Texas 2019 - 86th Regular

Texas House Bill HB4648 Compare Versions

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1	1	2019S0262-1 02/22/19
2	2	By: Burrows H.B. No. 4648
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the creation and operations of a health care provider
8	8	participation program by the Lubbock County Hospital District.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
11	11	amended by adding Chapter 298C to read as follows:
12	12	CHAPTER 298C. LUBBOCK COUNTY HOSPITAL DISTRICT HEALTH CARE
13	13	PROVIDER PARTICIPATION PROGRAM
14	14	SUBCHAPTER A. GENERAL PROVISIONS
15	15	Sec. 298C.001. PURPOSE. The purpose of this chapter is to
16	16	authorize the district to administer a health care provider
17	17	participation program to provide additional compensation to
18	18	nonpublic hospitals by collecting mandatory payments from each
19	19	nonpublic hospital in the district to be used to provide the
20	20	nonfederal share of a Medicaid supplemental payment program and for
21	21	other purposes as authorized under this chapter.
22	22	Sec. 298C.002. DEFINITIONS. In this chapter:
23	23	(1) "Board" means the board of hospital managers of
24	24	the district.
25	25	(2) "Commissioners court" means the Commissioners
26	26	Court of Lubbock County.
27	27	(3) "County" means Lubbock County.
28	28	(4) "District" means the Lubbock County Hospital
29	29	District of Lubbock County, Texas.
30	30	(5) "Institutional health care provider" means a
31	31	nonpublic hospital located in the district that provides inpatient
32	32	hospital services.
33	33	(6) "Paying hospital" means an institutional health
34	34	care provider required to make a mandatory payment under this
35	35	chapter.
36	36	(7) "Program" means the health care provider
37	37	participation program authorized by this chapter.
38	38	Sec. 298C.003. APPLICABILITY. This chapter applies only to
39	39	the Lubbock County Hospital District of Lubbock County, Texas.
40	40	Sec. 298C.004. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
41	41	PARTICIPATION IN PROGRAM. The board may authorize the district to
42	42	participate in a health care provider participation program on the
43	43	affirmative vote of a majority of the board, subject to the
44	44	provisions of this chapter.
45	45	SUBCHAPTER B. POWERS AND DUTIES
46	46	Sec. 298C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
47	47	PAYMENT. The board may authorize the collection of a mandatory
48	48	payment authorized under this chapter from an institutional health
49	49	care provider located in the district only in the manner provided by
50	50	this chapter.
51	51	Sec. 298C.052. INSTITUTIONAL HEALTH CARE PROVIDER
52	52	REPORTING. If the board authorizes the district to participate in a
53	53	program under this chapter, the board shall require each
54	54	institutional health care provider to submit to the district a copy
55	55	of any financial and utilization data required by and reported to
56	56	the Department of State Health Services under Sections 311.032 and
57	57	311.033 and any rules adopted by the executive commissioner of the
58	58	Health and Human Services Commission to implement those sections.
59	59	Sec. 298C.053. PROGRAM ADMINISTRATION. (a) The board,
60	60	subject to the approval of the commissioners court, shall delegate
61	61	all administrative responsibilities of the program, including
62	62	collection of mandatory payments, expenditures, and audits, to the
63	63	county.
64	64	(b) The commissioners court may adopt rules relating to the
65	65	administration of the program.
66	66	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
67	67	Sec. 298C.101. HEARING. (a) In each year that the board
68	68	authorizes a program under this chapter, the board shall hold a
69	69	public hearing on the amounts of any mandatory payments that the
70	70	board intends to require during the year and how the revenue derived
71	71	from those payments is to be spent.
72	72	(b) Not later than the fifth day before the date of the
73	73	hearing required under Subsection (a), the board shall publish
74	74	notice of the hearing in a newspaper of general circulation in the
75	75	district and provide written notice of the hearing to the chief
76	76	operating officer of each institutional health care provider in the
77	77	district.
78	78	(c) Determination of the amount of any mandatory payments to
79	79	be collected during the year shall be shown to be based on
80	80	reasonable estimates of the amount of revenue necessary to meet and
81	81	cover the nonfederal share of payments described by Section
82	82	298C.103(b)(1) that is otherwise unfunded, and is subject to the
83	83	final approval of the commissioners court.
84	84	Sec. 298C.102. LOCAL PROVIDER PARTICIPATION FUND;
85	85	DEPOSITORY. (a) If the board authorizes the collection of a
86	86	mandatory payment authorized under this chapter, and the
87	87	commissioners court approves such collection, the commissioners
88	88	court shall by resolution create a local provider participation
89	89	fund in one or more banks located in the district that are
90	90	designated by the commissioners court to serve as the depository
91	91	for mandatory payments received by the county.
92	92	(b) All income received by the county under this chapter,
93	93	including the revenue from mandatory payments remaining after
94	94	discounts and fees for assessing and collecting the payments are
95	95	deducted, shall be deposited with the county depository in the
96	96	county's local provider participation fund and may be withdrawn
97	97	only as provided by this chapter.
98	98	(c) All funds collected under this chapter shall be secured
99	99	in the manner provided by law for securing county funds.
100	100	Sec. 298C.103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY.
101	101	(a) The local provider participation fund established under
102	102	Section 298C.102 consists of:
103	103	(1) all mandatory payments authorized under this
104	104	chapter and received by the county;
105	105	(2) money received from the Health and Human Services
106	106	Commission as a refund of an intergovernmental transfer from the
107	107	local provider participation fund to the state as the nonfederal
108	108	share of Medicaid supplemental payment program payments, provided
109	109	that the intergovernmental transfer does not receive a federal
110	110	matching payment; and
111	111	(3) the earnings of the fund.
112	112	(b) Money deposited to the local provider participation
113	113	fund may be used only to:
114	114	(1) fund intergovernmental transfers from the county
115	115	to the state to provide the nonfederal share of:
116	116	(A) uncompensated care payments for nonpublic
117	117	hospitals and delivery system reform incentive payments for
118	118	nonpublic hospitals, if those payments are authorized under the
119	119	Texas Healthcare Transformation and Quality Improvement Program
120	120	waiver issued under Section 1115 of the federal Social Security Act
121	121	(42 U.S.C. Section 1315);
122	122	(B) uniform rate enhancements for nonpublic
123	123	hospitals in the Medicaid managed care service area in which the
124	124	district is located;
125	125	(C) payments available to nonpublic hospitals
126	126	under another waiver program authorizing payments that are
127	127	substantially similar to Medicaid payments to nonpublic hospitals
128	128	described by Paragraph (A) or (B); or
129	129	(D) any reimbursement to nonpublic hospitals for
130	130	which federal matching funds are available;
131	131	(2) subject to Section 298C.151(d), pay the
132	132	administrative expenses of the county in administering the program,
133	133	including collateralization of deposits;
134	134	(3) refund a portion of a mandatory payment collected
135	135	in error from a paying hospital; and
136	136	(4) refund to paying hospitals a proportionate share
137	137	of the money that the county:
138	138	(A) receives from the Health and Human Services
139	139	Commission that is not used to fund the nonfederal share of payments
140	140	described by Subdivision (1); or
141	141	(B) determines cannot be used to fund the
142	142	nonfederal share of payments described by Subdivision (1).
143	143	(c) Money in the local provider participation fund may not
144	144	be commingled with other county funds.
145	145	(d) An intergovernmental transfer of funds described by
146	146	Subsection (b)(1) and any funds received by the county as a result
147	147	of an intergovernmental transfer described by that subsection may
148	148	not be used by the county or any other entity to expand Medicaid
149	149	eligibility under the Patient Protection and Affordable Care Act
150	150	(Pub. L. No. 111-148) as amended by the Health Care and Education
151	151	Reconciliation Act of 2010 (Pub. L. No. 111-152).
