Bill Text: TX HB15 | 2013-2014 | 83rd Legislature | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to level of care designations for hospitals that provide neonatal and maternal services.
Spectrum: Slight Partisan Bill (Republican 7-4)
Status: (Passed) 2013-06-14 - Effective on 9/1/13 [HB15 Detail]
Download: Texas-2013-HB15-Engrossed.html
Bill Title: Relating to level of care designations for hospitals that provide neonatal and maternal services.
Spectrum: Slight Partisan Bill (Republican 7-4)
Status: (Passed) 2013-06-14 - Effective on 9/1/13 [HB15 Detail]
Download: Texas-2013-HB15-Engrossed.html
83R18574 JSC-D | ||
By: Kolkhorst, Coleman, Zerwas, Geren, | H.B. No. 15 | |
Cortez, et al. |
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relating to level of care designations for hospitals that provide | ||
neonatal and maternal services. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Chapter 241, Health and Safety Code, is amended | ||
by adding Subchapter H to read as follows: | ||
SUBCHAPTER H. HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL AND | ||
MATERNAL CARE | ||
Sec. 241.181. DEFINITIONS. In this subchapter: | ||
(1) "Department" means the Department of State Health | ||
Services. | ||
(2) "Executive commissioner" means the executive | ||
commissioner of the Health and Human Services Commission. | ||
Sec. 241.182. LEVEL OF CARE DESIGNATIONS. (a) The | ||
executive commissioner, in accordance with the rules adopted under | ||
Section 241.183, shall assign level of care designations to each | ||
hospital based on the neonatal and maternal services provided at | ||
the hospital. | ||
(b) A hospital may receive different level designations for | ||
neonatal and maternal care, respectively. | ||
Sec. 241.183. RULES. (a) The executive commissioner, in | ||
consultation with the department, shall adopt rules: | ||
(1) establishing the levels of care for neonatal and | ||
maternal care to be assigned to hospitals; | ||
(2) prescribing criteria for designating levels of | ||
neonatal and maternal care, respectively, including specifying the | ||
minimum requirements to qualify for each level designation; | ||
(3) establishing a process for the assignment of | ||
levels of care to a hospital for neonatal and maternal care, | ||
respectively; | ||
(4) establishing a process for amending the level of | ||
care designation requirements, including a process for assisting | ||
facilities in implementing any changes made necessary by the | ||
amendments; | ||
(5) dividing the state into neonatal and maternal care | ||
regions; | ||
(6) facilitating transfer agreements through regional | ||
coordination; | ||
(7) requiring payment, other than quality or | ||
outcome-based funding, to be based on services provided by the | ||
facility, regardless of the facility's level of care designation; | ||
and | ||
(8) prohibiting the denial of a neonatal or maternal | ||
level of care designation to a hospital that meets the minimum | ||
requirements for that level of care designation. | ||
(b) The Health and Human Services Commission shall study | ||
patient transfers that are not medically necessary but would be | ||
cost-effective. Based on the study under this subsection, if the | ||
executive commissioner determines that the transfers are feasible | ||
and desirable, the executive commissioner may adopt rules | ||
addressing those transfers. | ||
(c) Each level of care designation must require a hospital | ||
to regularly submit outcome and other data to the department as | ||
required or requested. | ||
(d) The criteria a hospital must achieve to receive each | ||
level of care designation must be posted on the department's | ||
Internet website. | ||
Sec. 241.184. ASSIGNMENT OF LEVEL OF CARE DESIGNATION. (a) | ||
The executive commissioner, in consultation with the department, | ||
shall assign the appropriate level of care designation to each | ||
hospital that meets the minimum standards for that level of care. | ||
The executive commissioner shall evaluate separately the neonatal | ||
and maternal services provided at the hospital and assign the | ||
respective level of care designations accordingly. | ||
(b) Every three years, the executive commissioner and the | ||
department shall review the level of care designations assigned to | ||
each hospital and, as necessary, assign a hospital a different | ||
level of care designation or remove the hospital's level of care | ||
designation. | ||
(c) A hospital may request a change of designation at any | ||
time. On request under this subsection, the executive commissioner | ||
and the department shall review the hospital's request and, as | ||
necessary, change the hospital's level of care designation. | ||
Sec. 241.185. HOSPITAL FAILING TO ACHIEVE MINIMUM LEVELS OF | ||
CARE. A hospital that does not meet the minimum requirements for | ||
any level of care designation for neonatal or maternal services: | ||
(1) may not receive a level of care designation for | ||
those services; and | ||
(2) is not eligible to receive reimbursement through | ||
the Medicaid program for neonatal or maternal services, as | ||
applicable, except emergency services required to be provided or | ||
reimbursed under state or federal law. | ||
Sec. 241.186. PERINATAL ADVISORY COUNCIL. (a) In this | ||
section, "advisory council" means the Perinatal Advisory Council | ||
established under this section. | ||
(b) The advisory council consists of 17 members appointed by | ||
the executive commissioner as follows: | ||
(1) four physicians licensed to practice medicine | ||
under Subtitle B, Title 3, Occupations Code, specializing in | ||
neonatology: | ||
(A) at least two of whom practice in a Level III | ||
or IV neonatal intensive care unit; and | ||
(B) at least one of whom practices in a neonatal | ||
intensive care unit of a hospital located in a rural area; | ||
(2) one physician licensed to practice medicine under | ||
Subtitle B, Title 3, Occupations Code, specializing in general | ||
pediatrics; | ||
(3) two physicians licensed to practice medicine under | ||
Subtitle B, Title 3, Occupations Code, specializing in | ||
obstetrics-gynecology; | ||
(4) two physicians licensed to practice medicine under | ||
Subtitle B, Title 3, Occupations Code, specializing in maternal | ||
