Texas 2019 - 86th Regular

Texas Senate Bill SB1545 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 1545
	1	+	86R31261 JCG-F
	2	+	By: Menéndez S.B. No. 1545
	3	+	(Martinez Fischer)
	4	+	Substitute the following for S.B. No. 1545: No.
2	5
3	6
	7	+	A BILL TO BE ENTITLED
4	8		AN ACT
5	9		relating to the creation and operations of a health care provider
6	10		participation program by the Bexar County Hospital District.
7	11		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	12		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
9	13		amended by adding Chapter 298F to read as follows:
10	14		CHAPTER 298F. BEXAR COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
11	15		PARTICIPATION PROGRAM
12	16		SUBCHAPTER A. GENERAL PROVISIONS
13	17		Sec. 298F.001. DEFINITIONS. In this chapter:
14	18		(1) "Board" means the board of hospital managers of
15	19		the district.
16	20		(2) "District" means the Bexar County Hospital
17	21		District.
18	22		(3) "Institutional health care provider" means a
19	23		nonpublic hospital located in the district that provides inpatient
20	24		hospital services.
21	25		(4) "Paying provider" means an institutional health
22	26		care provider required to make a mandatory payment under this
23	27		chapter.
24	28		(5) "Program" means the health care provider
25	29		participation program authorized by this chapter.
26	30		Sec. 298F.002. APPLICABILITY. This chapter applies only to
27	31		the Bexar County Hospital District.
28	32		Sec. 298F.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
29	33		PARTICIPATION IN PROGRAM. The board may authorize the district to
30	34		participate in a health care provider participation program on the
31	35		affirmative vote of a majority of the board, subject to the
32	36		provisions of this chapter.
33	37		Sec. 298F.004. EXPIRATION. (a) Subject to Section
34	38		298F.153(d), the authority of the district to administer and
35	39		operate a program under this chapter expires December 31, 2023.
36	40		(b) This chapter expires December 31, 2023.
37	41		SUBCHAPTER B. POWERS AND DUTIES OF BOARD
38	42		Sec. 298F.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
39	43		PAYMENT. The board may require a mandatory payment authorized
40	44		under this chapter by an institutional health care provider in the
41	45		district only in the manner provided by this chapter.
42	46		Sec. 298F.052. RULES AND PROCEDURES. The board may adopt
43	47		rules relating to the administration of the program, including
44	48		collection of the mandatory payments, expenditures, audits, and any
45	49		other administrative aspects of the program.
46	50		Sec. 298F.053. INSTITUTIONAL HEALTH CARE PROVIDER
47	51		REPORTING. If the board authorizes the district to participate in a
48	52		program under this chapter, the board shall require each
49	53		institutional health care provider to submit to the district a copy
50	54		of any financial and utilization data reported in the provider's
51	55		Medicare cost report submitted for the previous fiscal year or for
52	56		the closest subsequent fiscal year for which the provider submitted
53	57		the Medicare cost report.
54	58		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
55	59		Sec. 298F.101. HEARING. (a) In each year that the board
56	60		authorizes a program under this chapter, the board shall hold a
57	61		public hearing on the amounts of any mandatory payments that the
58	62		board intends to require during the year and how the revenue derived
59	63		from those payments is to be spent.
60	64		(b) Not later than the fifth day before the date of the
61	65		hearing required under Subsection (a), the board shall publish
62	66		notice of the hearing in a newspaper of general circulation in the
63	67		district and provide written notice of the hearing to each paying
64	68		provider in the district.
65	69		(c) A representative of a paying provider is entitled to
66	70		appear at the public hearing and be heard regarding any matter
67	71		related to the mandatory payments authorized under this chapter.
68	72		Sec. 298F.102. DEPOSITORY. (a) If the board requires a
69	73		mandatory payment authorized under this chapter, the board shall
70	74		designate one or more banks as a depository for the district's local
71	75		provider participation fund.
