with respect to an intergovernmental transfer of funds described by
Subsection (b)(1) made by the local government, any funds received
by the state, local government, or other entity as a result of that
transfer may not be used by the state, local government, or any
other entity to:
(1) expand Medicaid eligibility under the Patient
Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
No. 111-152); or
(2) fund the nonfederal share of payments to nonpublic
hospitals available through the Medicaid disproportionate share
hospital program or the delivery system reform incentive payment
program.
SUBCHAPTER D. MANDATORY PAYMENTS
Sec. 300.0151. MANDATORY PAYMENTS. (a) Except as provided
by Subsection (e), if the governing body of a local government
authorizes a health care provider participation program under this
chapter, the governing body shall require an annual mandatory
payment to be assessed on the net patient revenue of each
institutional health care provider located in the hospital
district, county, or municipality, as applicable. The governing
body of the local government shall provide that the mandatory
payment is to be assessed at least annually, but not more often than
quarterly. In the first year in which the mandatory payment is
required, the mandatory payment is assessed on the net patient
revenue of an institutional health care provider located in the
hospital district, county, or municipality, as applicable, as
determined by the data reported to the Department of State Health
Services under Sections 311.032 and 311.033 in the most recent
fiscal year for which that data was reported. If the institutional
health care provider did not report any data under those sections,
the provider's net patient revenue is the amount of that revenue as
contained in the provider's Medicare cost report submitted for the
previous fiscal year or for the closest subsequent fiscal year for
which the provider submitted the Medicare cost report. The local
government shall update the amount of the mandatory payment on an
annual basis.
(b) The amount of a mandatory payment authorized under this
chapter for a local government must be uniformly proportionate with
the amount of net patient revenue generated by each paying hospital
in the hospital district, county, or municipality, as applicable,
as permitted under federal law. A health care provider
participation program authorized under this chapter may not hold
harmless any institutional health care provider, as required under
42 U.S.C. Section 1396b(w).
(c) The governing body of a local government that authorizes
a program under this chapter shall set the amount of the mandatory
payment. The aggregate amount of the mandatory payments required
of all paying hospitals in the hospital district, county, or
municipality, as applicable, may not exceed six percent of the
aggregate net patient revenue from hospital services provided by
all paying hospitals in the hospital district, county, or
municipality, as applicable.
(d) Subject to Subsection (c), the governing body of a local
government shall set the mandatory payments in amounts that in the
aggregate will generate sufficient revenue to cover the
administrative expenses of the local government for activities
under this chapter and to fund an intergovernmental transfer
described by Section 300.0103(b)(1). The annual amount of revenue
from mandatory payments that shall be paid for administrative
expenses for activities under this chapter by the local government
may not exceed $150,000, plus the cost of collateralization of
deposits, regardless of actual expenses.
(e) A paying hospital may not add a mandatory payment
required under this section as a surcharge to a patient.
(f) A mandatory payment required by the governing body of a
hospital district under this chapter is not a tax for purposes of
the applicable provision of Article IX, Texas Constitution.
Sec. 300.0152. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. (a) A hospital district may designate an official of the
district or contract with another person to assess and collect the
mandatory payments authorized under this chapter.
(b) A county or municipality may collect or, using a
competitive bidding process, contract for the assessment and
collection of mandatory payments authorized under this chapter.
(c) The person charged by the local government with the
assessment and collection of mandatory payments shall charge and
deduct from the mandatory payments collected for the local
government a collection fee in an amount not to exceed the person's
usual and customary charges for like services.
(d) If the person charged with the assessment and collection
of mandatory payments is an official of the local government, any
revenue from a collection fee charged under Subsection (c) shall be
deposited in the local government general fund and, if appropriate,
shall be reported as fees of the local government.
Sec. 300.0153. CORRECTION OF INVALID PROVISION OR
PROCEDURE. (a) This chapter does not authorize a local government
to collect mandatory payments for the purpose of raising general
revenue or any amount in excess of the amount reasonably necessary
to fund the nonfederal share of a Medicaid supplemental payment
program or Medicaid managed care rate enhancements for nonpublic
hospitals and to cover the administrative expenses of the local
government associated with activities under this chapter and other
uses of the fund described by Section 300.0103(b).
(b) To the extent any provision or procedure under this
chapter causes a mandatory payment authorized under this chapter to
be ineligible for federal matching funds, the local government may
provide by rule for an alternative provision or procedure that
conforms to the requirements of the federal Centers for Medicare
and Medicaid Services. A rule adopted under this section may not
create, impose, or materially expand the legal or financial
liability or responsibility of the local government or an
institutional health care provider in the local hospital district,
county, or municipality, as applicable, beyond the provisions of
this chapter. This section does not require the governing body of a
local government to adopt a rule.
