Texas 2019 - 86th Regular

Texas Senate Bill SB2256 Compare Versions

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1	1	By: Kolkhorst S.B. No. 2256
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to the creation and operations of health care provider
7	7	participation programs in local jurisdictions in this state.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
10	10	amended by adding Chapter 300 to read as follows:
11	11	CHAPTER 300. HEALTH CARE PROVIDER PARTICIPATION PROGRAMS IN
12	12	CERTAIN POLITICAL SUBDIVISIONS IN THIS STATE
13	13	SUBCHAPTER A. GENERAL PROVISIONS
14	14	Sec. 300.0001. PURPOSE. The purpose of this chapter is to
15	15	authorize a hospital district, county, or municipality in this
16	16	state to administer a health care provider participation program to
17	17	provide additional compensation to hospitals by collecting
18	18	mandatory payments from each hospital in the jurisdiction.
19	19	Sec. 300.0002. DEFINITIONS. In this chapter:
20	20	(1) "Institutional health care provider" means a nonpublic
21	21	hospital in the local jurisdiction that provides
22	22	inpatient hospital services.
23	23	(2) "Local jurisdiction" means a hospital district, county,
24	24	or municipality.
25	25	(3) "Paying hospital" means an institutional health care
26	26	provider required to make a mandatory payment under this chapter.
27	27	(4) "Program" means a health care provider participation
28	28	program authorized by this chapter.
29	29	Sec. 300.0003. APPLICABILITY. This chapter applies to a
30	30	local jurisdiction that is located in this state.
31	31	Sec. 300.0004. LOCAL JURISDICTION HEALTH CARE PROVIDER
32	32	PARTICIPATION PROGRAM; ORDER REQUIRED FOR PARTICIPATION. The
33	33	governing body of a local jurisdiction may only adopt an order
34	34	authorizing that local jurisdiction to participate in a health care
35	35	provider participation program after an affirmative vote of the
36	36	majority of the governing body.
37	37	SUBCHAPTER B. POWERS AND DUTIES OF A GOVERNING BODY OF A LOCAL
38	38	JURISDICTION
39	39	Sec. 300.0051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
40	40	PAYMENT. The governing body of a local jurisdiction may require a
41	41	mandatory payment authorized under this chapter by an institutional
42	42	health care provider in that local jurisdiction only in the manner
43	43	provided by this chapter.
44	44	Sec. 300.0052. RULES AND PROCEDURES. The governing body of
45	45	a local jurisdiction may adopt rules relating to the administration
46	46	of the health care provider participation program in the local
47	47	jurisdiction, including collection of the mandatory payments,
48	48	expenditures, audits, and any other administrative aspects of the
49	49	program.
50	50	Sec. 300.0053. INSTITUTIONAL HEALTH CARE PROVIDER
51	51	REPORTING. If the governing body of a local jurisdiction
52	52	authorizes the local jurisdiction to participate in a health care
53	53	provider participation program under this chapter, the governing
54	54	body shall require each institutional health care provider to
55	55	submit to the local jurisdiction a copy of any financial and
56	56	utilization data required by and reported to the Department of
57	57	State Health Services under Sections 311.032 and 311.033 and any
58	58	rules adopted by the executive commissioner of the Health and Human
59	59	Services Commission to implement those sections.
60	60	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
61	61	Sec. 300.0101. HEARING. (a) In each year that the
62	62	governing body of a local jurisdiction authorizes a health care
63	63	provider participation program under this chapter, the governing
64	64	body shall hold a public hearing on the amounts of any mandatory
65	65	payments that the governing body intends to require during the year
66	66	and how the revenue derived from those payments is to be spent.
67	67	(b) Not later than the fifth day before the date of the
68	68	hearing required under Subsection (a), the governing body shall
69	69	publish notice of the hearing in a newspaper of general circulation
70	70	in the county and provide written notice of the hearing to the chief
71	71	operating officer of each institutional health care provider in the
72	72	local jurisdiction.
73	73	(c) A representative of a paying hospital is entitled to
74	74	appear at the time and place designated in the public notice and to
75	75	be heard regarding any matter related to the mandatory payments
76	76	authorized under this chapter.
77	77	Sec. 300.0102. LOCAL PROVIDER PARTICIPATION FUND;
78	78	DEPOSITORY. (a) Each governing body of a local jurisdiction that
79	79	collects a mandatory payment authorized under this chapter shall
80	80	create a local provider participation fund.
81	81	(b) If a governing body of a local jurisdiction creates a
82	82	local provider participation fund, the governing body shall
83	83	designate one or more banks as a depository for the mandatory
84	84	payments received by the local jurisdiction.
85	85	(c) All funds collected under this chapter shall be secured
86	86	in the manner provided for securing other local jurisdiction funds.
