LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION April 4, 2023 TO: Honorable Victoria Neave Criado, Chair, House Committee on County Affairs FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB4775 by Darby (Relating to the operations of certain local health care provider participation programs.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB4775, As Introduced : a negative impact of ($3,671,020) through the biennium ending August 31, 2025. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2024($1,862,149)2025($1,808,871)2026($1,810,631)2027($1,812,410)2028($1,814,210)All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGeneral Revenue Fund1 Probable (Cost) fromGR Match For Medicaid758 Probable (Cost) fromFederal Funds555 Change in Number of State Employees from FY 20232024($1,283,750)($578,399)($590,128)16.02025($1,240,640)($568,231)($600,296)16.02026($1,242,064)($568,567)($599,960)16.02027($1,243,504)($568,906)($599,621)16.02028($1,244,960)($569,250)($599,277)16.0 Fiscal AnalysisThe bill would define qualifying assessment basis as any basis consistent with 42. U.S.C Section 1396b(w) on which a commissioners court of a county requires mandatory payments to be assessed. The bill would remove the requirement that the commissioners court shall require a health care provider to submit certain financial data and would amend the type of data that may be collected.The bill would allow a commissioners court to request that the Health and Human Services Commission (HHSC) submit a request for relief, or waiver of certain federal requirements, to ensure the provider participation program is administered efficiently.The bill would allow the commissioners court to assess the mandatory payment on a qualifying assessment basis, not net patient revenue.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 88TH LEGISLATIVE REGULAR SESSION
April 4, 2023
TO: Honorable Victoria Neave Criado, Chair, House Committee on County Affairs FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB4775 by Darby (Relating to the operations of certain local health care provider participation programs.), As Introduced
TO: Honorable Victoria Neave Criado, Chair, House Committee on County Affairs
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB4775 by Darby (Relating to the operations of certain local health care provider participation programs.), As Introduced
Honorable Victoria Neave Criado, Chair, House Committee on County Affairs
Honorable Victoria Neave Criado, Chair, House Committee on County Affairs
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB4775 by Darby (Relating to the operations of certain local health care provider participation programs.), As Introduced
HB4775 by Darby (Relating to the operations of certain local health care provider participation programs.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for HB4775, As Introduced : a negative impact of ($3,671,020) through the biennium ending August 31, 2025. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
Estimated Two-year Net Impact to General Revenue Related Funds for HB4775, As Introduced : a negative impact of ($3,671,020) through the biennium ending August 31, 2025. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
General Revenue-Related Funds, Five- Year Impact:
2024 ($1,862,149)
2025 ($1,808,871)
2026 ($1,810,631)
2027 ($1,812,410)
2028 ($1,814,210)
All Funds, Five-Year Impact:
2024 ($1,283,750) ($578,399) ($590,128) 16.0
2025 ($1,240,640) ($568,231) ($600,296) 16.0
2026 ($1,242,064) ($568,567) ($599,960) 16.0
2027 ($1,243,504) ($568,906) ($599,621) 16.0
2028 ($1,244,960) ($569,250) ($599,277) 16.0
Fiscal Analysis
The bill would define qualifying assessment basis as any basis consistent with 42. U.S.C Section 1396b(w) on which a commissioners court of a county requires mandatory payments to be assessed. The bill would remove the requirement that the commissioners court shall require a health care provider to submit certain financial data and would amend the type of data that may be collected.The bill would allow a commissioners court to request that the Health and Human Services Commission (HHSC) submit a request for relief, or waiver of certain federal requirements, to ensure the provider participation program is administered efficiently.The bill would allow the commissioners court to assess the mandatory payment on a qualifying assessment basis, not net patient revenue.
Methodology
The analysis assumes HHSC would require 16.0 Full-time Equivalents (FTE) to evaluate the collection of mandatory payments from institutional healthcare providers to ensure compliance with federal regulations. The analysis assumes 1.0 Financial Analyst III, 1.0 Financial Analyst IV, 1.0 Financial Examiner V, 1.0 Financial Examiner VI, 1.0 Financial Examiner VII, would be required to conduct financial examinations to ensure the local governmental entity's basis of the mandatory payments uses credible data sources.Additionally, 1.0 Project Manager IV, 6.0 Program Specialists VII, 1.0 Manager VII, 2.0 Attorneys IV, and 1.0 Attorney V would be required for coordination with the local entity to establish rules and apply for and negotiate a waiver of uniformity from the U.S. Department of Health and Human Services and to ensure that the assessment of mandatory payments complies with federal requirements that the funds are permissible for the non-federal share used in the Texas Medicaid program.The nonfederal share of Texas Medicaid supplemental payments is supported largely by local public provider funds provided to HHSC by intergovernmental transfer. HHSC reports that there would be a significant impact to funds received through the intergovernmental transfer and federal funds for Medicaid and CHIP client services while a waiver application is pending. HHSC estimates the All Funds decrease to be $64,831,404 in fiscal year 2024 and $64,831,404 in fiscal year 2025 and on. This does not affect the state's General Revenue funds.
Technology
FTE-related technology costs are estimated to be $51,421 in fiscal year 2024 and $8,381 in each subsequent year.
Local Government Impact
According to the Health and Human Services Commission, local units of government operating public hospitals and clinics as Medicaid provider could experience decreased revenue from provider payments.
Source Agencies: b > td > 529 Health and Human Services Commission
529 Health and Human Services Commission
LBB Staff: b > td > JMc, AF, ER, CST, NV
JMc, AF, ER, CST, NV