Texas 2025 - 89th Regular

Texas Senate Bill SB2655 Compare Versions

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

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1	1	89R15305 SRA-F
2	2	By: Flores S.B. No. 2655
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
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 or a public
28	28	hospital;
29	29	(2) has a population of more than 46,000 and less than
30	30	50,000; and
31	31	(3) is adjacent to the county containing the state
32	32	capital.
33	33	Sec. 292E.003. COUNTY HEALTH CARE PROVIDER PARTICIPATION
34	34	PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
35	35	provider participation program authorizes a county to collect a
36	36	mandatory payment from each institutional health care provider
37	37	located in the county to be deposited in a local provider
38	38	participation fund established by the county. Money in the fund may
39	39	be used by the county as provided by Section 292E.103(c).
40	40	(b) The commissioners court of a county may adopt an order
41	41	authorizing the county to participate in the program, subject to
42	42	the limitations provided by this chapter.
43	43	SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
44	44	Sec. 292E.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
45	45	PAYMENTS. The commissioners court of a county may require a
46	46	mandatory payment under this chapter by an institutional health
47	47	care provider in the county only in the manner provided by this
48	48	chapter.
49	49	Sec. 292E.052. MAJORITY VOTE REQUIRED. The commissioners
50	50	court of a county may not authorize the county to collect a
51	51	mandatory payment under this chapter without an affirmative vote of
52	52	a majority of the members of the commissioners court.
53	53	Sec. 292E.053. RULES AND PROCEDURES. After the
54	54	commissioners court of a county has voted to require a mandatory
55	55	payment authorized under this chapter, the commissioners court may
56	56	adopt rules relating to the administration of the program,
57	57	including the collection of a mandatory payment, expenditures, an
58	58	audit, and any other administrative aspect of the program.
59	59	Sec. 292E.054. INSTITUTIONAL HEALTH CARE PROVIDER
60	60	REPORTING. If the commissioners court of a county authorizes the
61	61	county to participate in a program under this chapter, the
62	62	commissioners court shall require each institutional health care
63	63	provider to submit to the county a copy of any financial and
64	64	utilization data required by and reported to the Department of
65	65	State Health Services under Sections 311.032 and 311.033 and any
66	66	rules adopted by the executive commissioner of the Health and Human
67	67	Services Commission to implement those sections.
68	68	SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
69	69	Sec. 292E.101. HEARING. (a) In each year that the
70	70	commissioners court of a county authorizes a mandatory payment
71	71	under this chapter, the commissioners court shall hold a public
72	72	hearing on the amounts of any mandatory payments that the county
73	73	intends to require during the year and how the revenue derived from
74	74	those payments is to be spent.
75	75	(b) Not later than the fifth day before the date of the
76	76	hearing required under Subsection (a), the commissioners court
77	77	shall publish notice of the hearing in a newspaper of general
78	78	circulation in the county and provide written notice of the hearing
79	79	to each institutional health care provider located in the county.
80	80	(c) A representative of a paying provider is entitled to
81	81	appear at the public hearing and be heard regarding any matter
82	82	related to the mandatory payments authorized under this chapter.
83	83	Sec. 292E.102. DEPOSITORY. (a) The commissioners court of
84	84	a county that requires a mandatory payment under this chapter shall
85	85	designate one or more banks as the depository for the county's local
86	86	provider participation fund.
87	87	(b) All income received by a county under this chapter shall
88	88	be deposited with the depository designated under Subsection (a) in
89	89	the county's local provider participation fund and may be withdrawn
90	90	only as provided by this chapter.
91	91	(c) All money collected under this chapter shall be secured
92	92	in the manner provided for securing other county money.
93	93	Sec. 292E.103. LOCAL PROVIDER PARTICIPATION FUND;
94	94	AUTHORIZED USES OF MONEY. (a) A county that requires a mandatory
95	95	payment under this chapter shall create a local provider
96	96	participation fund.
