S.B. No. 2448
AN ACT
relating to the creation and operations of a health care provider
participation program by the Lubbock County Hospital District of
Lubbock County, Texas.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
amended by adding Chapter 298C to read as follows:
CHAPTER 298C. LUBBOCK COUNTY HOSPITAL DISTRICT OF LUBBOCK COUNTY,
TEXAS: HEALTH CARE PROVIDER PARTICIPATION PROGRAM
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 298C.001. PURPOSE. The purpose of this chapter is to
authorize the district to administer a health care provider
participation program to provide additional compensation to
nonpublic hospitals by collecting mandatory payments from each
nonpublic hospital in the district to be used to provide the
nonfederal share of a Medicaid supplemental payment program and for
other purposes as authorized under this chapter.
Sec. 298C.002. DEFINITIONS. In this chapter:
(1) "Board" means the board of hospital managers of
the district.
(2) "District" means the Lubbock County Hospital
District of Lubbock County, Texas.
(3) "Institutional health care provider" means a
nonpublic hospital located in the district that provides inpatient
hospital services.
(4) "Paying hospital" means an institutional health
care provider required to make a mandatory payment under this
chapter.
(5) "Program" means the health care provider
participation program authorized by this chapter.
Sec. 298C.003. APPLICABILITY. This chapter applies only to
the Lubbock County Hospital District of Lubbock County, Texas.
Sec. 298C.004. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
PARTICIPATION IN PROGRAM. The board may authorize the district to
participate in a health care provider participation program on the
affirmative vote of a majority of the board, subject to the
provisions of this chapter.
SUBCHAPTER B. POWERS AND DUTIES OF BOARD
Sec. 298C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
PAYMENT. The board may require a mandatory payment authorized
under this chapter from an institutional health care provider in
the district only in the manner provided by this chapter.
Sec. 298C.052. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING. If the board authorizes the district to participate in a
program under this chapter, the board shall require each
institutional health care provider to submit to the district a copy
of any financial and utilization data required by and reported to
the Department of State Health Services under Sections 311.032 and
311.033 and any rules adopted by the executive commissioner of the
Health and Human Services Commission to implement those sections.
Sec. 298C.053. RULES AND PROCEDURES. The board may adopt
rules relating to the administration of the health care provider
participation program, including collection of the mandatory
payments, expenditures, audits, and any other administrative
aspects of the program.
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
Sec. 298C.101. HEARING. (a) In each year that the board
authorizes a program under this chapter, the board shall hold a
public hearing on the amounts of any mandatory payments that the
board intends to require during the year and how the revenue derived
from those payments is to be spent.
(b) Not later than the fifth day before the date of the
hearing required under Subsection (a), the board shall publish
notice of the hearing in a newspaper of general circulation in the
district and provide written notice of the hearing to the chief
operating officer of each institutional health care provider in the
district.
(c) The board's determination of the amount of mandatory
payments to be collected during the year must be shown to be based
on reasonable estimates of the amount of revenue necessary to fund
intergovernmental transfers from the district to the state
providing the nonfederal share of payments described by Section
298C.103(b)(1) that is otherwise unfunded.
Sec. 298C.102. LOCAL PROVIDER PARTICIPATION FUND;
DEPOSITORY. (a) If the board collects a mandatory payment
authorized under this chapter, the board shall create a local
provider participation fund in one or more banks located in the
district that are designated by the district as a depository for
public funds.
(b) All money received by the district under this chapter,
including the amount of revenue from mandatory payments remaining
after deducting any discounts and fees for assessing and collecting
the payments, shall be deposited with a depository designated under
Subsection (a).
(c) The board may withdraw or use money in the fund only for
a purpose authorized under this chapter.
(d) All funds collected under this chapter shall be secured
in the manner provided by Chapter 1053, Special District Local Laws
Code, for securing public funds of the district.
Sec. 298C.103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY.
(a) The local provider participation fund established under
Section 298C.102 consists of:
(1) all mandatory payments authorized under this
chapter and received by the district;
(2) money received from the Health and Human Services
Commission as a refund of an intergovernmental transfer from the
district to the state as the nonfederal share of Medicaid
supplemental payment program payments, provided that the
intergovernmental transfer does not receive a federal matching
payment; and
(3) the earnings of the fund.
