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Texas Senate Bill SB2022

Texas 2019 - 86th Regular

Texas Senate Bill SB2022 Compare Versions

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11 By: Miles, Alvarado, Taylor S.B. No. 2022
2- (In the Senate - Filed March 7, 2019; March 21, 2019, read
3- first time and referred to Committee on Intergovernmental
4- Relations; April 11, 2019, reported adversely, with favorable
5- Committee Substitute by the following vote: Yeas 7, Nays 0;
6- April 11, 2019, sent to printer.)
7-Click here to see the committee vote
8- COMMITTEE SUBSTITUTE FOR S.B. No. 2022 By: Alvarado
92
103
114 A BILL TO BE ENTITLED
125 AN ACT
13- relating to the creation and operations of a health care provider
14- participation program by the Harris County Hospital District.
6+ relating to the creation and operations of health care provider
7+ participation programs in Harris County Hospital District.
158 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
169 SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
17- amended by adding Chapter 299 to read as follows:
18- CHAPTER 299. HARRIS COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
19- PARTICIPATION PROGRAM
10+ amended by adding Chapter ___ to read as follows:
11+ CHAPTER ___. HARRIS COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
12+ PARTICIPATION PROGRAM.
2013 SUBCHAPTER A. GENERAL PROVISIONS
21- Sec. 299.001. DEFINITIONS. In this chapter:
22- (1) "Board" means the board of hospital managers of
23- the district.
14+ Sec. ___.001 DEFINITIONS. In this chapter:
15+ (1) "Board" means the board of trustees of the
16+ district.
2417 (2) "District" means the Harris County Hospital
2518 District.
2619 (3) "Institutional health care provider" means a
2720 nonpublic hospital located in the district that provides inpatient
2821 hospital services.
2922 (4) "Paying provider" means an institutional health
3023 care provider required to make a mandatory payment under this
3124 chapter.
3225 (5) "Program" means the health care provider
3326 participation program authorized by this chapter.
34- Sec. 299.002. APPLICABILITY. This chapter applies only to
35- the Harris County Hospital District.
36- Sec. 299.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
27+ Sec. ___.002 APPLICABILITY. This chapter applies only to the
28+ Harris County Hospital District.
29+ Sec. ___.003 HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
3730 PARTICIPATION IN PROGRAM. The board may authorize the district to
3831 participate in a health care provider participation program on the
39- affirmative vote of a majority of the board, subject to the
32+ affirmative vote of the majority of the board, subject to the
4033 provisions of this chapter.
41- Sec. 299.004. EXPIRATION. (a) Subject to Section
42- 299.153(d), the authority of the district to administer and operate
34+ Sec. ___.004 EXPIRATION.
35+ (a) The authority of the district to administer and operate
4336 a program under this chapter expires December 31, 2021.
4437 (b) This chapter expires December 31, 2021.
4538 SUBCHAPTER B. POWERS AND DUTIES OF BOARD
46- Sec. 299.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
39+ Sec. ___.051 LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
4740 PAYMENT. The board may require a mandatory payment authorized
4841 under this chapter by an institutional health care provider in the
4942 district only in the manner provided by this chapter.
50- Sec. 299.052. RULES AND PROCEDURES. The board may adopt
51- rules relating to the administration of the program, including
52- collection of the mandatory payments, expenditures, audits, and any
53- other administrative aspects of the program.
54- Sec. 299.053. INSTITUTIONAL HEALTH CARE PROVIDER
55- REPORTING. If the board authorizes the district to participate in a
56- program under this chapter, the board shall require each
57- institutional health care provider to submit to the district a copy
58- of any financial and utilization data as reported in the provider's
59- Medicare cost report submitted for the previous fiscal year or for
60- the closest subsequent fiscal year for which the provider submitted
61- the Medicare cost report.
43+ Sec. ___.052 RULES AND PROCEDURES. The board may adopt rules
44+ relating to the administration of the program, including collection
45+ of the mandatory payments, expenditures, audits, and any other
46+ administrative aspects of the program.
47+ Sec. ___.053 PAYING PROVIDER REPORTING. If the board
48+ authorizes the district to participate in a program under this
49+ chapter, the board shall require each paying provider to submit to
50+ the district a copy of any financial and utilization data as
51+ reported in the paying provider's Medicare cost report for the
52+ previous fiscal year or for the closest subsequent fiscal year for
53+ which the paying provider submitted the Medicare cost report.
