Texas 2019 - 86th Regular

Texas Senate Bill SB2423 Compare Versions

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1	1	By: Birdwell S.B. No. 2423
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 certain counties.
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 299 to read as follows:
11	11	CHAPTER 299. COUNTY HEALTH CARE PROVIDER PARTICIPATION
12	12	PROGRAM IN CERTAIN COUNTIES
13	13	SUBCHAPTER A. GENERAL PROVISIONS
14	14	Sec. 299.001. DEFINITIONS. In this chapter:
15	15	(1) "Institutional health care provider" means a
16	16	nonpublic hospital that provides inpatient hospital services.
17	17	(2) "Paying hospital" means an institutional health
18	18	care provider required to make a mandatory payment under this
19	19	chapter.
20	20	(3) "Program" means the county health care provider
21	21	participation program authorized by this chapter.
22	22	Sec. 299.002. APPLICABILITY. This chapter applies only to
23	23	a county that:
24	24	(1) is adjacent to two counties with a population of
25	25	1,000,000 or more; and
26	26	(2) borders the Trinity River.
27	27	Sec. 299.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
28	28	PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
29	29	provider participation program authorizes a county to collect a
30	30	mandatory payment from each institutional health care provider
31	31	located in the county to be deposited in a local provider
32	32	participation fund established by the county. Money in the fund may
33	33	be used by the county to fund certain intergovernmental transfers
34	34	and indigent care programs as provided by this chapter.
35	35	(b) The commissioners court may adopt an order authorizing a
36	36	county to participate in the program, subject to the limitations
37	37	provided by this chapter.
38	38	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
39	39	Sec. 299.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
40	40	PAYMENT. The commissioners court of a county may require a
41	41	mandatory payment authorized under this chapter by an institutional
42	42	health care provider in the county only in the manner provided by
43	43	this chapter.
44	44	Sec. 299.052. MAJORITY VOTE REQUIRED. The commissioners
45	45	court of a county may not authorize the county to collect a
46	46	mandatory payment authorized under this chapter without an
47	47	affirmative vote of a majority of the members of the commissioners
48	48	court.
49	49	Sec. 299.053. RULES AND PROCEDURES. After the
50	50	commissioners court has voted to require a mandatory payment
51	51	authorized under this chapter, the commissioners court may adopt
52	52	rules relating to the administration of the mandatory payment.
53	53	Sec. 299.054. INSTITUTIONAL HEALTH CARE PROVIDER
54	54	REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
55	55	county that collects a mandatory payment authorized under this
56	56	chapter shall require each institutional health care provider to
57	57	submit to the county a copy of any financial and utilization data
58	58	required by and reported to the Department of State Health Services
59	59	under Sections 311.032 and 311.033 and any rules adopted by the
60	60	executive commissioner of the Health and Human Services Commission
61	61	to implement those sections.
62	62	(b) The commissioners court of a county that collects a
63	63	mandatory payment authorized under this chapter may inspect the
64	64	records of an institutional health care provider to the extent
65	65	necessary to ensure compliance with the requirements of Subsection
66	66	(a).
67	67	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
68	68	Sec. 299.101. HEARING. (a) Each year, the commissioners
69	69	court of a county that collects a mandatory payment authorized
70	70	under this chapter shall hold a public hearing on the amounts of any
71	71	mandatory payments that the commissioners court intends to require
72	72	during the year and how the revenue derived from those payments is
73	73	to be spent.
74	74	(b) Not later than the 10th day before the date of the
75	75	hearing required under Subsection (a), the commissioners court of
76	76	the county shall publish notice of the hearing in a newspaper of
77	77	general circulation in the county.
78	78	(c) A representative of a paying hospital is entitled to
79	79	appear at the time and place designated in the public notice and to
80	80	be heard regarding any matter related to the mandatory payments
81	81	authorized under this chapter.
82	82	Sec. 299.102. DEPOSITORY. (a) The commissioners court of
83	83	each county that collects a mandatory payment authorized under this
84	84	chapter by resolution shall designate one or more banks located in
85	85	the county as the depository for mandatory payments received by the
86	86	county. A bank designated as a depository serves for two years or
87	87	until a successor is designated.