(b) Money deposited to the local provider participation
fund may be used only to:
(1) fund intergovernmental transfers from the
district to the state to provide the nonfederal share of Medicaid
payments for:
(A) uncompensated care and delivery system
reform incentive payments to nonpublic hospitals, if those payments
are authorized under the Texas Healthcare Transformation and
Quality Improvement Program waiver issued under Section 1115 of the
federal Social Security Act (42 U.S.C. Section 1315);
(B) uniform rate enhancements for nonpublic
hospitals in the Medicaid managed care service area in which the
district is located;
(C) payments available to nonpublic hospitals
under another waiver program authorizing payments that are
substantially similar to Medicaid payments to nonpublic hospitals
described by Paragraph (A) or (B); or
(D) any reimbursement to nonpublic hospitals for
which federal matching funds are available;
(2) subject to Section 298C.151(d), pay the
administrative expenses of the district in administering the
program, including collateralization of deposits;
(3) refund a portion of a mandatory payment collected
in error from a paying hospital; and
(4) refund to paying hospitals a proportionate share
of the money that the district:
(A) receives from the Health and Human Services
Commission that is not used to fund the nonfederal share of Medicaid
supplemental payment program payments described by Subdivision
(1); or
(B) determines cannot be used to fund the
nonfederal share of Medicaid supplemental payment program payments
described by Subdivision (1).
(c) Money in the local provider participation fund may not
be commingled with other district funds.
(d) An intergovernmental transfer of funds described by
Subsection (b)(1) and any funds received by the district as a result
of an intergovernmental transfer described by that subsection may
not be used by the district or any other entity to expand Medicaid
eligibility under the Patient Protection and Affordable Care Act
(Pub. L. No. 111-148) as amended by the Health Care and Education
Reconciliation Act of 2010 (Pub. L. No. 111-152).
SUBCHAPTER D. MANDATORY PAYMENTS
Sec. 298C.151. MANDATORY PAYMENTS. (a) If the board
authorizes a program under this chapter, the board shall require an
annual mandatory payment to be assessed on the net patient revenue
of each institutional health care provider located in the district.
The board may provide that the mandatory payment is to be collected
at least annually, but not more often than quarterly. In the first
year in which the mandatory payment is required, the mandatory
payment is assessed on the net patient revenue of an institutional
health care provider as determined by the data reported to the
Department of State Health Services under Sections 311.032 and
311.033 in the most recent fiscal year for which that data was
reported. If the institutional health care provider did not report
any data under those sections, the provider's net patient revenue
is the amount of that revenue as contained in the provider's
Medicare cost report submitted for the previous fiscal year or for
the closest subsequent fiscal year for which the provider submitted
the Medicare cost report. The district shall update the amount of
the mandatory payment on an annual basis and may update the amount
on a more frequent basis.
(b) The amount of a mandatory payment authorized under this
chapter must be a uniform percentage of the amount of net patient
revenue generated by each paying hospital in the district. A
mandatory payment authorized under this chapter may not hold
harmless any institutional health care provider, as required under
42 U.S.C. Section 1396b(w).
(c) The aggregate amount of the mandatory payments required
of all paying hospitals in the district may not exceed six percent
of the aggregate net patient revenue of all paying hospitals in the
district.
(d) Subject to the maximum amount prescribed by Subsection
(c) and this subsection, the board shall set the mandatory payments
in amounts that in the aggregate will generate sufficient revenue
to cover the administrative expenses of the district for activities
under this chapter, fund an intergovernmental transfer described by
Section 298C.103(b)(1), or make other payments authorized under
this chapter. The amount of the mandatory payments must be based on
reasonable estimates of the amount of revenue necessary to cover
the administrative expenses, intergovernmental transfers, and
other payments described by this subsection as authorized under
this chapter. The amount of revenue from mandatory payments that
may be used for administrative expenses by the district in a year
may not exceed $25,000, plus the cost of collateralization of
deposits. If the board demonstrates to the paying hospitals that
the costs of administering the program under this chapter,
excluding those costs associated with the collateralization of
deposits, exceed $25,000 in any year, on consent of all of the
paying hospitals, the district may use additional revenue from
mandatory payments received under this chapter to compensate the
district for its administrative expenses. A paying hospital may
not unreasonably withhold consent to compensate the district for
administrative expenses.
(e) A paying hospital may not add a mandatory payment
required under this section as a surcharge to a patient or insurer.
(f) A mandatory payment under this chapter is not a tax for
purposes of Section 9, Article IX, Texas Constitution, or Chapter
1053, Special District Local Laws Code.
Sec. 298C.152. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. The district may collect or contract for the assessment
and collection of mandatory payments authorized under this chapter.
Sec. 298C.153. CORRECTION OF INVALID PROVISION OR
PROCEDURE. To the extent any provision or procedure under this
chapter causes a mandatory payment authorized under this chapter to
be ineligible for federal matching funds, the board may provide by
rule for an alternative provision or procedure that conforms to the
requirements of the federal Centers for Medicare and Medicaid
Services. A rule adopted under this section may not create, impose,
or materially expand the legal or financial liability or
responsibility of the district or an institutional health care
provider in the district beyond the provisions of this chapter.
This section does not require the board to adopt a rule.
SECTION 2. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2019.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 2448 passed the Senate on
April 17, 2019, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 2448 passed the House on
May 17, 2019, by the following vote: Yeas 129, Nays 18, two
present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor