Texas 2025 - 89th Regular

Texas House Bill HB3305 Compare Versions

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1	1	89R21594 SRA-D
2	2	By: Richardson H.B. No. 3305
3	3	Substitute the following for H.B. No. 3305:
4	4	By: Bell of Montgomery C.S.H.B. No. 3305
5	5
6	6
7	7
8	8
9	9	A BILL TO BE ENTITLED
10	10	AN ACT
11	11	relating to the creation and operations of a health care provider
12	12	participation program in certain counties.
13	13	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
14	14	SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
15	15	amended by adding Chapter 292F to read as follows:
16	16	CHAPTER 292F. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
17	17	CERTAIN COUNTIES
18	18	SUBCHAPTER A. GENERAL PROVISIONS
19	19	Sec. 292F.001. DEFINITIONS. In this chapter:
20	20	(1) "Institutional health care provider" means a
21	21	nonpublic hospital that provides inpatient hospital services.
22	22	(2) "Paying provider" means an institutional health
23	23	care provider required to make a mandatory payment under this
24	24	chapter.
25	25	(3) "Program" means a county health care provider
26	26	participation program authorized by this chapter.
27	27	Sec. 292F.002. APPLICABILITY. This chapter applies only to
28	28	a county that:
29	29	(1) is not served by a hospital district;
30	30	(2) has a population of one million or more;
31	31	(3) contains all or part of a municipality with a
32	32	population of one million or more; and
33	33	(4) is adjacent to a county with a population of 2.5
34	34	million or more.
35	35	Sec. 292F.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
36	36	PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
37	37	provider participation program authorizes a county to collect a
38	38	mandatory payment from each institutional health care provider
39	39	located in the county to be deposited in a local provider
40	40	participation fund established by the county. Money in the fund may
41	41	be used by the county as provided by Section 292F.103(c).
42	42	(b) The commissioners court of a county may adopt an order
43	43	authorizing the county to participate in the program, subject to
44	44	the limitations provided by this chapter.
45	45	Sec. 292F.004. EXPIRATION. (a) Subject to Section
46	46	292F.153(c), the authority of the county to administer and operate
47	47	a program under this chapter expires December 31, 2030.
48	48	(b) This chapter expires December 31, 2030.
49	49	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
50	50	Sec. 292F.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
51	51	PAYMENTS. The commissioners court of a county may require a
52	52	mandatory payment under this chapter by an institutional health
53	53	care provider in the county only in the manner provided by this
54	54	chapter.
55	55	Sec. 292F.052. MAJORITY VOTE REQUIRED. The commissioners
56	56	court of a county may not authorize the county to collect a
57	57	mandatory payment under this chapter without an affirmative vote of
58	58	a majority of the members of the commissioners court.
59	59	Sec. 292F.053. RULES AND PROCEDURES. After the
60	60	commissioners court of a county has voted to require a mandatory
61	61	payment authorized under this chapter, the commissioners court may
62	62	adopt rules relating to the administration of the program,
63	63	including the collection of a mandatory payment, expenditures, an
64	64	audit, and any other administrative aspect of the program.
65	65	Sec. 292F.054. INSTITUTIONAL HEALTH CARE PROVIDER
66	66	REPORTING. If the commissioners court of a county authorizes the
67	67	county to participate in a program under this chapter, the
68	68	commissioners court shall require each institutional health care
69	69	provider to submit to the county a copy of any financial and
70	70	utilization data required by and reported to the Department of
71	71	State Health Services under Sections 311.032 and 311.033 and any
72	72	rules adopted by the executive commissioner of the Health and Human
73	73	Services Commission to implement those sections.
74	74	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
75	75	Sec. 292F.101. HEARING. (a) In each year that the
76	76	commissioners court of a county authorizes a mandatory payment
77	77	under this chapter, the commissioners court shall hold a public
78	78	hearing on the amounts of any mandatory payments that the county
79	79	intends to require during the year and how the revenue derived from
80	80	those payments is to be spent.
81	81	(b) Not later than the fifth day before the date of the
82	82	hearing required under Subsection (a), the commissioners court
83	83	shall publish notice of the hearing in a newspaper of general
84	84	circulation in the county and provide written notice of the hearing
85	85	to each institutional health care provider located in the county.
86	86	(c) A representative of a paying provider is entitled to
87	87	appear at the public hearing and be heard regarding any matter
88	88	related to the mandatory payments authorized under this chapter.
89	89	Sec. 292F.102. DEPOSITORY. (a) The commissioners court of
90	90	a county that requires a mandatory payment under this chapter shall
91	91	designate one or more banks as the depository for the county's local
92	92	provider participation fund.
93	93	(b) All income received by a county under this chapter shall
94	94	be deposited with the depository designated under Subsection (a) in
95	95	the county's local provider participation fund and may be withdrawn
96	96	only as provided by this chapter.
