Texas 2023 - 88th Regular

Texas House Bill HB4110 Compare Versions

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Version 2 (New)

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1	1	By: Guillen H.B. No. 4110
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to certain administrative penalties and procedures
7	7	associated with aging, community-based, and long-term care service
8	8	providers and the establishment of a task force to study certain
9	9	rules and policies related to those services.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 161.089, Human Resources Code, is
12	12	amended by amending Subsections (b), (c), (c-1), (e), (f), and (g)
13	13	and adding Subsections (b-1), (g-1), and (g-2) to read as follows:
14	14	(b) Subject to Subsection (b-1), the [The] commission may
15	15	assess and collect an administrative penalty against a provider who
16	16	participates in a program to which this section applies for a
17	17	violation of a law or rule relating to the program. If the
18	18	commission assesses an administrative penalty against a provider
19	19	for a violation of a law or rule, the commission may not impose a
20	20	payment hold against or otherwise withhold contract payments from
21	21	the provider for the same violation of a law or rule.
22	22	(b-1) The commission may not assess an administrative
23	23	penalty under this section for minor violations unless those
24	24	violations are of a continuing nature or are not corrected by the
25	25	provider.
26	26	(c) The [After consulting with appropriate stakeholders,
27	27	the] executive commissioner by rule shall [develop and adopt rules
28	28	regarding the imposition of administrative penalties under this
29	29	section. The rules must]:
30	30	(1) specify each violation that warrants [the types of
31	31	violations that warrant] imposition of an administrative penalty
32	32	based on:
33	33	(A) the seriousness of the violation, including:
34	34	(i) the nature, circumstances, extent, and
35	35	gravity of the violation; and
36	36	(ii) the hazard created by the violation to
37	37	the health and safety of an individual; and
38	38	(B) whether the provider had identified the
39	39	violation as part of the provider's internal quality assurance
40	40	process and made appropriate progress on correcting the identified
41	41	violation;
42	42	(2) establish a schedule of appropriate and graduated
43	43	penalties for each [progressive administrative penalties in
44	44	accordance with the relative type, frequency, and seriousness of a]
45	45	violation based on:
46	46	(A) the seriousness of the violation, including:
47	47	(i) the nature, circumstances, extent, and
48	48	gravity of the violation; and
49	49	(ii) the hazard created by the violation to
50	50	the health and safety of an individual;
51	51	(B) the provider's history of previous
52	52	violations;
53	53	(C) whether the provider had identified the
54	54	violation as part of the provider's internal quality assurance
55	55	process and made appropriate progress on correcting the identified
56	56	violation;
57	57	(D) the amount necessary to deter future
58	58	violations;
59	59	(E) other than for a violation identified under
60	60	Paragraph (C), the provider's effort to correct the violation; and
61	61	(F) any other matters that justice may require;
62	62	(3) prescribe reasonable amounts to be imposed for
63	63	each violation giving rise to an administrative penalty, subject to
64	64	Subdivision (4);
65	65	(4) authorize the imposition of an administrative
66	66	penalty in an amount not to exceed $5,000 for each violation;
67	67	(5) provide that a provider commits a separate
68	68	violation each day the provider continues to violate the law or
69	69	rule, except that each day of a violation occurring before the day
70	70	on which the provider receives written notice of the violation from
71	71	the commission does not constitute a separate violation and is
72	72	considered to be one violation;
73	73	(6) ensure standard and consistent application of
74	74	administrative penalties throughout the state; and
75	75	(7) provide for an administrative appeals process to
76	76	adjudicate claims and appeals relating to the imposition of an
77	77	administrative penalty under this section that is in accordance
78	78	with Chapter 2001, Government Code[; and
79	79	[(8) ensure standard and consistent interpretation of
80	80	service delivery rules and consistent application of
81	81	administrative penalties throughout this state].
82	82	(c-1) The [On adoption of the rules under Subsection (c),
83	83	the] executive commissioner shall maintain [develop]
84	84	interpretative guidelines for regulatory staff and providers
85	85	regarding the imposition of administrative penalties under this
86	86	section.
87	87	(e) Except as provided by Subsection (f), the executive
88	88	commissioner by rule shall provide to a provider who has
89	89	implemented a plan of correction a reasonable period of time
90	90	following the first day of a [date the commission sends notice to
91	91	the provider of the] violation to correct the violation before the
92	92	commission may assess an administrative penalty. [The period may
93	93	not be less than 45 days.]
94	94	(f) The commission may assess an administrative penalty on
95	95	provision of written notice of a violation to a provider without
96	96	providing the provider with a reasonable period of time [to a
97	97	provider] to correct the violation if the violation:
98	98	(1) [represents a pattern of violation that] results
99	99	in serious [actual] harm or death;
100	100	(2) constitutes a serious threat to health or safety
101	101	and was not corrected by the provider or the provider has not made
102	102	demonstrable progress toward correcting the violation before
