Texas 2019 - 86th Regular

Texas House Bill HB4548 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 4548
	1	+	By: Wray (Senate Sponsor - Birdwell) H.B. No. 4548
	2	+	(In the Senate - Received from the House May 7, 2019;
	3	+	May 8, 2019, read first time and referred to Committee on
	4	+	Intergovernmental Relations; May 15, 2019, reported favorably by
	5	+	the following vote: Yeas 7, Nays 0; May 15, 2019, sent to printer.)
	6	+	Click here to see the committee vote
2	7
3	8
	9	+	A BILL TO BE ENTITLED
4	10		AN ACT
5	11		relating to the creation and operations of health care provider
6	12		participation programs in certain counties.
7	13		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	14		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
9	15		amended by adding Chapter 292C to read as follows:
10	16		CHAPTER 292C. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
11	17		CERTAIN COUNTIES WITH HOSPITAL DISTRICT BORDERING OKLAHOMA
12	18		SUBCHAPTER A. GENERAL PROVISIONS
13	19		Sec. 292C.001. DEFINITIONS. In this chapter:
14	20		(1) "Institutional health care provider" means a
15	21		nonpublic hospital that provides inpatient hospital services and
16	22		that is not located within the boundaries of a hospital district.
17	23		(2) "Paying hospital" means an institutional health
18	24		care provider required to make a mandatory payment under this
19	25		chapter.
20	26		(3) "Program" means the county health care provider
21	27		participation program authorized by this chapter.
22	28		Sec. 292C.002. APPLICABILITY. This chapter applies only to
23	29		a county that:
24	30		(1) contains a hospital district that is not
25	31		countywide;
26	32		(2) has a population of more than 125,000; and
27	33		(3) borders Oklahoma.
28	34		Sec. 292C.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
29	35		PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
30	36		provider participation program authorizes a county to collect a
31	37		mandatory payment from each institutional health care provider
32	38		located in the county to be deposited in a local provider
33	39		participation fund established by the county. Money in the fund may
34	40		be used by the county to fund certain intergovernmental transfers
35	41		as provided by this chapter.
36	42		(b) The commissioners court of a county may adopt an order
37	43		authorizing the county to participate in the program, subject to
38	44		the limitations provided by this chapter.
39	45		Sec. 292C.004. EXPIRATION. The authority of a county to
40	46		administer and operate a program under this chapter expires
41	47		December 31, 2023.
42	48		SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
43	49		Sec. 292C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
44	50		PAYMENT. The commissioners court of a county may require a
45	51		mandatory payment authorized under this chapter by an institutional
46	52		health care provider in the county only in the manner provided by
47	53		this chapter.
48	54		Sec. 292C.052. MAJORITY VOTE REQUIRED. The commissioners
49	55		court of a county may not authorize the county to collect a
50	56		mandatory payment authorized under this chapter without an
51	57		affirmative vote of a majority of the members of the commissioners
52	58		court.
53	59		Sec. 292C.053. RULES AND PROCEDURES. After the
54	60		commissioners court of a county has voted to require a mandatory
55	61		payment authorized under this chapter, the commissioners court may
56	62		adopt rules relating to the administration of the mandatory
57	63		payment.
58	64		Sec. 292C.054. INSTITUTIONAL HEALTH CARE PROVIDER
59	65		REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
60	66		county that collects a mandatory payment authorized under this
61	67		chapter shall require each institutional health care provider
62	68		located in the county to submit to the county a copy of any
63	69		financial and utilization data required by and reported to the
64	70		Department of State Health Services under Sections 311.032 and
65	71		311.033 and any rules adopted by the executive commissioner of the
66	72		Health and Human Services Commission to implement those sections.
67	73		(b) The commissioners court of a county that collects a
68	74		mandatory payment authorized under this chapter may inspect the
69	75		records of an institutional health care provider to the extent
70	76		necessary to ensure compliance with the requirements of Subsection
71	77		(a).
72	78		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
73	79		Sec. 292C.101. HEARING. (a) Each year, the commissioners
74	80		court of a county that collects a mandatory payment authorized
75	81		under this chapter shall hold a public hearing on the amounts of any
76	82		mandatory payments that the commissioners court intends to require
77	83		during the year.