(c) The local government may only assess and collect a
mandatory payment authorized under this chapter if a waiver
program, uniform rate enhancement, or reimbursement described by
Section 300.0103(b)(1) is available to the local government.
Sec. 300.0154. REPORTING REQUIREMENTS. (a) The governing
body of each local government that authorizes a program under this
chapter shall report information to the Health and Human Services
Commission regarding the program on a schedule determined by the
commission.
(b) The information must include:
(1) the amount of the mandatory payments required and
collected in each year the program is authorized;
(2) any expenditure of money attributable to mandatory
payments collected under this chapter, including:
(A) any contract with an entity for the
administration or operation of a program authorized by this
chapter; or
(B) a contract with a person for the assessment
and collection of a mandatory payment as authorized under Section
300.0152; and
(3) the amount of money attributable to mandatory
payments collected under this chapter that is used for any other
purpose.
(c) The executive commissioner of the Health and Human
Services Commission shall adopt rules to administer this section.
Sec. 300.0155. EXPIRATION OF AUTHORITY. The authority of a
local government to administer and operate a program under this
chapter expires on September 1 following the second anniversary of
the date the governing body of the local government adopted the
order or ordinance authorizing the local government to participate
in the program as provided by Section 300.0004.
Sec. 300.0156. AUTHORITY TO REFUSE FOR VIOLATION. The
Health and Human Services Commission may refuse to accept money
from a local provider participation fund established under this
chapter if the commission determines that doing so may violate
federal law.
SECTION 2. Subtitle D, Title 4, Health and Safety Code, is
amended by adding Chapter 300A to read as follows:
CHAPTER 300A. HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
DISTRICTS COMPOSED OF CERTAIN LOCAL GOVERNMENTS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 300A.0001. PURPOSE. The purpose of this chapter is to
authorize certain local governments to create a district to
administer a health care provider participation program to provide
additional compensation to certain hospitals in the district by
collecting mandatory payments from each of those hospitals in the
district to be used to provide the nonfederal share of a Medicaid
supplemental payment program and for other purposes as authorized
under this chapter.
Sec. 300A.0002. DEFINITIONS. In this chapter:
(1) "Board" means the board of directors of a
district.
(2) "Director" means a member of the board.
(3) "District" means a health care provider
participation district created under this chapter.
(4) "Institutional health care provider" means a
nonpublic hospital that provides inpatient hospital services.
(5) "Local government" means a hospital district,
county, or municipality to which this chapter applies.
(6) "Paying hospital" means an institutional health
care provider required to make a mandatory payment under this
chapter.
(7) "Program" means a health care provider
participation program authorized by this chapter.
Sec. 300A.0003. APPLICABILITY. This chapter applies only
to:
(1) a hospital district that:
(A) is not participating in a health care
provider participation program authorized by another chapter of
this subtitle; and
(B) has only one institutional health care
provider located in the district; and
(2) a county or municipality that:
(A) is not participating in a health care
provider participation program authorized by another chapter of
this subtitle;
(B) is not served by a hospital district or a
public hospital; and
(C) has only one institutional health care
provider located in the county or municipality.
SUBCHAPTER B. CREATION, OPERATION, AND DISSOLUTION OF DISTRICT
Sec. 300A.0021. CREATION BY CONCURRENT ORDERS. (a) A local
government and one or more other local governments may create a
district by adopting concurrent orders.
(b) A concurrent order to create a district must:
(1) be approved by the governing body of each creating
local government;
(2) contain identical provisions; and
(3) define the boundaries of the district to be
coextensive with the combined boundaries of each creating local
government.
Sec. 300A.0022. POWERS. A district may authorize and
administer a health care provider participation program in
accordance with this chapter.
Sec. 300A.0023. BOARD OF DIRECTORS. (a) If three or more
local governments create a district, the presiding officer of the
governing body of each local government that creates the district
shall appoint one director.
(b) If two local governments create a district:
(1) the presiding officer of the governing body of the
most populous local government shall appoint two directors; and
(2) the presiding officer of the governing body of the
other local government shall appoint one director.
(c) Directors serve staggered two-year terms, with as near
as possible to one-half of the directors' terms expiring each year.
(d) A vacancy in the office of director shall be filled for
the unexpired term in the same manner as the original appointment.
(e) The board shall elect from among its members a
president. The president may vote and may cast an additional vote
to break a tie.
(f) The board shall also elect from among its members a vice
president.
(g) The board shall appoint a secretary, who need not be a
director.
(h) Each officer of the board serves for a term of one year.
