Texas 2025 - 89th Regular

Texas Senate Bill SB1443 Compare Versions

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1	1	89R2690 SRA-F
2	2	By: Hughes, Nichols S.B. No. 1443
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the continuation and operation of a health care
10	10	provider participation district created by certain local
11	11	governments to administer a health care provider participation
12	12	program.
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 300C to read as follows:
16	16	CHAPTER 300C. HEALTH CARE PROVIDER PARTICIPATION DISTRICTS CREATED
17	17	BY CERTAIN LOCAL GOVERNMENTS
18	18	SUBCHAPTER A. GENERAL PROVISIONS
19	19	Sec. 300C.0001. PURPOSE. The purpose of this chapter is to
20	20	authorize a health care provider participation district created by
21	21	certain local governments to administer a health care provider
22	22	participation program to provide additional compensation to
23	23	certain hospitals in the district by collecting mandatory payments
24	24	from each of those hospitals in the district to be used to provide
25	25	the nonfederal share of a Medicaid supplemental payment program and
26	26	for other purposes as authorized under this chapter.
27	27	Sec. 300C.0002. DEFINITIONS. In this chapter:
28	28	(1) "Board" means the board of directors of a
29	29	district.
30	30	(2) "Director" means a member of the board.
31	31	(3) "District" means a health care provider
32	32	participation district created under Chapter 300A and operating
33	33	under this chapter.
34	34	(4) "Institutional health care provider" means a
35	35	nonpublic hospital that provides inpatient hospital services.
36	36	(5) "Local government" means a hospital district,
37	37	county, or municipality to which this chapter applies.
38	38	(6) "Paying hospital" means an institutional health
39	39	care provider required to make a mandatory payment under this
40	40	chapter.
41	41	(7) "Program" means a health care provider
42	42	participation program authorized by this chapter.
43	43	Sec. 300C.0003. APPLICABILITY. This chapter applies only
44	44	to a local government that jointly created a health care provider
45	45	participation district by concurrent order under Chapter 300A and
46	46	is:
47	47	(1) a county with a population of more than 80,000 and
48	48	less than 90,000 that borders the Trinity River;
49	49	(2) a county with a population of more than 45,000 and
50	50	less than 55,000 that borders Oklahoma; or
51	51	(3) a hospital district located in a county that has a
52	52	population of more than 30,000 and contains a portion of Jim Chapman
53	53	Lake.
54	54	SUBCHAPTER B. OPERATION AND DISSOLUTION OF DISTRICT
55	55	Sec. 300C.0021. OPERATION. (a) A health care provider
56	56	participation district created under Chapter 300A may operate under
57	57	and be governed by the provisions of this chapter instead of Chapter
58	58	300A if:
59	59	(1) each local government that jointly created the
60	60	district adopts a concurrent order authorizing the district to
61	61	operate under and be governed by the provisions of this chapter; and
62	62	(2) the district's board ratifies the concurrent order
63	63	adopted by each participating local government.
64	64	(b) A concurrent order authorizing a district to operate
65	65	under this chapter must:
66	66	(1) be approved by the governing body of each
67	67	participating local government;
68	68	(2) contain provisions that are identical to the
69	69	provisions of the concurrent order adopted by each other
70	70	participating local government;
71	71	(3) affirm that the district's territory is the area
72	72	contained within the boundaries of each participating local
73	73	government; and
74	74	(4) provide that the district begins to operate under
75	75	this chapter immediately on the expiration of the district's
76	76	authority to administer and operate a program under Chapter 300A.
77	77	Sec. 300C.0022. POWERS. (a) A district may authorize and
78	78	administer a health care provider participation program in
79	79	accordance with this chapter.
80	80	(b) Notwithstanding Section 300A.0155, a district that
81	81	complies with the provisions of this chapter may administer and
82	82	operate a health care provider participation program under this
83	83	chapter after its authority to administer and operate a program
84	84	under Chapter 300A has expired.
85	85	Sec. 300C.0023. BOARD OF DIRECTORS. (a) If three or more
86	86	local governments adopt concurrent orders authorizing a health care
87	87	provider participation district to operate under this chapter, the
88	88	presiding officer of the governing body of each local government
89	89	that created the district shall appoint one director.
90	90	(b) If two local governments adopt concurrent orders
91	91	described by Subsection (a):
92	92	(1) the presiding officer of the governing body of the
93	93	most populous local government shall appoint two directors; and
94	94	(2) the presiding officer of the governing body of the
95	95	local government not described by Subdivision (1) shall appoint one
96	96	director.
97	97	(c) Directors serve staggered two-year terms, with as near
98	98	as possible to one-half of the directors' terms expiring each year.
