Texas 2023 - 88th Regular

Texas House Bill HB4835 Compare Versions

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1	1	H.B. No. 4835
2	2
3	3
4	4	AN ACT
5	5	relating to the creation and operations of certain health care
6	6	provider participation programs.
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 292D to read as follows:
10	10	CHAPTER 292D. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
11	11	CERTAIN COUNTIES BORDERING NECHES RIVER
12	12	SUBCHAPTER A. GENERAL PROVISIONS
13	13	Sec. 292D.001. DEFINITIONS. In this chapter:
14	14	(1) "Institutional health care provider" means a
15	15	nonpublic hospital that provides inpatient hospital services.
16	16	(2) "Paying hospital" means an institutional health
17	17	care provider required to make a mandatory payment under this
18	18	chapter.
19	19	(3) "Program" means the county health care provider
20	20	participation program authorized by this chapter.
21	21	Sec. 292D.002. APPLICABILITY. This chapter applies only to
22	22	a county that:
23	23	(1) is not served by a hospital district;
24	24	(2) has a population of more than 250,000; and
25	25	(3) borders the Neches River.
26	26	Sec. 292D.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
27	27	PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
28	28	provider participation program authorizes a county to collect a
29	29	mandatory payment from each institutional health care provider
30	30	located in the county to be deposited in a local provider
31	31	participation fund established by the county. Money in the fund may
32	32	be used by the county as provided by Section 292D.103(c).
33	33	(b) The commissioners court may adopt an order authorizing a
34	34	county to participate in the program, subject to the limitations
35	35	provided by this chapter.
36	36	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
37	37	Sec. 292D.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
38	38	PAYMENTS. The commissioners court of a county may require a
39	39	mandatory payment authorized under this chapter by an institutional
40	40	health care provider in the county only in the manner provided by
41	41	this chapter.
42	42	Sec. 292D.052. MAJORITY VOTE REQUIRED. The commissioners
43	43	court of a county may not authorize the county to collect a
44	44	mandatory payment authorized under this chapter without an
45	45	affirmative vote of a majority of the members of the commissioners
46	46	court.
47	47	Sec. 292D.053. RULES AND PROCEDURES. The commissioners
48	48	court may adopt rules relating to the administration of the
49	49	program, including the collection of a mandatory payment,
50	50	expenditures, an audit, and any other administrative aspect of the
51	51	program.
52	52	Sec. 292D.054. INSTITUTIONAL HEALTH CARE PROVIDER
53	53	REPORTING; INSPECTION OF RECORDS. (a) If the commissioners court
54	54	of a county authorizes the county to participate in a program under
55	55	this chapter, the commissioners court shall require each
56	56	institutional health care provider to submit to the county a copy of
57	57	any financial and utilization data required by and reported to the
58	58	Department of State Health Services under Sections 311.032 and
59	59	311.033 and any rules adopted by the executive commissioner of the
60	60	Health and Human Services Commission to implement those sections.
61	61	(b) The commissioners court of a county that collects a
62	62	mandatory payment authorized under this chapter may inspect the
63	63	records of an institutional health care provider to the extent
64	64	necessary to ensure compliance with the requirements of Subsection
65	65	(a).
66	66	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
67	67	Sec. 292D.101. HEARING. (a) In each year that the
68	68	commissioners court of a county authorizes a program under this
69	69	chapter, the commissioners court shall hold a public hearing on the
70	70	amounts of any mandatory payments that the commissioners court
71	71	intends to require during the year and how the revenue derived from
72	72	those payments is to be spent.
73	73	(b) Not later than the fifth day before the date of the
74	74	hearing required under Subsection (a), the commissioners court of
75	75	the county shall publish notice of the hearing in a newspaper of
76	76	general circulation in the county and provide written notice of the
77	77	hearing to each institutional health care provider located in the
78	78	county.
79	79	(c) A representative of a paying hospital is entitled to
80	80	appear at the public hearing and be heard regarding any matter
81	81	related to the mandatory payments authorized under this chapter.