(i) The board shall fill a vacancy in a board office for the
unexpired term.
(j) A majority of the members of the board voting must
concur in a matter relating to the business of the district.
Sec. 300A.0024. QUALIFICATIONS FOR OFFICE. (a) To be
eligible to serve as a director, a person must be a resident of the
local government that appoints the person under Section 300A.0023.
(b) An employee of the district may not serve as a director.
Sec. 300A.0025. COMPENSATION. (a) Directors and officers
serve without compensation but may be reimbursed for actual
expenses incurred in the performance of official duties.
(b) Expenses reimbursed under this section must be:
(1) reported in the district's minute book or other
district records; and
(2) approved by the board.
Sec. 300A.0026. AUTHORITY TO SUE AND BE SUED. The board may
sue and be sued on behalf of the district.
Sec. 300A.0027. DISTRICT FINANCES. Subchapter F, Chapter
287, other than Sections 287.129 and 287.130, applies to the
district in the same manner that those provisions apply to a health
services district created under Chapter 287. This section does not
authorize the district to issue bonds.
Sec. 300A.0028. DISSOLUTION. A district shall be dissolved
if the local governments that created the district adopt concurrent
orders to dissolve the district and the concurrent orders contain
identical provisions.
Sec. 300A.0029. ADMINISTRATION OF PROPERTY, DEBTS, AND
ASSETS AFTER DISSOLUTION. (a) After dissolution of a district
under Section 300A.0028, the board shall continue to control and
administer any property, debts, and assets of the district until
all funds have been disposed of and all district debts have been
paid or settled.
(b) As soon as practicable after the dissolution of the
district, the board shall transfer to each institutional health
care provider in the district the provider's proportionate share of
any remaining funds in any local provider participation fund
created by the district under Section 300A.0102.
(c) If, after administering any property and assets, the
board determines that the district's property and assets are
insufficient to pay the debts of the district, the district shall
transfer the remaining debts to the local governments that created
the district in proportion to the funds contributed to the district
by each local government, including a paying hospital in the local
government.
(d) If, after complying with Subsections (b) and (c) and
administering the property and assets, the board determines that
unused funds remain, the board shall transfer the unused funds to
the local governments that created the district in proportion to
the funds contributed to the district by each local government,
including a paying hospital in the local government.
Sec. 300A.0030. ACCOUNTING AFTER DISSOLUTION. After the
district has paid all its debts and has disposed of all its assets
and funds as prescribed by Section 300A.0029, the board shall
provide an accounting to each local government that created the
district. The accounting must show the manner in which the assets
and debts of the district were distributed.
SUBCHAPTER C. HEALTH CARE PROVIDER PARTICIPATION PROGRAM; POWERS
AND DUTIES OF DISTRICT BOARD
Sec. 300A.0051. HEALTH CARE PROVIDER PARTICIPATION
PROGRAM. The board of a district may authorize the district to
participate in a health care provider participation program on the
affirmative vote of a majority of the board, subject to the
provisions of this chapter.
Sec. 300A.0052. LIMITATION ON AUTHORITY TO REQUIRE
MANDATORY PAYMENT. The board may require a mandatory payment
authorized under this chapter by an institutional health care
provider in the district only in the manner provided by this
chapter.
Sec. 300A.0053. RULES AND PROCEDURES. The board may adopt
rules relating to the administration of the health care provider
participation program in the district, including collection of the
mandatory payments, expenditures, audits, and any other
administrative aspects of the program.
Sec. 300A.0054. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING. If the board authorizes the district to participate in a
health care provider participation program under this chapter, the
board shall require each institutional health care provider located
in the district to submit to the district a copy of any financial
and utilization data required by and reported to the Department of
State Health Services under Sections 311.032 and 311.033 and any
rules adopted by the executive commissioner of the Health and Human
Services Commission to implement those sections.
SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
Sec. 300A.0101. HEARING. (a) In each year that the board
authorizes a health care provider participation program under this
chapter, the board shall hold a public hearing on the amounts of any
mandatory payments that the board intends to require during the
year and how the revenue derived from those payments is to be spent.
(b) Not later than the fifth day before the date of the
hearing required under Subsection (a), the board shall publish
notice of the hearing in a newspaper of general circulation in each
local government that creates the district and provide written
notice of the hearing to the chief operating officer of each
institutional health care provider in the district.
(c) A representative of a paying hospital is entitled to
appear at the time and place designated in the public notice and be
heard regarding any matter related to the mandatory payments
authorized under this chapter.
Sec. 300A.0102. LOCAL PROVIDER PARTICIPATION FUND;
DEPOSITORY. (a) If the board collects a mandatory payment
authorized under this chapter, the board shall create a local
provider participation fund in one or more banks designated by the
district as a depository for the mandatory payments received by the
district.
