Texas 2019 - 86th Regular

Texas Senate Bill SB2286 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 2286
	1	+	86R24089 JCG-F
	2	+	By: Fallon S.B. No. 2286
	3	+	(Frank)
	4	+	Substitute the following for S.B. No. 2286: No.
2	5
3	6
	7	+	A BILL TO BE ENTITLED
4	8		AN ACT
5	9		relating to the creation and operations of health care provider
6	10		participation programs in certain counties.
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 292C to read as follows:
10	14		CHAPTER 292C. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
11	15		CERTAIN COUNTIES WITH HOSPITAL DISTRICT BORDERING OKLAHOMA
12	16		SUBCHAPTER A. GENERAL PROVISIONS
13	17		Sec. 292C.001. DEFINITIONS. In this chapter:
14	18		(1) "Institutional health care provider" means a
15	19		nonpublic hospital that provides inpatient hospital services and
16	20		that is not located within the boundaries of a hospital district.
17	21		(2) "Paying hospital" means an institutional health
18	22		care provider required to make a mandatory payment under this
19	23		chapter.
20	24		(3) "Program" means the county health care provider
21	25		participation program authorized by this chapter.
22	26		Sec. 292C.002. APPLICABILITY. This chapter applies only to
23	27		a county that:
24	28		(1) contains a hospital district that is not
25	29		countywide;
26	30		(2) has a population of more than 125,000; and
27	31		(3) borders Oklahoma.
28	32		Sec. 292C.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
29	33		PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
30	34		provider participation program authorizes a county to collect a
31	35		mandatory payment from each institutional health care provider
32	36		located in the county to be deposited in a local provider
33	37		participation fund established by the county. Money in the fund may
34	38		be used by the county to fund certain intergovernmental transfers
35	39		as provided by this chapter.
36	40		(b) The commissioners court of a county may adopt an order
37	41		authorizing the county to participate in the program, subject to
38	42		the limitations provided by this chapter.
39	43		Sec. 292C.004. EXPIRATION. The authority of a county to
40	44		administer and operate a program under this chapter expires
41	45		December 31, 2023.
42	46		SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
43	47		Sec. 292C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
44	48		PAYMENT. The commissioners court of a county may require a
45	49		mandatory payment authorized under this chapter by an institutional
46	50		health care provider in the county only in the manner provided by
47	51		this chapter.
48	52		Sec. 292C.052. MAJORITY VOTE REQUIRED. The commissioners
49	53		court of a county may not authorize the county to collect a
50	54		mandatory payment authorized under this chapter without an
51	55		affirmative vote of a majority of the members of the commissioners
52	56		court.
53	57		Sec. 292C.053. RULES AND PROCEDURES. After the
54	58		commissioners court of a county has voted to require a mandatory
55	59		payment authorized under this chapter, the commissioners court may
56	60		adopt rules relating to the administration of the mandatory
57	61		payment.
58	62		Sec. 292C.054. INSTITUTIONAL HEALTH CARE PROVIDER
59		-	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of
60		-	a county that collects a mandatory payment authorized under this
	63	+	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
	64	+	county that collects a mandatory payment authorized under this
61	65		chapter shall require each institutional health care provider
62	66		located in the county to submit to the county a copy of any
63	67		financial and utilization data required by and reported to the
64	68		Department of State Health Services under Sections 311.032 and
65	69		311.033 and any rules adopted by the executive commissioner of the
66	70		Health and Human Services Commission to implement those sections.
67	71		(b) The commissioners court of a county that collects a
68	72		mandatory payment authorized under this chapter may inspect the
69	73		records of an institutional health care provider to the extent
70	74		necessary to ensure compliance with the requirements of Subsection
71	75		(a).
72	76		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
73	77		Sec. 292C.101. HEARING. (a) Each year, the commissioners
74	78		court of a county that collects a mandatory payment authorized
75	79		under this chapter shall hold a public hearing on the amounts of any
76	80		mandatory payments that the commissioners court intends to require
77	81		during the year.
78	82		(b) Not later than the fifth day before the date of the
79	83		hearing required under Subsection (a), the commissioners court of
80	84		the county shall publish notice of the hearing in a newspaper of
81	85		general circulation in the county.
82	86		(c) A representative of a paying hospital is entitled to
83	87		appear at the time and place designated in the public notice and to
84	88		be heard regarding any matter related to the mandatory payments
85	89		authorized under this chapter.
86	90		Sec. 292C.102. DEPOSITORY. (a) The commissioners court of
87	91		each county that collects a mandatory payment authorized under this
88	92		chapter by resolution shall designate one or more banks located in
89	93		the county as the depository for mandatory payments received by the
90	94		county.