82	82	Sec. 292D.102. DEPOSITORY. (a) The commissioners court of
83	83	each county that collects a mandatory payment authorized under this
84	84	chapter by resolution shall designate one or more banks located in
85	85	the county as the depository for mandatory payments received by the
86	86	county.
87	87	(b) All income received by a county under this chapter,
88	88	including the revenue from mandatory payments remaining after
89	89	discounts and fees for assessing and collecting the payments are
90	90	deducted, shall be deposited with the county depository in the
91	91	county's local provider participation fund and may be withdrawn
92	92	only as provided by this chapter.
93	93	(c) All funds under this chapter shall be secured in the
94	94	manner provided for securing county funds.
95	95	Sec. 292D.103. LOCAL PROVIDER PARTICIPATION FUND;
96	96	AUTHORIZED USES OF MONEY. (a) Each county that collects a
97	97	mandatory payment authorized under this chapter shall create a
98	98	local provider participation fund.
99	99	(b) The local provider participation fund of a county
100	100	consists of:
101	101	(1) all revenue received by the county attributable to
102	102	mandatory payments authorized under this chapter, including any
103	103	penalties and interest attributable to delinquent payments;
104	104	(2) money received from the Health and Human Services
105	105	Commission as a refund of an intergovernmental transfer from the
106	106	county to the state for the purpose of providing the nonfederal
107	107	share of Medicaid supplemental payment program payments, provided
108	108	that the intergovernmental transfer does not receive a federal
109	109	matching payment; and
110	110	(3) the earnings of the fund.
111	111	(c) Money deposited to the local provider participation
112	112	fund may be used only to:
113	113	(1) fund intergovernmental transfers from the county
114	114	to the state to provide the nonfederal share of Medicaid payments
115	115	for:
116	116	(A) uncompensated care payments to nonpublic
117	117	hospitals, if those payments are authorized under the Texas
118	118	Healthcare Transformation and Quality Improvement Program waiver
119	119	issued under Section 1115 of the federal Social Security Act (42
120	120	U.S.C. Section 1315), or a successor waiver program authorizing
121	121	similar Medicaid supplemental payment programs;
122	122	(B) uniform rate enhancements for nonpublic
123	123	hospitals in the Medicaid managed care service area in which the
124	124	county is located;
125	125	(C) payments available under another waiver
126	126	program authorizing payments that are substantially similar to
127	127	Medicaid payments to nonpublic hospitals described by Paragraph (A)
128	128	or (B);
129	129	(D) payments to Medicaid managed care
130	130	organizations that are dedicated for payment to hospitals; or
131	131	(E) any reimbursement to nonpublic hospitals for
132	132	which federal matching funds are available;
133	133	(2) subject to Section 292D.151(d), pay the
134	134	administrative expenses of the county in administering the program,
135	135	including collateralization of deposits;
136	136	(3) refund all or a portion of a mandatory payment
137	137	collected in error from a paying hospital;
138	138	(4) refund to paying hospitals a proportionate share
139	139	of the money attributable to mandatory payments collected under
140	140	this chapter that the county:
141	141	(A) receives from the Health and Human Services
142	142	Commission that is not used to fund the nonfederal share of Medicaid
143	143	supplemental payment program payments; or
144	144	(B) determines cannot be used to fund the
145	145	nonfederal share of Medicaid supplemental payment program
146	146	payments;
147	147	(5) transfer funds to the Health and Human Services
148	148	Commission if the county is legally required to transfer the funds
149	149	to address a disallowance of federal matching funds with respect to
150	150	payments, rate enhancements, and reimbursements for which the
151	151	county made intergovernmental transfers described by Subdivision
152	152	(1); and
153	153	(6) reimburse the county if the county is required by
154	154	the rules governing the uniform rate enhancement program described
155	155	by Subdivision (1)(B) to incur an expense or forego Medicaid
156	156	reimbursements from the state because the balance of the local
157	157	provider participation fund is not sufficient to fund that rate
158	158	enhancement program.