72	76		(b) All funds collected under this chapter shall be secured
73	77		in the manner provided for securing other district funds.
74	78		Sec. 298F.103. LOCAL PROVIDER PARTICIPATION FUND;
75		-	AUTHORIZED USES OF MONEY. (a) If the district requires a
76		-	~~mandatory~~ payment authorized under this chapter, the district shall
77		-	~~create a~~ local provider participation fund.
	79	+	AUTHORIZED USES OF MONEY. (a) If the district requires a mandatory
	80	+	payment authorized under this chapter, the district shall create a
	81	+	local provider participation fund.
78	82		(b) The local provider participation fund consists of:
79	83		(1) all revenue received by the district attributable
80	84		to mandatory payments authorized under this chapter;
81	85		(2) money received from the Health and Human Services
82	86		Commission as a refund of an intergovernmental transfer under the
83	87		program, provided that the intergovernmental transfer does not
84	88		receive a federal matching payment; and
85	89		(3) the earnings of the fund.
86	90		(c) Money deposited to the local provider participation
87	91		fund of the district may be used only to:
88	92		(1) fund intergovernmental transfers from the
89	93		district to the state to provide the nonfederal share of Medicaid
90	94		payments for:
91	95		(A) payments to nonpublic hospitals, if those
92	96		payments are authorized under the Texas Healthcare Transformation
93	97		and Quality Improvement Program waiver issued under Section 1115 of
94	98		the federal Social Security Act (42 U.S.C. Section 1315);
95	99		(B) uniform rate enhancements for nonpublic
96	100		hospitals in the Medicaid managed care service area in which the
97	101		district is located;
98	102		(C) payments available under another federal
99	103		waiver program authorizing Medicaid payments to nonpublic
100	104		hospitals;
101	105		(D) any payments to Medicaid managed care
102	106		organizations for the benefit of nonpublic hospitals and for which
103	107		federal matching funds are available; or
104	108		(E) any reimbursement to nonpublic hospitals for
105	109		which federal matching funds are available;
106	110		(2) subject to Section 298F.151(d), pay the
107	111		administrative expenses of the district in administering the
108	112		program, including collateralization of deposits;
109	113		(3) refund a mandatory payment collected in error from
110	114		a paying provider;
111	115		(4) refund to paying providers a proportionate share
112	116		of the money that the district:
113	117		(A) receives from the Health and Human Services
114	118		Commission that is not used to fund the nonfederal share of Medicaid
115	119		supplemental payment program payments; or
116	120		(B) determines cannot be used to fund the
117	121		nonfederal share of Medicaid supplemental payment program
118	122		payments; and
119	123		(5) transfer funds to the Health and Human Services
120	124		Commission if the district is legally required to transfer the
121	125		funds to address a disallowance of federal matching funds with
122	126		respect to programs for which the district made intergovernmental
123	127		transfers described by Subdivision (1).
124	128		(d) Money in the local provider participation fund may not
125	129		be commingled with other district funds.
126	130		(e) Notwithstanding any other provision of this chapter,
127	131		with respect to an intergovernmental transfer of funds described by
128	132		Subsection (c)(1) made by the district, any funds received by the
129	133		state, district, or other entity as a result of that transfer may
130	134		not be used by the state, district, or any other entity to:
131	135		(1) expand Medicaid eligibility under the Patient
132	136		Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
133	137		by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
134	138		No. 111-152); or
135	139		(2) fund the nonfederal share of payments to nonpublic
136	140		hospitals available through the Medicaid disproportionate share
137	141		hospital program.
