87R17270 JCG-D
By: Coleman H.B. No. 1338
Substitute the following for H.B. No. 1338:
By: Anderson C.S.H.B. No. 1338
A BILL TO BE ENTITLED
AN ACT
relating to the continuation and operations of a health care
provider participation program by the Harris County Hospital
District.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 299.001, Health and Safety Code, is
amended by adding Subdivision (6) to read as follows:
(6) "Qualifying assessment basis" means the health
care item, health care service, or other health care-related basis
consistent with 42 U.S.C. Section 1396b(w) on which the board
requires mandatory payments to be assessed under this chapter.
SECTION 2. Section 299.004, Health and Safety Code, is
amended to read as follows:
Sec. 299.004. EXPIRATION. (a) Subject to Section
299.153(d), the authority of the district to administer and operate
a program under this chapter expires December 31, 2023 [2021].
(b) This chapter expires December 31, 2023 [2021].
SECTION 3. Section 299.053, Health and Safety Code, is
amended to read as follows:
Sec. 299.053. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING. If the board authorizes the district to participate in a
program under this chapter, the board may [shall] require each
institutional health care provider to submit to the district a copy
of any financial and utilization data as reported in:
(1) the provider's Medicare cost report [submitted]
for the most recent [previous fiscal year or for the closest
subsequent] fiscal year for which the provider submitted the
Medicare cost report; or
(2) a report other than the report described by
Subdivision (1) that the board considers reliable and is submitted
by or to the provider for the most recent fiscal year.
SECTION 4. Section 299.103(c), Health and Safety Code, is
amended to read as follows:
(c) Money deposited to the local provider participation
fund of the district 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 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 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 299.151(d), pay the
administrative expenses of the district in administering the
program, including collateralization of deposits;
(3) refund a mandatory payment collected in error from
a paying provider;
(4) refund to a paying provider, in an amount that is
proportionate to the mandatory payments made under this chapter by
the provider during the 12 months preceding the date of the refund,
[providers a proportionate share of] the money attributable to
mandatory payments collected under this chapter 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; or
(B) determines cannot be used to fund the
nonfederal share of Medicaid supplemental payment program
payments; and
(5) transfer funds to the Health and Human Services
Commission if the district is legally required to transfer the
funds to address a disallowance of federal matching funds with
respect to programs for which the district made intergovernmental
transfers described by Subdivision (1).
SECTION 5. The heading to Section 299.151, Health and
Safety Code, is amended to read as follows:
Sec. 299.151. MANDATORY PAYMENTS [BASED ON PAYING PROVIDER
NET PATIENT REVENUE].
SECTION 6. Section 299.151, Health and Safety Code, is
amended by amending Subsections (a), (b), and (c) and adding
Subsections (a-1) and (a-2) to read as follows:
(a) If the board authorizes a health care provider
participation program under this chapter, the board may require [a]
mandatory payments [payment] to be assessed against each
institutional health care provider located in the district, either
annually or periodically throughout the year at the discretion of
the board, on the basis of a health care item, health care service,
or other health care-related basis that is consistent with the
requirements of 42 U.S.C. Section 1396b(w) [the net patient revenue
of each institutional health care provider located in the
district]. The qualifying assessment basis must be the same for
each institutional health care provider in the district. The board
shall provide an institutional health care provider written notice
of each assessment under this section [subsection], and the
provider has 30 calendar days following the date of receipt of the
notice to pay the assessment.
(a-1) Except as otherwise provided by this subsection, the
qualifying assessment basis must be determined by the board using
information contained in an institutional health care provider's
Medicare cost report for the most recent fiscal year for which the
provider submitted the report. If the provider is not required to
submit a Medicare cost report, or if the Medicare cost report
submitted by the provider does not contain information necessary to
determine the qualifying assessment basis, the qualifying
assessment basis may be determined by the board using information
contained in another report the board considers reliable that is
submitted by or to the provider for the most recent fiscal year. To
the extent practicable, the board shall use the same type of report
to determine the qualifying assessment basis for each paying
provider in the district.
(a-2) [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 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.] If [the] mandatory
payments are [payment is] required, the district shall update the
amount of the mandatory payments [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 uniformly proportionate with the qualifying
assessment basis for [amount of net patient revenue generated by]
each paying provider in the district as permitted under federal
law. A health care provider participation program authorized under
this chapter may not hold harmless any institutional health care
provider, as required under 42 U.S.C. Section 1396b(w).
(c) If the board requires a mandatory payment authorized
under this chapter, the board shall set the amount of the mandatory
payment, subject to the limitations of this chapter. The aggregate
amount of the mandatory payments required of all paying providers
in the district may not exceed six [four] percent of the aggregate
net patient revenue from hospital services provided by all paying
providers in the district.
SECTION 7. Subchapter D, Chapter 299, Health and Safety
Code, is amended by adding Section 299.154 to read as follows:
Sec. 299.154. REQUEST FOR CERTAIN RELIEF. If 42 U.S.C.
Section 1396b(w) or 42 C.F.R. Part 433 Subpart B is revised or
interpreted in a manner that impedes the operations of a program
under this chapter, and the operations may be improved by a request
for relief under 42 C.F.R. Section 433.72, the board may request the
Health and Human Services Commission to submit, and if requested
the commission shall submit, a request to the Centers for Medicare
and Medicaid Services for relief under 42 C.F.R. Section 433.72.
SECTION 8. 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, 2021.