Texas 2023 - 88th Regular

Texas House Bill HB4700 Compare Versions

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1	1	H.B. No. 4700
2	2
3	3
4	4	AN ACT
5	5	relating to the creation and operations of a health care provider
6	6	participation program by the Nacogdoches County Hospital District.
7	7	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	8	SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
9	9	amended by adding Chapter 298H to read as follows:
10	10	CHAPTER 298H. NACOGDOCHES COUNTY HOSPITAL DISTRICT HEALTH CARE
11	11	PROVIDER PARTICIPATION PROGRAM
12	12	SUBCHAPTER A. GENERAL PROVISIONS
13	13	Sec. 298H.001. DEFINITIONS. In this chapter:
14	14	(1) "Board" means the board of directors of the
15	15	district.
16	16	(2) "District" means the Nacogdoches County Hospital
17	17	District.
18	18	(3) "Institutional health care provider" means a
19	19	nonpublic hospital located in the district that provides inpatient
20	20	hospital services.
21	21	(4) "Paying provider" means an institutional health
22	22	care provider required to make a mandatory payment under this
23	23	chapter.
24	24	(5) "Program" means the health care provider
25	25	participation program authorized by this chapter.
26	26	Sec. 298H.002. APPLICABILITY. This chapter applies only to
27	27	the Nacogdoches County Hospital District.
28	28	Sec. 298H.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
29	29	PARTICIPATION IN PROGRAM. (a) The board may authorize the district
30	30	to participate in a health care provider participation program on
31	31	the affirmative vote of a majority of the board, subject to the
32	32	provisions of this chapter.
33	33	(b) The board may not authorize the district to participate
34	34	in a health care provider participation program under Chapter 300
35	35	or 300A.
36	36	Sec. 298H.004. EXPIRATION. (a) Subject to Section
37	37	298H.153(d), the authority of the district to administer and
38	38	operate a program under this chapter expires December 31, 2027.
39	39	(b) This chapter expires December 31, 2027.
40	40	SUBCHAPTER B. POWERS AND DUTIES OF BOARD
41	41	Sec. 298H.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
42	42	PAYMENT. The board may require a mandatory payment authorized
43	43	under this chapter by an institutional health care provider located
44	44	in the district only in the manner provided by this chapter.
45	45	Sec. 298H.052. RULES AND PROCEDURES. The board may adopt
46	46	rules relating to the administration of the program, including
47	47	collection of the mandatory payments, expenditures, audits, and
48	48	other administrative aspects of the program.
49	49	Sec. 298H.053. INSTITUTIONAL HEALTH CARE PROVIDER
50	50	REPORTING. If the board authorizes the district to participate in a
51	51	program under this chapter, the board may require each
52	52	institutional health care provider to submit to the district a copy
53	53	of any financial and utilization data reported in the provider's
54	54	Medicare cost report submitted for the most recent fiscal year for
55	55	which the provider submitted the Medicare cost report.
56	56	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
57	57	Sec. 298H.101. HEARING. (a) In each year that the board
58	58	authorizes a program under this chapter, the board shall hold a
59	59	public hearing on the amounts of any mandatory payments that the
60	60	board intends to require during the year and how the revenue derived
61	61	from those payments is to be spent.
62	62	(b) Not later than the fifth day before the date of the
63	63	hearing required under Subsection (a), the board shall publish
64	64	notice of the hearing in a newspaper of general circulation in the
65	65	district.
66	66	(c) A representative of a paying provider is entitled to
67	67	appear at the public hearing and be heard regarding any matter
68	68	related to the mandatory payments authorized under this chapter.
69	69	Sec. 298H.102. DEPOSITORY. (a) If the board requires a
70	70	mandatory payment authorized under this chapter, the board shall
71	71	designate one or more banks as a depository for the district's local
72	72	provider participation fund.
73	73	(b) All funds collected under this chapter shall be secured
74	74	in the manner provided for securing other district funds.
75	75	Sec. 298H.103. LOCAL PROVIDER PARTICIPATION FUND;
76	76	AUTHORIZED USES OF MONEY. (a) If the district requires a
77	77	mandatory payment authorized under this chapter, the district shall
78	78	create a local provider participation fund.
