Texas 2019 - 86th Regular

Texas Senate Bill SB1099 Compare Versions

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

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1	1	86R2754 JCG-F
2	2	By: Buckingham S.B. No. 1099
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.
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 293C to read as follows:
12	12	CHAPTER 293C. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
13	13	CERTAIN COUNTIES NOT BORDERING CERTAIN POPULOUS COUNTIES
14	14	SUBCHAPTER A. GENERAL PROVISIONS
15	15	Sec. 293C.001. DEFINITIONS. In this chapter:
16	16	(1) "Institutional health care provider" means a
17	17	nonpublic hospital that provides inpatient hospital services.
18	18	(2) "Paying hospital" means an institutional health
19	19	care provider required to make a mandatory payment under this
20	20	chapter.
21	21	(3) "Program" means a county health care provider
22	22	participation program authorized by this chapter.
23	23	Sec. 293C.002. APPLICABILITY. This chapter applies only to
24	24	a county that:
25	25	(1) is not served by a hospital district or a public
26	26	hospital;
27	27	(2) has a population of more than 125,000 and less than
28	28	140,000; and
29	29	(3) is not adjacent to a county with a population of
30	30	one million or more.
31	31	Sec. 293C.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
32	32	PROGRAM. (a) A county health care provider participation program
33	33	authorizes a county to collect a mandatory payment from each
34	34	institutional health care provider located in the county to be
35	35	deposited in a local provider participation fund established by the
36	36	county. Money in the fund may be used by the county to fund certain
37	37	intergovernmental transfers and indigent care programs as provided
38	38	by this chapter.
39	39	(b) The commissioners court of a county may adopt an order
40	40	authorizing the county to participate in the program, subject to
41	41	the limitations provided by this chapter.
42	42	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
43	43	Sec. 293C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
44	44	PAYMENT. The commissioners court of a county may require a
45	45	mandatory payment authorized under this chapter by an institutional
46	46	health care provider in the county only in the manner provided by
47	47	this chapter.
48	48	Sec. 293C.052. MAJORITY VOTE REQUIRED. The commissioners
49	49	court of a county may not authorize the county to collect a
50	50	mandatory payment authorized under this chapter without an
51	51	affirmative vote of a majority of the members of the commissioners
52	52	court.
53	53	Sec. 293C.053. RULES AND PROCEDURES. After the
54	54	commissioners court of a county has voted to require a mandatory
55	55	payment authorized under this chapter, the commissioners court may
56	56	adopt rules relating to the administration of the mandatory
57	57	payment.
58	58	Sec. 293C.054. INSTITUTIONAL HEALTH CARE PROVIDER
59	59	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
60	60	county that collects a mandatory payment authorized under this
61	61	chapter shall require each institutional health care provider
62	62	located in the county to submit to the county a copy of any
63	63	financial and utilization data required by and reported to the
64	64	Department of State Health Services under Sections 311.032 and
65	65	311.033 and any rules adopted by the executive commissioner of the
66	66	Health and Human Services Commission to implement those sections.
67	67	(b) The commissioners court of a county that collects a
68	68	mandatory payment authorized under this chapter may inspect the
69	69	records of an institutional health care provider to the extent
70	70	necessary to ensure compliance with the requirements of Subsection
71	71	(a).
72	72	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
73	73	Sec. 293C.101. HEARING. (a) Each year, the commissioners
74	74	court of a county that collects a mandatory payment authorized
75	75	under this chapter shall hold a public hearing on the amounts of any
76	76	mandatory payments that the commissioners court intends to require
77	77	during the year.
78	78	(b) Not later than the fifth day before the date of the
79	79	hearing required under Subsection (a), the commissioners court of
80	80	the county shall publish notice of the hearing in a newspaper of
81	81	general circulation in the county.
82	82	(c) A representative of a paying hospital is entitled to
83	83	appear at the public hearing and be heard regarding any matter
84	84	related to the mandatory payments authorized under this chapter.
85	85	Sec. 293C.102. DEPOSITORY. (a) The commissioners court of
86	86	each county that collects a mandatory payment authorized under this
87	87	chapter by resolution shall designate one or more banks located in
88	88	the county as the depository for mandatory payments received by the
89	89	county.
90	90	(b) All income received by a county under this chapter,
91	91	including the revenue from mandatory payments remaining after
92	92	discounts and fees for assessing and collecting the payments are
93	93	deducted, shall be deposited with the county depository in the
94	94	county's local provider participation fund and may be withdrawn
95	95	only as provided by this chapter.
96	96	(c) All funds under this chapter shall be secured in the
97	97	manner provided for securing county funds.
98	98	Sec. 293C.103. LOCAL PROVIDER PARTICIPATION FUND;
99	99	AUTHORIZED USES OF MONEY. (a) Each county that collects a
100	100	mandatory payment authorized under this chapter shall create a
101	101	local provider participation fund.
102	102	(b) The local provider participation fund of a county
103	103	consists of:
104	104	(1) all revenue received by the county attributable to
105	105	mandatory payments authorized under this chapter, including any
106	106	penalties and interest attributable to delinquent payments;
107	107	(2) money received from the Health and Human Services
108	108	Commission as a refund of an intergovernmental transfer from the
109	109	county to the state for the purpose of providing the nonfederal
110	110	share of Medicaid supplemental payment program payments, provided
111	111	that the intergovernmental transfer does not receive a federal
112	112	matching payment; and
113	113	(3) the earnings of the fund.
114	114	(c) Money deposited to the local provider participation
115	115	fund may be used only to:
116	116	(1) fund intergovernmental transfers from the county
117	117	to the state to provide:
118	118	(A) the nonfederal share of a Medicaid
119	119	supplemental payment program authorized under the state Medicaid
120	120	plan, the Texas Healthcare Transformation and Quality Improvement
121	121	Program waiver issued under Section 1115 of the federal Social
122	122	Security Act (42 U.S.C. Section 1315), or a successor waiver
123	123	program authorizing similar Medicaid supplemental payment
124	124	programs; or
125	125	(B) payments to Medicaid managed care
126	126	organizations that are dedicated for payment to hospitals;
127	127	(2) subsidize indigent programs;
128	128	(3) pay the administrative expenses of the county
129	129	solely for activities under this chapter;
130	130	(4) refund a portion of a mandatory payment collected
131	131	in error from a paying hospital; and
132	132	(5) refund to paying hospitals the proportionate share
133	133	of money received by the county that is not used to fund the
134	134	nonfederal share of Medicaid supplemental payment program
135	135	payments.
136	136	(d) Money in the local provider participation fund may not
137	137	be commingled with other county funds.
138	138	(e) An intergovernmental transfer of funds described by
139	139	Subsection (c)(1) and any funds received by the county as a result
140	140	of an intergovernmental transfer described by that subsection may
141	141	not be used by the county or any other entity to expand Medicaid
142	142	eligibility under the Patient Protection and Affordable Care Act
143	143	(Pub. L. No. 111-148) as amended by the Health Care and Education
144	144	Reconciliation Act of 2010 (Pub. L. No. 111-152).
145	145	SUBCHAPTER D. MANDATORY PAYMENTS
146	146	Sec. 293C.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
147	147	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
148	148	commissioners court of a county that collects a mandatory payment
149	149	authorized under this chapter may require an annual mandatory
150	150	payment to be assessed on the net patient revenue of each
151	151	institutional health care provider located in the county. The
152	152	commissioners court may provide for the mandatory payment to be
153	153	assessed quarterly. In the first year in which the mandatory
154	154	payment is required, the mandatory payment is assessed on the net
155	155	patient revenue of an institutional health care provider as
156	156	determined by the data reported to the Department of State Health
157	157	Services under Sections 311.032 and 311.033 in the fiscal year
158	158	ending in 2017 or, if the institutional health care provider did not
159	159	report any data under those sections in that fiscal year, as
160	160	determined by the institutional health care provider's Medicare
161	161	cost report submitted for the 2017 fiscal year or for the closest
162	162	subsequent fiscal year for which the provider submitted the
163	163	Medicare cost report. The county shall update the amount of the
164	164	mandatory payment on an annual basis.
165	165	(b) The amount of a mandatory payment authorized under this
166	166	chapter must be uniformly proportionate with the amount of net
167	167	patient revenue generated by each paying hospital in the county. A
168	168	mandatory payment authorized under this chapter may not hold
169	169	harmless any institutional health care provider, as required under
170	170	42 U.S.C. Section 1396b(w).
171	171	(c) The commissioners court of a county that collects a
172	172	mandatory payment authorized under this chapter shall set the
173	173	amount of the mandatory payment. The amount of the mandatory
174	174	payment required of each paying hospital may not exceed six percent
175	175	of the hospital's net patient revenue.
176	176	(d) Subject to the maximum amount prescribed by Subsection
177	177	(c), the commissioners court of a county that collects a mandatory
178	178	payment authorized under this chapter shall set the mandatory
179	179	payments in amounts that in the aggregate will generate sufficient
180	180	revenue to cover the administrative expenses of the county for
181	181	activities under this chapter, to fund an intergovernmental
182	182	transfer described by Section 293C.103(c)(1), and to pay for
183	183	indigent programs, except that the amount of revenue from mandatory
184	184	payments used for administrative expenses of the county for
185	185	activities under this chapter in a year may not exceed the lesser of
186	186	four percent of the total revenue generated from the mandatory
187	187	payment or $20,000.
188	188	(e) A paying hospital may not add a mandatory payment
189	189	required under this section as a surcharge to a patient.
190	190	Sec. 293C.152. ASSESSMENT AND COLLECTION OF MANDATORY
191	191	PAYMENTS. The county may collect or contract for the assessment and
192	192	collection of mandatory payments authorized under this chapter.
193	193	Sec. 293C.153. INTEREST, PENALTIES, AND DISCOUNTS.
194	194	Interest, penalties, and discounts on mandatory payments required
195	195	under this chapter are governed by the law applicable to county ad
196	196	valorem taxes.
197	197	Sec. 293C.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
198	198	PROCEDURE. (a) The purpose of this chapter is to generate revenue
199	199	by collecting from institutional health care providers a mandatory
200	200	payment to be used to provide an intergovernmental transfer
201	201	described by Section 293C.103(c)(1).
202	202	(b) To the extent any provision or procedure under this
203	203	chapter causes a mandatory payment authorized under this chapter to
204	204	be ineligible for federal matching funds, the county may provide by
205	205	rule for an alternative provision or procedure that conforms to the
206	206	requirements of the federal Centers for Medicare and Medicaid
207	207	Services.
208	208	SECTION 2. If before implementing any provision of this Act
209	209	a state agency determines that a waiver or authorization from a
210	210	federal agency is necessary for implementation of that provision,
211	211	the agency affected by the provision shall request the waiver or
212	212	authorization and may delay implementing that provision until the
213	213	waiver or authorization is granted.
214	214	SECTION 3. This Act takes effect immediately if it receives
215	215	a vote of two-thirds of all the members elected to each house, as
216	216	provided by Section 39, Article III, Texas Constitution. If this
217	217	Act does not receive the vote necessary for immediate effect, this
218	218	Act takes effect September 1, 2019.