Texas 2019 - 86th Regular

Texas Senate Bill SB2448 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	S.B. No. 2448
	1	+	By: Perry S.B. No. 2448
	2	+	(Burrows)
2	3
3	4
	5	+	A BILL TO BE ENTITLED
4	6		AN ACT
5	7		relating to the creation and operations of a health care provider
6	8		participation program by the Lubbock County Hospital District of
7	9		Lubbock County, Texas.
8	10		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	11		SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
10	12		amended by adding Chapter 298C to read as follows:
11	13		CHAPTER 298C. LUBBOCK COUNTY HOSPITAL DISTRICT OF LUBBOCK COUNTY,
12	14		TEXAS: HEALTH CARE PROVIDER PARTICIPATION PROGRAM
13	15		SUBCHAPTER A. GENERAL PROVISIONS
14	16		Sec. 298C.001. PURPOSE. The purpose of this chapter is to
15	17		authorize the district to administer a health care provider
16	18		participation program to provide additional compensation to
17	19		nonpublic hospitals by collecting mandatory payments from each
18	20		nonpublic hospital in the district to be used to provide the
19	21		nonfederal share of a Medicaid supplemental payment program and for
20	22		other purposes as authorized under this chapter.
21	23		Sec. 298C.002. DEFINITIONS. In this chapter:
22	24		(1) "Board" means the board of hospital managers of
23	25		the district.
24	26		(2) "District" means the Lubbock County Hospital
25	27		District of Lubbock County, Texas.
26	28		(3) "Institutional health care provider" means a
27	29		nonpublic hospital located in the district that provides inpatient
28	30		hospital services.
29	31		(4) "Paying hospital" means an institutional health
30	32		care provider required to make a mandatory payment under this
31	33		chapter.
32	34		(5) "Program" means the health care provider
33	35		participation program authorized by this chapter.
34	36		Sec. 298C.003. APPLICABILITY. This chapter applies only to
35	37		the Lubbock County Hospital District of Lubbock County, Texas.
36	38		Sec. 298C.004. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
37	39		PARTICIPATION IN PROGRAM. The board may authorize the district to
38	40		participate in a health care provider participation program on the
39	41		affirmative vote of a majority of the board, subject to the
40	42		provisions of this chapter.
41	43		SUBCHAPTER B. POWERS AND DUTIES OF BOARD
42	44		Sec. 298C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
43	45		PAYMENT. The board may require a mandatory payment authorized
44	46		under this chapter from an institutional health care provider in
45	47		the district only in the manner provided by this chapter.
46	48		Sec. 298C.052. INSTITUTIONAL HEALTH CARE PROVIDER
47	49		REPORTING. If the board authorizes the district to participate in a
48	50		program under this chapter, the board shall require each
49	51		institutional health care provider to submit to the district a copy
50	52		of any financial and utilization data required by and reported to
51	53		the Department of State Health Services under Sections 311.032 and
52	54		311.033 and any rules adopted by the executive commissioner of the
53	55		Health and Human Services Commission to implement those sections.
54	56		Sec. 298C.053. RULES AND PROCEDURES. The board may adopt
55	57		rules relating to the administration of the health care provider
56	58		participation program, including collection of the mandatory
57	59		payments, expenditures, audits, and any other administrative
58	60		aspects of the program.
59	61		SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
60	62		Sec. 298C.101. HEARING. (a) In each year that the board
61	63		authorizes a program under this chapter, the board shall hold a
62	64		public hearing on the amounts of any mandatory payments that the
63	65		board intends to require during the year and how the revenue derived
64	66		from those payments is to be spent.
65	67		(b) Not later than the fifth day before the date of the
66	68		hearing required under Subsection (a), the board shall publish
67	69		notice of the hearing in a newspaper of general circulation in the
68	70		district and provide written notice of the hearing to the chief
69	71		operating officer of each institutional health care provider in the
70	72		district.
71	73		(c) The board's determination of the amount of mandatory
72	74		payments to be collected during the year must be shown to be based
73	75		on reasonable estimates of the amount of revenue necessary to fund
74	76		intergovernmental transfers from the district to the state
75	77		providing the nonfederal share of payments described by Section
76	78		298C.103(b)(1) that is otherwise unfunded.
77	79		Sec. 298C.102. LOCAL PROVIDER PARTICIPATION FUND;
78	80		DEPOSITORY. (a) If the board collects a mandatory payment
79	81		authorized under this chapter, the board shall create a local
80	82		provider participation fund in one or more banks located in the
81	83		district that are designated by the district as a depository for
82	84		public funds.