91	95		(b) All income received by a county under this chapter,
92	96		including the revenue from mandatory payments remaining after
93	97		discounts and fees for assessing and collecting the payments are
94	98		deducted, shall be deposited with the county depository in the
95	99		county's local provider participation fund and may be withdrawn
96	100		only as provided by this chapter.
97	101		(c) All funds under this chapter shall be secured in the
98	102		manner provided for securing county funds.
99	103		Sec. 292C.103. LOCAL PROVIDER PARTICIPATION FUND;
100	104		AUTHORIZED USES OF MONEY. (a) Each county that collects a
101	105		mandatory payment authorized under this chapter shall create a
102	106		local provider participation fund.
103	107		(b) The local provider participation fund of a county
104	108		consists of:
105	109		(1) all revenue received by the county attributable to
106	110		mandatory payments authorized under this chapter, including any
107	111		penalties and interest attributable to delinquent payments;
108	112		(2) money received from the Health and Human Services
109	113		Commission as a refund of an intergovernmental transfer from the
110	114		county to the state for the purpose of providing the nonfederal
111	115		share of Medicaid supplemental payment program payments, provided
112	116		that the intergovernmental transfer does not receive a federal
113	117		matching payment; and
114	118		(3) the earnings of the fund.
115	119		(c) Money deposited to the local provider participation
116	120		fund may be used only to:
117	121		(1) fund intergovernmental transfers from the county
118	122		to the state to provide:
119	123		(A) the nonfederal share of a Medicaid
120	124		supplemental payment program authorized under the state Medicaid
121	125		plan, the Texas Healthcare Transformation and Quality Improvement
122	126		Program waiver issued under Section 1115 of the federal Social
123	127		Security Act (42 U.S.C. Section 1315), or a successor waiver
124	128		program authorizing similar Medicaid supplemental payment
125	129		programs; or
126	130		(B) payments to Medicaid managed care
127	131		organizations that are dedicated for payment to hospitals;
128	132		(2) pay the administrative expenses of the county
129	133		solely for activities under this chapter;
130	134		(3) refund a portion of a mandatory payment collected
131	135		in error from a paying hospital; and
132	136		(4) refund to paying hospitals the proportionate share
133	137		of money received by the county that is not used to fund the
134	138		nonfederal share of Medicaid supplemental payment program
135	139		payments.
136	140		(d) Money deposited to the local provider participation
137	141		fund may not be used to pay for the services of a consultant or a
138	142		person required to register under Chapter 305, Government Code.
139	143		(e) Money in the local provider participation fund may not
140	144		be commingled with other county funds.
141	145		(f) An intergovernmental transfer of funds described by
142	146		Subsection (c)(1) and any funds received by the county as a result
143	147		of an intergovernmental transfer described by that subsection may
144	148		not be used by the county or any other entity to expand Medicaid
145	149		eligibility under the Patient Protection and Affordable Care Act
146	150		(Pub. L. No. 111-148) as amended by the Health Care and Education
147	151		Reconciliation Act of 2010 (Pub. L. No. 111-152).
148	152		SUBCHAPTER D. MANDATORY PAYMENTS
149	153		Sec. 292C.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
150		-	NET PATIENT REVENUE. (a) Except as provided by Subsection (e),
151		-	~~the~~ commissioners court of a county that collects a mandatory
152		-	~~payment~~ authorized under this chapter may require an annual
153		-	~~mandatory~~ payment to be assessed on the net patient revenue of each
	154	+	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
	155	+	commissioners court of a county that collects a mandatory payment
	156	+	authorized under this chapter may require an annual mandatory
	157	+	payment to be assessed on the net patient revenue of each
154	158		institutional health care provider located in the county. The
155	159		commissioners court may provide for the mandatory payment to be
156	160		assessed quarterly. In the first year in which the mandatory
157	161		payment is required, the mandatory payment is assessed on the net
158	162		patient revenue of an institutional health care provider as
159	163		determined by the data reported to the Department of State Health
160	164		Services under Sections 311.032 and 311.033 in the fiscal year
161	165		ending in 2017 or, if the institutional health care provider did not
162	166		report any data under those sections in that fiscal year, as
163	167		determined by the institutional health care provider's Medicare
164	168		cost report submitted for the 2017 fiscal year or for the closest
165	169		subsequent fiscal year for which the provider submitted the
166	170		Medicare cost report. The county shall update the amount of the
167	171		mandatory payment on an annual basis.