138	142		SUBCHAPTER D. MANDATORY PAYMENTS
139	143		Sec. 298F.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
140	144		NET PATIENT REVENUE. (a) If the board authorizes a health care
141	145		provider participation program under this chapter, for each year
142	146		the program is authorized, the board may require a mandatory
143	147		payment to be assessed on the net patient revenue of each
144	148		institutional health care provider located in the district. The
145	149		board may provide for the mandatory payment to be assessed
146	150		periodically throughout the year. The board shall provide an
147	151		institutional health care provider written notice of each
148	152		assessment under this subsection, and the provider has 30 calendar
149	153		days following the date of receipt of the notice to pay the
150	154		assessment. In the first year in which the mandatory payment is
151	155		required, the mandatory payment is assessed on the net patient
152	156		revenue of an institutional health care provider, which is the
153	157		amount of that revenue as reported in the provider's Medicare cost
154	158		report submitted for the previous fiscal year or for the closest
155	159		subsequent fiscal year for which the provider submitted the
156	160		Medicare cost report. If the mandatory payment is required, the
157	161		district shall update the amount of the mandatory payment on an
158	162		annual basis.
159	163		(b) The amount of a mandatory payment authorized under this
160	164		chapter must be uniformly proportionate with the amount of net
161	165		patient revenue generated by each paying provider in the district
162	166		as permitted under federal law. A health care provider
163	167		participation program authorized under this chapter may not hold
164	168		harmless any institutional health care provider, as required under
165	169		42 U.S.C. Section 1396b(w).
166	170		(c) If the board requires a mandatory payment authorized
167	171		under this chapter, the board shall set the amount of the mandatory
168	172		payment, subject to the limitations of this chapter. The aggregate
169	173		amount of the mandatory payments required of all paying providers
170	174		in the district may not exceed six percent of the aggregate net
171	175		patient revenue from hospital services provided by all paying
172	176		providers in the district.
173	177		(d) Subject to Subsection (c), if the board requires a
174	178		mandatory payment authorized under this chapter, the board shall
175	179		set the mandatory payments in amounts that in the aggregate will
176	180		generate sufficient revenue to cover the administrative expenses of
177	181		the district for activities under this chapter and to fund an
178	182		intergovernmental transfer described by Section 298F.103(c)(1).
179	183		The amount of revenue from mandatory payments that may be used for
180	184		administrative expenses by the district in a year for activities
181	185		under this chapter may not exceed $184,000, plus the cost of
182	186		collateralization of deposits. If the board demonstrates to the
183	187		paying providers that the costs of administering the health care
184	188		provider participation program under this chapter, excluding those
185	189		costs associated with the collateralization of deposits, exceed
186	190		$184,000 in any year, on consent of all of the paying providers, the
187	191		district may use additional revenue from mandatory payments
188	192		received under this chapter to compensate the district for its
189	193		administrative expenses. A paying provider may not unreasonably
190	194		withhold consent to compensate the district for administrative
191	195		expenses.
192	196		(e) A paying provider may not add a mandatory payment
193	197		required under this section as a surcharge to a patient.
194	198		(f) A mandatory payment assessed under this chapter is not a
195	199		tax for hospital purposes for purposes of Section 4, Article IX,
196	200		Texas Constitution, or Section 281.045 of this code.
197	201		Sec. 298F.152. ASSESSMENT AND COLLECTION OF MANDATORY
198	202		PAYMENTS. (a) The district may designate an official of the
199	203		district or contract with another person to assess and collect the
200	204		mandatory payments authorized under this chapter.
201	205		(b) The person charged by the district with the assessment
202	206		and collection of mandatory payments shall charge and deduct from
203	207		the mandatory payments collected for the district a collection fee
204	208		in an amount not to exceed the person's usual and customary charges
205	209		for like services.
206	210		(c) If the person charged with the assessment and collection
207	211		of mandatory payments is an official of the district, any revenue
208	212		from a collection fee charged under Subsection (b) shall be
209	213		deposited in the district general fund and, if appropriate, shall
210	214		be reported as fees of the district.
211	215		Sec. 298F.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
212		-	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
213		-	~~chapter~~ is to authorize the district to establish a program to
214		-	~~enable the~~ district to collect mandatory payments from
215		-	~~institutional health~~ care providers to fund the nonfederal share of
216		-	~~a Medicaid~~ supplemental payment program or the Medicaid managed
217		-	~~care rate~~ enhancements for nonpublic hospitals to support the
218		-	~~provision of~~ health care by institutional health care providers to
219		-	~~district~~ residents in need of health care.