99	99	(d) A vacancy in the office of director shall be filled for
100	100	the unexpired term in the same manner as the original appointment.
101	101	(e) The board shall elect from among its members a president
102	102	and a vice president.
103	103	(f) The president may vote and may cast an additional vote
104	104	to break a tie.
105	105	(g) The board shall appoint a secretary, who need not be a
106	106	director.
107	107	(h) Each officer of the board serves for a term of one year.
108	108	(i) The board shall fill a vacancy in a board office for the
109	109	unexpired term.
110	110	(j) A majority of the members of the board voting must
111	111	concur in a matter relating to the business of the district.
112	112	Sec. 300C.0024. QUALIFICATIONS FOR OFFICE. (a) To be
113	113	eligible to serve as a director, a person must be a resident of the
114	114	local government that appoints the person.
115	115	(b) An employee of the district may not serve as a director.
116	116	Sec. 300C.0025. COMPENSATION. (a) Directors and officers
117	117	serve without compensation but may be reimbursed for actual
118	118	expenses incurred in the performance of official duties.
119	119	(b) Expenses reimbursed under this section must be:
120	120	(1) reported in the district's minute book or other
121	121	district records; and
122	122	(2) approved by the board.
123	123	Sec. 300C.0026. AUTHORITY TO SUE AND BE SUED. The board may
124	124	sue and be sued on behalf of the district.
125	125	Sec. 300C.0027. DISTRICT FINANCES. (a) Except as
126	126	otherwise provided by this section, Subchapter F, Chapter 287,
127	127	applies to a district in the same manner that the provisions of that
128	128	subchapter apply to a health services district created under
129	129	Chapter 287.
130	130	(b) Sections 287.129 and 287.130 do not apply to a district.
131	131	(c) This section does not authorize a district to issue
132	132	bonds.
133	133	Sec. 300C.0028. DISSOLUTION. A district shall be dissolved
134	134	if the local governments that created the district adopt concurrent
135	135	orders to dissolve the district and the concurrent orders contain
136	136	identical provisions.
137	137	Sec. 300C.0029. ADMINISTRATION OF PROPERTY, DEBTS, AND
138	138	ASSETS AFTER DISSOLUTION. (a) After dissolution of a district
139	139	under Section 300C.0028, the board shall continue to control and
140	140	administer any property, debts, and assets of the district until
141	141	all of the district's property and assets have been disposed of and
142	142	all of the district's debts have been paid or settled.
143	143	(b) As soon as practicable after the dissolution of the
144	144	district, the board shall transfer to each institutional health
145	145	care provider in the district the provider's proportionate share of
146	146	any remaining money in any local provider participation fund
147	147	created by the district.
148	148	(c) If, after administering the district's property and
149	149	assets, the board determines that the property and assets are
150	150	insufficient to pay the debts of the district, the district shall
151	151	transfer the remaining debts to the local governments that created
152	152	the district in proportion to the money contributed to the district
153	153	by each local government, including a paying hospital in the local
154	154	government.
155	155	(d) If, after complying with Subsections (b) and (c) and
156	156	administering the district's property and assets, the board
157	157	determines that unused money remains, the board shall transfer the
158	158	unused money to the local governments that created the district in
159	159	proportion to the money contributed to the district by each local
160	160	government, including a paying hospital in the local government.
161	161	Sec. 300C.0030. ACCOUNTING AFTER DISSOLUTION. After the
162	162	district has paid or settled all its debts and has disposed of all
163	163	its property and assets, including money, as prescribed by Section
164	164	300C.0029, the board shall provide an accounting to each local
165	165	government that created the district. The accounting must show the
166	166	manner in which the property, assets, and debts of the district were
167	167	distributed.
168	168	SUBCHAPTER C. HEALTH CARE PROVIDER PARTICIPATION PROGRAM; POWERS
169	169	AND DUTIES OF DISTRICT BOARD
170	170	Sec. 300C.0051. HEALTH CARE PROVIDER PARTICIPATION
171	171	PROGRAM. The board of a district may authorize the district to
172	172	participate in a health care provider participation program on the
173	173	affirmative vote of a majority of the board, subject to the
174	174	provisions of this chapter.
175	175	Sec. 300C.0052. LIMITATION ON AUTHORITY OF BOARD TO REQUIRE
176	176	MANDATORY PAYMENT. (a) The board may require a mandatory payment
177	177	authorized under this chapter by an institutional health care
178	178	provider in the district only in the manner provided by this
179	179	chapter.
180	180	(b) The board may not require a mandatory payment under this
181	181	chapter during a period for which the board requires a mandatory
182	182	payment under Chapter 300A.