6254 SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
63- Sec. 299.101. HEARING. (a) In each year that the board
64- authorizes a program under this chapter, the board shall hold a
65- public hearing on the amounts of any mandatory payments that the
66- board intends to require during the year and how the revenue derived
67- from those payments is to be spent.
55+ Sec. ___.101 HEARING.
56+ (a) In each year that the board authorizes a program under
57+ this chapter, the board shall hold a public hearing on the amounts
58+ of any mandatory payments that the board intends to require during
59+ the year and how the revenue derived from those payments is to be
60+ spent.
6861 (b) Not later than the fifth day before the date of the
6962 hearing required under Subsection (a), the board shall publish
7063 notice of the hearing in a newspaper of general circulation in the
71- district and provide written notice of the hearing to each
72- institutional health care provider in the district.
64+ district and provide written notice.
7365 (c) A representative of a paying provider is entitled to
74- appear at the public hearing and be heard regarding any matter
66+ appear at the public hearing and to be heard regarding any matter
7567 related to the mandatory payments authorized under this chapter.
76- Sec. 299.102. DEPOSITORY. (a) If the board requires a
77- mandatory payment authorized under this chapter, the board shall
78- designate one or more banks as a depository for the district's local
79- provider participation fund.
68+ Sec. ___.102 DEPOSITORY.
69+ (a) If the board requires a mandatory payment authorized
70+ under this chapter, the board shall designate one or more banks as a
71+ depository for the district's local provider participation fund.
8072 (b) All funds collected under this chapter shall be secured
8173 in the manner provided for securing other district funds.
82- Sec. 299.103. LOCAL PROVIDER PARTICIPATION FUND;
83- AUTHORIZED USES OF MONEY. (a) If the district requires a
84- mandatory payment authorized under this chapter, the district shall
85- create a local provider participation fund.
74+ Sec. ___.103 LOCAL PROVIDER PARTICIPATION FUND; AUTHORIZED
75+ USES OF MONEY.
76+ (a) If the district requires a mandatory payment authorized
77+ under this chapter, the district shall create a local provider
78+ participation fund.
8679 (b) The local provider participation fund consists of:
8780 (1) all revenue received by the district attributable
8881 to mandatory payments authorized under this chapter;
8982 (2) money received from the Health and Human Services
9083 Commission as a refund of an intergovernmental transfer under the
9184 program, provided that the intergovernmental transfer does not
9285 receive a federal matching payment; and
9386 (3) the earnings of the fund.
9487 (c) Money deposited to the local provider participation
9588 fund of the district may be used only to:
9689 (1) fund intergovernmental transfers from the
9790 district to the state to provide the nonfederal share of Medicaid
9891 payments for:
9992 (A) uncompensated care payments to nonpublic
10093 hospitals, if those payments are authorized under the Texas
10194 Healthcare Transformation and Quality Improvement Program waiver
10295 issued under Section 1115 of the federal Social Security Act (42
10396 U.S.C. Section 1315);
10497 (B) uniform rate enhancements for nonpublic
10598 hospitals in the Medicaid managed care service area in which the
10699 district is located;
107100 (C) payments available under another waiver
108101 program authorizing payments that are substantially similar to
109- Medicaid payments to nonpublic hospitals described by Paragraph (A)
110- or (B); or
102+ Medicaid payments to nonpublic hospitals described by Subdivision
103+ (A) or (B); or
111104 (D) any reimbursement to nonpublic hospitals for
112105 which federal matching funds are available;
113- (2) subject to Section 299.151(d), pay the
106+ (2) subject to Section ___.151(d), pay the
114107 administrative expenses of the district in administering the
115108 program, including collateralization of deposits;
116109 (3) refund a mandatory payment collected in error from
117110 a paying provider;
118111 (4) refund to paying providers a proportionate share
119- of the money attributable to mandatory payments collected under
120- this chapter that the district:
112+ of a mandatory payment that the district:
121113 (A) receives from the Health and Human Services
122114 Commission that is not used to fund the nonfederal share of Medicaid
123115 supplemental payment program payments; or
124116 (B) determines cannot be used to fund the
125117 nonfederal share of Medicaid supplemental payment program
126118 payments; and
127119 (5) transfer funds to the Health and Human Services
128- Commission if the district is legally required to transfer the
129- funds to address a disallowance of federal matching funds with
130- respect to programs for which the district made intergovernmental
131- transfers described by Subdivision (1).
120+ Commission if the district is legally required to transfer funds to
121+ address a disallowance of federal matching funds with respect to
122+ programs for which the district made intergovernmental transfers
123+ described by Subdivision (1).
132124 (d) Money in the local provider participation fund may not
133125 be commingled with other district funds.
134126 (e) Notwithstanding any other provision of this chapter,
135127 with respect to an intergovernmental transfer of funds described by
136128 Subsection (c)(1) made by the district, any funds received by the
137129 state, district, or other entity as a result of the transfer may not
138130 be used by the state, district, or any other entity to:
139131 (1) expand Medicaid eligibility under the Patient
140132 Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
141133 by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
142134 No. 111-152); or
143135 (2) fund the nonfederal share of payments to nonpublic
144136 hospitals available through the Medicaid disproportionate share
145137 hospital program or the delivery system reform incentive payment
146138 program.
147139 SUBCHAPTER D. MANDATORY PAYMENTS
148- Sec. 299.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
149- NET PATIENT REVENUE. (a) If the board authorizes a health care
150- provider participation program under this chapter, the board may
151- require a mandatory payment to be assessed, either annually or
152- periodically throughout the year at the discretion of the board, on
153- the net patient revenue of each institutional health care provider
154- located in the district. The board shall provide an institutional
155- health care provider written notice of each assessment under this
156- subsection, and the provider has 30 calendar days following the
157- date of receipt of the notice to pay the assessment. In the first
158- year in which the mandatory payment is required, the mandatory
159- payment is assessed on the net patient revenue of an institutional
160- health care provider, as determined by the provider's Medicare cost
161- report submitted for the previous fiscal year or for the closest
162- subsequent fiscal year for which the provider submitted the
163- Medicare cost report. If the mandatory payment is required, the
164- district shall update the amount of the mandatory payment on an
165- annual basis and may update the amount on a more frequent basis.
140+ Sec. ___.151 MANDATORY PAYMENTS BASED ON PAYING PROVIDER NET
141+ PATIENT REVENUE.
142+ (a) If the board authorizes a health care provider
143+ participation program under this chapter, the board may require a
144+ mandatory payment to be assessed on the net patient revenue of each
145+ paying provider located in the district. The board may provide for
146+ the mandatory payment to be assessed incrementally throughout the
147+ year; provided, however, that paying providers shall have thirty
148+ (30) calendar days upon receipt of written notice from the district
149+ to make any mandatory payment. In the first year in which the
150+ mandatory payment is required, the mandatory payment is assessed on
151+ the net patient revenue of a paying provider as determined by the
152+ paying provider's copy of its Medicare cost report for the previous
153+ fiscal year or for the closest subsequent fiscal year for which the
154+ paying provider submitted the Medicare cost report.
166155 (b) The amount of a mandatory payment authorized under this
167156 chapter must be uniformly proportionate with the amount of net
168157 patient revenue generated by each paying provider in the district
169158 as permitted under federal law. A health care provider
170159 participation program authorized under this chapter may not hold
171160 harmless any institutional health care provider, as required under
172161 42 U.S.C. Section 1396b(w).
173162 (c) If the board requires a mandatory payment authorized
174163 under this chapter, the board shall set the amount of the mandatory
175164 payment, subject to the limitations of this chapter. The aggregate
176165 amount of the mandatory payments required of all paying providers
177166 in the district may not exceed four percent of the aggregate net
178167 patient revenue from hospital services provided by all paying
179168 providers in the district.
180169 (d) Subject to Subsection (c), if the board requires a
181170 mandatory payment authorized under this chapter, the board shall
182171 set the mandatory payments in amounts that in the aggregate will
183172 generate sufficient revenue to cover the administrative expenses of
184173 the district for activities under this chapter and to fund an
185- intergovernmental transfer described by Section 299.103(c)(1).
186- The annual amount of revenue from mandatory payments used for
187- administrative expenses by the district for activities under this
188- chapter is $600,000, plus the cost of collateralization of
189- deposits, regardless of actual expenses.
174+ intergovernmental transfer described by Section ___.103(c)(1). Of
175+ the annual amount of revenue received by the district attributable
176+ to mandatory payments authorized under this chapter, 0.25% shall be
177+ paid to the district for administrative expenses.
190178 (e) A paying provider may not add a mandatory payment
191179 required under this section as a surcharge to a patient.