78	84		(b) Not later than the fifth day before the date of the
79	85		hearing required under Subsection (a), the commissioners court of
80	86		the county shall publish notice of the hearing in a newspaper of
81	87		general circulation in the county.
82	88		(c) A representative of a paying hospital is entitled to
83	89		appear at the time and place designated in the public notice and to
84	90		be heard regarding any matter related to the mandatory payments
85	91		authorized under this chapter.
86	92		Sec. 292C.102. DEPOSITORY. (a) The commissioners court of
87	93		each county that collects a mandatory payment authorized under this
88	94		chapter by resolution shall designate one or more banks located in
89	95		the county as the depository for mandatory payments received by the
90	96		county.
91	97		(b) All income received by a county under this chapter,
92	98		including the revenue from mandatory payments remaining after
93	99		discounts and fees for assessing and collecting the payments are
94	100		deducted, shall be deposited with the county depository in the
95	101		county's local provider participation fund and may be withdrawn
96	102		only as provided by this chapter.
97	103		(c) All funds under this chapter shall be secured in the
98	104		manner provided for securing county funds.
99	105		Sec. 292C.103. LOCAL PROVIDER PARTICIPATION FUND;
100	106		AUTHORIZED USES OF MONEY. (a) Each county that collects a
101	107		mandatory payment authorized under this chapter shall create a
102	108		local provider participation fund.
103	109		(b) The local provider participation fund of a county
104	110		consists of:
105	111		(1) all revenue received by the county attributable to
106	112		mandatory payments authorized under this chapter, including any
107	113		penalties and interest attributable to delinquent payments;
108	114		(2) money received from the Health and Human Services
109	115		Commission as a refund of an intergovernmental transfer from the
110	116		county to the state for the purpose of providing the nonfederal
111	117		share of Medicaid supplemental payment program payments, provided
112	118		that the intergovernmental transfer does not receive a federal
113	119		matching payment; and
114	120		(3) the earnings of the fund.
115	121		(c) Money deposited to the local provider participation
116	122		fund may be used only to:
117	123		(1) fund intergovernmental transfers from the county
118	124		to the state to provide:
119	125		(A) the nonfederal share of a Medicaid
120	126		supplemental payment program authorized under the state Medicaid
121	127		plan, the Texas Healthcare Transformation and Quality Improvement
122	128		Program waiver issued under Section 1115 of the federal Social
123	129		Security Act (42 U.S.C. Section 1315), or a successor waiver
124	130		program authorizing similar Medicaid supplemental payment
125	131		programs; or
126	132		(B) payments to Medicaid managed care
127	133		organizations that are dedicated for payment to hospitals;
128	134		(2) pay the administrative expenses of the county
129	135		solely for activities under this chapter;
130	136		(3) refund a portion of a mandatory payment collected
131	137		in error from a paying hospital; and
132	138		(4) refund to paying hospitals the proportionate share
133	139		of money received by the county that is not used to fund the
134	140		nonfederal share of Medicaid supplemental payment program
135	141		payments.
136	142		(d) Money deposited to the local provider participation
137	143		fund may not be used to pay for the services of a consultant or a
138	144		person required to register under Chapter 305, Government Code.
139	145		(e) Money in the local provider participation fund may not
140	146		be commingled with other county funds.
141	147		(f) An intergovernmental transfer of funds described by
142	148		Subsection (c)(1) and any funds received by the county as a result
143	149		of an intergovernmental transfer described by that subsection may
144	150		not be used by the county or any other entity to expand Medicaid
145	151		eligibility under the Patient Protection and Affordable Care Act
146	152		(Pub. L. No. 111-148) as amended by the Health Care and Education
147	153		Reconciliation Act of 2010 (Pub. L. No. 111-152).
148	154		SUBCHAPTER D. MANDATORY PAYMENTS
149	155		Sec. 292C.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
150	156		NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
151	157		commissioners court of a county that collects a mandatory payment
152	158		authorized under this chapter may require an annual mandatory
153	159		payment to be assessed on the net patient revenue of each
154	160		institutional health care provider located in the county. The
155	161		commissioners court may provide for the mandatory payment to be
156	162		assessed quarterly. In the first year in which the mandatory
157	163		payment is required, the mandatory payment is assessed on the net
158	164		patient revenue of an institutional health care provider as
159	165		determined by the data reported to the Department of State Health
160	166		Services under Sections 311.032 and 311.033 in the fiscal year
161	167		ending in 2017 or, if the institutional health care provider did not
162	168		report any data under those sections in that fiscal year, as
163	169		determined by the institutional health care provider's Medicare
164	170		cost report submitted for the 2017 fiscal year or for the closest
165	171		subsequent fiscal year for which the provider submitted the
166	172		Medicare cost report. The county shall update the amount of the
167	173		mandatory payment on an annual basis.
168	174		(b) The amount of a mandatory payment authorized under this
169	175		chapter must be uniformly proportionate with the amount of net
170	176		patient revenue generated by each paying hospital in the county. A
171	177		mandatory payment authorized under this chapter may not hold
172	178		harmless any institutional health care provider, as required under
173	179		42 U.S.C. Section 1396b(w).
174	180		(c) The commissioners court of a county that collects a
175	181		mandatory payment authorized under this chapter shall set the
176	182		amount of the mandatory payment. The amount of the mandatory
177	183		payment required of each paying hospital may not exceed six percent
178	184		of the paying hospital's net patient revenue.
179	185		(d) Subject to the maximum amount prescribed by Subsection
180	186		(c), the commissioners court of a county that collects a mandatory
181	187		payment authorized under this chapter shall set the mandatory
182	188		payments in amounts that in the aggregate will generate sufficient
183	189		revenue to cover the administrative expenses of the county for
184	190		activities under this chapter and to fund an intergovernmental
185	191		transfer described by Section 292C.103(c)(1), except that the
186	192		amount of revenue from mandatory payments used for administrative
187	193		expenses of the county for activities under this chapter in a year
188	194		may not exceed $20,000, plus the cost of collateralization of
189	195		deposits. If the county demonstrates to the paying hospitals that
190	196		the costs of administering the program under this chapter,
191	197		excluding those costs associated with the collateralization of
192	198		deposits, exceed $20,000 in any year, on consent of a majority of
193	199		the paying hospitals, the county may use additional revenue from
194	200		mandatory payments received under this chapter to compensate the
195	201		county for its administrative expenses. A paying hospital may not
196	202		unreasonably withhold consent to compensate the county for
197	203		administrative expenses.
198	204		(e) A paying hospital may not add a mandatory payment
199	205		required under this section as a surcharge to a patient.
200	206		Sec. 292C.152. ASSESSMENT AND COLLECTION OF MANDATORY
201	207		PAYMENTS. The county may collect or contract for the assessment and
202	208		collection of mandatory payments authorized under this chapter.
203	209		Sec. 292C.153. INTEREST, PENALTIES, AND DISCOUNTS.
204	210		Interest, penalties, and discounts on mandatory payments required
205	211		under this chapter are governed by the law applicable to county ad
206	212		valorem taxes.
207	213		Sec. 292C.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
208	214		PROCEDURE. (a) The purpose of this chapter is to generate revenue
209	215		by collecting from institutional health care providers a mandatory
210	216		payment to be used to provide the nonfederal share of a Medicaid
211	217		supplemental payment program.
212	218		(b) To the extent any provision or procedure under this
213	219		chapter causes a mandatory payment authorized under this chapter to
214	220		be ineligible for federal matching funds, the county may provide by
215	221		rule for an alternative provision or procedure that conforms to the
216	222		requirements of the federal Centers for Medicare and Medicaid
217	223		Services.
218	224		SECTION 2. Subtitle D, Title 4, Health and Safety Code, is
219	225		amended by adding Chapter 296A to read as follows:
220	226		CHAPTER 296A. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
221	227		CERTAIN COUNTIES BORDERING TWO POPULOUS COUNTIES
222	228		SUBCHAPTER A. GENERAL PROVISIONS
223	229		Sec. 296A.001. DEFINITIONS. In this chapter:
224	230		(1) "Institutional health care provider" means a
225	231		nonpublic hospital that provides inpatient hospital services.