183	183	Sec. 300C.0053. RULES AND PROCEDURES. The board may adopt
184	184	rules relating to the administration of the health care provider
185	185	participation program in the district, including collection of the
186	186	mandatory payments, expenditures, audits, and any other
187	187	administrative aspects of the program.
188	188	Sec. 300C.0054. INSTITUTIONAL HEALTH CARE PROVIDER
189	189	REPORTING. If the board authorizes the district to participate in a
190	190	health care provider participation program under this chapter, the
191	191	board shall require each institutional health care provider located
192	192	in the district to submit to the district a copy of any financial
193	193	and utilization data required by and reported to the Department of
194	194	State Health Services under Sections 311.032 and 311.033 and any
195	195	rules adopted by the executive commissioner of the Health and Human
196	196	Services Commission to implement those sections.
197	197	SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS
198	198	Sec. 300C.0101. HEARING. (a) In each year that the board
199	199	authorizes a health care provider participation program under this
200	200	chapter, the board shall hold a public hearing on the amounts of any
201	201	mandatory payments that the board intends to require during the
202	202	year and how the revenue derived from those payments is to be spent.
203	203	(b) Not later than the fifth day before the date of the
204	204	hearing required under Subsection (a), the board shall publish
205	205	notice of the hearing in a newspaper of general circulation in each
206	206	local government that created the district and provide written
207	207	notice of the hearing to the chief operating officer of each
208	208	institutional health care provider in the district.
209	209	(c) A representative of a paying hospital is entitled to
210	210	appear at the time and place designated in the public notice and be
211	211	heard regarding any matter related to the mandatory payments
212	212	authorized under this chapter.
213	213	Sec. 300C.0102. LOCAL PROVIDER PARTICIPATION FUND;
214	214	DEPOSITORY. (a) The board shall deposit all mandatory payments
215	215	received by a district in the local provider participation fund
216	216	created by the district under Chapter 300A.
217	217	(b) The board may designate one or more banks at which to
218	218	locate the local provider participation fund.
219	219	(c) The board may withdraw or use money in the district's
220	220	local provider participation fund only for a purpose authorized
221	221	under this chapter.
222	222	(d) All funds collected under this chapter shall be secured
223	223	in the manner provided for securing public funds.
224	224	Sec. 300C.0103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY.
225	225	(a) The local provider participation fund described by Section
226	226	300C.0102 consists of:
227	227	(1) all revenue received by the district attributable
228	228	to mandatory payments authorized under this chapter;
229	229	(2) money received from the Health and Human Services
230	230	Commission as a refund of an intergovernmental transfer from the
231	231	district to the state for the purpose of providing the nonfederal
232	232	share of Medicaid supplemental payment program payments, provided
233	233	that the intergovernmental transfer does not receive a federal
234	234	matching payment;
235	235	(3) money received by the district and deposited to
236	236	the fund in accordance with Chapter 300A that remains in the fund on
237	237	the date the district begins to operate under this chapter; and
238	238	(4) the earnings of the fund.
239	239	(b) Money deposited to the local provider participation
240	240	fund may be used only to:
241	241	(1) fund intergovernmental transfers from the
242	242	district to the state to provide the nonfederal share of Medicaid
243	243	payments for:
244	244	(A) uncompensated care payments to nonpublic
245	245	hospitals, if those payments are authorized under the Texas
246	246	Healthcare Transformation and Quality Improvement Program waiver
247	247	issued under Section 1115 of the federal Social Security Act (42
248	248	U.S.C. Section 1315);
249	249	(B) uniform rate enhancements for nonpublic
250	250	hospitals in the Medicaid managed care service area in which the
251	251	district is located;
252	252	(C) payments available under another waiver
253	253	program authorizing payments that are substantially similar to
254	254	Medicaid payments to nonpublic hospitals described by Paragraph (A)
255	255	or (B); or
256	256	(D) any reimbursement to nonpublic hospitals for
257	257	which federal matching funds are available;
258	258	(2) subject to Section 300C.0151(d), pay the
259	259	administrative expenses of the district in administering the
260	260	program, including collateralization of deposits;
261	261	(3) refund all or a portion of a mandatory payment
262	262	collected in error from a paying hospital, regardless of whether
263	263	the payment was collected under this chapter or Chapter 300A;
264	264	(4) refund to paying hospitals a proportionate share
265	265	of the money that the district:
266	266	(A) receives from the Health and Human Services
267	267	Commission that is not used to fund the nonfederal share of Medicaid
268	268	supplemental payment program payments; or
269	269	(B) determines cannot be used to fund the
270	270	nonfederal share of Medicaid supplemental payment program
271	271	payments;
272	272	(5) transfer funds to the Health and Human Services
273	273	Commission if the district is required by law to transfer the funds
274	274	to address a disallowance of federal matching funds with respect to
275	275	payments, rate enhancements, and reimbursements for which the
276	276	district made intergovernmental transfers described by Subdivision
277	277	(1); and
278	278	(6) reimburse the district if the district is required
279	279	by the rules governing the uniform rate enhancement program
280	280	described by Subdivision (1)(B) to incur an expense or forego
281	281	Medicaid reimbursements from the state because the balance of the
282	282	local provider participation fund is not sufficient to fund that
283	283	rate enhancement program.