87	87	Sec. 300.0103. LOCAL PROVIDER PARTICIPATION FUND;
88	88	AUTHORIZED USES OF MONEY. (a) The local provider participation
89	89	fund established by a local jurisdiction under Section 300.0102
90	90	consists of:
91	91	(1) all revenue received by the local jurisdiction
92	92	attributable to mandatory payments authorized under this chapter;
93	93	(2) money received from the Health and Human Services
94	94	Commission as a refund of an intergovernmental transfer from the
95	95	local jurisdiction to the state for the purpose of providing the
96	96	nonfederal share of Medicaid supplemental payment program
97	97	payments, provided that the intergovernmental transfer does not
98	98	receive a federal matching payment; and
99	99	(3) the earnings of the fund.
100	100	(b) Money deposited to the local provider participation
101	101	fund of a local jurisdiction may be used only to:
102	102	1) fund intergovernmental transfers from the local
103	103	jurisdiction to the state to provide the nonfederal share of
104	104	Medicaid payments for:
105	105	(A) uncompensated care payments to nonpublic
106	106	hospitals, if those payments are authorized under the Texas
107	107	Healthcare Transformation and Quality Improvement Program waiver
108	108	issued under Section 1115 of the federal Social Security Act (42
109	109	U.S.C. Section 1315);
110	110	(B) uniform rate enhancements for nonpublic
111	111	hospitals in Medicaid managed care;
112	112	(C) payments available under another waiver
113	113	program authorizing payments that are substantially similar to
114	114	Medicaid payments to nonpublic hospitals described by Subdivision
115	115	(A) or (B); or
116	116	(D) any reimbursement to nonpublic hospitals for
117	117	which federal matching funds are available;
118	118	(2) pay costs associated with indigent care provided
119	119	by institutional health care providers in the local jurisdiction;
120	120	(3) pay the administrative expenses of the local
121	121	jurisdiction in administering the program, including
122	122	collateralization of deposits;
123	123	(4) refund a portion of a mandatory payment collected
124	124	in error from a paying hospital;
125	125	(5) refund to paying hospitals a proportionate share
126	126	of the money that the local jurisdiction:
127	127	(A) receives from the Health and Human Services
128	128	Commission that is not used to fund the nonfederal share of Medicaid
129	129	supplemental payment program payments; or
130	130	(B) determines cannot be used to fund the
131	131	nonfederal share of Medicaid supplemental payment program
132	132	payments.
133	133	(6) transfer funds to the Health and Human Services
134	134	Commission if the local jurisdiction is legally required to
135	135	transfer the funds to address a disallowance of federal matching
136	136	funds with respect to programs for which the local jurisdiction
137	137	made intergovernmental transfers described in Subdivision (1); and
138	138	(7) reimburse the local jurisdiction if the local
139	139	jurisdiction is required by the rules governing the uniform rate
140	140	enhancement program described by Subdivision (1)(B) to incur an
141	141	expense or forego Medicaid reimbursements from the state because
142	142	the balance of the local provider participation fund is not
143	143	sufficient to fund that rate enhancement program.
144	144	(c) Money in the local provider participation fund of a
145	145	local jurisdiction may not be commingled with other local
146	146	jurisdiction funds.
147	147	(d) Notwithstanding any other provision of this chapter,
148	148	with respect to an intergovernmental transfer of funds described by
149	149	Subsection (b)(1) made by the local jurisdiction, any funds
150	150	received by the state, local jurisdiction, or other entity as a
151	151	result of that transfer may not be used by the state, local
152	152	jurisdiction, or any other entity to:
153	153	(1) expand Medicaid eligibility under the Patient
154	154	Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
155	155	by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
156	156	No. 111-152); or
157	157	(2) fund the nonfederal share of payments to nonpublic
158	158	hospitals available through the Medicaid disproportionate share
159	159	hospital program or the delivery system reform incentive payment
160	160	program.
161	161	SUBCHAPTER D. MANDATORY PAYMENTS
162	162	Sec. 300.0151. MANDATORY PAYMENTS. (a) Except as provided
163	163	by Subsection (e), if the governing body of a local jurisdiction
164	164	authorizes a health care provider participation program under this
165	165	chapter, the governing body shall require an annual mandatory
166	166	payment to be assessed on the net patient revenue of each
167	167	institutional health care provider located in the local
168	168	jurisdiction. The governing body of the local jurisdiction shall
169	169	provide that the mandatory payment is to be collected at least
170	170	annually, but not more often than quarterly. In the first year in
171	171	which the mandatory payment is required, the mandatory payment is
172	172	assessed on the net patient revenue of an institutional health care
173	173	provider located in the local jurisdiction as determined by the
174	174	data reported to the Department of State Health Services under
175	175	Sections 311.032 and 311.033 in the most recent fiscal year for
176	176	which that data was reported. If the institutional health care
177	177	provider did not report any data under those sections, the
178	178	provider's net patient revenue is the amount of that revenue as
179	179	contained in the provider's Medicare cost report submitted for the
180	180	previous fiscal year or for the closest subsequent fiscal year for
181	181	which the provider submitted the Medicare cost report. The local
182	182	jurisdiction shall update the amount of the mandatory payment on an
183	183	annual basis.
