By: Coleman H.B. No. 3085
A BILL TO BE ENTITLED
AN ACT
relating to health care provider participation programs in this
State.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Title 4, Health and Safety Code, is amended by
adding Subtitle D-1 before Chapter 288 as follows:
Subtitle D-1. PROVIDER PARTICIPATION PROGRAMS
SECTION 2. Chapter 289, Health and Safety Code, is deleted
and replaced by the following new Chapter 289 to read as follows:
CHAPTER 289. PROVISIONS OF GENERAL APPLICABILITY TO PROVIDER
PARTICIPATION PROGRAMS
Sec. 289.0001 PURPOSE. This chapter provides provisions
that apply to all provider participation programs in this Subtitle
D-1, including those operated by a county health care funding
district under Chapter 288.
Sec. 289.0101. BASIS FOR MANDATORY PAYMENTS.
Notwithstanding language elsewhere in this Subtitle D-1, a local
government administering a program under this subtitle may utilize
a basis other than the net patient revenue of each institutional
health care provider to compute the mandatory payments.
Specifically, a local government entity administering a program
under this subtitle may utilize any basis permitted by federal law
at 42 U.S.C. Section 1396b(w) and 42 C.F.R. Section 433.68.
Sec. 289.0102. DOCUMENTATION. If the documentation, that
is to be submitted by institutional health care providers to the
local government as specified elsewhere in this Subtitle D-1, is
insufficient for a local government to assure that all
institutional health care providers are assessed a mandatory
payment that is consistent with this subtitle and federal law at 42
U.S.C. Section 1396b(w) and 42 C.F.R. Section 433.68, a local
government may require and use additional documentation to
effectuate that purpose.
Sec. 289.0103. AUTHORITY TO REQUEST WAIVER. If federal law
at 42 U.S.C. Section 1396b(w) or 42 C.F.R. Part 433 Subpart B is
revised, or interpreted by the Centers for Medicare & Medicaid
Services, in ways that impede the operation of local provider
participation programs, and a local government administering a
program under this subtitle determines that it would be beneficial
for the Health and Human Services Commission to obtain a waiver from
the Centers for Medicare & Medicaid Services as permitted by 42
U.S.C. Section 1396b(w)(3) and 42 C.F.R. Section 433.68(e), then
the local government may request that the Commission submit such
waiver request. If a request is submitted to the Commission, the
Commission shall submit such waiver request to the Centers for
Medicare & Medicaid Services on behalf of the local government,
along with documentation justifying that waiver request provided by
the local government. If the waiver request is granted, then the
local government, consistent with the terms of the waiver granted,
need not comply with requirements elsewhere in this subtitle that
mandatory payments be assessed on each provider and that the amount
of the mandatory payment be uniformly proportionate with the amount
of net patient revenue.
SECTION 3. Chapter 290, Health and Safety Code, is deleted.
SECTION 4. Section 298C.004, Health and Safety Code, is
amended to read as follows:
Sec. 298C.004. EXPIRATION. (a) Subject to Section
298C.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 5. Section 298E.103(e)(2), Health and Safety Code,
is amended to read as follows:
(2) fund the nonfederal share of payments to hospitals
available through [the Medicaid disproportionate share hospital
program or] the delivery system reform incentive payment program.
SECTION 6. 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 7. Section 299.151(c), Health and Safety Code, is
amended to read as follows:
(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 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.