Texas 2019 - 86th Regular

Texas Senate Bill SB1751 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 1751
	1	+	By: Rodríguez S.B. No. 1751
	2	+	(Moody)
2	3
3	4
	5	+	A BILL TO BE ENTITLED
4	6		AN ACT
5	7		relating to the creation and operations of a health care provider
6	8		participation program by the El Paso County Hospital District.
7	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	10		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
9	11		amended by adding Chapter 298G to read as follows:
10	12		CHAPTER 298G. EL PASO COUNTY HOSPITAL DISTRICT HEALTH CARE
11	13		PROVIDER PARTICIPATION PROGRAM
12	14		SUBCHAPTER A. GENERAL PROVISIONS
13	15		Sec. 298G.001. DEFINITIONS. In this chapter:
14	16		(1) "Board" means the board of hospital managers of
15	17		the district.
16	18		(2) "District" means the El Paso County Hospital
17	19		District.
18	20		(3) "Institutional health care provider" means a
19	21		nonpublic hospital located in the district that provides inpatient
20	22		hospital services.
21	23		(4) "Paying provider" means an institutional health
22	24		care provider required to make a mandatory payment under this
23	25		chapter.
24	26		(5) "Program" means the health care provider
25	27		participation program authorized by this chapter.
26	28		Sec. 298G.002. APPLICABILITY. This chapter applies only to
27	29		the El Paso County Hospital District.
28	30		Sec. 298G.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
29	31		PARTICIPATION IN PROGRAM. The board may authorize the district to
30	32		participate in a health care provider participation program on the
31	33		affirmative vote of a majority of the board, subject to the
32	34		provisions of this chapter.
33	35		Sec. 298G.004. EXPIRATION. (a) Subject to Section
34	36		298G.153(d), the authority of the district to administer and
35	37		operate a program under this chapter expires December 31, 2023.
36	38		(b) This chapter expires December 31, 2023.
37	39		SUBCHAPTER B. POWERS AND DUTIES OF BOARD
38	40		Sec. 298G.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
39	41		PAYMENT. The board may require a mandatory payment authorized
40	42		under this chapter by an institutional health care provider in the
41	43		district only in the manner provided by this chapter.
42	44		Sec. 298G.052. RULES AND PROCEDURES. The board may adopt
43	45		rules relating to the administration of the program, including
44	46		collection of the mandatory payments, expenditures, audits, and any
45	47		other administrative aspects of the program.
46	48		Sec. 298G.053. INSTITUTIONAL HEALTH CARE PROVIDER
47	49		REPORTING. If the board authorizes the district to participate in a
48	50		program under this chapter, the board shall require each
49	51		institutional health care provider to submit to the district a copy
50	52		of any financial and utilization data reported in the provider's
51	53		Medicare cost report submitted for the previous fiscal year or for
52	54		the closest subsequent fiscal year for which the provider submitted
53	55		the Medicare cost report.
54	56		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
55	57		Sec. 298G.101. HEARING. (a) In each year that the board
56	58		authorizes a program under this chapter, the board shall hold a
57	59		public hearing on the amounts of any mandatory payments that the
58	60		board intends to require during the year and how the revenue derived
59	61		from those payments is to be spent.
60	62		(b) Not later than the fifth day before the date of the
61	63		hearing required under Subsection (a), the board shall publish
62	64		notice of the hearing in a newspaper of general circulation in the
63	65		district.
64	66		(c) A representative of a paying provider is entitled to
65	67		appear at the public hearing and be heard regarding any matter
66	68		related to the mandatory payments authorized under this chapter.
67	69		Sec. 298G.102. DEPOSITORY. (a) If the board requires a
68	70		mandatory payment authorized under this chapter, the board shall
69	71		designate one or more banks as a depository for the district's local
70	72		provider participation fund.
71	73		(b) All funds collected under this chapter shall be secured
72	74		in the manner provided for securing other district funds.
73	75		Sec. 298G.103. LOCAL PROVIDER PARTICIPATION FUND;
74	76		AUTHORIZED USES OF MONEY. (a) If the district requires a
75	77		mandatory payment authorized under this chapter, the district shall
76	78		create a local provider participation fund.
77	79		(b) The local provider participation fund consists of:
78	80		(1) all revenue received by the district attributable
79	81		to mandatory payments authorized under this chapter;
80	82		(2) money received from the Health and Human Services
81	83		Commission as a refund of an intergovernmental transfer under the
82	84		program, provided that the intergovernmental transfer does not
83	85		receive a federal matching payment; and
84	86		(3) the earnings of the fund.