103	103	receiving the notice of the violation from the commission [is
104	104	widespread in scope and results in actual harm]; or
105	105	(3) [is widespread in scope and constitutes a
106	106	potential for actual harm;
107	107	[(4) constitutes an immediate threat to the health or
108	108	safety of a recipient;
109	109	[(5) substantially limits the provider's ability to
110	110	provide care; or
111	111	[(6)] is a violation in which a provider:
112	112	(A) wilfully interferes with the work of a
113	113	representative of the commission or the enforcement of a law
114	114	relating to a program to which this section applies;
115	115	(B) fails to pay a penalty assessed by the
116	116	commission under this section not later than the 10th day after the
117	117	date the assessment of the penalty becomes final, subject to
118	118	Section 161.0891; or
119	119	(C) fails to submit a plan of correction not
120	120	later than the 10th day after the date the provider receives a
121	121	statement of the violation.
122	122	(g) Notwithstanding any other provision of this section, an
123	123	administrative penalty ceases to be incurred on the date a
124	124	violation is corrected. For purposes of this section, the date of
125	125	correction is the date identified by the provider and submitted to
126	126	the commission with evidence of the correction. Penalties do not
127	127	accrue for a violation until a provider receives written notice of
128	128	the violation and of all elements of the violation that must be
129	129	corrected by the provider to achieve compliance.
130	130	(g-1) Notwithstanding requirements for a provider to notify
131	131	the service planning team of a significant change in condition, if
132	132	the commission identifies a violation resulting from a deficiency
133	133	of services authorized in a service plan, including potential
134	134	hazards to the health and safety of an individual, the commission
135	135	shall provide an amount of time determined sufficient by the
136	136	commission for the service planning team to modify the service plan
137	137	before imposing an administrative penalty.
138	138	(g-2) Notwithstanding any other law, the commission may
139	139	waive or reduce any applicable penalty if the commission determines
140	140	that strict enforcement of the rule or law would impose a hardship
141	141	or otherwise not be in the best interest of persons supported by the
142	142	provider.
143	143	SECTION 2. Section 161.0891(g), Human Resources Code, is
144	144	amended to read as follows:
145	145	(g) The commission may not offer amelioration to a provider:
146	146	(1) more than three times in a two-year period;
147	147	(2) more than one time in a two-year period for the
148	148	same or similar violation; or
149	149	(3) for a violation that resulted in [hazard to the
150	150	health or safety of a recipient, including] serious harm to or death
151	151	of a recipient[, or that substantially limits the provider's
152	152	ability to provide care].
153	153	SECTION 3. (a) In this section:
154	154	(1) "Commission" means the Health and Human Services
155	155	Commission.
156	156	(2) "Executive commissioner" means the executive
157	157	commissioner of the commission.
158	158	(3) "Task force" means the home and community-based
159	159	services waiver program regulation task force established by this
160	160	section.
161	161	(b) The commission shall establish the home and
162	162	community-based services waiver program regulation task force to:
163	163	(1) review all rules and policies adopted by the
164	164	commission that are applicable to services provided under the home
165	165	and community-based services (HCS) and Texas home living (TxHmL)
166	166	Medicaid waiver program; and
167	167	(2) provide to the executive commissioner
168	168	recommendations on:
169	169	(A) clarifying the rules and policies;
170	170	(B) reducing administrative burdens; and
171	171	(C) repealing or reversing any duplicative or
172	172	conflicting rules or policies that are not required by state or
173	173	federal law.
174	174	(c) Not later than December 1, 2023, the executive
175	175	commissioner shall appoint the following members to the task force:
176	176	(1) representatives of providers under the home and
177	177	community-based services (HCS) and Texas home living (TxHmL)
178	178	Medicaid waiver programs; and
179	179	(2) representatives of appropriate health and human
180	180	services agency functions, including regulatory, waiver, and
181	181	billing functions.
182	182	(d) Not later than December 1, 2024, the commission shall
183	183	prepare and submit to the legislature a report that includes:
184	184	(1) recommendations made by the task force; and
185	185	(2) any administrative changes made by the commission
186	186	as a result of those recommendations.
187	187	(e) This section expires September 1, 2025.
188	188	SECTION 4. The following provisions of the Human Resources
189	189	Code are repealed:
190	190	(1) Sections 161.089(d) and (h); and
191	191	(2) Section 161.0891(h).
192	192	SECTION 5. Section 161.089, Human Resources Code, as
193	193	amended by this Act, applies only to a violation that occurs on or
194	194	after the effective date of this Act. A violation that occurs before
195	195	the effective date of this Act is governed by the law in effect on
196	196	the date the violation occurred, and that law is continued in effect
197	197	for that purpose.
198	198	SECTION 6. This Act takes effect immediately if it receives
199	199	a vote of two-thirds of all the members elected to each house, as
200	200	provided by Section 39, Article III, Texas Constitution. If this
201	201	Act does not receive the vote necessary for immediate effect, this
202	202	Act takes effect September 1, 2023.