(b) The board may withdraw or use money in the local
provider participation fund of the district only for a purpose
authorized under this chapter.
(c) All funds collected under this chapter shall be secured
in the manner provided for securing public funds.
Sec. 300A.0103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY.
(a) The local provider participation fund established under
Section 300A.0102 consists of:
(1) all revenue received by the district attributable
to mandatory payments authorized under this chapter;
(2) money received from the Health and Human Services
Commission as a refund of an intergovernmental transfer from the
district to the state for the purpose of providing the nonfederal
share of Medicaid supplemental payment program payments, provided
that the intergovernmental transfer does not receive a federal
matching payment; and
(3) the earnings of the fund.
(b) Money deposited to the local provider participation
fund may be used only to:
(1) fund intergovernmental transfers from the
district to the state to provide the nonfederal share of Medicaid
payments for:
(A) uncompensated care payments to nonpublic
hospitals, if those payments are authorized under the Texas
Healthcare Transformation and Quality Improvement Program waiver
issued under Section 1115 of the federal Social Security Act (42
U.S.C. Section 1315);
(B) uniform rate enhancements for nonpublic
hospitals in the Medicaid managed care service area in which the
district is located;
(C) payments available under another waiver
program authorizing payments that are substantially similar to
Medicaid payments to nonpublic hospitals described by Paragraph (A)
or (B); or
(D) any reimbursement to nonpublic hospitals for
which federal matching funds are available;
(2) subject to Section 300A.0151(d), pay the
administrative expenses of the district in administering the
program, including collateralization of deposits;
(3) refund all or a portion of a mandatory payment
collected in error from a paying hospital;
(4) refund to paying hospitals a proportionate share
of the money that the district:
(A) receives from the Health and Human Services
Commission that is not used to fund the nonfederal share of Medicaid
supplemental payment program payments; or
(B) determines cannot be used to fund the
nonfederal share of Medicaid supplemental payment program
payments;
(5) transfer funds to the Health and Human Services
Commission if the district is required by law to transfer the funds
to address a disallowance of federal matching funds with respect to
payments, rate enhancements, and reimbursements for which the
district made intergovernmental transfers described by Subdivision
(1); and
(6) reimburse the district if the district is required
by the rules governing the uniform rate enhancement program
described by Subdivision (1)(B) to incur an expense or forego
Medicaid reimbursements from the state because the balance of the
local provider participation fund is not sufficient to fund that
rate enhancement program.
(c) Money in the local provider participation fund may not
be commingled with other district funds or other funds of a local
government that creates the district.
(d) Notwithstanding any other provision of this chapter,
with respect to an intergovernmental transfer of funds described by
Subsection (b)(1) made by the district, any funds received by the
state, district, or other entity as a result of the transfer may not
be used by the state, district, or any other entity to:
(1) expand Medicaid eligibility under the Patient
Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
No. 111-152); or
(2) fund the nonfederal share of payments to nonpublic
hospitals available through the Medicaid disproportionate share
hospital program or the delivery system reform incentive payment
program.
Sec. 300A.0104. ACCOUNTING OF FUNDS. The district shall
maintain an accounting of the funds received from each local
government that creates the district, including a paying hospital
located in a hospital district, county, or municipality that
created the district, as applicable.
SUBCHAPTER E. MANDATORY PAYMENTS
Sec. 300A.0151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if
the board authorizes a health care provider participation program
under this chapter, the district shall require an annual mandatory
payment to be assessed on the net patient revenue of each
institutional health care provider located in the district. The
board shall provide that the mandatory payment is to be assessed at
least annually, but not more often than quarterly. In the first
year in which the mandatory payment is required, the mandatory
payment is assessed on the net patient revenue of an institutional
health care provider located in the district as determined by the
data reported to the Department of State Health Services under
Sections 311.032 and 311.033 in the most recent fiscal year for
which that data was reported. If the institutional health care
provider did not report any data under those sections, the
provider's net patient revenue is the amount of that revenue as
contained in the provider's Medicare cost report submitted for the
previous fiscal year or for the closest subsequent fiscal year for
which the provider submitted the Medicare cost report. The
district shall update the amount of the mandatory payment on an
annual basis.
(b) The amount of a mandatory payment authorized under this
chapter must be uniformly proportionate with the amount of net
patient revenue generated by each paying hospital in the district
as permitted under federal law. A health care provider
participation program authorized under this chapter may not hold
harmless any institutional health care provider, as required under
42 U.S.C. Section 1396b(w).
(c) The board shall set the amount of a mandatory payment
authorized under this chapter. The aggregate amount of the
mandatory payments required of all paying hospitals in the district
may not exceed six percent of the aggregate net patient revenue from
hospital services provided by all paying hospitals in the district.