85	87		(c) Money deposited to the local provider participation
86	88		fund of the district may be used only to:
87	89		(1) fund intergovernmental transfers from the
88	90		district to the state to provide the nonfederal share of:
89	91		(A) any payment to nonpublic hospitals, if those
90	92		payments are authorized under the Texas Healthcare Transformation
91	93		and Quality Improvement Program waiver issued under Section 1115 of
92	94		the federal Social Security Act (42 U.S.C. Section 1315); or
93	95		(B) Medicaid payments for:
94	96		(i) uniform rate enhancements for nonpublic
95	97		hospitals in the Medicaid managed care service area in which the
96	98		district is located;
97	99		(ii) payments available under another
98	100		waiver program authorizing payments that are substantially similar
99	101		to Medicaid payments described by Paragraph (A) or Subparagraph (i)
100	102		to nonpublic hospitals or any payments to Medicaid managed care
101	103		organizations for the benefit of nonpublic hospitals; or
102	104		(iii) any reimbursement to nonpublic
103	105		hospitals located in the district for which federal matching funds
104	106		are available;
105	107		(2) subject to Section 298G.151(d), pay the
106	108		administrative expenses of the district in administering the
107	109		program, including collateralization of deposits;
108	110		(3) refund a mandatory payment collected in error from
109	111		a paying provider;
110	112		(4) refund to paying providers a proportionate share
111	113		of the money that the district:
112	114		(A) receives from the Health and Human Services
113	115		Commission that is not used to fund the nonfederal share of Medicaid
114	116		payments; or
115	117		(B) determines cannot be used to fund the
116	118		nonfederal share of Medicaid supplemental payment program
117	119		payments; and
118	120		(5) transfer funds to the Health and Human Services
119	121		Commission if the district is legally required to transfer the
120	122		funds to address a disallowance of federal matching funds with
121	123		respect to programs for which the district made intergovernmental
122	124		transfers described by Subdivision (1).
123	125		(d) Money in the local provider participation fund may not
124	126		be commingled with other district funds.
125	127		(e) Notwithstanding any other provision of this chapter,
126	128		with respect to an intergovernmental transfer of funds described by
127	129		Subsection (c)(1) made by the district, any funds received by the
128	130		state, district, or other entity as a result of the transfer may not
129	131		be used by the state, district, or any other entity to expand
130	132		Medicaid eligibility under the Patient Protection and Affordable
131	133		Care Act (Pub. L. No. 111-148) as amended by the Health Care and
132	134		Education Reconciliation Act of 2010 (Pub. L. No. 111-152).
133	135		SUBCHAPTER D. MANDATORY PAYMENTS
134	136		Sec. 298G.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
135	137		NET PATIENT REVENUE. (a) If the board authorizes a health care
136	138		provider participation program under this chapter, the board may
137	139		require a mandatory payment to be assessed, either annually or
138	140		periodically throughout the year at the discretion of the board, on
139	141		the net patient revenue of each institutional health care provider
140	142		located in the district. The board shall provide an institutional
141	143		health care provider written notice of each assessment under this
142	144		subsection, and the provider has 30 calendar days following the
143	145		date of receipt of the notice to make the assessed mandatory
144	146		payment. In the first year in which the mandatory payment is
145	147		required, the mandatory payment is assessed on the net patient
146	148		revenue of an institutional health care provider, as determined by
147	149		the provider's Medicare cost report submitted for the previous
148	150		fiscal year or for the closest subsequent fiscal year for which the
149	151		provider submitted the Medicare cost report. If the mandatory
150	152		payment is required, the district shall update the amount of the
151	153		mandatory payment on an annual basis.
152	154		(b) The amount of a mandatory payment authorized under this
153	155		chapter must be uniformly proportionate with the amount of net
154	156		patient revenue generated by each paying provider in the district
155	157		as permitted under federal law. A health care provider
156	158		participation program authorized under this chapter may not hold
157	159		harmless any paying provider, as required under 42 U.S.C. Section
158	160		1396b(w).
159	161		(c) If the board requires a mandatory payment authorized
160	162		under this chapter, the board shall set the amount of the mandatory
161	163		payment, subject to the limitations of this chapter. The aggregate
162	164		amount of the mandatory payments required of all paying providers
163	165		in the district may not exceed six percent of the aggregate net
164	166		patient revenue from hospital services provided by all paying
165	167		providers in the district.
166	168		(d) Subject to Subsection (c), if the board requires a
167	169		mandatory payment authorized under this chapter, the board shall
168	170		set the mandatory payments in amounts that in the aggregate will
169	171		generate sufficient revenue to cover the administrative expenses of
170	172		the district for activities under this chapter and to fund an
171	173		intergovernmental transfer described by Section 298G.103(c)(1).
172	174		The annual amount of revenue from mandatory payments that shall be
173	175		paid for administrative expenses by the district is $150,000, plus
174	176		the cost of collateralization of deposits, regardless of actual
175	177		expenses.
