Texas 2021 - 87th Regular

Texas Senate Bill SB1073 Compare Versions

Only one version of the bill is available at this time.

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1	1	87R4842 JCG-F
2	2	By: Hughes S.B. No. 1073
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the operations of health care provider participation
8	8	programs in certain counties.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 291A.001, Health and Safety Code, is
11	11	amended by amending Subdivisions (1) and (2) and adding Subdivision
12	12	(4) to read as follows:
13	13	(1) "Institutional health care provider" means a
14	14	[nonpublic] hospital that is not owned and operated by a federal or
15	15	state government and provides inpatient hospital services. The term
16	16	includes a hospital that is owned and operated by a municipality or
17	17	county and provides inpatient hospital services.
18	18	(2) "Paying provider [hospital]" means an
19	19	institutional health care provider required to make a mandatory
20	20	payment under this chapter.
21	21	(4) "Qualifying assessment basis" means the health
22	22	care item, health care service, or other health care-related basis
23	23	consistent with 42 U.S.C. Section 1396b(w) on which a commissioners
24	24	court requires mandatory payments to be assessed under this
25	25	chapter.
26	26	SECTION 2. Section 291A.003(a), Health and Safety Code, is
27	27	amended to read as follows:
28	28	(a) A county health care provider participation program
29	29	authorizes a county to collect a mandatory payment from each
30	30	institutional health care provider located in the county to be
31	31	deposited in a local provider participation fund established by the
32	32	county. Money in the fund may be used by the county to fund certain
33	33	intergovernmental transfers [and indigent care programs] as
34	34	provided by this chapter.
35	35	SECTION 3. Section 291A.054(a), Health and Safety Code, is
36	36	amended to read as follows:
37	37	(a) The commissioners court of a county that collects a
38	38	mandatory payment authorized under this chapter may [shall] require
39	39	each institutional health care provider to submit to the county a
40	40	copy of any financial and utilization data as [required by and]
41	41	reported in:
42	42	(1) the provider's Medicare cost report for the most
43	43	recent fiscal year for which the provider submitted the Medicare
44	44	cost report; or
45	45	(2) a report other than the report described by
46	46	Subdivision (1) that the commissioners court considers reliable and
47	47	is submitted by or to the provider for the most recent fiscal year
48	48	[to the Department of State Health Services under Sections 311.032
49	49	and 311.033 and any rules adopted by the executive commissioner of
50	50	the Health and Human Services Commission to implement those
51	51	sections].
52	52	SECTION 4. Section 291A.101, Health and Safety Code, is
53	53	amended to read as follows:
54	54	Sec. 291A.101. HEARING. (a) Each year, the commissioners
55	55	court of a county that collects a mandatory payment authorized
56	56	under this chapter shall hold at least one [a] public hearing on the
57	57	amounts of the [any] mandatory payments that the commissioners
58	58	court intends to require during the year and how the revenue derived
59	59	from those payments is to be spent.
60	60	(b) Not later than the fifth day before the date of a [the]
61	61	hearing required under Subsection (a), the commissioners court of
62	62	the county shall publish notice of the hearing in a newspaper of
63	63	general circulation in the county.
64	64	(c) A representative of a paying provider [hospital] is
65	65	entitled to appear at the time and place designated in the public
66	66	notice and to be heard regarding any matter related to the mandatory
67	67	payments authorized under this chapter.
68	68	SECTION 5. Section 291A.103(c), Health and Safety Code, is
69	69	amended to read as follows:
70	70	(c) Money deposited to the local provider participation
71	71	fund may be used only to:
72	72	(1) fund intergovernmental transfers from the county
73	73	to the state to provide:
74	74	(A) the nonfederal share of [a] Medicaid
75	75	supplemental payment program payments authorized under the state
76	76	Medicaid plan, the Texas Healthcare Transformation and Quality
77	77	Improvement Program waiver issued under Section 1115 of the federal
78	78	Social Security Act (42 U.S.C. Section 1315), or a successor waiver
79	79	program authorizing similar Medicaid supplemental payment
80	80	programs; or
81	81	(B) payments to Medicaid managed care
82	82	organizations that are dedicated for payment to hospitals;
83	83	(2) [subsidize indigent programs;
84	84	[(3)] pay the administrative expenses of the county
85	85	solely for activities under this chapter;
86	86	(3) [(4)] refund a portion of a mandatory payment
87	87	collected in error from a paying provider [hospital]; and
88	88	(4) [(5)] refund to a paying provider, in an amount
89	89	that is proportionate to the mandatory payments made under this
90	90	chapter by the provider during the 12 months preceding the date of
91	91	the refund, the [hospitals the proportionate share of] money
92	92	attributable to mandatory payments collected under this chapter
93	93	that the county:
94	94	(A) receives from the Health and Human Services
95	95	Commission [received by the county] that is not used to fund the
96	96	nonfederal share of Medicaid supplemental payment program
97	97	payments; or
98	98	(B) determines cannot be used to fund the
99	99	nonfederal share of Medicaid supplemental payment program
100	100	payments.