97	97	(b) The local provider participation fund of a county
98	98	consists of:
99	99	(1) all revenue received by the county attributable to
100	100	mandatory payments authorized under this chapter;
101	101	(2) money received from the Health and Human Services
102	102	Commission as a refund of an intergovernmental transfer described
103	103	by Subsection (c)(1), provided that the intergovernmental transfer
104	104	does not receive a federal 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, or
124	124	that may benefit nonpublic hospitals as determined by the
125	125	commissioners court, for which federal matching funds are
126	126	available;
127	127	(2) subject to Section 292E.151(e), pay the
128	128	administrative expenses of the county in administering the program,
129	129	including collateralization of deposits;
130	130	(3) refund all or a portion of a mandatory payment
131	131	collected in error from a paying provider;
132	132	(4) refund to paying providers a proportionate share
133	133	of the money that the county:
134	134	(A) receives from the Health and Human Services
135	135	Commission that is not used to fund the nonfederal share of Medicaid
136	136	supplemental payment program payments; or
137	137	(B) determines cannot be used to fund the
138	138	nonfederal share of Medicaid supplemental payment program
139	139	payments; and
140	140	(5) transfer funds to the Health and Human Services
141	141	Commission if the county is legally required to transfer the funds
142	142	to address a disallowance of federal matching funds with respect to
143	143	any program for which intergovernmental transfers described by
144	144	Subdivision (1) were made.
145	145	(d) Money in the local provider participation fund may not
146	146	be commingled with other county money.
147	147	(e) Notwithstanding any other provision of this chapter,
148	148	with respect to an intergovernmental transfer of funds described by
149	149	Subsection (c)(1) made by the county, any funds received by the
150	150	state, county, or other entity as a result of the transfer may not
151	151	be used by the state, county, or other entity to expand Medicaid
152	152	eligibility under the Patient Protection and Affordable Care Act
153	153	(Pub. L. No. 111-148) as amended by the Health Care and Education
154	154	Reconciliation Act of 2010 (Pub. L. No. 111-152).
155	155	SUBCHAPTER D. MANDATORY PAYMENTS
156	156	Sec. 292E.151. MANDATORY PAYMENTS BASED ON PAYING PROVIDER
157	157	NET PATIENT REVENUE. (a) Except as provided by Subsection (f), if
158	158	the commissioners court of a county authorizes a program under this
159	159	chapter, the commissioners court may require an annual mandatory
160	160	payment to be assessed on the net patient revenue of each
161	161	institutional health care provider located in the county. The
162	162	commissioners court may provide for the mandatory payment to be
163	163	assessed quarterly. In the first year in which the mandatory
164	164	payment is required, the mandatory payment is assessed on the net
165	165	patient revenue of an institutional health care provider as
166	166	determined by the data reported to the Department of State Health
167	167	Services under Sections 311.032 and 311.033 in the most recent
168	168	fiscal year for which that data was reported. If the institutional
169	169	health care provider did not report any data under those sections,
170	170	the provider's net patient revenue is the amount of that revenue as
171	171	contained in the provider's Medicare cost report submitted for the
172	172	most recent fiscal year for which the provider submitted the
173	173	Medicare cost report. If the mandatory payment is required, the
174	174	commissioners court shall update the amount of the mandatory
175	175	payment on an annual basis.
176	176	(b) The commissioners court of a county that requires a
177	177	mandatory payment under this chapter shall provide each
178	178	institutional health care provider on which the payment will be
179	179	assessed written notice of an assessment under this chapter. The
180	180	institutional health care provider must pay the assessment not
181	181	later than the 30th day after the date the provider receives the
182	182	written notice.
183	183	(c) The amount of a mandatory payment authorized under this
184	184	chapter must be uniformly proportionate with the amount of net
185	185	patient revenue generated by each paying provider in the
186	186	administering county. A program may not hold harmless any
187	187	institutional health care provider, as required under 42 U.S.C.
188	188	Section 1396b(w) and 42 C.F.R. Section 433.68.
189	189	(d) The commissioners court of a county that requires a
190	190	mandatory payment under this chapter shall set the amount of the
191	191	mandatory payment. The aggregate amount of the mandatory payment
192	192	required of all paying providers in the county may not exceed six
193	193	percent of the aggregate net patient revenue from hospital services
194	194	provided by all paying providers in the county.