159	159	(d) Money in the local provider participation fund may not
160	160	be commingled with other county funds.
161	161	(e) Notwithstanding any other provision of this chapter,
162	162	with respect to an intergovernmental transfer of funds described by
163	163	Subsection (c)(1) made by the county, any funds received by the
164	164	state or county as a result of the transfer may not be used by the
165	165	state, county, or any other entity to:
166	166	(1) expand Medicaid eligibility under the Patient
167	167	Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
168	168	by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
169	169	No. 111-152); or
170	170	(2) fund the nonfederal share of payments to nonpublic
171	171	hospitals available through the Medicaid disproportionate share
172	172	hospital program.
173	173	SUBCHAPTER D. MANDATORY PAYMENTS
174	174	Sec. 292D.151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
175	175	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if
176	176	the commissioners court of a county authorizes a program under this
177	177	chapter, the commissioners court may require an annual mandatory
178	178	payment to be assessed on the net patient revenue of each
179	179	institutional health care provider located in the county. The
180	180	commissioners court shall provide that the mandatory payment is to
181	181	be assessed at least annually, but not more often than
182	182	quarterly. In the first year in which the mandatory payment is
183	183	required, the mandatory payment is assessed on the net patient
184	184	revenue of an institutional health care provider as determined by
185	185	the data reported to the Department of State Health Services under
186	186	Sections 311.032 and 311.033 in the most recent fiscal year for
187	187	which that data was reported. If the institutional health care
188	188	provider did not report any data under those sections, the
189	189	provider's net patient revenue is the amount of that revenue as
190	190	contained in the provider's Medicare cost report submitted for the
191	191	previous fiscal year or for the closest subsequent fiscal year for
192	192	which the provider submitted the Medicare cost report. The
193	193	commissioners court shall update the amount of the mandatory
194	194	payment on an annual basis.
195	195	(b) The amount of a mandatory payment authorized under this
196	196	chapter must be uniformly proportionate with the amount of net
197	197	patient revenue generated by each paying hospital in the county. A
198	198	mandatory payment authorized under this chapter may not hold
199	199	harmless any institutional health care provider, as required under
200	200	42 U.S.C. Section 1396b(w).
201	201	(c) The commissioners court of a county that collects a
202	202	mandatory payment authorized under this chapter shall set the
203	203	amount of the mandatory payment. The aggregate amount of the
204	204	mandatory payment required of all paying hospitals may not exceed
205	205	six percent of the aggregate net patient revenue from hospital
206	206	services provided by all paying hospitals in the county.
207	207	(d) Subject to Subsection (c), the commissioners court of a
208	208	county that collects a mandatory payment authorized under this
209	209	chapter shall set the mandatory payments in amounts that in the
210	210	aggregate will generate sufficient revenue to cover the
211	211	administrative expenses of the county for activities under this
212	212	chapter and to fund an intergovernmental transfer described by
213	213	Section 292D.103(c)(1). The annual amount of revenue from mandatory
214	214	payments that may be used to pay the administrative expenses of the
215	215	county for activities under this chapter may not exceed $150,000,
216	216	plus the cost of collateralization of deposits, regardless of
217	217	actual expenses.
218	218	(e) A paying hospital may not add a mandatory payment
219	219	required under this section as a surcharge to a patient.
220	220	Sec. 292D.152. ASSESSMENT AND COLLECTION OF MANDATORY
221	221	PAYMENTS. (a) The county may collect or, using a competitive
222	222	bidding process, contract for the assessment and collection of
223	223	mandatory payments authorized under this chapter.
224	224	(b) The person charged by the county with the assessment and
225	225	collection of mandatory payments shall charge and deduct from the
226	226	mandatory payments collected for the county a collection fee in an
227	227	amount not to exceed the person's usual and customary charges for
228	228	like services.
229	229	(c) If the person charged with the assessment and collection
230	230	of mandatory payments is an official of the county, any revenue from
231	231	a collection fee charged under Subsection (b) shall be deposited in
232	232	the county general fund and, if appropriate, shall be reported as
233	233	fees of the county.
234	234	Sec. 292D.153. INTEREST, PENALTIES, AND
235	235	DISCOUNTS. Interest, penalties, and discounts on mandatory
236	236	payments required under this chapter are governed by the law
237	237	applicable to county ad valorem taxes.
238	238	Sec. 292D.154. PURPOSE; CORRECTION OF INVALID PROVISION OR
239	239	PROCEDURE. (a) The purpose of this chapter is to generate revenue
240	240	by collecting from institutional health care providers a mandatory
241	241	payment to be used to provide the nonfederal share of certain
242	242	Medicaid programs as described by Section 292D.103(c)(1).
243	243	(b) To the extent any provision or procedure under this
244	244	chapter causes a mandatory payment authorized under this chapter to
245	245	be ineligible for federal matching funds, the commissioners court
246	246	of the county administering the program may provide by rule for an
247	247	alternative provision or procedure that conforms to the
248	248	requirements of the federal Centers for Medicare and Medicaid
249	249	Services. A rule adopted under this section may not create, impose,
250	250	or materially expand the legal or financial liability or
251	251	responsibility of the county or an institutional health care
252	252	provider located in the county beyond the provisions of this
253	253	chapter. This section does not require the commissioners court of a
254	254	county to adopt a rule.
255	255	(c) The county may only assess and collect a mandatory
256	256	payment authorized under this chapter if a waiver program, uniform
257	257	rate enhancement, or reimbursement described by Section
258	258	292D.103(c)(1) is available to the county.
259	259	SECTION 2. Section 300.0003, Health and Safety Code, is
260	260	amended to read as follows:
261	261	Sec. 300.0003. APPLICABILITY. (a) Except as provided by
262	262	Subsection (b), this [This] chapter applies only to:
263	263	(1) a hospital district that is not participating in a
264	264	health care provider participation program authorized by another
265	265	chapter of this subtitle; and
266	266	(2) a county or municipality that:
267	267	(A) is not participating in a health care
268	268	provider participation program authorized by another chapter of
269	269	this subtitle; and
270	270	(B) is not served by a hospital district or a
271	271	public hospital.
272	272	(b) This chapter does not apply to a municipality that is
273	273	located in a county described by Section 292D.002.
274	274	SECTION 3. Chapter 295, Health and Safety Code, is
275	275	repealed.
276	276	SECTION 4. (a) In this section, "paying hospital" has the
277	277	meaning assigned by Section 295.001, Health and Safety Code.
278	278	(b) If on the date Chapter 295, Health and Safety Code, is
279	279	repealed by this Act a municipality to which that chapter applies
280	280	has not transferred any remaining amount of mandatory payments
281	281	assessed and collected by the municipality under that chapter
282	282	before its repeal to the Health and Human Services Commission, the
283	283	municipality shall refund to each paying hospital in the
284	284	municipality that hospital's proportionate share of the remaining
285	285	amount of mandatory payments.
286	286	(c) This section expires September 1, 2025.
287	287	SECTION 5. (a) Except as provided by Subsection (b) of this
288	288	section, this Act takes effect September 1, 2023.
289	289	(b) The section of this Act adding Chapter 292D, Health and
290	290	Safety Code, takes effect September 1, 2025.
291	291	______________________________ ______________________________
292	292	President of the Senate Speaker of the House
293	293	I certify that H.B. No. 4835 was passed by the House on May 2,
294	294	2023, by the following vote: Yeas 141, Nays 4, 1 present, not
295	295	voting.
296	296	______________________________
297	297	Chief Clerk of the House
298	298	I certify that H.B. No. 4835 was passed by the Senate on May
299	299	23, 2023, by the following vote: Yeas 30, Nays 1.
300	300	______________________________
301	301	Secretary of the Senate
302	302	APPROVED: _____________________
303	303	Date
304	304	_____________________
305	305	Governor