79	79	(b) The local provider participation fund consists of:
80	80	(1) all revenue received by the district attributable
81	81	to the mandatory payments authorized under this chapter;
82	82	(2) money received from the Health and Human Services
83	83	Commission as a refund of an intergovernmental transfer under the
84	84	program, provided that the intergovernmental transfer does not
85	85	receive a federal matching payment; and
86	86	(3) the earnings of the fund.
87	87	(c) Money deposited to the local provider participation
88	88	fund of the district may be used only to:
89	89	(1) fund intergovernmental transfers from the
90	90	district to the state to provide the nonfederal share of Medicaid
91	91	supplemental payments for:
92	92	(A) uncompensated care payments to nonpublic
93	93	hospitals, if those payments are authorized under the Texas
94	94	Healthcare Transformation and Quality Improvement Program waiver
95	95	issued under Section 1115 of the federal Social Security Act (42
96	96	U.S.C. Section 1315);
97	97	(B) rate enhancements for nonpublic hospitals in
98	98	the Medicaid managed care service area in which the district is
99	99	located;
100	100	(C) payments available under another waiver
101	101	program authorizing payments that are substantially similar to
102	102	Medicaid payments to nonpublic hospitals described by Paragraph (A)
103	103	or (B); or
104	104	(D) any reimbursement to nonpublic hospitals for
105	105	which federal matching funds are available;
106	106	(2) subject to Section 298H.151(d), pay the
107	107	administrative expenses of the district in administering the
108	108	program, including collateralization of deposits;
109	109	(3) refund a mandatory payment collected in error from
110	110	a paying provider;
111	111	(4) refund to paying providers a proportionate share
112	112	of the money that the district:
113	113	(A) receives from the Health and Human Services
114	114	Commission that is not used to fund the nonfederal share of Medicaid
115	115	supplemental payments or rate enhancements described by
116	116	Subdivision (1); or
117	117	(B) determines cannot be used to fund the
118	118	nonfederal share of Medicaid supplemental payments or rate
119	119	enhancements described by Subdivision (1); and
120	120	(5) transfer funds to the Health and Human Services
121	121	Commission if the district is legally required to transfer the
122	122	funds to address a disallowance of federal matching funds with
123	123	respect to Medicaid supplemental payments for which the district
124	124	made intergovernmental transfers described by Subdivision (1).
125	125	(d) Money in the local provider participation fund may not
126	126	be commingled with other district funds.
127	127	(e) Notwithstanding any other provision of this chapter,
128	128	with respect to an intergovernmental transfer of funds described by
129	129	Subsection (c)(1) made by the district, any funds received by the
130	130	state, district, or other entity as a result of that transfer may
131	131	not be used by the state, district, or other entity to expand
132	132	Medicaid eligibility under the Patient Protection and Affordable
133	133	Care Act (Pub. L. No. 111-148) as amended by the Health Care and
134	134	Education Reconciliation Act of 2010 (Pub. L. No. 111-152).
135	135	SUBCHAPTER D. MANDATORY PAYMENTS
136	136	Sec. 298H.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
137	137	NET PATIENT REVENUE. (a) If the board authorizes a health care
138	138	provider participation program under this chapter, the board may
139	139	require a mandatory payment to be assessed, either annually or
140	140	periodically throughout the year at the discretion of the board, on
141	141	the net patient revenue of each institutional health care provider
142	142	located in the district. The board shall provide an institutional
143	143	health care provider written notice of each assessment under this
144	144	subsection, and the provider has 30 calendar days following the
145	145	date of receipt of the notice to make the assessed mandatory
146	146	payment. In the first year in which the mandatory payment is
147	147	required, the mandatory payment is assessed on the net patient
148	148	revenue of an institutional health care provider, as determined by
149	149	the provider's Medicare cost report submitted for the most recent
150	150	fiscal year for which the provider submitted the Medicare cost
151	151	report. If the mandatory payment is required, the district shall
152	152	periodically update the amount of the mandatory payment.
153	153	(b) The amount of a mandatory payment authorized under this
154	154	chapter must be determined in a manner that ensures the revenue
155	155	generated qualifies for federal matching funds under federal law,
156	156	consistent with 42 U.S.C. Section 1396b(w).
157	157	(c) If the board requires a mandatory payment authorized
158	158	under this chapter, the board shall set the amount of the mandatory
159	159	payment, subject to the limitations of this chapter. The aggregate
160	160	amount of the mandatory payments required of all paying providers
161	161	in the district may not exceed six percent of the aggregate net
162	162	patient revenue from hospital services provided in the district.
