Texas 2025 - 89th Regular

Texas Senate Bill SB1578 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R8522 MPF-D
2	2	By: Parker S.B. No. 1578
3	3
4	4
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the creation and operations of a health care provider
10	10	participation program in certain counties.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Subtitle D, Title 4, Health and Safety Code, is
13	13	amended by adding Chapter 292E to read as follows:
14	14	CHAPTER 292E. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
15	15	CERTAIN COUNTIES BORDERING TWO POPULOUS COUNTIES
16	16	SUBCHAPTER A. GENERAL PROVISIONS
17	17	Sec. 292E.001. DEFINITIONS. In this chapter:
18	18	(1) "Institutional health care provider" means a
19	19	nonpublic hospital that provides inpatient hospital services.
20	20	(2) "Paying provider" means an institutional health
21	21	care provider required to make a mandatory payment under this
22	22	chapter.
23	23	(3) "Program" means a county health care provider
24	24	participation program authorized by this chapter.
25	25	Sec. 292E.002. APPLICABILITY. This chapter applies only to
26	26	a county that:
27	27	(1) is not served by a hospital district;
28	28	(2) has a population of more than 900,000; and
29	29	(3) borders two counties, each of which has a
30	30	population of two million or more.
31	31	Sec. 292E.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
32	32	PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
33	33	provider participation program authorizes a county to collect a
34	34	mandatory payment from each institutional health care provider
35	35	located in the county to be deposited in a local provider
36	36	participation fund established by the county. Money in the fund may
37	37	be used by the county as provided by Section 292E.103(c).
38	38	(b) The commissioners court of a county may adopt an order
39	39	authorizing the county to participate in the program, subject to
40	40	the limitations provided by this chapter.
41	41	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
42	42	Sec. 292E.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
43	43	PAYMENTS. The commissioners court of a county may require a
44	44	mandatory payment under this chapter by an institutional health
45	45	care provider in the county only in the manner provided by this
46	46	chapter.
47	47	Sec. 292E.052. MAJORITY VOTE REQUIRED. The commissioners
48	48	court of a county may not authorize the county to collect a
49	49	mandatory payment under this chapter without an affirmative vote of
50	50	a majority of the members of the commissioners court.
51	51	Sec. 292E.053. RULES AND PROCEDURES. After the
52	52	commissioners court of a county has voted to require a mandatory
53	53	payment authorized under this chapter, the commissioners court may
54	54	adopt rules relating to the administration of the program,
55	55	including the collection of a mandatory payment, expenditures, an
56	56	audit, and any other administrative aspect of the program.
57	57	Sec. 292E.054. INSTITUTIONAL HEALTH CARE PROVIDER
58	58	REPORTING. If the commissioners court of a county authorizes the
59	59	county to participate in a program under this chapter, the
60	60	commissioners court shall require each institutional health care
61	61	provider to submit to the county a copy of any financial and
62	62	utilization data required by and reported to the Department of
63	63	State Health Services under Sections 311.032 and 311.033 and any
64	64	rules adopted by the executive commissioner of the Health and Human
65	65	Services Commission to implement those sections.
66	66	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
67	67	Sec. 292E.101. HEARING. (a) In each year that the
68	68	commissioners court of a county authorizes a mandatory payment
69	69	under this chapter, the commissioners court shall hold a public
70	70	hearing on the amounts of any mandatory payments that the county
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
75	75	shall publish notice of the hearing in a newspaper of general
76	76	circulation in the county and provide written notice of the hearing
77	77	to each institutional health care provider located in the county.
78	78	(c) A representative of a paying provider is entitled to
79	79	appear at the public hearing and be heard regarding any matter
80	80	related to the mandatory payments authorized under this chapter.
81	81	Sec. 292E.102. DEPOSITORY. (a) The commissioners court of
82	82	a county that requires a mandatory payment under this chapter shall
83	83	designate one or more banks as the depository for the county's local
84	84	provider participation fund.
85	85	(b) All income received by a county under this chapter shall
86	86	be deposited with the depository designated under Subsection (a) in
87	87	the county's local provider participation fund and may be withdrawn
88	88	only as provided by this chapter.
89	89	(c) All money collected under this chapter shall be secured
90	90	in the manner provided for securing other county money.
91	91	Sec. 292E.103. LOCAL PROVIDER PARTICIPATION FUND;
92	92	AUTHORIZED USES OF MONEY. (a) A county that requires a mandatory
93	93	payment under this chapter shall create a local provider
94	94	participation fund.