176	178		(e) A paying provider may not add a mandatory payment
177	179		required under this section as a surcharge to a patient.
178	180		(f) A mandatory payment assessed under this chapter is not a
179	181		tax for hospital purposes for purposes of Section 4, Article IX,
180	182		Texas Constitution, or Section 281.045 of this code.
181	183		Sec. 298G.152. ASSESSMENT AND COLLECTION OF MANDATORY
182	184		PAYMENTS. (a) The district may designate an official of the
183	185		district or contract with another person to assess and collect the
184	186		mandatory payments authorized under this chapter.
185	187		(b) The person charged by the district with the assessment
186	188		and collection of mandatory payments shall charge and deduct from
187	189		the mandatory payments collected for the district a collection fee
188	190		in an amount not to exceed the person's usual and customary charges
189	191		for like services.
190	192		(c) If the person charged with the assessment and collection
191	193		of mandatory payments is an official of the district, any revenue
192	194		from a collection fee charged under Subsection (b) shall be
193	195		deposited in the district general fund and, if appropriate, shall
194	196		be reported as fees of the district.
195	197		Sec. 298G.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
196	198		PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
197	199		chapter is to authorize the district to establish a program to
198	200		enable the district to collect mandatory payments from
199	201		institutional health care providers to fund the nonfederal share of
200	202		a Medicaid supplemental payment program or the Medicaid managed
201	203		care rate enhancements for nonpublic hospitals to support the
202	204		provision of health care by institutional health care providers to
203	205		district residents in need of health care.
204	206		(b) This chapter does not authorize the district to collect
205	207		mandatory payments for the purpose of raising general revenue or
206	208		any amount in excess of the amount reasonably necessary to:
207	209		(1) fund the nonfederal share of a Medicaid
208	210		supplemental payment program or Medicaid managed care rate
209	211		enhancements for nonpublic hospitals; and
210	212		(2) cover the administrative expenses of the district
211	213		associated with activities under this chapter and other uses of the
212	214		fund described by Section 298G.103(c).
213	215		(c) To the extent any provision or procedure under this
214	216		chapter causes a mandatory payment authorized under this chapter to
215	217		be ineligible for federal matching funds, the board may provide by
216	218		rule for an alternative provision or procedure that conforms to the
217	219		requirements of the federal Centers for Medicare and Medicaid
218	220		Services. A rule adopted under this section may not create, impose,
219	221		or materially expand the legal or financial liability or
220	222		responsibility of the district or an institutional health care
221	223		provider in the district beyond the provisions of this chapter.
222	224		This section does not require the board to adopt a rule.
223	225		(d) The district may only assess and collect a mandatory
224	226		payment authorized under this chapter if a waiver program, uniform
225	227		rate enhancement, or reimbursement described by Section
226	228		298G.103(c)(1) is available to nonpublic hospitals in the district.
227	229		SECTION 2. As soon as practicable after the expiration of
228	230		the authority of the El Paso County Hospital District to administer
229	231		and operate a health care provider participation program under
230	232		Chapter 298G, Health and Safety Code, as added by this Act, the
231	233		board of hospital managers of the El Paso County Hospital District
232	234		shall transfer to each institutional health care provider in the
233	235		district that provider's proportionate share of any remaining funds
234	236		in any local provider participation fund created by the district
235	237		under Section 298G.103, Health and Safety Code, as added by this
236	238		Act.
237	239		SECTION 3. If before implementing any provision of this Act
238	240		a state agency determines that a waiver or authorization from a
239	241		federal agency is necessary for implementation of that provision,
240	242		the agency affected by the provision shall request the waiver or
241	243		authorization and may delay implementing that provision until the
242	244		waiver or authorization is granted.
243	245		SECTION 4. This Act takes effect immediately if it receives
244	246		a vote of two-thirds of all the members elected to each house, as
245	247		provided by Section 39, Article III, Texas Constitution. If this
246	248		Act does not receive the vote necessary for immediate effect, this
247	249		Act takes effect September 1, 2019.
248		-	______________________________ ______________________________
249		-	President of the Senate Speaker of the House
250		-	I hereby certify that S.B. No. 1751 passed the Senate on
251		-	April 9, 2019, by the following vote: Yeas 31, Nays 0.
252		-	______________________________
253		-	Secretary of the Senate
254		-	I hereby certify that S.B. No. 1751 passed the House on
255		-	May 14, 2019, by the following vote: Yeas 126, Nays 15, two
256		-	present not voting.
257		-	______________________________
258		-	Chief Clerk of the House
259		-	Approved:
260		-	______________________________
261		-	Date
262		-	______________________________
263		-	Governor