195	195	(e) Subject to Subsection (d), the commissioners court of a
196	196	county that requires a mandatory payment under this chapter shall
197	197	set the mandatory payments in amounts that in the aggregate will
198	198	generate sufficient revenue to cover the administrative expenses of
199	199	the county for activities under this chapter and to fund an
200	200	intergovernmental transfer described by Section 292E.103(c)(1).
201	201	The annual amount of revenue from mandatory payments that may be
202	202	used to pay the administrative expenses of the county for
203	203	activities under this chapter may not exceed $20,000, plus the cost
204	204	of collateralization of deposits, regardless of actual expenses.
205	205	(f) A paying provider may not add a mandatory payment
206	206	required under this section as a surcharge to a patient.
207	207	(g) A mandatory payment assessed under this chapter is not a
208	208	tax for hospital purposes for purposes of Section 4, Article IX,
209	209	Texas Constitution.
210	210	Sec. 292E.152. ASSESSMENT AND COLLECTION OF MANDATORY
211	211	PAYMENTS. (a) The county may collect or contract for the assessment
212	212	and collection of mandatory payments authorized under this chapter.
213	213	(b) The person charged by the county with the assessment and
214	214	collection of mandatory payments shall charge and deduct from the
215	215	mandatory payments collected for the county a collection fee in an
216	216	amount not to exceed the person's usual and customary charges for
217	217	like services.
218	218	(c) If the person charged with the assessment and collection
219	219	of mandatory payments is an official of the county, any revenue from
220	220	a collection fee charged under Subsection (b) shall be deposited in
221	221	the county general fund and, if appropriate, shall be reported as
222	222	fees of the county.
223	223	Sec. 292E.153. PURPOSE; CORRECTION OF INVALID PROVISION OR
224	224	PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
225	225	chapter is to authorize a county to establish a program to enable
226	226	the county to collect mandatory payments from institutional health
227	227	care providers to fund the nonfederal share of certain Medicaid
228	228	programs as described by Section 292E.103(c)(1).
229	229	(b) To the extent any provision or procedure under this
230	230	chapter causes a mandatory payment authorized under this chapter to
231	231	be ineligible for federal matching funds, the commissioners court
232	232	of the county administering the program may provide by rule for an
233	233	alternative provision or procedure that conforms to the
234	234	requirements of the federal Centers for Medicare and Medicaid
235	235	Services. A rule adopted under this section may not create, impose,
236	236	or materially expand the legal or financial liability or
237	237	responsibility of the county or an institutional health care
238	238	provider located in the county beyond the provisions of this
239	239	chapter. This section does not require the commissioners court of a
240	240	county to adopt a rule.
241	241	(c) A county administering a program may only assess and
242	242	collect a mandatory payment authorized under this chapter if a
243	243	waiver program, uniform rate enhancement, or reimbursement
244	244	described by Section 292E.103(c)(1) is available to the county.
245	245	(d) This chapter does not authorize a county administering a
246	246	program to collect mandatory payments for the purpose of raising
247	247	general revenue or any amount in excess of the amount reasonably
248	248	necessary to fund the nonfederal share of a Medicaid supplemental
249	249	payment program or Medicaid managed care rate enhancements for
250	250	nonpublic hospitals and to cover the administrative expenses of the
251	251	county associated with activities under this chapter.
252	252	SECTION 2. If before implementing any provision of this Act
253	253	a state agency determines that a waiver or authorization from a
254	254	federal agency is necessary for implementation of that provision,
255	255	the agency affected by the provision shall request the waiver or
256	256	authorization and may delay implementing that provision until the
257	257	waiver or authorization is granted.
258	258	SECTION 3. This Act takes effect immediately if it receives
259	259	a vote of two-thirds of all the members elected to each house, as
260	260	provided by Section 39, Article III, Texas Constitution. If this
261	261	Act does not receive the vote necessary for immediate effect, this
262	262	Act takes effect September 1, 2025.