95	95	(b) The local provider participation fund of a county
96	96	consists of:
97	97	(1) all revenue received by the county attributable to
98	98	mandatory payments authorized under this chapter;
99	99	(2) money received from the Health and Human Services
100	100	Commission as a refund of an intergovernmental transfer from the
101	101	county to the state for the purpose of providing the nonfederal
102	102	share of Medicaid supplemental payment program payments, provided
103	103	that the intergovernmental transfer does not receive a federal
104	104	matching payment; and
105	105	(3) the earnings of the fund.
106	106	(c) Money deposited to a county's local provider
107	107	participation fund may be used only to:
108	108	(1) fund intergovernmental transfers from the county
109	109	to the state to provide the nonfederal share of Medicaid payments
110	110	for:
111	111	(A) uncompensated care payments to nonpublic
112	112	hospitals authorized under the Texas Healthcare Transformation and
113	113	Quality Improvement Program waiver issued under Section 1115 of the
114	114	federal Social Security Act (42 U.S.C. Section 1315), or a
115	115	successor waiver program authorizing similar Medicaid supplemental
116	116	payment programs;
117	117	(B) uniform rate enhancements or other directed
118	118	payment programs for nonpublic hospitals;
119	119	(C) payments available under another waiver
120	120	program authorizing payments that are substantially similar to
121	121	Medicaid payments to nonpublic hospitals described by Paragraph (A)
122	122	or (B); or
123	123	(D) any reimbursement to nonpublic hospitals for
124	124	which federal matching funds are available;
125	125	(2) subject to Section 292E.151(e), pay the
126	126	administrative expenses of the county in administering the program,
127	127	including collateralization of deposits;
128	128	(3) refund all or a portion of a mandatory payment
129	129	collected in error from a paying provider;
130	130	(4) refund to paying providers a proportionate share
131	131	of the money that the county:
132	132	(A) receives from the Health and Human Services
133	133	Commission that is not used to fund the nonfederal share of Medicaid
134	134	supplemental payment program payments; or
135	135	(B) determines cannot be used to fund the
136	136	nonfederal share of Medicaid supplemental payment program
137	137	payments; and
138	138	(5) transfer funds to the Health and Human Services
139	139	Commission if the county is legally required to transfer the funds
140	140	to address a disallowance of federal matching funds with respect to
141	141	any intergovernmental transfers described by Subdivision (1).
142	142	(d) Money in the local provider participation fund may not
143	143	be commingled with other county money.
144	144	(e) Notwithstanding any other provision of this chapter,
145	145	with respect to an intergovernmental transfer of funds described by
146	146	Subsection (c)(1) made by the county, any funds received by the
147	147	state, county, or other entity as a result of the transfer may not
148	148	be used by the state, county, or entity to:
149	149	(1) expand Medicaid eligibility under the Patient
150	150	Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
151	151	by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
152	152	No. 111-152); or
153	153	(2) fund the nonfederal share of payments to nonpublic
154	154	hospitals available through the Medicaid disproportionate share
155	155	hospital program.
156	156	SUBCHAPTER D. MANDATORY PAYMENTS
157	157	Sec. 292E.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
158	158	NET PATIENT REVENUE. (a) Except as provided by Subsection (f), if
159	159	the commissioners court of a county authorizes a program under this
160	160	chapter, the commissioners court may require an annual mandatory
161	161	payment to be assessed on the net patient revenue of each
162	162	institutional health care provider located in the county. The
163	163	commissioners court may provide for the mandatory payment to be
164	164	assessed quarterly. In the first year in which the mandatory
165	165	payment is required, the mandatory payment is assessed on the net
166	166	patient revenue of an institutional health care provider as
167	167	determined by the data reported to the Department of State Health
168	168	Services under Sections 311.032 and 311.033 in the most recent
169	169	fiscal year for which that data was reported. If the institutional
170	170	health care provider did not report any data under those sections,
171	171	the provider's net patient revenue is the amount of that revenue as
172	172	contained in the provider's Medicare cost report submitted for the
173	173	most recent fiscal year for which the provider submitted the
174	174	Medicare cost report. If the mandatory payment is required, the
175	175	commissioners court shall update the amount of the mandatory
176	176	payment on an annual basis.
