Texas 2019 - 86th Regular

Texas Senate Bill SB2315 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 2315
	1	+	86R32194 SRA-D
	2	+	By: Hinojosa S.B. No. 2315
	3	+	(Herrero, Coleman)
	4	+	Substitute the following for S.B. No. 2315: 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 Nueces 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 298C to read as follows:
10	14		CHAPTER 298C. NUECES COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
11	15		PARTICIPATION PROGRAM
12	16		SUBCHAPTER A. GENERAL PROVISIONS
13	17		Sec. 298C.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 Nueces County Hospital
17	21		District.
18	22		(3) "Institutional health care provider" means a
19	23		hospital that is not owned and operated by a federal or state
20	24		government and provides inpatient 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. 298C.002. APPLICABILITY. This chapter applies only to
27	31		the Nueces County Hospital District.
28	32		Sec. 298C.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. 298C.004. EXPIRATION. (a) Subject to Section
34	38		298C.153(d), the authority of the district to administer and
35	39		operate a program under this chapter expires December 31, 2021.
36	40		(b) This chapter expires December 31, 2021.
37	41		SUBCHAPTER B. POWERS AND DUTIES OF BOARD
38	42		Sec. 298C.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 located
41	45		in the district only in the manner provided by this chapter.
42	46		Sec. 298C.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. 298C.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 located in the district to
50	54		submit to the district a copy of any financial and utilization data
51	55		required by and reported to the Department of State Health Services
52	56		under Sections 311.032 and 311.033 and any rules adopted by the
53	57		executive commissioner of the Health and Human Services Commission
54	58		to implement those sections.
55	59		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
56	60		Sec. 298C.101. HEARING. (a) In each fiscal year that the
57	61		board authorizes a program under this chapter, the board shall hold
58	62		a public hearing on the amounts of any mandatory payments that the
59	63		board intends to require during the year and how the revenue derived
60	64		from those payments is to be spent.
61	65		(b) Not later than the fifth day before the date of the
62	66		hearing required under Subsection (a), the board shall publish
63	67		notice of the hearing in a newspaper of general circulation in the
64	68		district and provide written notice of the hearing to each
65	69		institutional health care provider located in the district.
66	70		Sec. 298C.102. DEPOSITORY. (a) If the board requires a
67	71		mandatory payment authorized under this chapter, the board shall
68	72		designate one or more banks as a depository for the district's local
69	73		provider participation fund.
70	74		(b) All funds collected under this chapter shall be secured
71	75		in the manner provided for securing other district funds.
72	76		Sec. 298C.103. LOCAL PROVIDER PARTICIPATION FUND;
73	77		AUTHORIZED USES OF MONEY. (a) If the district requires a
74	78		mandatory payment authorized under this chapter, the district shall
75	79		create a local provider participation fund.
76	80		(b) The local provider participation fund consists of:
77	81		(1) all revenue received by the district attributable
78	82		to mandatory payments authorized under this chapter;
79	83		(2) money received from the Health and Human Services
80	84		Commission as a refund of an intergovernmental transfer under the
81	85		program, provided that the intergovernmental transfer does not
82	86		receive a federal matching payment; and
83	87		(3) the earnings of the fund.
