88R6128 MPF-F
By: Blanco S.B. No. 849
A BILL TO BE ENTITLED
AN ACT
relating to the continuation and operations of a health care
provider participation program by the El Paso County Hospital
District.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 298G.001, Health and Safety Code, is
amended by adding Subdivision (6) to read as follows:
(6) "Qualifying assessment basis" means any basis
consistent with 42 U.S.C. Section 1396b(w) on which the board
requires mandatory payments to be assessed under this chapter.
SECTION 2. Section 298G.004, Health and Safety Code, is
amended to read as follows:
Sec. 298G.004. EXPIRATION. (a) Subject to Section
298G.153(d), the authority of the district to administer and
operate a program under this chapter expires December 31, 2027
[2023].
(b) This chapter expires December 31, 2027 [2023].
SECTION 3. Section 298G.053, Health and Safety Code, is
amended to read as follows:
Sec. 298G.053. INSTITUTIONAL HEALTH CARE PROVIDER
REPORTING. If the board authorizes the district to participate in a
program under this chapter, the board may [shall] require each
institutional health care provider to submit to the district a copy
of any financial and utilization data reported in:
(1) the provider's Medicare cost report [submitted]
for the most recent [previous fiscal year or for the closest
subsequent] fiscal year for which the provider submitted the
Medicare cost report; or
(2) a report other than the report described by
Subdivision (1) that the board considers reliable and is submitted
by or to the provider for the most recent fiscal year.
SECTION 4. Section 298G.103(c), Health and Safety Code, is
amended to read as follows:
(c) Money deposited to the local provider participation
fund of the district may be used only to:
(1) fund intergovernmental transfers from the
district to the state to provide the nonfederal share of:
(A) any payment to nonpublic hospitals, if those
payments are authorized under the Texas Healthcare Transformation
and Quality Improvement Program waiver issued under Section 1115 of
the federal Social Security Act (42 U.S.C. Section 1315); or
(B) Medicaid payments for:
(i) uniform rate enhancements for nonpublic
hospitals in the Medicaid managed care service area in which the
district is located;
(ii) payments available under another
waiver program authorizing payments that are substantially similar
to Medicaid payments described by Paragraph (A) or Subparagraph (i)
to nonpublic hospitals or any payments to Medicaid managed care
organizations for the benefit of nonpublic hospitals; or
(iii) any reimbursement to nonpublic
hospitals located in the district for which federal matching funds
are available;
(2) subject to Section 298G.151(d), pay the
administrative expenses of the district in administering the
program, including collateralization of deposits;
(3) refund a mandatory payment collected in error from
a paying provider;
(4) refund to a paying provider, in an amount that is
proportionate to the mandatory payments made under this chapter by
the provider during the 12 months preceding the date of the refund,
[providers a proportionate share of] the money that the district:
(A) receives from the Health and Human Services
Commission that is not used to fund the nonfederal share of Medicaid
payments; or
(B) determines cannot be used to fund the
nonfederal share of Medicaid supplemental payment program
payments; and
(5) transfer funds to the Health and Human Services
Commission if the district is legally required to transfer the
funds to address a disallowance of federal matching funds with
respect to programs for which the district made intergovernmental
transfers described by Subdivision (1).
SECTION 5. The heading to Section 298G.151, Health and
Safety Code, is amended to read as follows:
Sec. 298G.151. MANDATORY PAYMENTS [BASED ON PAYING PROVIDER
NET PATIENT REVENUE].
SECTION 6. Section 298G.151, Health and Safety Code, is
amended by amending Subsections (a), (b), and (c) and adding
Subsections (a-1) and (a-2) to read as follows:
(a) If the board authorizes a health care provider
participation program under this chapter, the board may require a
mandatory payment to be assessed against each institutional
provider located in the district, either annually or periodically
throughout the year at the discretion of the board, on a qualifying
assessment basis [the net patient revenue of each institutional
health care provider located in the district]. The qualifying
assessment basis must be the same for each institutional health
care provider in the district. The board shall provide an
institutional health care provider written notice of each
assessment under this section [subsection], and the provider has 30
calendar days following the date of receipt of the notice to make
the assessed mandatory payment.
(a-1) Except as otherwise provided by this subsection, the
qualifying assessment basis must be determined by the board using
information contained in an institutional health care provider's
Medicare cost report for the most recent fiscal year for which the
provider submitted the report. If the provider is not required to
submit a Medicare cost report, or if the Medicare cost report
submitted by the provider does not contain information necessary to
determine the qualifying assessment basis, the qualifying
assessment basis may be determined by the board using information
contained in another report the board considers reliable that is
submitted by or to the provider for the most recent fiscal year. To
the extent practicable, the board shall use the same type of report
to determine the qualifying assessment basis for each paying
provider in the district.
(a-2) [In the first year in which the mandatory payment is
required, the mandatory payment is assessed on the net patient
revenue of an institutional health care provider, as determined by
the provider's Medicare cost report submitted for the previous
fiscal year or for the closest subsequent fiscal year for which the
provider submitted the Medicare cost report.] If a [the] mandatory
payment is required, the district shall periodically update the
amount of the mandatory payment [on an annual basis].
(b) The amount of a mandatory payment authorized under this
chapter must be determined in a manner that ensures [uniformly
proportionate with] the [amount of net patient] revenue generated
qualifies for federal matching funds [by each paying provider in
the district as permitted] under federal law, consistent with [. A
health care provider participation program authorized under this
chapter may not hold harmless any paying provider, as required
under] 42 U.S.C. Section 1396b(w).
(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 percent of the aggregate net
patient revenue from hospital services provided [by all paying
providers] in the district.
SECTION 7. Subchapter D, Chapter 298G, Health and Safety
Code, is amended by adding Section 298G.154 to read as follows:
Sec. 298G.154. INTEREST AND PENALTIES. The district may
impose and collect interest and penalties on delinquent mandatory
payments assessed under this chapter in any amount that does not
exceed the maximum amount authorized for other delinquent payments
owed to the district.
SECTION 8. 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, 2023.