284	284	(c) Money in the local provider participation fund may not
285	285	be commingled with other district money or other money of a local
286	286	government that created the district.
287	287	(d) Notwithstanding any other provision of this chapter,
288	288	with respect to an intergovernmental transfer of funds described by
289	289	Subsection (b)(1) made by the district, any funds received by the
290	290	state, district, or other entity as a result of the transfer may not
291	291	be used by the state, district, or any other entity to expand
292	292	Medicaid eligibility under the Patient Protection and Affordable
293	293	Care Act (Pub. L. No. 111-148) as amended by the Health Care and
294	294	Education Reconciliation Act of 2010 (Pub. L. No. 111-152).
295	295	Sec. 300C.0104. ACCOUNTING. The district shall maintain an
296	296	accounting of the money received from each local government that
297	297	created the district, including a paying hospital located in a
298	298	hospital district, county, or municipality that created the
299	299	district, as applicable.
300	300	SUBCHAPTER E. MANDATORY PAYMENTS
301	301	Sec. 300C.0151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
302	302	NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if
303	303	the board authorizes a health care provider participation program
304	304	under this chapter, the district shall require an annual mandatory
305	305	payment to be assessed on the net patient revenue of each
306	306	institutional health care provider located in the district. The
307	307	board shall provide that the mandatory payment is to be assessed at
308	308	least annually, but not more often than quarterly. In the first
309	309	year in which the mandatory payment is required, the mandatory
310	310	payment is assessed on the net patient revenue of an institutional
311	311	health care provider located in the district as determined by the
312	312	data reported to the Department of State Health Services under
313	313	Sections 311.032 and 311.033 in the most recent fiscal year for
314	314	which that data was reported. If the institutional health care
315	315	provider did not report any data under those sections, the
316	316	provider's net patient revenue is the amount of that revenue as
317	317	contained in the provider's Medicare cost report submitted for the
318	318	previous fiscal year or for the closest subsequent fiscal year for
319	319	which the provider submitted the Medicare cost report. The
320	320	district shall update the amount of the mandatory payment on an
321	321	annual basis.
322	322	(b) The amount of a mandatory payment authorized under this
323	323	chapter must be uniformly proportionate with the amount of net
324	324	patient revenue generated by each paying hospital in the district
325	325	as permitted under federal law. A health care provider
326	326	participation program authorized under this chapter may not hold
327	327	harmless any institutional health care provider, as required under
328	328	42 U.S.C. Section 1396b(w) and 42 C.F.R. Section 433.68.
329	329	(c) The board shall set the amount of a mandatory payment
330	330	authorized under this chapter. The aggregate amount of the
331	331	mandatory payments required of all paying hospitals in the district
332	332	may not exceed six percent of the aggregate net patient revenue from
333	333	hospital services provided by all paying hospitals in the district.
334	334	(d) Subject to Subsection (c), the board shall set the
335	335	mandatory payments in amounts that in the aggregate will generate
336	336	sufficient revenue to cover the administrative expenses of the
337	337	district for activities under this chapter and to fund an
338	338	intergovernmental transfer described by Section 300C.0103(b)(1).
339	339	The annual amount of revenue from mandatory payments that shall be
340	340	paid for administrative expenses by the district for activities
341	341	under this chapter may not exceed $150,000, plus the cost of
342	342	collateralization of deposits, regardless of actual expenses.
343	343	(e) A paying hospital may not add a mandatory payment
344	344	required under this section as a surcharge to a patient.
345	345	(f) For purposes of any hospital district that participates
346	346	in a district authorized to operate under this chapter, a mandatory
347	347	payment assessed under this chapter is not a tax for hospital
348	348	purposes for purposes of the applicable provision of Article IX,
349	349	Texas Constitution.
350	350	Sec. 300C.0152. ASSESSMENT AND COLLECTION OF MANDATORY
351	351	PAYMENTS. (a) The district may designate an official of the
352	352	district or contract with another person to assess and collect the
353	353	mandatory payments authorized under this chapter.