97	97	(c) All money collected under this chapter shall be secured
98	98	in the manner provided for securing other county money.
99	99	Sec. 292F.103. LOCAL PROVIDER PARTICIPATION FUND;
100	100	AUTHORIZED USES OF MONEY. (a) A county that requires a mandatory
101	101	payment under this chapter shall create a local provider
102	102	participation fund.
103	103	(b) The local provider participation fund of a county
104	104	consists of:
105	105	(1) all revenue received by the county attributable to
106	106	mandatory payments authorized under this chapter;
107	107	(2) money received from the Health and Human Services
108	108	Commission as a refund of an intergovernmental transfer from the
109	109	county to the state for the purpose of providing the nonfederal
110	110	share of Medicaid supplemental payment program payments, provided
111	111	that the intergovernmental transfer does not receive a federal
112	112	matching payment; and
113	113	(3) the earnings of the fund.
114	114	(c) Money deposited to a county's local provider
115	115	participation fund may be used only to:
116	116	(1) fund intergovernmental transfers from the county
117	117	to the state to provide the nonfederal share of Medicaid payments
118	118	for:
119	119	(A) uncompensated care payments to nonpublic
120	120	hospitals authorized under the Texas Healthcare Transformation and
121	121	Quality Improvement Program waiver issued under Section 1115 of the
122	122	federal Social Security Act (42 U.S.C. Section 1315), or a
123	123	successor waiver program authorizing similar Medicaid supplemental
124	124	payment programs;
125	125	(B) uniform rate enhancements or other directed
126	126	payment programs for nonpublic hospitals;
127	127	(C) payments available under another waiver
128	128	program authorizing payments that are substantially similar to
129	129	Medicaid payments to nonpublic hospitals described by Paragraph (A)
130	130	or (B); or
131	131	(D) any reimbursement to nonpublic hospitals for
132	132	which federal matching funds are available;
133	133	(2) subject to Section 292F.151(e), 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 provider;
138	138	(4) refund to paying providers a proportionate share
139	139	of the money that the county:
140	140	(A) receives from the Health and Human Services
141	141	Commission that is not used to fund the nonfederal share of Medicaid
142	142	supplemental payment program payments; or
143	143	(B) determines cannot be used to fund the
144	144	nonfederal share of Medicaid supplemental payment program
145	145	payments; and
146	146	(5) transfer funds to the Health and Human Services
147	147	Commission if the county is legally required to transfer the funds
148	148	to address a disallowance of federal matching funds with respect to
149	149	any intergovernmental transfers described by Subdivision (1).
150	150	(d) Money in the local provider participation fund may not
151	151	be commingled with other county money.
152	152	(e) Notwithstanding any other provision of this chapter,
153	153	with respect to an intergovernmental transfer of funds described by
154	154	Subsection (c)(1) made by the county, any funds received by the
155	155	state, county, or other entity as a result of the transfer may not
156	156	be used by the state, county, or entity to:
157	157	(1) expand Medicaid eligibility under the Patient
158	158	Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
159	159	by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
160	160	No. 111-152); or
161	161	(2) fund the nonfederal share of payments to nonpublic
162	162	hospitals available through the Medicaid disproportionate share
163	163	hospital program.
164	164	SUBCHAPTER D. MANDATORY PAYMENTS
165	165	Sec. 292F.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
166	166	NET PATIENT REVENUE. (a) Except as provided by Subsection (f), if
167	167	the commissioners court of a county authorizes a program under this
168	168	chapter, the commissioners court may require an annual mandatory
169	169	payment to be assessed on the net patient revenue of each
170	170	institutional health care provider located in the county. The
171	171	commissioners court may provide for the mandatory payment to be
172	172	assessed quarterly. In the first year in which the mandatory
173	173	payment is required, the mandatory payment is assessed on the net
174	174	patient revenue of an institutional health care provider as
175	175	determined by the data reported to the Department of State Health
176	176	Services under Sections 311.032 and 311.033 in the most recent
177	177	fiscal year for which that data was reported. If the institutional
178	178	health care provider did not report any data under those sections,
179	179	the provider's net patient revenue is the amount of that revenue as
180	180	contained in the provider's Medicare cost report submitted for the
181	181	most recent fiscal year for which the provider submitted the
182	182	Medicare cost report. If the mandatory payment is required, the
183	183	commissioners court shall update the amount of the mandatory
184	184	payment on an annual basis.
185	185	(b) The commissioners court of a county that requires a
186	186	mandatory payment under this chapter shall provide each
187	187	institutional health care provider on which the payment will be
188	188	assessed written notice of an assessment under this chapter. The
189	189	institutional health care provider must pay the assessment not
190	190	later than the 30th day after the date the provider receives the
191	191	written notice.