168	172		(b) The amount of a mandatory payment authorized under this
169	173		chapter must be uniformly proportionate with the amount of net
170	174		patient revenue generated by each paying hospital in the county. A
171	175		mandatory payment authorized under this chapter may not hold
172	176		harmless any institutional health care provider, as required under
173	177		42 U.S.C. Section 1396b(w).
174	178		(c) The commissioners court of a county that collects a
175	179		mandatory payment authorized under this chapter shall set the
176	180		amount of the mandatory payment. The amount of the mandatory
177	181		payment required of each paying hospital may not exceed six percent
178	182		of the paying hospital's net patient revenue.
179	183		(d) Subject to the maximum amount prescribed by Subsection
180	184		(c), the commissioners court of a county that collects a mandatory
181	185		payment authorized under this chapter shall set the mandatory
182	186		payments in amounts that in the aggregate will generate sufficient
183	187		revenue to cover the administrative expenses of the county for
184	188		activities under this chapter and to fund an intergovernmental
185	189		transfer described by Section 292C.103(c)(1), except that the
186	190		amount of revenue from mandatory payments used for administrative
187	191		expenses of the county for activities under this chapter in a year
188	192		may not exceed $20,000, plus the cost of collateralization of
189	193		deposits. If the county demonstrates to the paying hospitals that
190	194		the costs of administering the program under this chapter,
191	195		excluding those costs associated with the collateralization of
192	196		deposits, exceed $20,000 in any year, on consent of a majority of
193	197		the paying hospitals, the county may use additional revenue from
194	198		mandatory payments received under this chapter to compensate the
195	199		county for its administrative expenses. A paying hospital may not
196	200		unreasonably withhold consent to compensate the county for
197	201		administrative expenses.
198	202		(e) A paying hospital may not add a mandatory payment
199	203		required under this section as a surcharge to a patient.
200	204		Sec. 292C.152. ASSESSMENT AND COLLECTION OF MANDATORY
201	205		PAYMENTS. The county may collect or contract for the assessment and
202	206		collection of mandatory payments authorized under this chapter.
203	207		Sec. 292C.153. INTEREST, PENALTIES, AND DISCOUNTS.
204	208		Interest, penalties, and discounts on mandatory payments required
205	209		under this chapter are governed by the law applicable to county ad
206	210		valorem taxes.
207	211		Sec. 292C.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
208	212		PROCEDURE. (a) The purpose of this chapter is to generate revenue
209	213		by collecting from institutional health care providers a mandatory
210	214		payment to be used to provide the nonfederal share of a Medicaid
211	215		supplemental payment program.
212	216		(b) To the extent any provision or procedure under this
213	217		chapter causes a mandatory payment authorized under this chapter to
214	218		be ineligible for federal matching funds, the county may provide by
215	219		rule for an alternative provision or procedure that conforms to the
216	220		requirements of the federal Centers for Medicare and Medicaid
217	221		Services.
218	222		SECTION 2. As soon as practicable after the expiration of
219	223		the authority of a county to administer and operate a health care
220	224		provider participation program under Chapter 292C, Health and
221	225		Safety Code, as added by this Act, the commissioners court of the
222	226		county shall transfer to the institutional health care providers in
223	227		the county a proportionate share of any remaining funds in any local
224	228		provider participation fund created by the county under Section
225	229		292C.103, Health and Safety Code, as added by this Act.
226	230		SECTION 3. If before implementing any provision of this Act
227	231		a state agency determines that a waiver or authorization from a
228	232		federal agency is necessary for implementation of that provision,
229	233		the agency affected by the provision shall request the waiver or
230	234		authorization and may delay implementing that provision until the
231	235		waiver or authorization is granted.
232	236		SECTION 4. This Act takes effect immediately if it receives
233	237		a vote of two-thirds of all the members elected to each house, as
234	238		provided by Section 39, Article III, Texas Constitution. If this
235	239		Act does not receive the vote necessary for immediate effect, this
236	240		Act takes effect September 1, 2019.
237		-	______________________________ ______________________________
238		-	President of the Senate Speaker of the House
239		-	I hereby certify that S.B. No. 2286 passed the Senate on
240		-	April 29, 2019, by the following vote: Yeas 31, Nays 0; and that
241		-	the Senate concurred in House amendment on May 21, 2019, by the
242		-	following vote: Yeas 31, Nays 0.
243		-	______________________________
244		-	Secretary of the Senate
245		-	I hereby certify that S.B. No. 2286 passed the House, with
246		-	amendment, on May 14, 2019, by the following vote: Yeas 127,
247		-	Nays 14, two present not voting.
248		-	______________________________
249		-	Chief Clerk of the House
250		-	Approved:
251		-	______________________________
252		-	Date
253		-	______________________________
254		-	Governor