(d) Subject to Subsection (c), the board shall set the
mandatory payments in amounts that in the aggregate will generate
sufficient revenue to cover the administrative expenses of the
district for activities under this chapter and to fund an
intergovernmental transfer described by Section 300A.0103(b)(1).
The annual amount of revenue from mandatory payments that shall be
paid for administrative expenses by the district for activities
under this chapter may not exceed $150,000, plus the cost of
collateralization of deposits, regardless of actual expenses.
(e) A paying hospital may not add a mandatory payment
required under this section as a surcharge to a patient.
(f) For purposes of any hospital district that creates a
district under this chapter, a mandatory payment assessed under
this chapter is not a tax for hospital purposes for purposes of the
applicable provision of Article IX, Texas Constitution.
Sec. 300A.0152. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. (a) The district may designate an official of the
district or contract with another person to assess and collect the
mandatory payments authorized under this chapter.
(b) The person charged by the district with the assessment
and collection of mandatory payments shall charge and deduct from
the mandatory payments collected for the district a collection fee
in an amount not to exceed the person's usual and customary charges
for like services.
(c) If the person charged with the assessment and collection
of mandatory payments is an official of the district, any revenue
from a collection fee charged under Subsection (b) shall be
deposited in the district general fund and, if appropriate, shall
be reported as fees of the district.
Sec. 300A.0153. CORRECTION OF INVALID PROVISION OR
PROCEDURE; LIMITATION OF AUTHORITY. (a) This chapter does not
authorize the district to collect mandatory payments for the
purpose of raising general revenue or any amount in excess of the
amount reasonably necessary to:
(1) fund the nonfederal share of a Medicaid
supplemental payment program or Medicaid managed care rate
enhancements for nonpublic hospitals; and
(2) cover the administrative expenses of the district
associated with activities under this chapter and other uses of the
fund described by Section 300A.0103(b).
(b) To the extent any provision or procedure under this
chapter causes a mandatory payment authorized under this chapter to
be ineligible for federal matching funds, the board may provide by
rule for an alternative provision or procedure that conforms to the
requirements of the federal Centers for Medicare and Medicaid
Services. A rule adopted under this section may not create, impose,
or materially expand the legal or financial liability or
responsibility of the district or an institutional health care
provider in the district beyond the provisions of this chapter.
This section does not require the board to adopt a rule.
(c) The district may only assess and collect a mandatory
payment authorized under this chapter if a waiver program, uniform
rate enhancement, or reimbursement described by Section
300A.0103(b)(1) is available to the district.
Sec. 300A.0154. REPORTING REQUIREMENTS. (a) The board of a
district that authorizes a program under this chapter shall report
information to the Health and Human Services Commission regarding
the program on a schedule determined by the commission.
(b) The information must include:
(1) the amount of the mandatory payments required and
collected in each year the program is authorized;
(2) any expenditure of money attributable to mandatory
payments collected under this chapter, including:
(A) any contract with an entity for the
administration or operation of a program authorized by this
chapter; or
(B) a contract with a person for the assessment
and collection of a mandatory payment as authorized under Section
300A.0152; and
(3) the amount of money attributable to mandatory
payments collected under this chapter that is used for any other
purpose.
(c) The executive commissioner of the Health and Human
Services Commission shall adopt rules to administer this section.
Sec. 300A.0155. EXPIRATION OF AUTHORITY. The authority of
a district to administer and operate a program under this chapter
expires on September 1 following the second anniversary of the date
the board of the district authorized the district to participate in
the program as provided by Section 300A.0051.
Sec. 300A.0156. AUTHORITY TO REFUSE FOR VIOLATION. The
Health and Human Services Commission may refuse to accept money
from a local provider participation fund established under this
chapter if the commission determines that doing so may violate
federal law.
SECTION 3. As soon as practicable after the expiration of
the authority of a local government to administer and operate a
health care provider participation program under Chapter 300 or
300A, Health and Safety Code, as added by this Act, the governing
body of the local government shall transfer to each institutional
health care provider in the boundaries of the local government that
provider's proportionate share of any remaining funds in any local
provider participation fund created by the local government under
Chapter 300 or 300A, Health and Safety Code, as added by this Act.
SECTION 4. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 5. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2019.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 4289 was passed by the House on May 8,
2019, by the following vote: Yeas 101, Nays 40, 1 present, not
voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 4289 was passed by the Senate on May
22, 2019, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor