87R11192 JCG-F
By: Hinojosa S.B. No. 1328
A BILL TO BE ENTITLED
AN ACT
relating to the operation of certain health care provider
participation programs in this state.
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 300B to read as follows:
CHAPTER 300B. PROVISIONS GENERALLY APPLICABLE TO HEALTH CARE
PROVIDER PARTICIPATION PROGRAMS
Sec. 300B.0001. DEFINITION. In this chapter, "qualifying
local government" means a county, municipality, hospital district,
or county health care funding district established under Chapter
288 to which this chapter applies under Section 300B.0002.
Sec. 300B.0002. APPLICABILITY. This chapter applies only
to:
(1) a hospital district that is participating in a
health care provider participation program authorized by another
chapter of this subtitle; and
(2) a county, municipality, or health care funding
district established under Chapter 288 that is:
(A) participating in a health care provider
participation program authorized by another chapter of this
subtitle; and
(B) not served by a hospital district or a public
hospital.
Sec. 300B.0003. CONFLICT OF LAWS. This chapter prevails
over another provision of this subtitle to the extent of any
conflict.
Sec. 300B.0004. ASSESSMENT BASIS. (a) The governing body
of a qualifying local government may require mandatory payments to
be assessed against each institutional health care provider located
in the qualifying local government 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)
and 42 C.F.R. Section 433.68.
(b) A qualifying local government that requires mandatory
payments to be assessed in the manner provided by this section is
not required to assess mandatory payments on the net patient
revenue of each institutional health care provider located in the
qualifying local government.
Sec. 300B.0005. ADDITIONAL REPORTING. The governing body
of a qualifying local government that is unable to assess mandatory
payments in a manner consistent with the requirements of 42 U.S.C.
Section 1396b(w) and 42 C.F.R. Section 433.68 using information
reported to the governing body by an institutional health care
provider may require the institutional health care provider to
submit additional information to the governing body if the
information is necessary to ensure mandatory payments are assessed
in a manner consistent with those requirements.
Sec. 300B.0006. WAIVER REQUEST. (a) Subject to Subsection
(b), the governing body of a qualifying local government may
request the Health and Human Services Commission to submit on the
governing body's behalf a request to the Centers for Medicare and
Medicaid Services for a waiver of any provision of federal law that:
(1) relates to the operation of a health care provider
participation program; and
(2) requires:
(A) mandatory payments to be assessed on each
institutional health care provider located in the qualifying local
government; or
(B) the amount of a mandatory payment to be
uniformly proportionate with the amount of net patient revenue of
the institutional health care provider against which the payment is
assessed.
(b) The governing body of a qualifying local government may
submit a request under Subsection (a) only if:
(1) federal law is amended by the United States
Congress or interpreted by the Centers for Medicare and Medicaid
Services in a manner that impedes the operation of the health care
provider participation program authorized by the qualifying local
government;
(2) the governing body of the qualifying local
government determines that the waiver would wholly or partly remove
the impediment described by Subdivision (1); and
(3) the Centers for Medicare and Medicaid Services are
authorized by law to grant the waiver.
(c) If the governing body of a qualifying local government
submits a request under Subsection (a) to the Health and Human
Services Commission, the commission shall submit a request for a
waiver on behalf of the qualifying local government to the Centers
for Medicare and Medicaid Services. The commission shall include
with the waiver request any supporting documentation provided by
the governing body of the qualifying local government.
(d) If the waiver is granted by the Centers for Medicare and
Medicaid Services, the governing body of the qualifying local
government is not required to comply with any provision of this
subtitle or other law that imposes a requirement that is
substantially equivalent to a requirement that is the subject of
the waiver during the period for which the waiver is in effect.
SECTION 2. Section 298C.004, Health and Safety Code, as
added by Chapter 694 (S.B. 2315), Acts of the 86th Legislature,
Regular Session, 2019, 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 3. Section 298E.103(e), Health and Safety Code, is
amended to read as follows:
(e) Notwithstanding any other provision of this chapter,
with respect to an intergovernmental transfer of funds described by
Subsection (c)(1) made by a district, any funds received by the
state, district, or other entity as a result of that transfer may
not be used by the state, district, or any other entity to:
(1) 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); or
(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 4. 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 5. 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 6. Chapters 289 and 290, Health and Safety Code, are
repealed.
SECTION 7. 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.