226	232		(2) "Paying hospital" means an institutional health
227	233		care provider required to make a mandatory payment under this
228	234		chapter.
229	235		(3) "Program" means the county health care provider
230	236		participation program authorized by this chapter.
231	237		Sec. 296A.002. APPLICABILITY. This chapter applies only to
232	238		a county that:
233	239		(1) is not served by a hospital district or a public
234	240		hospital; and
235	241		(2) has a population of less than 600,000 and borders
236	242		two counties both with populations of one million or more.
237	243		Sec. 296A.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
238	244		PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
239	245		provider participation program authorizes a county to collect a
240	246		mandatory payment from each institutional health care provider
241	247		located in the county to be deposited in a local provider
242	248		participation fund established by the county. Money in the fund may
243	249		be used by the county to fund certain intergovernmental transfers
244	250		and indigent care programs as provided by this chapter.
245	251		(b) The commissioners court may adopt an order authorizing a
246	252		county to participate in the program, subject to the limitations
247	253		provided by this chapter.
248	254		SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
249	255		Sec. 296A.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
250	256		PAYMENT. The commissioners court of a county may require a
251	257		mandatory payment authorized under this chapter by an institutional
252	258		health care provider in the county only in the manner provided by
253	259		this chapter.
254	260		Sec. 296A.052. MAJORITY VOTE REQUIRED. The commissioners
255	261		court of a county may not authorize the county to collect a
256	262		mandatory payment authorized under this chapter without an
257	263		affirmative vote of a majority of the members of the commissioners
258	264		court.
259	265		Sec. 296A.053. RULES AND PROCEDURES. After the
260	266		commissioners court has voted to require a mandatory payment
261	267		authorized under this chapter, the commissioners court may adopt
262	268		rules relating to the administration of the mandatory payment.
263	269		Sec. 296A.054. INSTITUTIONAL HEALTH CARE PROVIDER
264	270		REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
265	271		county that collects a mandatory payment authorized under this
266	272		chapter shall require each institutional health care provider to
267	273		submit to the county a copy of any financial and utilization data
268	274		required by and reported to the Department of State Health Services
269	275		under Sections 311.032 and 311.033 and any rules adopted by the
270	276		executive commissioner of the Health and Human Services Commission
271	277		to implement those sections.
272	278		(b) The commissioners court of a county that collects a
273	279		mandatory payment authorized under this chapter may inspect the
274	280		records of an institutional health care provider to the extent
275	281		necessary to ensure compliance with the requirements of Subsection
276	282		(a).
277	283		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
278	284		Sec. 296A.101. HEARING. (a) Each year, the commissioners
279	285		court of a county that collects a mandatory payment authorized
280	286		under this chapter shall hold a public hearing on the amounts of any
281	287		mandatory payments that the commissioners court intends to require
282	288		during the year and how the revenue derived from those payments is
283	289		to be spent.
284	290		(b) Not later than the 10th day before the date of the
285	291		hearing required under Subsection (a), the commissioners court of
286	292		the county shall publish notice of the hearing in a newspaper of
287	293		general circulation in the county.
288	294		(c) A representative of a paying hospital is entitled to
289	295		appear at the time and place designated in the public notice and to
290	296		be heard regarding any matter related to the mandatory payments
291	297		authorized under this chapter.
292	298		Sec. 296A.102. DEPOSITORY. (a) The commissioners court of
293	299		each county that collects a mandatory payment authorized under this
294	300		chapter by resolution shall designate one or more banks located in
295	301		the county as the depository for mandatory payments received by the
296	302		county. A bank designated as a depository serves for two years or
297	303		until a successor is designated.
298	304		(b) All income received by a county under this chapter,
299	305		including the revenue from mandatory payments remaining after
300	306		discounts and fees for assessing and collecting the payments are
301	307		deducted, shall be deposited with the county depository in the
302	308		county's local provider participation fund and may be withdrawn
303	309		only as provided by this chapter.