83	85		(b) All money received by the district under this chapter,
84	86		including the amount of revenue from mandatory payments remaining
85	87		after deducting any discounts and fees for assessing and collecting
86	88		the payments, shall be deposited with a depository designated under
87	89		Subsection (a).
88	90		(c) The board may withdraw or use money in the fund only for
89	91		a purpose authorized under this chapter.
90	92		(d) All funds collected under this chapter shall be secured
91	93		in the manner provided by Chapter 1053, Special District Local Laws
92	94		Code, for securing public funds of the district.
93	95		Sec. 298C.103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY.
94	96		(a) The local provider participation fund established under
95	97		Section 298C.102 consists of:
96	98		(1) all mandatory payments authorized under this
97	99		chapter and received by the district;
98	100		(2) money received from the Health and Human Services
99	101		Commission as a refund of an intergovernmental transfer from the
100	102		district to the state as the nonfederal share of Medicaid
101	103		supplemental payment program payments, provided that the
102	104		intergovernmental transfer does not receive a federal matching
103	105		payment; and
104	106		(3) the earnings of the fund.
105	107		(b) Money deposited to the local provider participation
106	108		fund may be used only to:
107	109		(1) fund intergovernmental transfers from the
108	110		district to the state to provide the nonfederal share of Medicaid
109	111		payments for:
110	112		(A) uncompensated care and delivery system
111	113		reform incentive payments to nonpublic hospitals, if those payments
112	114		are authorized under the Texas Healthcare Transformation and
113	115		Quality Improvement Program waiver issued under Section 1115 of the
114	116		federal Social Security Act (42 U.S.C. Section 1315);
115	117		(B) uniform rate enhancements for nonpublic
116	118		hospitals in the Medicaid managed care service area in which the
117	119		district is located;
118	120		(C) payments available to nonpublic hospitals
119	121		under another waiver program authorizing payments that are
120	122		substantially similar to Medicaid payments to nonpublic hospitals
121	123		described by Paragraph (A) or (B); or
122	124		(D) any reimbursement to nonpublic hospitals for
123	125		which federal matching funds are available;
124	126		(2) subject to Section 298C.151(d), pay the
125	127		administrative expenses of the district in administering the
126	128		program, including collateralization of deposits;
127	129		(3) refund a portion of a mandatory payment collected
128	130		in error from a paying hospital; and
129	131		(4) refund to paying hospitals a proportionate share
130	132		of the money that the district:
131	133		(A) receives from the Health and Human Services
132	134		Commission that is not used to fund the nonfederal share of Medicaid
133	135		supplemental payment program payments described by Subdivision
134	136		(1); or
135	137		(B) determines cannot be used to fund the
136	138		nonfederal share of Medicaid supplemental payment program payments
137	139		described by Subdivision (1).
138	140		(c) Money in the local provider participation fund may not
139	141		be commingled with other district funds.
140	142		(d) An intergovernmental transfer of funds described by
141	143		Subsection (b)(1) and any funds received by the district as a result
142	144		of an intergovernmental transfer described by that subsection may
143	145		not be used by the district or any other entity to expand Medicaid
144	146		eligibility under the Patient Protection and Affordable Care Act
145	147		(Pub. L. No. 111-148) as amended by the Health Care and Education
146	148		Reconciliation Act of 2010 (Pub. L. No. 111-152).
147	149		SUBCHAPTER D. MANDATORY PAYMENTS
148	150		Sec. 298C.151. MANDATORY PAYMENTS. (a) If the board
149	151		authorizes a program under this chapter, the board shall require an
150	152		annual mandatory payment to be assessed on the net patient revenue
151	153		of each institutional health care provider located in the district.
152	154		The board may provide that the mandatory payment is to be collected
153	155		at least annually, but not more often than quarterly. In the first
154	156		year in which the mandatory payment is required, the mandatory
155	157		payment is assessed on the net patient revenue of an institutional
156	158		health care provider as determined by the data reported to the
157	159		Department of State Health Services under Sections 311.032 and
158	160		311.033 in the most recent fiscal year for which that data was
159	161		reported. If the institutional health care provider did not report
160	162		any data under those sections, the provider's net patient revenue
161	163		is the amount of that revenue as contained in the provider's
162	164		Medicare cost report submitted for the previous fiscal year or for
163	165		the closest subsequent fiscal year for which the provider submitted
164	166		the Medicare cost report. The district shall update the amount of
165	167		the mandatory payment on an annual basis and may update the amount
166	168		on a more frequent basis.
