Texas 2019 - 86th Regular

Texas House Bill HB4740 Compare Versions

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

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1	1	86R24741 JCG-D
2	2	By: Zerwas H.B. No. 4740
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the creation and operations of health care provider
8	8	participation programs in certain counties bordering a populous
9	9	county.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
12	12	amended by adding Chapter 296B to read as follows:
13	13	CHAPTER 296B. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
14	14	CERTAIN COUNTIES BORDERING A POPULOUS COUNTY
15	15	SUBCHAPTER A. GENERAL PROVISIONS
16	16	Sec. 296B.001. DEFINITIONS. In this chapter:
17	17	(1) "Institutional health care provider" means a
18	18	nonpublic hospital that provides inpatient hospital services.
19	19	(2) "Paying hospital" means an institutional health
20	20	care provider required to make a mandatory payment under this
21	21	chapter.
22	22	(3) "Program" means the county health care provider
23	23	participation program authorized by this chapter.
24	24	Sec. 296B.002. APPLICABILITY. This chapter applies only to
25	25	a county that:
26	26	(1) is not served by a hospital district or a public
27	27	hospital; and
28	28	(2) has a population of more than 550,000 and borders a
29	29	county with a population of 3.3 million or more.
30	30	Sec. 296B.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
31	31	PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
32	32	provider participation program authorizes a county to collect a
33	33	mandatory payment from each institutional health care provider
34	34	located in the county to be deposited in a local provider
35	35	participation fund established by the county. Money in the fund may
36	36	be used by the county to fund certain intergovernmental transfers
37	37	and indigent care programs as provided by this chapter.
38	38	(b) The commissioners court may adopt an order authorizing a
39	39	county to participate in the program, subject to the limitations
40	40	provided by this chapter.
41	41	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
42	42	Sec. 296B.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
43	43	PAYMENT. The commissioners court of a county may require a
44	44	mandatory payment authorized under this chapter by an institutional
45	45	health care provider in the county only in the manner provided by
46	46	this chapter.
47	47	Sec. 296B.052. MAJORITY VOTE REQUIRED. The commissioners
48	48	court of a county may not authorize the county to collect a
49	49	mandatory payment authorized under this chapter without an
50	50	affirmative vote of a majority of the members of the commissioners
51	51	court.
52	52	Sec. 296B.053. RULES AND PROCEDURES. After the
53	53	commissioners court has voted to require a mandatory payment
54	54	authorized under this chapter, the commissioners court may adopt
55	55	rules relating to the administration of the mandatory payment.
56	56	Sec. 296B.054. INSTITUTIONAL HEALTH CARE PROVIDER
57	57	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
58	58	county that collects a mandatory payment authorized under this
59	59	chapter shall require each institutional health care provider to
60	60	submit to the county a copy of any financial and utilization data
61	61	required by and reported to the Department of State Health Services
62	62	under Sections 311.032 and 311.033 and any rules adopted by the
63	63	executive commissioner of the Health and Human Services Commission
64	64	to implement those sections.
65	65	(b) The commissioners court of a county that collects a
66	66	mandatory payment authorized under this chapter may inspect the
67	67	records of an institutional health care provider to the extent
68	68	necessary to ensure compliance with the requirements of Subsection
69	69	(a).
70	70	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
71	71	Sec. 296B.101. HEARING. (a) Each year, the commissioners
72	72	court of a county that collects a mandatory payment authorized
73	73	under this chapter shall hold a public hearing on the amounts of any
74	74	mandatory payments that the commissioners court intends to require
75	75	during the year.
76	76	(b) Not later than the fifth day before the date of the
77	77	hearing required under Subsection (a), the commissioners court of
78	78	the county shall publish notice of the hearing in a newspaper of
79	79	general circulation in the county.
80	80	(c) A representative of a paying hospital is entitled to
81	81	appear at the time and place designated in the public notice and to
82	82	be heard regarding any matter related to the mandatory payments
83	83	authorized under this chapter.
84	84	Sec. 296B.102. DEPOSITORY. (a) The commissioners court of
85	85	each county that collects a mandatory payment authorized under this
86	86	chapter by resolution shall designate one or more banks located in
87	87	the county as the depository for mandatory payments received by the
88	88	county.
89	89	(b) All income received by a county under this chapter,
90	90	including the revenue from mandatory payments remaining after
91	91	discounts and fees for assessing and collecting the payments are
92	92	deducted, shall be deposited with the county depository in the
93	93	county's local provider participation fund and may be withdrawn
94	94	only as provided by this chapter.
95	95	(c) All funds under this chapter shall be secured in the
96	96	manner provided for securing county funds.
97	97	Sec. 296B.103. LOCAL PROVIDER PARTICIPATION FUND;
98	98	AUTHORIZED USES OF MONEY. (a) Each county that collects a
99	99	mandatory payment authorized under this chapter shall create a
100	100	local provider participation fund.
101	101	(b) The local provider participation fund of a county
102	102	consists of:
103	103	(1) all revenue received by the county attributable to
104	104	mandatory payments authorized under this chapter, including any
105	105	penalties and interest attributable to delinquent payments;
106	106	(2) money received from the Health and Human Services
107	107	Commission as a refund of an intergovernmental transfer from the
108	108	county to the state for the purpose of providing the nonfederal
109	109	share of Medicaid supplemental payment program payments, provided
110	110	that the intergovernmental transfer does not receive a federal
111	111	matching payment; and
112	112	(3) the earnings of the fund.
113	113	(c) Money deposited to the local provider participation
114	114	fund may be used only to:
115	115	(1) fund intergovernmental transfers from the county
116	116	to the state to provide:
117	117	(A) the nonfederal share of a Medicaid
118	118	supplemental payment program authorized under the state Medicaid
119	119	plan, the Texas Healthcare Transformation and Quality Improvement
120	120	Program waiver issued under Section 1115 of the federal Social
121	121	Security Act (42 U.S.C. Section 1315), or a successor waiver
122	122	program authorizing similar Medicaid supplemental payment
123	123	programs; or
124	124	(B) payments to Medicaid managed care
125	125	organizations that are dedicated for payment to hospitals;
126	126	(2) subsidize indigent programs;
127	127	(3) pay the administrative expenses of the county for
128	128	activities under this chapter;
129	129	(4) refund a portion of a mandatory payment collected
130	130	in error from a paying hospital; and
131	131	(5) refund to paying hospitals the proportionate share
132	132	of money received by the county that is not used to fund the
133	133	nonfederal share of Medicaid supplemental payment program
134	134	payments.
135	135	(d) Money in the local provider participation fund may not
136	136	be commingled with other county funds.
137	137	(e) An intergovernmental transfer of funds described by
138	138	Subsection (c)(1) and any funds received by the county as a result
139	139	of an intergovernmental transfer described by Subsection (c)(1) may
140	140	not be used by the county or any other entity to expand Medicaid
141	141	eligibility under the Patient Protection and Affordable Care Act
142	142	(Pub. L. No. 111-148) as amended by the Health Care and Education
143	143	Reconciliation Act of 2010 (Pub. L. No. 111-152).
144	144	SUBCHAPTER D. MANDATORY PAYMENTS
145	145	Sec. 296B.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
146	146	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
147	147	commissioners court of a county that collects a mandatory payment
148	148	authorized under this chapter may require an annual mandatory
149	149	payment to be assessed on the net patient revenue of each
150	150	institutional health care provider located in the county. The
151	151	commissioners court may provide for the mandatory payment to be
152	152	assessed quarterly. In the first year in which the mandatory
153	153	payment is required, the mandatory payment is assessed on the net
154	154	patient revenue of an institutional health care provider as
155	155	determined by the data reported to the Department of State Health
156	156	Services under Sections 311.032 and 311.033 in the fiscal year
157	157	ending in 2017 or, if the institutional health care provider did not
158	158	report any data under those sections in that fiscal year, as
159	159	determined by the institutional health care provider's Medicare
160	160	cost report submitted for the 2017 fiscal year or for the closest
161	161	subsequent fiscal year for which the provider submitted the
162	162	Medicare cost report. The county shall update the amount of the
163	163	mandatory payment on an annual basis.
164	164	(b) The amount of a mandatory payment authorized under this
165	165	chapter must be uniformly proportionate with the amount of net
166	166	patient revenue generated by each paying hospital in the county. A
167	167	mandatory payment authorized under this chapter may not hold
168	168	harmless any institutional health care provider, as required under
169	169	42 U.S.C. Section 1396b(w).
170	170	(c) The commissioners court of a county that collects a
171	171	mandatory payment authorized under this chapter shall set the
172	172	amount of the mandatory payment. The amount of the mandatory
173	173	payment required of each paying hospital may not exceed six percent
174	174	of the paying hospital's net patient revenue.
175	175	(d) Subject to the maximum amount prescribed by Subsection
176	176	(c), the commissioners court of a county that collects a mandatory
177	177	payment authorized under this chapter shall set the mandatory
178	178	payments in amounts that in the aggregate will generate sufficient
179	179	revenue to cover the administrative expenses of the county for
180	180	activities under this chapter, to fund an intergovernmental
181	181	transfer described by Section 296B.103(c)(1), and to pay for
182	182	indigent programs, except that the amount of revenue from mandatory
183	183	payments used for administrative expenses of the county for
184	184	activities under this chapter in a year may not exceed the lesser of
185	185	four percent of the total revenue generated from the mandatory
186	186	payment or $20,000.
187	187	(e) A paying hospital may not add a mandatory payment
188	188	required under this section as a surcharge to a patient.
189	189	Sec. 296B.152. ASSESSMENT AND COLLECTION OF MANDATORY
190	190	PAYMENTS. The county may collect or contract for the assessment and
191	191	collection of mandatory payments authorized under this chapter.
192	192	Sec. 296B.153. INTEREST, PENALTIES, AND DISCOUNTS.
193	193	Interest, penalties, and discounts on mandatory payments required
194	194	under this chapter are governed by the law applicable to county ad
195	195	valorem taxes.
196	196	Sec. 296B.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
197	197	PROCEDURE. (a) The purpose of this chapter is to generate revenue
198	198	by collecting from institutional health care providers a mandatory
199	199	payment to be used to provide the nonfederal share of a Medicaid
200	200	supplemental payment program.
201	201	(b) To the extent any provision or procedure under this
202	202	chapter causes a mandatory payment authorized under this chapter to
203	203	be ineligible for federal matching funds, the county may provide by
204	204	rule for an alternative provision or procedure that conforms to the
205	205	requirements of the federal Centers for Medicare and Medicaid
206	206	Services.
207	207	SECTION 2. If before implementing any provision of this Act
208	208	a state agency determines that a waiver or authorization from a
209	209	federal agency is necessary for implementation of that provision,
210	210	the agency affected by the provision shall request the waiver or
211	211	authorization and may delay implementing that provision until the
212	212	waiver or authorization is granted.
213	213	SECTION 3. This Act takes effect immediately if it receives
214	214	a vote of two-thirds of all the members elected to each house, as
215	215	provided by Section 39, Article III, Texas Constitution. If this
216	216	Act does not receive the vote necessary for immediate effect, this
217	217	Act takes effect September 1, 2019.