88	88	(b) All income received by a county under this chapter,
89	89	including the revenue from mandatory payments remaining after
90	90	discounts and fees for assessing and collecting the payments are
91	91	deducted, shall be deposited with the county depository in the
92	92	county's local provider participation fund and may be withdrawn
93	93	only as provided by this chapter.
94	94	(c) All funds under this chapter shall be secured in the
95	95	manner provided for securing county funds.
96	96	Sec. 299.103. LOCAL PROVIDER PARTICIPATION FUND;
97	97	AUTHORIZED USES OF MONEY. (a) Each county shall create a local
98	98	provider participation fund.
99	99	(b) The local provider participation fund of a county
100	100	consists of:
101	101	(1) all revenue received by the county attributable to
102	102	mandatory payments authorized under this chapter, including any
103	103	amounts received attributable to a suit to enforce liability for
104	104	and collect a delinquent mandatory payment;
105	105	(2) money received from the Health and Human Services
106	106	Commission as a refund of an intergovernmental transfer from the
107	107	county to the state for the purpose of providing the nonfederal
108	108	share of Medicaid supplemental payment program payments, provided
109	109	that the intergovernmental transfer does not receive a federal
110	110	matching payment; and
111	111	(3) the earnings of the fund.
112	112	(c) Money deposited to the local provider participation
113	113	fund may be used only to:
114	114	(1) fund intergovernmental transfers from the county
115	115	to the state to provide:
116	116	(A) the nonfederal share of a Medicaid
117	117	supplemental payment program authorized under the state Medicaid
118	118	plan, under the Texas Healthcare Transformation and Quality
119	119	Improvement Program waiver issued under Section 1115 of the federal
120	120	Social Security Act (42 U.S.C. Section 1315), or under a successor
121	121	waiver program authorizing similar Medicaid supplemental payment
122	122	programs; or
123	123	(B) payments to Medicaid managed care
124	124	organizations that are dedicated for payment to hospitals;
125	125	(2) subsidize indigent programs;
126	126	(3) pay the administrative expenses of the county;
127	127	(4) refund a portion of a mandatory payment collected
128	128	in error from a paying hospital; and
129	129	(5) refund to paying hospitals the proportionate share
130	130	of money received by the county from the Health and Human Services
131	131	Commission that is not used to fund the nonfederal share of Medicaid
132	132	supplemental payment program payments;
133	133	(6) refund to paying hospitals the proportionate share
134	134	of money that the county determines cannot be used to fund the
135	135	nonfederal share of Medicaid supplemental payment program payment;
136	136	and
137	137	(7) pay for any reasonable expenses the county incurs
138	138	in order to collect delinquent mandatory payments, including any
139	139	attorney's fees incurred as a result of contracting with an
140	140	attorney to represent the county in seeking and enforcing the
141	141	collection of delinquent mandatory payments.
142	142	(d) Money in the local provider participation fund may not
143	143	be commingled with other county funds.
144	144	(e) An intergovernmental transfer of funds described by
145	145	Subsection (c)(1) and any funds received by the county as a result
146	146	of an intergovernmental transfer described by that subsection may
147	147	not be used by the county or any other entity to expand Medicaid
148	148	eligibility under the Patient Protection and Affordable Care Act
149	149	(Pub. L. No. 111-148) as amended by the Health Care and Education
150	150	Reconciliation Act of 2010 (Pub. L. No. 111-152).
151	151	SUBCHAPTER D. MANDATORY PAYMENTS
152	152	Sec. 299.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
153	153	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
154	154	commission of a county may require an annual mandatory payment to be
155	155	assessed quarterly on the net patient revenue of an institutional
156	156	health care provider located in the county. In the first year in
157	157	which the mandatory payment is required, the mandatory payment is
158	158	assessed on the net patient revenue of an institutional health care
159	159	provider as determined by the data reported to the Department of
160	160	State Health Services under Sections 311.032 and 311.033 in the
161	161	fiscal year ending in 2010. The county may update the amount of the
162	162	mandatory payment on an annual basis.
163	163	(b) The amount of a mandatory payment authorized under this
164	164	chapter must be uniformly proportionate with the amount of net
165	165	patient revenue generated by each paying hospital in the county. A
166	166	mandatory payment authorized under this chapter may not hold
167	167	harmless any institutional health care provider, as required under
168	168	42 U.S.C. Section 1396b(w).