163	163	(d) Subject to Subsection (c), if the board requires a
164	164	mandatory payment authorized under this chapter, the board shall
165	165	set the mandatory payments in amounts that in the aggregate will
166	166	generate sufficient revenue to cover the administrative expenses of
167	167	the district for activities under this chapter and to fund an
168	168	intergovernmental transfer described by Section 298H.103(c)(1).
169	169	The annual amount of revenue from the mandatory payments used by the
170	170	district may not exceed $150,000, plus the cost of
171	171	collateralization of deposits, regardless of actual expenses.
172	172	(e) A paying provider may not add a mandatory payment
173	173	required under this section as a surcharge to a patient.
174	174	(f) A mandatory payment assessed under this chapter is not a
175	175	tax for hospital purposes for purposes of Section 9, Article IX,
176	176	Texas Constitution, or Section 1069.301, Special District Local
177	177	Laws Code.
178	178	Sec. 298H.152. ASSESSMENT AND COLLECTION OF MANDATORY
179	179	PAYMENTS. (a) The district may designate an official of the
180	180	district or contract with another person to assess and collect the
181	181	mandatory payments authorized under this chapter.
182	182	(b) The person charged by the district with the assessment
183	183	and collection of the mandatory payments may not charge the
184	184	district a fee for assessing and collecting the payments unless the
185	185	district authorizes the fee in writing.
186	186	(c) If the person charged with the assessment and collection
187	187	of the mandatory payments is an official of the district, any
188	188	revenue from a fee authorized under Subsection (b) shall be
189	189	deposited in the district general fund and, if appropriate, shall
190	190	be reported as fees of the district.
191	191	Sec. 298H.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
192	192	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
193	193	chapter is to authorize the district to establish a program to
194	194	enable the district to collect the mandatory payments from
195	195	institutional health care providers to fund the nonfederal share of
196	196	a Medicaid supplemental payment program or the Medicaid managed
197	197	care rate enhancements for nonpublic hospitals to support the
198	198	provision of health care by institutional health care providers to
199	199	district residents in need of health care.
200	200	(b) This chapter does not authorize the district to collect
201	201	the mandatory payments for the purpose of raising general revenue
202	202	or any amount in excess of the amount reasonably necessary to:
203	203	(1) fund the nonfederal share of a Medicaid
204	204	supplemental payment program or the Medicaid managed care rate
205	205	enhancements for nonpublic hospitals; and
206	206	(2) cover the administrative expenses of the district
207	207	associated with activities under this chapter and other uses of the
208	208	fund described by Section 298H.103(c).
209	209	(c) To the extent any provision or procedure under this
210	210	chapter causes a mandatory payment authorized under this chapter to
211	211	be ineligible for federal matching funds, the board may provide by
212	212	rule for an alternative provision or procedure that conforms to the
213	213	requirements of the federal Centers for Medicare and Medicaid
214	214	Services. A rule adopted under this section may not create,
215	215	impose, or materially expand the legal or financial liability or
216	216	responsibility of the district or an institutional health care
217	217	provider in the district beyond the provisions of this
218	218	chapter. This section does not require the board to adopt a rule.
219	219	(d) The district may only assess and collect a mandatory
220	220	payment authorized under this chapter if a waiver program, rate
221	221	enhancement, or reimbursement described by Section 298H.103(c)(1)
222	222	is available for nonpublic hospitals located in the district.
223	223	SECTION 2. This Act takes effect immediately if it receives
224	224	a vote of two-thirds of all the members elected to each house, as
225	225	provided by Section 39, Article III, Texas Constitution. If this
226	226	Act does not receive the vote necessary for immediate effect, this
227	227	Act takes effect September 1, 2023.
228	228	______________________________ ______________________________
229	229	President of the Senate Speaker of the House
230	230	I certify that H.B. No. 4700 was passed by the House on April
231	231	28, 2023, by the following vote: Yeas 117, Nays 26, 2 present, not
232	232	voting.
233	233	______________________________
234	234	Chief Clerk of the House
235	235	I certify that H.B. No. 4700 was passed by the Senate on May
236	236	16, 2023, by the following vote: Yeas 30, Nays 1.
237	237	______________________________
238	238	Secretary of the Senate
239	239	APPROVED: _____________________
240	240	Date
241	241	_____________________
242	242	Governor