192	192	(c) The amount of a mandatory payment authorized under this
193	193	chapter must be uniformly proportionate with the amount of net
194	194	patient revenue generated by each paying provider in the county. A
195	195	mandatory payment authorized under this chapter may not hold
196	196	harmless any institutional health care provider, as required under
197	197	42 U.S.C. Section 1396b(w) and 42 C.F.R. Section 433.68.
198	198	(d) The commissioners court of a county that requires a
199	199	mandatory payment under this chapter shall set the amount of the
200	200	mandatory payment. The aggregate amount of the mandatory payment
201	201	required of all paying providers may not exceed six percent of the
202	202	aggregate net patient revenue from hospital services provided by
203	203	all paying providers in the county.
204	204	(e) Subject to Subsection (d), the commissioners court of a
205	205	county that requires a mandatory payment under this chapter shall
206	206	set the mandatory payments in amounts that in the aggregate will
207	207	generate sufficient revenue to cover the administrative expenses of
208	208	the county for activities under this chapter and to fund an
209	209	intergovernmental transfer described by Section 292F.103(c)(1).
210	210	The annual amount of revenue from mandatory payments that may be
211	211	used to pay the administrative expenses of the county for
212	212	activities under this chapter may not exceed $150,000, plus the
213	213	cost of collateralization of deposits, regardless of actual
214	214	expenses.
215	215	(f) A paying provider may not add a mandatory payment
216	216	required under this section as a surcharge to a patient.
217	217	Sec. 292F.152. ASSESSMENT AND COLLECTION OF MANDATORY
218	218	PAYMENTS. (a) The county may collect or contract for the assessment
219	219	and collection of mandatory payments authorized under this chapter.
220	220	(b) The person charged by the county with the assessment and
221	221	collection of mandatory payments shall charge and deduct from the
222	222	mandatory payments collected for the county a collection fee in an
223	223	amount not to exceed the person's usual and customary charges for
224	224	like services.
225	225	(c) If the person charged with the assessment and collection
226	226	of mandatory payments is an official of the county, any revenue from
227	227	a collection fee charged under Subsection (b) shall be deposited in
228	228	the county general fund and, if appropriate, shall be reported as
229	229	fees of the county.
230	230	Sec. 292F.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
231	231	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
232	232	chapter is to authorize a county to establish a program to enable
233	233	the county to collect mandatory payments from institutional health
234	234	care providers to fund the nonfederal share of certain Medicaid
235	235	programs as described by Section 292F.103(c)(1).
236	236	(b) To the extent any provision or procedure under this
237	237	chapter causes a mandatory payment authorized under this chapter to
238	238	be ineligible for federal matching funds, the commissioners court
239	239	of the county administering the program may provide by rule for an
240	240	alternative provision or procedure that conforms to the
241	241	requirements of the federal Centers for Medicare and Medicaid
242	242	Services. A rule adopted under this section may not create, impose,
243	243	or materially expand the legal or financial liability or
244	244	responsibility of the county or an institutional health care
245	245	provider located in the county beyond the provisions of this
246	246	chapter. This section does not require the commissioners court of a
247	247	county to adopt a rule.
248	248	(c) A county administering a program may only assess and
249	249	collect a mandatory payment authorized under this chapter if a
250	250	waiver program, uniform rate enhancement, or reimbursement
251	251	described by Section 292F.103(c)(1) is available to the county.
252	252	(d) This chapter does not authorize a county administering a
253	253	program to collect mandatory payments for the purpose of raising
254	254	general revenue or any amount in excess of the amount reasonably
255	255	necessary to fund the nonfederal share of a Medicaid supplemental
256	256	payment program or Medicaid managed care rate enhancements for
257	257	nonpublic hospitals and to cover the administrative expenses of the
258	258	county associated with activities under this chapter.
259	259	SECTION 2. As soon as practicable after the expiration of
260	260	the authority of a county to administer and operate a health care
261	261	provider participation program under Chapter 292F, Health and
262	262	Safety Code, as added by this Act, the commissioners court of the
263	263	county shall transfer to each institutional health care provider in
264	264	the county that provider's proportionate share of any remaining
265	265	funds in any local provider participation fund created by the
266	266	county under Section 292F.103, Health and Safety Code, as added by
267	267	this Act.
268	268	SECTION 3. If before implementing any provision of this Act
269	269	a state agency determines that a waiver or authorization from a
270	270	federal agency is necessary for implementation of that provision,
271	271	the agency affected by the provision shall request the waiver or
272	272	authorization and may delay implementing that provision until the
273	273	waiver or authorization is granted.
274	274	SECTION 4. This Act takes effect immediately if it receives
275	275	a vote of two-thirds of all the members elected to each house, as
276	276	provided by Section 39, Article III, Texas Constitution. If this
277	277	Act does not receive the vote necessary for immediate effect, this
278	278	Act takes effect September 1, 2025.