	216	+	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this chapter
	217	+	is to authorize the district to establish a program to enable the
	218	+	district to collect mandatory payments from institutional health
	219	+	care providers to fund the nonfederal share of a Medicaid
	220	+	supplemental payment program or the Medicaid managed care rate
	221	+	enhancements for nonpublic hospitals to support the provision of
	222	+	health care by institutional health care providers to district
	223	+	residents in need of health care.
220	224		(b) This chapter does not authorize the district to collect
221	225		mandatory payments for the purpose of raising general revenue or
222	226		any amount in excess of the amount reasonably necessary to fund the
223	227		nonfederal share of a Medicaid supplemental payment program or
224	228		Medicaid managed care rate enhancements for nonpublic hospitals and
225	229		to cover the administrative expenses of the district associated
226	230		with activities under this chapter and other amounts for which the
227	231		fund may be used as described by Section 298F.103(c).
228	232		(c) To the extent any provision or procedure under this
229	233		chapter causes a mandatory payment authorized under this chapter to
230	234		be ineligible for federal matching funds, the board may provide by
231	235		rule for an alternative provision or procedure that conforms to the
232	236		requirements of the federal Centers for Medicare and Medicaid
233	237		Services. A rule adopted under this section may not create, impose,
234	238		or materially expand the legal or financial liability or
235	239		responsibility of the district or an institutional health care
236	240		provider in the district beyond the provisions of this chapter.
237	241		This section does not require the board to adopt a rule.
238	242		(d) The district may only assess and collect a mandatory
239	243		payment authorized under this chapter if a waiver program, uniform
240	244		rate enhancement, reimbursement, or other payment described by
241	245		Section 298F.103(c)(1) is available to nonpublic hospitals in the
242	246		district.
243	247		SECTION 2. As soon as practicable after the expiration of
244	248		the authority of the Bexar County Hospital District to administer
245	249		and operate a health care provider participation program under
246	250		Chapter 298F, Health and Safety Code, as added by this Act, the
247	251		board of hospital managers of the Bexar County Hospital District
248	252		shall transfer to each institutional health care provider in the
249	253		district that provider's proportionate share of any remaining funds
250	254		in any local provider participation fund created by the district
251	255		under Section 298F.103, Health and Safety Code, as added by this
252	256		Act.
253	257		SECTION 3. If before implementing any provision of this Act
254	258		a state agency determines that a waiver or authorization from a
255	259		federal agency is necessary for implementation of that provision,
256	260		the agency affected by the provision shall request the waiver or
257	261		authorization and may delay implementing that provision until the
258	262		waiver or authorization is granted.
259	263		SECTION 4. This Act takes effect immediately if it receives
260	264		a vote of two-thirds of all the members elected to each house, as
261	265		provided by Section 39, Article III, Texas Constitution. If this
262	266		Act does not receive the vote necessary for immediate effect, this
263	267		Act takes effect September 1, 2019.
264		-	______________________________ ______________________________
265		-	President of the Senate Speaker of the House
266		-	I hereby certify that S.B. No. 1545 passed the Senate on
267		-	April 11, 2019, by the following vote: Yeas 31, Nays 0; and that
268		-	the Senate concurred in House amendment on May 21, 2019, by the
269		-	following vote: Yeas 31, Nays 0.
270		-	______________________________
271		-	Secretary of the Senate
272		-	I hereby certify that S.B. No. 1545 passed the House, with
273		-	amendment, on May 14, 2019, by the following vote: Yeas 125,
274		-	Nays 16, two present not voting.
275		-	______________________________
276		-	Chief Clerk of the House
277		-	Approved:
278		-	______________________________
279		-	Date
280		-	______________________________
281		-	Governor