84	88		(c) Money deposited to the local provider participation
85	89		fund of the district may be used only to:
86	90		(1) fund intergovernmental transfers from the
87	91		district to the state to provide the nonfederal share of Medicaid
88	92		payments for:
89	93		(A) uncompensated care payments to hospitals in
90	94		the Medicaid managed care service area in which the district is
91	95		located, if those payments are authorized under the Texas
92	96		Healthcare Transformation and Quality Improvement Program waiver
93	97		issued under Section 1115 of the federal Social Security Act (42
94	98		U.S.C. Section 1315);
95	99		(B) delivery system reform incentive payments,
96	100		if those payments are authorized under the Texas Healthcare
97	101		Transformation and Quality Improvement Program waiver issued under
98	102		Section 1115 of the federal Social Security Act (42 U.S.C. Section
99	103		1315);
100	104		(C) uniform rate enhancements for hospitals in
101	105		the Medicaid managed care service area in which the district is
102	106		located;
103	107		(D) payments available under another waiver
104	108		program authorizing payments that are substantially similar to
105	109		Medicaid payments to hospitals described by Paragraph (A), (B), or
106	110		(C); or
107	111		(E) any reimbursement to hospitals for which
108	112		federal matching funds are available;
109	113		(2) subject to Section 298C.151(d), pay the
110	114		administrative expenses of the district in administering the
111	115		program, including collateralization of deposits;
112	116		(3) refund a mandatory payment collected in error from
113	117		a paying provider;
114	118		(4) refund to paying providers a proportionate share
115	119		of the money that the district:
116	120		(A) receives from the Health and Human Services
117	121		Commission that is not used to fund the nonfederal share of Medicaid
118	122		supplemental payment program payments or uniform rate enhancements
119	123		described by Subdivision (1)(C); or
120	124		(B) determines cannot be used to fund the
121	125		nonfederal share of Medicaid supplemental payment program payments
122	126		or uniform rate enhancements described by Subdivision (1)(C);
123	127		(5) transfer funds to the Health and Human Services
124	128		Commission if the district is legally required to transfer the
125	129		funds to address a disallowance of federal matching funds with
126	130		respect to programs for which the district made intergovernmental
127	131		transfers described by Subdivision (1); and
128	132		(6) reimburse the district if the district is required
129	133		by the rules governing the uniform rate enhancement program
130	134		described by Subdivision (1)(C) to incur an expense or forego
131	135		Medicaid reimbursements from the state because the balance of the
132	136		local provider participation fund is not sufficient to fund that
133	137		rate enhancement program.
134	138		(d) Money in the local provider participation fund may not
135	139		be commingled with other district funds.
136	140		(e) Notwithstanding any other provision of this chapter,
137	141		with respect to an intergovernmental transfer of funds described by
138	142		Subsection (c)(1) made by the district, any funds received by the
139	143		state, district, or other entity as a result of that transfer may
140	144		not be used by the state, district, or any other entity to expand
141	145		Medicaid eligibility under the Patient Protection and Affordable
142	146		Care Act (Pub. L. No. 111-148) as amended by the Health Care and
143	147		Education Reconciliation Act of 2010 (Pub. L. No. 111-152).
144	148		SUBCHAPTER D. MANDATORY PAYMENTS
145	149		Sec. 298C.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
146	150		NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if
147	151		the board authorizes a health care provider participation program
148	152		under this chapter, the board may require a mandatory payment to be
149	153		assessed, either annually or periodically throughout the fiscal
150	154		year at the discretion of the board, on the net patient revenue of
151	155		each institutional health care provider located in the district.
152	156		The board shall provide an institutional health care provider
153	157		written notice of each assessment under this subsection, and the
154	158		provider has 30 calendar days following the date of receipt of the
155	159		notice to pay the assessment. In the first fiscal year in which the
156	160		mandatory payment is required, the mandatory payment is assessed on
157	161		the net patient revenue of an institutional health care provider as
158	162		determined by the data reported to the Department of State Health
159	163		Services under Sections 311.032 and 311.033 in the most recent
160	164		fiscal year for which that data was reported. If the institutional
161	165		health care provider did not report any data under those sections,
162	166		the provider's net patient revenue is the amount of that revenue as
163	167		contained in the provider's Medicare cost report submitted for the
164	168		previous fiscal year or for the closest subsequent fiscal year for
165	169		which the provider submitted the Medicare cost report. If the
166	170		mandatory payment is required, the district shall update the amount
167	171		of the mandatory payment on an annual basis.
168	172		(b) The amount of a mandatory payment assessed under this
169	173		chapter by the board must be uniformly proportionate with the
170	174		amount of net patient revenue generated by each paying provider in
171	175		the district as permitted under federal law. A health care provider
172	176		participation program authorized under this chapter may not hold
173	177		harmless any institutional health care provider, as required under
174	178		42 U.S.C. Section 1396b(w).