304	310		(c) All funds under this chapter shall be secured in the
305	311		manner provided for securing county funds.
306	312		Sec. 296A.103. LOCAL PROVIDER PARTICIPATION FUND;
307	313		AUTHORIZED USES OF MONEY. (a) Each county that collects a
308	314		mandatory payment authorized under this chapter shall create a
309	315		local provider participation fund.
310	316		(b) The local provider participation fund of a county
311	317		consists of:
312	318		(1) all revenue received by the county attributable to
313	319		mandatory payments authorized under this chapter, including any
314	320		penalties and interest attributable to delinquent payments;
315	321		(2) money received from the Health and Human Services
316	322		Commission as a refund of an intergovernmental transfer from the
317	323		county to the state for the purpose of providing the nonfederal
318	324		share of Medicaid supplemental payment program payments, provided
319	325		that the intergovernmental transfer does not receive a federal
320	326		matching payment; and
321	327		(3) the earnings of the fund.
322	328		(c) Money deposited to the local provider participation
323	329		fund may be used only to:
324	330		(1) fund intergovernmental transfers from the county
325	331		to the state to provide:
326	332		(A) the nonfederal share of a Medicaid
327	333		supplemental payment program authorized under the state Medicaid
328	334		plan, the Texas Healthcare Transformation and Quality Improvement
329	335		Program waiver issued under Section 1115 of the federal Social
330	336		Security Act (42 U.S.C. Section 1315), or a successor waiver
331	337		program authorizing similar Medicaid supplemental payment
332	338		programs; or
333	339		(B) payments to Medicaid managed care
334	340		organizations that are dedicated for payment to hospitals;
335	341		(2) subsidize indigent programs;
336	342		(3) pay the administrative expenses of the county for
337	343		activities under this chapter;
338	344		(4) refund a portion of a mandatory payment collected
339	345		in error from a paying hospital; and
340	346		(5) refund to paying hospitals the proportionate share
341	347		of money received by the county from the Health and Human Services
342	348		Commission that is not used to fund the nonfederal share of Medicaid
343	349		supplemental payment program payments.
344	350		(d) Money in the local provider participation fund may not
345	351		be commingled with other county funds.
346	352		(e) An intergovernmental transfer of funds described by
347	353		Subsection (c)(1) and any funds received by the county as a result
348	354		of an intergovernmental transfer described by Subsection (c)(1) may
349	355		not be used by the county or any other entity to expand Medicaid
350	356		eligibility under the Patient Protection and Affordable Care Act
351	357		(Pub. L. No. 111-148) as amended by the Health Care and Education
352	358		Reconciliation Act of 2010 (Pub. L. No. 111-152).
353	359		SUBCHAPTER D. MANDATORY PAYMENTS
354	360		Sec. 296A.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
355	361		NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
356	362		commissioners court of a county that collects a mandatory payment
357	363		authorized under this chapter may require an annual mandatory
358	364		payment to be assessed on the net patient revenue of each
359	365		institutional health care provider located in the county. The
360	366		commissioners court may provide for the mandatory payment to be
361	367		assessed quarterly. In the first year in which the mandatory
362	368		payment is required, the mandatory payment is assessed on the net
363	369		patient revenue of an institutional health care provider as
364	370		determined by the data reported to the Department of State Health
365	371		Services under Sections 311.032 and 311.033 in the fiscal year
366	372		ending in 2017 or, if the institutional health care provider did not
367	373		report any data under those sections in that fiscal year, as
368	374		determined by the institutional health care provider's Medicare
369	375		cost report submitted for the 2017 fiscal year or for the closest
370	376		subsequent fiscal year for which the provider submitted the
371	377		Medicare cost report. The county shall update the amount of the
372	378		mandatory payment on an annual basis.
373	379		(b) The amount of a mandatory payment authorized under this
374	380		chapter must be uniformly proportionate with the amount of net
375	381		patient revenue generated by each paying hospital in the county. A
376	382		mandatory payment authorized under this chapter may not hold
377	383		harmless any institutional health care provider, as required under
378	384		42 U.S.C. Section 1396b(w).