167	169		(b) The amount of a mandatory payment authorized under this
168	170		chapter must be a uniform percentage of the amount of net patient
169	171		revenue generated by each paying hospital in the district. A
170	172		mandatory payment authorized under this chapter may not hold
171	173		harmless any institutional health care provider, as required under
172	174		42 U.S.C. Section 1396b(w).
173	175		(c) The aggregate amount of the mandatory payments required
174	176		of all paying hospitals in the district may not exceed six percent
175	177		of the aggregate net patient revenue of all paying hospitals in the
176	178		district.
177	179		(d) Subject to the maximum amount prescribed by Subsection
178	180		(c) and this subsection, the board shall set the mandatory payments
179	181		in amounts that in the aggregate will generate sufficient revenue
180	182		to cover the administrative expenses of the district for activities
181	183		under this chapter, fund an intergovernmental transfer described by
182	184		Section 298C.103(b)(1), or make other payments authorized under
183	185		this chapter. The amount of the mandatory payments must be based on
184	186		reasonable estimates of the amount of revenue necessary to cover
185	187		the administrative expenses, intergovernmental transfers, and
186	188		other payments described by this subsection as authorized under
187	189		this chapter. The amount of revenue from mandatory payments that
188	190		may be used for administrative expenses by the district in a year
189	191		may not exceed $25,000, plus the cost of collateralization of
190	192		deposits. If the board demonstrates to the paying hospitals that
191	193		the costs of administering the program under this chapter,
192	194		excluding those costs associated with the collateralization of
193	195		deposits, exceed $25,000 in any year, on consent of all of the
194	196		paying hospitals, the district may use additional revenue from
195	197		mandatory payments received under this chapter to compensate the
196	198		district for its administrative expenses. A paying hospital may
197	199		not unreasonably withhold consent to compensate the district for
198	200		administrative expenses.
199	201		(e) A paying hospital may not add a mandatory payment
200	202		required under this section as a surcharge to a patient or insurer.
201	203		(f) A mandatory payment under this chapter is not a tax for
202	204		purposes of Section 9, Article IX, Texas Constitution, or Chapter
203	205		1053, Special District Local Laws Code.
204	206		Sec. 298C.152. ASSESSMENT AND COLLECTION OF MANDATORY
205	207		PAYMENTS. The district may collect or contract for the assessment
206	208		and collection of mandatory payments authorized under this chapter.
207	209		Sec. 298C.153. CORRECTION OF INVALID PROVISION OR
208	210		PROCEDURE. To the extent any provision or procedure under this
209	211		chapter causes a mandatory payment authorized under this chapter to
210	212		be ineligible for federal matching funds, the board may provide by
211	213		rule for an alternative provision or procedure that conforms to the
212	214		requirements of the federal Centers for Medicare and Medicaid
213	215		Services. A rule adopted under this section may not create, impose,
214	216		or materially expand the legal or financial liability or
215	217		responsibility of the district or an institutional health care
216	218		provider in the district beyond the provisions of this chapter.
217	219		This section does not require the board to adopt a rule.
218	220		SECTION 2. If before implementing any provision of this Act
219	221		a state agency determines that a waiver or authorization from a
220	222		federal agency is necessary for implementation of that provision,
221	223		the agency affected by the provision shall request the waiver or
222	224		authorization and may delay implementing that provision until the
223	225		waiver or authorization is granted.
224	226		SECTION 3. This Act takes effect immediately if it receives
225	227		a vote of two-thirds of all the members elected to each house, as
226	228		provided by Section 39, Article III, Texas Constitution. If this
227	229		Act does not receive the vote necessary for immediate effect, this
228	230		Act takes effect September 1, 2019.
229		-	______________________________ ______________________________
230		-	President of the Senate Speaker of the House
231		-	I hereby certify that S.B. No. 2448 passed the Senate on
232		-	April 17, 2019, by the following vote: Yeas 31, Nays 0.
233		-	______________________________
234		-	Secretary of the Senate
235		-	I hereby certify that S.B. No. 2448 passed the House on
236		-	May 17, 2019, by the following vote: Yeas 129, Nays 18, two
237		-	present not voting.
238		-	______________________________
239		-	Chief Clerk of the House
240		-	Approved:
241		-	______________________________
242		-	Date
243		-	______________________________
244		-	Governor