192180 (f) A mandatory payment assessed under this chapter is not a
193181 tax for hospital purposes for purposes of Section 4, Article IX,
194182 Texas Constitution, or Section 281.045.
195- Sec. 299.152. ASSESSMENT AND COLLECTION OF MANDATORY
196- PAYMENTS. (a) The district may designate an official of the
197- district or contract with another person to assess and collect the
198- mandatory payments authorized under this chapter.
183+ Sec. ___.152 ASSESSMENT AND COLLECTION OF MANDATORY
184+ PAYMENTS.
185+ (a) The district may designate an official of the district
186+ or contract with another person to assess and collect the mandatory
187+ payments authorized under this chapter.
199188 (b) The person charged by the district with the assessment
200189 and collection of mandatory payments shall charge and deduct from
201190 the mandatory payments collected for the district a collection fee
202191 in an amount not to exceed the person's usual and customary charges
203192 for like services.
204193 (c) If the person charged with the assessment and collection
205194 of mandatory payments is an official of the district, any revenue
206195 from a collection fee charged under Subsection (b) shall be
207196 deposited in the district general fund and, if appropriate, shall
208197 be reported as fees of the district.
209- Sec. 299.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
210- PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
211- chapter is to authorize the district to establish a program to
212- enable the district to collect mandatory payments from
213- institutional health care providers to fund the nonfederal share of
214- a Medicaid supplemental payment program or the Medicaid managed
215- care rate enhancements for nonpublic hospitals to support the
216- provision of health care by institutional health care providers to
217- district residents in need of health care.
198+ Sec. ___.153 PURPOSE; CORRECTION OF INVALID PROVISION OR
199+ PROCEDURE; LIMITATION OF AUTHORITY.
200+ (a) The purpose of this chapter is to authorize the district
201+ to establish a program to enable the district to collect mandatory
202+ payments from institutional health care providers to fund the
203+ nonfederal share of a Medicaid supplemental payment program or the
204+ Medicaid managed care rate enhancements for nonpublic hospitals to
205+ support the provision of health care by institutional health care
206+ providers to district residents in need of health care.
218207 (b) This chapter does not authorize the district to collect
219208 mandatory payments for the purpose of raising general revenue or
220- any amount in excess of the amount reasonably necessary to:
221- (1) fund the nonfederal share of a Medicaid
222- supplemental payment program or Medicaid managed care rate
223- enhancements for nonpublic hospitals; and
224- (2) cover the administrative expenses of the district
225- associated with activities under this chapter and other uses of the
226- fund described by Section 299.103(c).
209+ any amount in excess of the amount reasonably necessary to fund the
210+ uses described in Section _____.103(c) to cover the administrative
211+ expenses of the district associated with activities under this
212+ chapter.
227213 (c) To the extent any provision or procedure under this
228214 chapter causes a mandatory payment authorized under this chapter to
229215 be ineligible for federal matching funds, the board may provide by
230216 rule for an alternative provision or procedure that conforms to the
231217 requirements of the federal Centers for Medicare and Medicaid
232218 Services. A rule adopted under this section may not create, impose,
233219 or materially expand the legal or financial liability or
234220 responsibility of the district or an institutional health care
235221 provider in the district beyond the provisions of this chapter.
236222 This section does not require the board to adopt a rule.
237223 (d) The district may only assess and collect a mandatory
238224 payment authorized under this chapter if a waiver program, uniform
239225 rate enhancement, or reimbursement described by Section
240- 299.103(c)(1) is available to the district.
241- SECTION 2. As soon as practicable after the expiration of
242- the authority of the Harris County Hospital District to administer
243- and operate a health care provider participation program under
244- Chapter 299, Health and Safety Code, as added by this Act, the board
245- of hospital managers of the Harris County Hospital District shall
246- transfer to each institutional health care provider in the district
247- that provider's proportionate share of any remaining funds in any
248- local provider participation fund created by the district under
249- Section 299.103, Health and Safety Code, as added by this Act.
250- SECTION 3. If before implementing any provision of this Act
251- a state agency determines that a waiver or authorization from a
252- federal agency is necessary for implementation of that provision,
253- the agency affected by the provision shall request the waiver or
254- authorization and may delay implementing that provision until the
255- waiver or authorization is granted.
256- SECTION 4. This Act takes effect immediately if it receives
257- a vote of two-thirds of all the members elected to each house, as
258- provided by Section 39, Article III, Texas Constitution. If this
259- Act does not receive the vote necessary for immediate effect, this
260- Act takes effect September 1, 2019.
261- * * * * *
226+ ___.103(c)(1) is available to the district.