101	101	SECTION 6. Section 291A.151, Health and Safety Code, is
102	102	amended to read as follows:
103	103	Sec. 291A.151. MANDATORY PAYMENTS [BASED ON PAYING HOSPITAL
104	104	NET PATIENT REVENUE]. (a) The [Except as provided by Subsection
105	105	(e), the] commissioners court of a county that authorizes a county
106	106	health care provider participation program [collects a mandatory
107	107	payment authorized] under this chapter may require [an annual]
108	108	mandatory payments [payment] to be assessed against [on the net
109	109	patient revenue of] each institutional health care provider located
110	110	in the county, either annually or periodically throughout the year
111	111	at the discretion of the commissioners court, on the basis of a
112	112	health care item, health care service, or other health care-related
113	113	basis that is consistent with the requirements of 42 U.S.C. Section
114	114	1396b(w). The commissioners court shall provide an institutional
115	115	health care provider written notice of each assessment under this
116	116	section not later than 30 days before the date the assessment is
117	117	due. The qualifying assessment basis must be the same for each
118	118	institutional health care provider in the county.
119	119	(a-1) Except as otherwise provided by this subsection, the
120	120	qualifying assessment basis must be determined by the commissioners
121	121	court using information contained in an institutional health care
122	122	provider's Medicare cost report for the most recent fiscal year for
123	123	which the provider submitted the report. If the provider is not
124	124	required to submit a Medicare cost report, or if the Medicare cost
125	125	report submitted by the provider does not contain information
126	126	necessary to determine the qualifying assessment basis, the
127	127	qualifying assessment basis may be determined by the commissioners
128	128	court using information contained in another report the
129	129	commissioners court considers reliable that is submitted by or to
130	130	the provider for the most recent fiscal year. To the extent
131	131	practicable, the commissioners court shall use the same type of
132	132	report to determine the qualifying assessment basis for each paying
133	133	provider in the county.
134	134	(a-2) If mandatory payments are required, the [The]
135	135	commissioners court [may provide for the mandatory payment to be
136	136	assessed quarterly. In the first year in which the mandatory
137	137	payment is required, the mandatory payment is assessed on the net
138	138	patient revenue of an institutional health care provider as
139	139	determined by the data reported to the Department of State Health
140	140	Services under Sections 311.032 and 311.033 in the fiscal year
141	141	ending in 2015 or, if the institutional health care provider did not
142	142	report any data under those sections in that fiscal year, as
143	143	determined by the institutional health care provider's Medicare
144	144	cost report submitted for the 2015 fiscal year or for the closest
145	145	subsequent fiscal year for which the provider submitted the
146	146	Medicare cost report. The county] shall update the amount of the
147	147	mandatory payments periodically [payment on an annual basis].
148	148	(b) The amount of a mandatory payment authorized under this
149	149	chapter must be determined in a manner that ensures the revenue
150	150	generated qualifies for federal matching funds under federal law,
151	151	consistent with [uniformly proportionate with the amount of net
152	152	patient revenue generated by each paying hospital in the county. A
153	153	mandatory payment authorized under this chapter may not hold
154	154	harmless any institutional health care provider, as required under]
155	155	42 U.S.C. Section 1396b(w).
156	156	(c) The commissioners court of a county that authorizes a
157	157	county health care provider participation program [collects a
158	158	mandatory payment authorized] under this chapter shall set the
159	159	amount of the mandatory payment. The amount of the mandatory
160	160	payment required of each paying provider [hospital] may not exceed
161	161	an amount that, when added to the amount of the mandatory payments
162	162	required from all other paying providers in the county, equals an
163	163	amount of revenue that exceeds six percent of the aggregate net
164	164	patient revenue of all paying providers in the county [hospital's
165	165	net patient revenue].
166	166	(d) Subject to the maximum amount prescribed by Subsection
167	167	(c), the commissioners court of a county that collects a mandatory
168	168	payment authorized under this chapter shall set the mandatory
169	169	payments in amounts that in the aggregate will generate sufficient
170	170	revenue to cover the administrative expenses of the county for
171	171	activities under this chapter and [,] to fund the nonfederal share
172	172	of Medicaid supplemental payment program payments [an
173	173	intergovernmental transfer described by Section 291A.103(c)(1),
174	174	and to pay for indigent programs], except that the amount of revenue
175	175	from mandatory payments used for administrative expenses of the
176	176	county for activities under this chapter in a year may not exceed
177	177	the lesser of four percent of the total revenue generated from the
178	178	mandatory payment or $20,000.
179	179	(e) A paying provider [hospital] may not add a mandatory
180	180	payment required under this section as a surcharge to a patient.
181	181	SECTION 7. Section 291A.154, Health and Safety Code, is
182	182	amended to read as follows:
183	183	Sec. 291A.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
184	184	PROCEDURE. (a) The purpose of this chapter is to generate revenue
185	185	by collecting from institutional health care providers a mandatory
186	186	payment to be used to provide the nonfederal share of [a] Medicaid
187	187	supplemental payment program payments.
188	188	(b) To the extent any provision or procedure under this
189	189	chapter causes a mandatory payment authorized under this chapter to
190	190	be ineligible for federal matching funds, a [the] county that
191	191	authorizes a county health care provider participation program
192	192	under this chapter may provide by rule for an alternative provision
193	193	or procedure that conforms to the requirements of the federal
194	194	Centers for Medicare and Medicaid Services. A rule adopted under
195	195	this section may not create, impose, or materially expand the legal
196	196	or financial liability or responsibility of the county or an
197	197	institutional health care provider in the county beyond the
198	198	provisions of this chapter. This section does not require the
199	199	commissioners court to adopt a rule.
200	200	(c) This chapter does not authorize a county that authorizes
201	201	a county health care provider participation program under this
202	202	chapter to collect mandatory payments for the purpose of raising
203	203	general revenue or any amount in excess of the amount reasonably
204	204	necessary for the purposes described by Sections 291A.103(c)(1) and
205	205	(2).
206	206	SECTION 8. Section 292.001, Health and Safety Code, is
207	207	amended by amending Subdivisions (1) and (2) and adding Subdivision
208	208	(4) to read as follows:
209	209	(1) "Institutional health care provider" means a
210	210	[nonpublic] hospital that is not owned and operated by a federal or
211	211	state government and provides inpatient hospital services. The term
212	212	includes a hospital that is owned and operated by a municipality or
213	213	county and provides inpatient hospital services.
214	214	(2) "Paying provider [hospital]" means an
215	215	institutional health care provider required to make a mandatory
216	216	payment under this chapter.
217	217	(4) "Qualifying assessment basis" means the health
218	218	care item, health care service, or other health care-related basis
219	219	consistent with 42 U.S.C. Section 1396b(w) on which a commissioners
220	220	court requires mandatory payments to be assessed under this
221	221	chapter.
222	222	SECTION 9. Section 292.003(a), Health and Safety Code, is
223	223	amended to read as follows:
224	224	(a) A county health care provider participation program
225	225	authorizes a county to collect a mandatory payment from each
226	226	institutional health care provider located in the county to be
227	227	deposited in a local provider participation fund established by the
228	228	county. Money in the fund may be used by the county to fund certain
229	229	intergovernmental transfers [and indigent care programs] as
230	230	provided by this chapter.
231	231	SECTION 10. Section 292.054(a), Health and Safety Code, is
232	232	amended to read as follows:
233	233	(a) The commissioners court of a county that collects a
234	234	mandatory payment authorized under this chapter may [shall] require
235	235	each institutional health care provider to submit to the county a
236	236	copy of any financial and utilization data as [required by and]
237	237	reported in:
238	238	(1) the provider's Medicare cost report for the most
239	239	recent fiscal year for which the provider submitted the Medicare
240	240	cost report; or
241	241	(2) a report other than the report described by
242	242	Subdivision (1) that the commissioners court considers reliable and
243	243	is submitted by or to the provider for the most recent fiscal year
244	244	[to the Department of State Health Services under Sections 311.032
245	245	and 311.033 and any rules adopted by the executive commissioner of
246	246	the Health and Human Services Commission to implement those
247	247	sections].
248	248	SECTION 11. Section 292.101, Health and Safety Code, is
249	249	amended to read as follows:
250	250	Sec. 292.101. HEARING. (a) Each year, the commissioners
251	251	court of a county that collects a mandatory payment authorized
252	252	under this chapter shall hold at least one [a] public hearing on the
253	253	amounts of the [any] mandatory payments that the commissioners
254	254	court intends to require during the year and how the revenue derived
255	255	from those payments is to be spent.
256	256	(b) Not later than the fifth day before the date of a [the]
257	257	hearing required under Subsection (a), the commissioners court of
258	258	the county shall publish notice of the hearing in a newspaper of
259	259	general circulation in the county.
260	260	(c) A representative of a paying provider [hospital] is
261	261	entitled to appear at the time and place designated in the public
262	262	notice and to be heard regarding any matter related to the mandatory
263	263	payments authorized under this chapter.
264	264	SECTION 12. Section 292.103(c), Health and Safety Code, is
265	265	amended to read as follows:
266	266	(c) Money deposited to the local provider participation
267	267	fund may be used only to:
268	268	(1) fund intergovernmental transfers from the county
269	269	to the state to provide:
270	270	(A) the nonfederal share of [a] Medicaid
271	271	supplemental payment program payments authorized under the state
272	272	Medicaid plan, the Texas Healthcare Transformation and Quality
273	273	Improvement Program waiver issued under Section 1115 of the federal
274	274	Social Security Act (42 U.S.C. Section 1315), or a successor waiver
275	275	program authorizing similar Medicaid supplemental payment
276	276	programs; or
277	277	(B) payments to Medicaid managed care
278	278	organizations that are dedicated for payment to hospitals;
279	279	(2) [subsidize indigent programs;
280	280	[(3)] pay the administrative expenses of the county
281	281	solely for activities under this chapter;
282	282	(3) [(4)] refund a portion of a mandatory payment
283	283	collected in error from a paying provider [hospital]; and
284	284	(4) [(5)] refund to a paying provider, in an amount
285	285	that is proportionate to the mandatory payments made under this
286	286	chapter by the provider during the 12 months preceding the date of
287	287	the refund, the [hospitals the proportionate share of] money
288	288	attributable to mandatory payments collected under this chapter
289	289	that the county:
290	290	(A) receives [received by the county] from the
291	291	Health and Human Services Commission that is not used to fund the
292	292	nonfederal share of Medicaid supplemental payment program
293	293	payments; or [and]
294	294	(B) [(6) refund to paying hospitals the
295	295	proportionate share of money that the county] determines cannot be
296	296	used to fund the nonfederal share of Medicaid supplemental payment
297	297	program payments.
298	298	SECTION 13. Section 292.151, Health and Safety Code, is
299	299	amended to read as follows:
300	300	Sec. 292.151. MANDATORY PAYMENTS [BASED ON PAYING HOSPITAL
301	301	NET PATIENT REVENUE]. (a) The [Except as provided by Subsection
302	302	(e), the] commissioners court of a county that authorizes a county
303	303	health care provider participation program [collects a mandatory
304	304	payment authorized] under this chapter may require [an annual]
305	305	mandatory payments [payment] to be assessed against [on the net
306	306	patient revenue of] each institutional health care provider located
307	307	in the county, either annually or periodically throughout the year
308	308	at the discretion of the commissioners court, on the basis of a
309	309	health care item, health care service, or other health care-related
310	310	basis that is consistent with the requirements of 42 U.S.C. Section
311	311	1396b(w). The commissioners court shall provide an institutional
312	312	health care provider written notice of each assessment under this
313	313	section not later than 30 days before the date the assessment is
314	314	due. The qualifying assessment basis must be the same for each
315	315	institutional health care provider in the county.
316	316	(a-1) Except as otherwise provided by this subsection, the
317	317	qualifying assessment basis must be determined by the commissioners
318	318	court using information contained in an institutional health care
319	319	provider's Medicare cost report for the most recent fiscal year for
320	320	which the provider submitted the report. If the provider is not
321	321	required to submit a Medicare cost report, or if the Medicare cost
322	322	report submitted by the provider does not contain information
323	323	necessary to determine the qualifying assessment basis, the
324	324	qualifying assessment basis may be determined by the commissioners
325	325	court using information contained in another report the
326	326	commissioners court considers reliable that is submitted by or to
327	327	the provider for the most recent fiscal year. To the extent
328	328	practicable, the commissioners court shall use the same type of
329	329	report to determine the qualifying assessment basis for each paying
330	330	provider in the county.
331	331	(a-2) If mandatory payments are required, the [The]
332	332	commissioners court [may provide for the mandatory payment to be
333	333	assessed quarterly. In the first year in which the mandatory
334	334	payment is required, the mandatory payment is assessed on the net
335	335	patient revenue of an institutional health care provider as
336	336	determined by the data reported to the Department of State Health
337	337	Services under Sections 311.032 and 311.033 in the fiscal year
338	338	ending in 2013 or, if the institutional health care provider did not
339	339	report any data under those sections in that fiscal year, as
340	340	determined by the institutional health care provider's Medicare
341	341	cost report submitted for the 2013 fiscal year or for the closest
342	342	subsequent fiscal year for which the provider submitted the
343	343	Medicare cost report. The county] shall update the amount of the
344	344	mandatory payments periodically [payment on an annual basis].
345	345	(b) The amount of a mandatory payment authorized under this
346	346	chapter must be determined in a manner that ensures the revenue
347	347	generated qualifies for federal matching funds under federal law,
348	348	consistent with [uniformly proportionate with the amount of net
349	349	patient revenue generated by each paying hospital in the county. A
350	350	mandatory payment authorized under this chapter may not hold
351	351	harmless any institutional health care provider, as required under]
352	352	42 U.S.C. Section 1396b(w).
353	353	(c) The commissioners court of a county that authorizes a
354	354	county health care provider participation program [collects a
355	355	mandatory payment authorized] under this chapter shall set the
356	356	amount of the mandatory payment. The amount of the mandatory
357	357	payment required of each paying provider [hospital] may not exceed
358	358	an amount that, when added to the amount of the mandatory payments
359	359	required from all other paying providers [hospitals] in the county,
360	360	equals an amount of revenue that exceeds six percent of the
361	361	aggregate net patient revenue of all paying providers [hospitals]
362	362	in the county.
363	363	(d) Subject to the maximum amount prescribed by Subsection
364	364	(c), the commissioners court of a county that collects a mandatory
365	365	payment authorized under this chapter shall set the mandatory
366	366	payments in amounts that in the aggregate will generate sufficient
367	367	revenue to cover the administrative expenses of the county for
368	368	activities under this chapter and [,] to fund the nonfederal share
369	369	of [a] Medicaid supplemental payment program payments, [and to pay
370	370	for indigent programs,] except that the amount of revenue from
371	371	mandatory payments used for administrative expenses of the county
372	372	for activities under this chapter in a year may not exceed the
373	373	lesser of four percent of the total revenue generated from the
374	374	mandatory payment or $20,000.
375	375	(e) A paying provider [hospital] may not add a mandatory
376	376	payment required under this section as a surcharge to a patient.
377	377	SECTION 14. Section 292.154, Health and Safety Code, is
378	378	amended to read as follows:
379	379	Sec. 292.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
380	380	PROCEDURE. (a) The purpose of this chapter is to generate revenue
381	381	by collecting from institutional health care providers a mandatory
382	382	payment to be used to provide the nonfederal share of [a] Medicaid
383	383	supplemental payment program payments.
384	384	(b) To the extent any provision or procedure under this
385	385	chapter causes a mandatory payment authorized under this chapter to
386	386	be ineligible for federal matching funds, a [the] county that
387	387	authorizes a county health care provider participation program
388	388	under this chapter may provide by rule for an alternative provision
389	389	or procedure that conforms to the requirements of the federal
390	390	Centers for Medicare and Medicaid Services. A rule adopted under
391	391	this section may not create, impose, or materially expand the legal
392	392	or financial liability or responsibility of the county or an
393	393	institutional health care provider in the county beyond the
394	394	provisions of this chapter. This section does not require the
395	395	commissioners court to adopt a rule.
396	396	(c) This chapter does not authorize a county that authorizes
397	397	a county health care provider participation program under this
398	398	chapter to collect mandatory payments for the purpose of raising
399	399	general revenue or any amount in excess of the amount reasonably
400	400	necessary for the purposes described by Sections 292.103(c)(1) and
401	401	(2).
402	402	SECTION 15. This Act takes effect immediately if it
403	403	receives a vote of two-thirds of all the members elected to each
404	404	house, as provided by Section 39, Article III, Texas Constitution.
405	405	If this Act does not receive the vote necessary for immediate
406	406	effect, this Act takes effect September 1, 2021.