177	177	(b) The commissioners court of a county that requires a
178	178	mandatory payment under this chapter shall provide each
179	179	institutional health care provider on which the payment will be
180	180	assessed written notice of an assessment under this chapter. The
181	181	institutional health care provider must pay the assessment not
182	182	later than the 30th day after the date the provider receives the
183	183	written notice.
184	184	(c) The amount of a mandatory payment authorized under this
185	185	chapter must be uniformly proportionate with the amount of net
186	186	patient revenue generated by each paying provider in the county. A
187	187	mandatory payment authorized under this chapter may not hold
188	188	harmless any institutional health care provider, as required under
189	189	42 U.S.C. Section 1396b(w) and 42 C.F.R. Section 433.68.
190	190	(d) The commissioners court of a county that requires a
191	191	mandatory payment under this chapter shall set the amount of the
192	192	mandatory payment. The aggregate amount of the mandatory payment
193	193	required of all paying providers may not exceed six percent of the
194	194	aggregate net patient revenue from hospital services provided by
195	195	all paying providers in the county.
196	196	(e) Subject to Subsection (d), the commissioners court of a
197	197	county that requires a mandatory payment under this chapter shall
198	198	set the mandatory payments in amounts that in the aggregate will
199	199	generate sufficient revenue to cover the administrative expenses of
200	200	the county for activities under this chapter and to fund an
201	201	intergovernmental transfer described by Section 292E.103(c)(1).
202	202	The annual amount of revenue from mandatory payments that may be
203	203	used to pay the administrative expenses of the county for
204	204	activities under this chapter may not exceed $150,000, plus the
205	205	cost of collateralization of deposits, regardless of actual
206	206	expenses.
207	207	(f) A paying provider may not add a mandatory payment
208	208	required under this section as a surcharge to a patient.
209	209	Sec. 292E.152. ASSESSMENT AND COLLECTION OF MANDATORY
210	210	PAYMENTS. (a) The county may collect or contract for the assessment
211	211	and collection of mandatory payments authorized under this chapter.
212	212	(b) The person charged by the county with the assessment and
213	213	collection of mandatory payments shall charge and deduct from the
214	214	mandatory payments collected for the county a collection fee in an
215	215	amount not to exceed the person's usual and customary charges for
216	216	like services.
217	217	(c) If the person charged with the assessment and collection
218	218	of mandatory payments is an official of the county, any revenue from
219	219	a collection fee charged under Subsection (b) shall be deposited in
220	220	the county general fund and, if appropriate, shall be reported as
221	221	fees of the county.
222	222	Sec. 292E.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
223	223	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
224	224	chapter is to authorize a county to establish a program to enable
225	225	the county to collect mandatory payments from institutional health
226	226	care providers to fund the nonfederal share of certain Medicaid
227	227	programs as described by Section 292E.103(c)(1).
228	228	(b) To the extent any provision or procedure under this
229	229	chapter causes a mandatory payment authorized under this chapter to
230	230	be ineligible for federal matching funds, the commissioners court
231	231	of the county administering the program may provide by rule for an
232	232	alternative provision or procedure that conforms to the
233	233	requirements of the federal Centers for Medicare and Medicaid
234	234	Services. A rule adopted under this section may not create, impose,
235	235	or materially expand the legal or financial liability or
236	236	responsibility of the county or an institutional health care
237	237	provider located in the county beyond the provisions of this
238	238	chapter. This section does not require the commissioners court of a
239	239	county to adopt a rule.
240	240	(c) A county administering a program may only assess and
241	241	collect a mandatory payment authorized under this chapter if a
242	242	waiver program, uniform rate enhancement, or reimbursement
243	243	described by Section 292E.103(c)(1) is available to the county.
244	244	(d) This chapter does not authorize a county administering a
245	245	program to collect mandatory payments for the purpose of raising
246	246	general revenue or any amount in excess of the amount reasonably
247	247	necessary to fund the nonfederal share of a Medicaid supplemental
248	248	payment program or Medicaid managed care rate enhancements for
249	249	nonpublic hospitals and to cover the administrative expenses of the
250	250	county associated with activities under this chapter.
251	251	SECTION 2. If before implementing any provision of this Act
252	252	a state agency determines that a waiver or authorization from a
253	253	federal agency is necessary for implementation of that provision,
254	254	the agency affected by the provision shall request the waiver or
255	255	authorization and may delay implementing that provision until the
256	256	waiver or authorization is granted.
257	257	SECTION 3. This Act takes effect September 1, 2025.