354	354	(b) The person charged by the district with the assessment
355	355	and collection of mandatory payments shall charge and deduct from
356	356	the mandatory payments collected for the district a collection fee
357	357	in an amount not to exceed the person's usual and customary charges
358	358	for like services.
359	359	(c) If the person charged with the assessment and collection
360	360	of mandatory payments is an official of the district, any revenue
361	361	from a collection fee charged under Subsection (b) shall be
362	362	deposited in the district's general fund and, if appropriate, shall
363	363	be reported as fees of the district.
364	364	Sec. 300C.0153. LIMITATION ON AUTHORITY; CORRECTION OF
365	365	INVALID PROVISION OR PROCEDURE. (a) This chapter does not
366	366	authorize the district to assess and collect mandatory payments for
367	367	the purpose of raising general revenue or any amount in excess of
368	368	the amount reasonably necessary to:
369	369	(1) fund the nonfederal share of a Medicaid
370	370	supplemental payment program or Medicaid managed care rate
371	371	enhancements for nonpublic hospitals; and
372	372	(2) cover the administrative expenses of the district
373	373	associated with activities under this chapter and other uses of the
374	374	fund described by Section 300C.0103(b).
375	375	(b) The district may assess and collect a mandatory payment
376	376	authorized under this chapter only if a waiver program, uniform
377	377	rate enhancement, or reimbursement described by Section
378	378	300C.0103(b)(1) is available to the district.
379	379	(c) To the extent any provision or procedure under this
380	380	chapter causes a mandatory payment authorized under this chapter to
381	381	be ineligible for federal matching funds, the board may provide by
382	382	rule for an alternative provision or procedure that conforms to the
383	383	requirements of the federal Centers for Medicare and Medicaid
384	384	Services. A rule adopted under this section may not create, impose,
385	385	or materially expand the legal or financial liability or
386	386	responsibility of the district or an institutional health care
387	387	provider in the district beyond the provisions of this chapter.
388	388	This section does not require the board to adopt a rule.
389	389	Sec. 300C.0154. REPORTING REQUIREMENTS. (a) The board of a
390	390	district that authorizes a program under this chapter shall report
391	391	information to the Health and Human Services Commission regarding
392	392	the program on a schedule determined by the commission.
393	393	(b) The information must include:
394	394	(1) the amount of the mandatory payments required and
395	395	collected in each year the program is authorized;
396	396	(2) any expenditure of money attributable to mandatory
397	397	payments collected under this chapter, including:
398	398	(A) any contract with an entity for the
399	399	administration or operation of a program authorized by this
400	400	chapter; or
401	401	(B) a contract with a person for the assessment
402	402	and collection of a mandatory payment as authorized under Section
403	403	300C.0152; and
404	404	(3) the amount of money attributable to mandatory
405	405	payments collected under this chapter that is used for a purpose
406	406	other than a purpose described by Subdivisions (1) and (2).
407	407	(c) The executive commissioner of the Health and Human
408	408	Services Commission shall adopt rules to administer this section.
409	409	Sec. 300C.0155. AUTHORITY TO REFUSE FOR VIOLATION. The
410	410	Health and Human Services Commission may refuse to accept money
411	411	from a local provider participation fund administered under this
412	412	chapter if the commission determines that acceptance of the money
413	413	may violate federal law.
414	414	SECTION 2. A director of a district appointed, or a board
415	415	officer elected, under Chapter 300A, Health and Safety Code, may
416	416	continue to serve the remainder of the director's or officer's term
417	417	in accordance with that chapter after the district begins to
418	418	operate under Chapter 300C, Health and Safety Code, as added by this
419	419	Act. A director or board officer that serves on the board of
420	420	directors of a health care provider participation district created
421	421	under Chapter 300A, Health and Safety Code, is eligible for
422	422	reappointment or re-election, as applicable, under Chapter 300C,
423	423	Health and Safety Code, as added by this Act, unless otherwise
424	424	disqualified.
425	425	SECTION 3. If before implementing any provision of this Act
426	426	a state agency determines that a waiver or authorization from a
427	427	federal agency is necessary for implementation of that provision,
428	428	the agency affected by the provision shall request the waiver or
429	429	authorization and may delay implementing that provision until the
430	430	waiver or authorization is granted.
431	431	SECTION 4. This Act takes effect immediately if it receives
432	432	a vote of two-thirds of all the members elected to each house, as
433	433	provided by Section 39, Article III, Texas Constitution. If this
434	434	Act does not receive the vote necessary for immediate effect, this
435	435	Act takes effect September 1, 2025.