152	152	SUBCHAPTER D. MANDATORY PAYMENTS
153	153	Sec. 298C.151. MANDATORY PAYMENTS. (a) If the board
154	154	authorizes a program under this chapter, the board, subject to the
155	155	approval of the commissioners court, may require an annual
156	156	mandatory payment to be assessed on the net patient revenue of each
157	157	institutional health care provider located in the district. The
158	158	commissioners court may provide that the mandatory payment is to be
159	159	collected at least annually, but not more often than quarterly. In
160	160	the first year in which the mandatory payment is required, the
161	161	mandatory payment is assessed on the net patient revenue of an
162	162	institutional health care provider as determined by the data
163	163	reported to the Department of State Health Services under Sections
164	164	311.032 and 311.033 in the most recent fiscal year for which that
165	165	data was reported. If the institutional health care provider did
166	166	not report any data under those sections, the provider's net
167	167	patient revenue is the amount of that revenue as contained in the
168	168	provider's Medicare cost report submitted for the previous fiscal
169	169	year or for the closest subsequent fiscal year for which the
170	170	provider submitted the Medicare cost report.
171	171	(b) The amount of a mandatory payment authorized under this
172	172	chapter must be a uniform percentage of the amount of net patient
173	173	revenue generated by each paying hospital in the district. A
174	174	mandatory payment authorized under this chapter may not hold
175	175	harmless any institutional health care provider, as required under
176	176	42 U.S.C. Section 1396b(w).
177	177	(c) The aggregate amount of the mandatory payments required
178	178	of all paying hospitals in the district may not exceed six percent
179	179	of the aggregate net patient revenue of all paying hospitals in the
180	180	district.
181	181	(d) Subject to the maximum amount prescribed by Subsection
182	182	(c), the board, with the approval of the commissioners court, shall
183	183	set the mandatory payments in amounts that in the aggregate will
184	184	generate sufficient revenue to cover the administrative expenses of
185	185	the county for activities under this chapter, fund an
186	186	intergovernmental transfer described by Section 298C.103(b)(1), or
187	187	make other payments authorized under this chapter. The mandatory
188	188	payment amounts must be set based on reasonable estimates of the
189	189	amount of revenue necessary to fully meet and cover authorized
190	190	expenses under this chapter. The amount of revenue from mandatory
191	191	payments that may be used for administrative expenses by the county
192	192	in a year may not exceed $25,000, plus the cost of collateralization
193	193	of deposits. If the county demonstrates to the paying hospitals
194	194	that the costs of administering the program under this chapter,
195	195	excluding those costs associated with the collateralization of
196	196	deposits, exceed $25,000 in any year, on consent of a majority of
197	197	all of the paying hospitals, the county may use additional revenue
198	198	from mandatory payments received under this chapter to compensate
199	199	the county for its administrative expenses. A paying hospital may
200	200	not unreasonably withhold consent to compensate the county for
201	201	administrative expenses.
202	202	(e) A paying hospital may not add a mandatory payment
203	203	required under this section as a surcharge to a patient or insurer.
204	204	(f) A mandatory payment under this chapter is not a tax for
205	205	purposes of Section 4, Article IX, Texas Constitution, or Chapter
206	206	1053, Special District Local Laws Code.
207	207	Sec. 298C.152. ASSESSMENT AND COLLECTION OF MANDATORY
208	208	PAYMENTS. The county may collect or contract for the assessment and
209	209	collection of mandatory payments authorized under this chapter.
210	210	Sec. 298C.153. CORRECTION OF INVALID PROVISION OR
211	211	PROCEDURE. To the extent any provision or procedure under this
212	212	chapter causes a mandatory payment authorized under this chapter to
213	213	be ineligible for federal matching funds, the board may provide by
214	214	rule for an alternative provision or procedure that conforms to the
215	215	requirements of the federal Centers for Medicare and Medicaid
216	216	Services. A rule adopted under this section may not create, impose,
217	217	or materially expand the legal or financial liability or
218	218	responsibility of the district or an institutional health care
219	219	provider in the district beyond the provisions of this chapter.
220	220	This section does not require the board to adopt a rule.
221	221	SECTION 2. If before implementing any provision of this Act
222	222	a state agency determines that a waiver or authorization from a
223	223	federal agency is necessary for implementation of that provision,
224	224	the agency affected by the provision shall request the waiver or
225	225	authorization and may delay implementing that provision until the
226	226	waiver or authorization is granted.
227	227	SECTION 3. This Act takes effect immediately if it receives
228	228	a vote of two-thirds of all the members elected to each house, as
229	229	provided by Section 39, Article III, Texas Constitution. If this
230	230	Act does not receive the vote necessary for immediate effect, this
231	231	Act takes effect September 1, 2019.