169	169	(c) The commissioners court of a county that collects a
170	170	mandatory payment authorized under this chapter shall set the
171	171	amount of the mandatory payment. The amount of the mandatory
172	172	payment required of each paying hospital may not exceed an amount
173	173	that, when added to the amount of the mandatory payments required
174	174	from all other paying hospitals in the county, equals an amount of
175	175	revenue that exceeds six percent of the aggregate net patient
176	176	revenue of all paying hospitals in the county.
177	177	(d) Subject to the maximum amount prescribed by Subsection
178	178	(c), the commissioners court of a county that collects a mandatory
179	179	payment authorized under this chapter shall set the mandatory
180	180	payments in amounts that in the aggregate will generate sufficient
181	181	revenue to cover the administrative expenses of the county for
182	182	activities under this chapter, to fund the nonfederal share of a
183	183	Medicaid supplemental payment program as described by Section
184	184	299.103(c)(1), and to pay for indigent programs, except that the
185	185	amount of revenue from mandatory payments used for administrative
186	186	expenses of the county for activities under this chapter in a year
187	187	may not exceed the lesser of four percent of the total revenue
188	188	generated from the mandatory payment or $20,000. Any reasonable
189	189	expenses the commission incurs in order to collect delinquent
190	190	mandatory payments, including any attorney's fees incurred as a
191	191	result of contracting with an attorney to represent the commission
192	192	in seeking and enforcing the collection of delinquent mandatory
193	193	payments, are not subject to the limitation described in this
194	194	subsection.
195	195	(e) A paying hospital may not add a mandatory payment
196	196	required under this section as a surcharge to a patient.
197	197	Sec. 299.152. ASSESSMENT AND COLLECTION OF MANDATORY
198	198	PAYMENTS. The county may collect or contract for the assessment and
199	199	collection of mandatory payments authorized under this chapter.
200	200	Sec. 299.153. INSTALLMENT PAYMENTS; ATTORNEY FOR
201	201	COLLECTION ACTIVITIES; SUIT. (a) A mandatory payment is considered
202	202	to be delinquent if it is not fully paid within 60 days of the due
203	203	date set by the county. The county may enter into an agreement with
204	204	an institutional health care provider that allows payment in
205	205	installments of a delinquent mandatory payment.
206	206	(b) The commission may contract with any competent attorney
207	207	to represent the county to seek and enforce the collection of
208	208	delinquent mandatory payments. The attorney's compensation is set
209	209	in the contract, but the total amount of compensation provided may
210	210	not exceed the lesser of (1) 20 percent of the amount of delinquent
211	211	mandatory payments collected and (2) $200,000.
212	212	(c) At any time after a mandatory payment becomes
213	213	delinquent, the county may file suit in a court of competent
214	214	jurisdiction to enforce liability for and collect the mandatory
215	215	payment. The county may recover attorney's fees in a suit to enforce
216	216	liability for and collect a delinquent mandatory payment. Any
217	217	amounts recovered or otherwise received as a result of a suit to
218	218	enforce liability for and collect a delinquent mandatory payment
219	219	shall be deposited into the local provider participation fund.
220	220	Sec. 299.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
221	221	PROCEDURE. (a) The purpose of this chapter is to generate revenue
222	222	by collecting from institutional health care providers a mandatory
223	223	payment to be used to provide the nonfederal share of a Medicaid
224	224	supplemental payment program.
225	225	(b) To the extent any provision or procedure under this
226	226	chapter causes a mandatory payment authorized under this chapter to
227	227	be ineligible for federal matching funds, the county may provide by
228	228	rule for an alternative provision or procedure that conforms to the
229	229	requirements of the federal Centers for Medicare and Medicaid
230	230	Services.
231	231	SECTION 2. If before implementing any provision of this Act
232	232	a state agency determines that a waiver or authorization from a
233	233	federal agency is necessary for implementation of that provision,
234	234	the agency affected by the provision shall request the waiver or
235	235	authorization and may delay implementing that provision until the
236	236	waiver or authorization is granted.
237	237	SECTION 3. This Act takes effect immediately if it receives
238	238	a vote of two-thirds of all the members elected to each house, as
239	239	provided by Section 39, Article III, Texas Constitution. If this
240	240	Act does not receive the vote necessary for immediate effect, this
241	241	Act takes effect September 1, 2019.