175	179		(c) If the board requires a mandatory payment authorized
176	180		under this chapter, the board shall set the amount of the mandatory
177	181		payment, subject to the limitations of this chapter. The aggregate
178	182		amount of the mandatory payments required of all paying providers
179	183		in the district may not exceed six percent of the aggregate net
180	184		patient revenue from hospital services provided by all paying
181	185		providers in the district.
182	186		(d) Subject to Subsection (c), if the board requires a
183	187		mandatory payment authorized under this chapter, the board shall
184	188		set the mandatory payments in amounts that in the aggregate will
185	189		generate sufficient revenue to cover the administrative expenses of
186	190		the district for activities under this chapter and to fund an
187	191		intergovernmental transfer described by Section 298C.103(c)(1).
188	192		The annual amount of revenue from mandatory payments that shall be
189	193		paid for administrative expenses by the district is $150,000, plus
190	194		the cost of collateralization of deposits, regardless of actual
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. 298C.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. 298C.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
212	216		PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
213	217		chapter is to authorize the district to establish a program to
214	218		enable the district to collect mandatory payments from
215	219		institutional health care providers to fund the nonfederal share of
216	220		a Medicaid supplemental payment program or the Medicaid managed
217	221		care rate enhancements for hospitals to support the provision of
218	222		health care by institutional health care providers located in the
219	223		district.
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 hospitals and to cover
225	229		the administrative expenses of the district associated with
226	230		activities under this chapter.
227	231		(c) To the extent any provision or procedure under this
228	232		chapter causes a mandatory payment authorized under this chapter to
229	233		be ineligible for federal matching funds, the board may provide by
230	234		rule for an alternative provision or procedure that conforms to the
231	235		requirements of the federal Centers for Medicare and Medicaid
232	236		Services. A rule adopted under this section may not create, impose,
233	237		or materially expand the legal or financial liability or
234	238		responsibility of the district or an institutional health care
235	239		provider in the district beyond the provisions of this chapter.
236	240		This section does not require the board to adopt a rule.
237	241		(d) The district may only assess and collect a mandatory
238	242		payment authorized under this chapter if a waiver program, uniform
239	243		rate enhancement, or reimbursement described by Section
240	244		298C.103(c)(1) is available to at least one institutional health
241	245		care provider located in the district.
242	246		SECTION 2. As soon as practicable after the expiration of
243	247		the authority of the Nueces County Hospital District to administer
244	248		and operate a health care provider participation program under
245	249		Chapter 298C, Health and Safety Code, as added by this Act, the
246	250		board of hospital managers of the Nueces County Hospital District
247	251		shall transfer to each institutional health care provider in the
248	252		district that provider's proportionate share of any remaining funds
249	253		in any local provider participation fund created by the district
250	254		under Section 298C.103, Health and Safety Code, as added by this
251	255		Act.
252	256		SECTION 3. If before implementing any provision of this Act
253	257		a state agency determines that a waiver or authorization from a
254	258		federal agency is necessary for implementation of that provision,
255	259		the agency affected by the provision shall request the waiver or
256	260		authorization and may delay implementing that provision until the
257	261		waiver or authorization is granted.
258	262		SECTION 4. This Act takes effect immediately if it receives
259	263		a vote of two-thirds of all the members elected to each house, as
260	264		provided by Section 39, Article III, Texas Constitution. If this
261	265		Act does not receive the vote necessary for immediate effect, this
262	266		Act takes effect September 1, 2019.
263		-	______________________________ ______________________________
264		-	President of the Senate Speaker of the House
265		-	I hereby certify that S.B. No. 2315 passed the Senate on
266		-	April 17, 2019, by the following vote: Yeas 31, Nays 0; and that
267		-	the Senate concurred in House amendment on May 23, 2019, by the
268		-	following vote: Yeas 31, Nays 0.
269		-	______________________________
270		-	Secretary of the Senate
271		-	I hereby certify that S.B. No. 2315 passed the House, with
272		-	amendment, on May 17, 2019, by the following vote: Yeas 127,
273		-	Nays 20, two present not voting.
274		-	______________________________
275		-	Chief Clerk of the House
276		-	Approved:
277		-	______________________________
278		-	Date
279		-	______________________________
280		-	Governor