379	385		(c) The commissioners court of a county that collects a
380	386		mandatory payment authorized under this chapter shall set the
381	387		amount of the mandatory payment. The amount of the mandatory
382	388		payment required of each paying hospital may not exceed an amount
383	389		that, when added to the amount of the mandatory payments required
384	390		from all other paying hospitals in the county, equals an amount of
385	391		revenue that exceeds six percent of the aggregate net patient
386	392		revenue of all paying hospitals in the county.
387	393		(d) Subject to the maximum amount prescribed by Subsection
388	394		(c), the commissioners court of a county that collects a mandatory
389	395		payment authorized under this chapter shall set the mandatory
390	396		payments in amounts that in the aggregate will generate sufficient
391	397		revenue to cover the administrative expenses of the county for
392	398		activities under this chapter, to fund the nonfederal share of a
393	399		Medicaid supplemental payment program, and to pay for indigent
394	400		programs, except that the amount of revenue from mandatory payments
395	401		used for administrative expenses of the county for activities under
396	402		this chapter in a year may not exceed the lesser of four percent of
397	403		the total revenue generated from the mandatory payment or $20,000.
398	404		(e) A paying hospital may not add a mandatory payment
399	405		required under this section as a surcharge to a patient.
400	406		Sec. 296A.152. ASSESSMENT AND COLLECTION OF MANDATORY
401	407		PAYMENTS. The county may collect or contract for the assessment and
402	408		collection of mandatory payments authorized under this chapter.
403	409		Sec. 296A.153. INTEREST, PENALTIES, AND DISCOUNTS.
404	410		Interest, penalties, and discounts on mandatory payments required
405	411		under this chapter are governed by the law applicable to county ad
406	412		valorem taxes.
407	413		Sec. 296A.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
408	414		PROCEDURE. (a) The purpose of this chapter is to generate revenue
409	415		by collecting from institutional health care providers a mandatory
410	416		payment to be used to provide the nonfederal share of a Medicaid
411	417		supplemental payment program.
412	418		(b) To the extent any provision or procedure under this
413	419		chapter causes a mandatory payment authorized under this chapter to
414	420		be ineligible for federal matching funds, the county may provide by
415	421		rule for an alternative provision or procedure that conforms to the
416	422		requirements of the federal Centers for Medicare and Medicaid
417	423		Services.
418	424		SECTION 3. As soon as practicable after the expiration of
419	425		the authority of a county to administer and operate a health care
420	426		provider participation program under Chapter 292C, Health and
421	427		Safety Code, as added by this Act, the commissioners court of the
422	428		county shall transfer to the institutional health care providers in
423	429		the county a proportionate share of any remaining funds in any local
424	430		provider participation fund created by the county under Section
425	431		292C.103, Health and Safety Code, as added by this Act.
426	432		SECTION 4. If before implementing any provision of this Act
427	433		a state agency determines that a waiver or authorization from a
428	434		federal agency is necessary for implementation of that provision,
429	435		the agency affected by the provision shall request the waiver or
430	436		authorization and may delay implementing that provision until the
431	437		waiver or authorization is granted.
432	438		SECTION 5. This Act takes effect immediately if it receives
433	439		a vote of two-thirds of all the members elected to each house, as
434	440		provided by Section 39, Article III, Texas Constitution. If this
435	441		Act does not receive the vote necessary for immediate effect, this
436	442		Act takes effect September 1, 2019.
437		-	______________________________ ______________________________
438		-	President of the Senate Speaker of the House
439		-	I certify that H.B. No. 4548 was passed by the House on May 7,
440		-	2019, by the following vote: Yeas 142, Nays 6, 1 present, not
441		-	voting.
442		-	______________________________
443		-	Chief Clerk of the House
444		-	I certify that H.B. No. 4548 was passed by the Senate on May
445		-	19, 2019, by the following vote: Yeas 31, Nays 0.
446		-	______________________________
447		-	Secretary of the Senate
448		-	APPROVED: _____________________
449		-	Date
450		-	_____________________
451		-	Governor
	443	+	* * * * *