184	184	(b) The amount of a mandatory payment authorized under this
185	185	chapter for a local jurisdiction must be uniformly proportionate
186	186	with the amount of net patient revenue generated by each paying
187	187	hospital in the local jurisdiction as permitted under federal law.
188	188	A health care provider participation program authorized under this
189	189	chapter may not hold harmless any institutional health care
190	190	provider, as required under 42 U.S.C. Section 1396b(w).
191	191	(c) The governing body of a local jurisdiction that
192	192	authorizes a program under this chapter shall set the amount of the
193	193	mandatory payment. The aggregate amount of the mandatory payments
194	194	required of all paying providers in the local jurisdiction may not
195	195	exceed six percent of the aggregate net patient revenue from
196	196	hospital services provided by all paying providers in the local
197	197	jurisdiction.
198	198	(d) Subject to Subsection (c), if the governing body of a
199	199	local jurisdiction requires a mandatory payment authorized under
200	200	this chapter, the governing body shall set the mandatory payments
201	201	in amounts that in the aggregate will generate sufficient revenue
202	202	to cover the administrative expenses of the district for activities
203	203	under this chapter and to fund an intergovernmental transfer
204	204	described by Section 300.103(b)(1). The annual amount of revenue
205	205	from mandatory payments that shall be paid for administrative
206	206	expenses by the local jurisdiction is not to exceed $150,000, plus
207	207	the cost of collateralization of deposits, regardless of actual
208	208	expenses.
209	209	(e) A paying hospital may not add a mandatory payment
210	210	required under this section as a surcharge to a patient.
211	211	(f) A mandatory payment under this chapter is not a tax for
212	212	purposes of Section 5(a), Article IX, Texas Constitution.
213	213	Sec. 300.0152. ASSESSMENT AND COLLECTION OF MANDATORY
214	214	PAYMENTS. (a) The local jurisdiction may designate an official of
215	215	the local jurisdiction or contract with another person to assess
216	216	and collect the mandatory payments authorized under this chapter.
217	217	(b) The person charged by the local jurisdiction with the
218	218	assessment and collection of mandatory payments shall charge and
219	219	deduct from the mandatory payments collected for the local
220	220	jurisdiction a collection fee in an amount not to exceed the
221	221	person's usual and customary charges for like services.
222	222	(c) If the person charged with the assessment and collection
223	223	of mandatory payments is an official of the local jurisdiction, any
224	224	revenue from a collection fee charged under Subsection (b) shall be
225	225	deposited in the local jurisdiction general fund and, if
226	226	appropriate, shall be reported as fees of the local jurisdiction.
227	227	Sec. 300.0153. CORRECTION OF INVALID PROVISION OR
228	228	PROCEDURE. (a) This chapter does not authorize a local
229	229	jurisdiction to collect mandatory payments for the purpose of
230	230	raising general revenue or any amount in excess of the amount
231	231	reasonably necessary to fund the nonfederal share of a Medicaid
232	232	supplemental payment program or Medicaid managed care rate
233	233	enhancements for nonpublic hospitals and to cover the
234	234	administrative expenses of the local jurisdiction associated with
235	235	activities under this chapter.
236	236	(b) To the extent any provision or procedure under this
237	237	chapter causes a mandatory payment authorized under this chapter to
238	238	be ineligible for federal matching funds, the local jurisdiction
239	239	may provide by rule or order for an alternative provision or
240	240	procedure that conforms to the requirements of the federal Centers
241	241	for Medicare and Medicaid Services. A rule or order adopted under
242	242	this section may not create, impose, or materially expand the legal
243	243	or financial liability or responsibility of the local jurisdiction
244	244	or an institutional health care provider in the local jurisdiction
245	245	beyond the provisions of this chapter. This section does not
246	246	require the governing body of a local jurisdiction to adopt a rule
247	247	or order.
248	248	(c) The local jurisdiction may only assess and collect a
249	249	mandatory payment authorized under this chapter if a waiver
250	250	program, uniform rate enhancement, or reimbursement described by
251	251	Section 300.103(b)(1) is available to the local jurisdiction.
252	252	SECTION 2. If before implementing any provision of this Act
253	253	a state agency determines that a waiver or authorization from a
254	254	federal agency is necessary for implementation of that provision,
255	255	the agency affected by the provision shall request the waiver or
256	256	authorization and may delay implementing that provision until the
257	257	waiver or authorization is granted.
258	258	SECTION 3. This Act takes effect immediately if it receives
259	259	a vote of two-thirds of all the members elected to each house, as
260	260	provided by Section 39, Article III, Texas Constitution. If this
261	261	Act does not receive the vote necessary for immediate effect, this
262	262	Act takes effect September 1, 2019.