fetal medicine; | ||
(5) one physician licensed to practice medicine under | ||
Subtitle B, Title 3, Occupations Code, specializing in family | ||
practice who provides obstetrical care in a rural community; | ||
(6) one registered nurse licensed under Subtitle E, | ||
Title 3, Occupations Code, with expertise in maternal health care | ||
delivery; | ||
(7) one registered nurse licensed under Subtitle E, | ||
Title 3, Occupations Code, with expertise in perinatal health care | ||
delivery; | ||
(8) one representative from a children's hospital; | ||
(9) one representative from a hospital with a Level II | ||
neonatal intensive care unit; | ||
(10) one representative from a rural hospital; | ||
(11) one representative from a general hospital; and | ||
(12) one ex officio representative from the office of | ||
the medical director of the Health and Human Services Commission. | ||
(c) To the extent possible, the executive commissioner | ||
shall appoint members to the advisory council who previously served | ||
on the Neonatal Intensive Care Unit Council established under | ||
Chapter 818 (H.B. 2636), Acts of the 82nd Legislature, Regular | ||
Session, 2011. | ||
(d) Members of the advisory council described by | ||
Subsections (b)(1)-(11) serve staggered three-year terms, with the | ||
terms of five or six of those members expiring September 1 of each | ||
year. A member may be reappointed to the advisory council. | ||
(e) A member of the advisory council serves without | ||
compensation but is entitled to reimbursement for actual and | ||
necessary travel expenses related to the performance of advisory | ||
council duties. | ||
(f) The department, with recommendations from the advisory | ||
council, shall develop a process for the designation and updates of | ||
levels of neonatal and maternal care at hospitals in accordance | ||
with this subchapter. | ||
(g) The advisory council shall: | ||
(1) develop and recommend criteria for designating | ||
levels of neonatal and maternal care, respectively, including | ||
specifying the minimum requirements to qualify for each level | ||
designation; | ||
(2) develop and recommend a process for the assignment | ||
of levels of care to a hospital for neonatal and maternal care, | ||
respectively; | ||
(3) make recommendations for the division of the state | ||
into neonatal and maternal care regions; | ||
(4) examine utilization trends relating to neonatal | ||
and maternal care; and | ||
(5) make recommendations related to improving | ||
neonatal and maternal outcomes. | ||
(h) In developing the criteria for the levels of neonatal | ||
and maternal care, the advisory council shall consider: | ||
(1) any recommendations or publications of the | ||
American Academy of Pediatrics and the American Congress of | ||
Obstetricians and Gynecologists, including "Guidelines for | ||
Perinatal Care"; | ||
(2) any guidelines developed by the Society of | ||
Maternal-Fetal Medicine; and | ||
(3) the geographic and varied needs of citizens of | ||
this state. | ||
(i) The advisory council shall submit a report detailing the | ||
advisory council's determinations and recommendations to the | ||
department and the executive commissioner not later than September | ||
1, 2015. | ||
(j) The advisory council shall continue to update its | ||
recommendations based on any relevant scientific or medical | ||
developments. | ||
(k) The advisory council is subject to Chapter 325, | ||
Government Code (Texas Sunset Act). Unless continued in existence | ||
as provided by that chapter, the advisory council is abolished and | ||
this section expires September 1, 2025. | ||
SECTION 2. (a) Not later than December 1, 2013, the | ||
executive commissioner of the Health and Human Services Commission | ||
shall appoint the members of the Perinatal Advisory Council as | ||
required by Section 241.186, Health and Safety Code, as added by | ||
this Act. Notwithstanding Section 241.186(d), Health and Safety | ||
Code, as added by this Act, the executive commissioner shall | ||
appoint: | ||
(1) two members described by Section 241.186(b)(1), | ||
Health and Safety Code, one member described by Section | ||
241.186(b)(3), Health and Safety Code, and the members described by | ||
Sections 241.186(b)(6) and (9), Health and Safety Code, to an | ||
initial term that expires September 1, 2017; | ||
(2) one member described by Section 241.186(b)(1), | ||
Health and Safety Code, one member described by Section | ||
241.186(b)(3), Health and Safety Code, one member described by | ||
Section 241.186(b)(4), Health and Safety Code, and the members | ||
described by Sections 241.186(b)(2), (7), and (10), Health and | ||
Safety Code, to an initial term that expires September 1, 2018; and | ||
(3) one member described by Section 241.186(b)(1), | ||
Health and Safety Code, one member described by Section | ||
241.186(b)(4), Health and Safety Code, and the members described by | ||
Sections 241.186(b)(5), (8), and (11), Health and Safety Code, to | ||
an initial term that expires September 1, 2019. | ||
(b) Not later than March 1, 2017, after consideration of the | ||
report of the Perinatal Advisory Council, the executive | ||
commissioner of the Health and Human Services Commission shall | ||
adopt the initial rules required by Section 241.183, Health and | ||
Safety Code, as added by this Act. | ||
(c) The executive commissioner of the Health and Human | ||
Services Commission shall complete for each hospital in this state: | ||
(1) the neonatal level of care designation not later | ||
than August 31, 2017; and | ||
(2) the maternal level of care designation not later | ||
than August 31, 2019. | ||
(d) Notwithstanding Section 241.185, Health and Safety | ||
Code, as added by this Act: | ||
(1) a hospital is not required to have a neonatal level | ||
of care designation as a condition of reimbursement through the | ||
Medicaid program before September 1, 2017; and | ||
(2) a hospital is not required to have a maternal level | ||
of care designation as a condition of reimbursement through the | ||
Medicaid program before September 1, 2019. | ||
SECTION 3. If before implementing any provision of this Act | ||
a state agency determines that a waiver or authorization from a | ||
federal agency is necessary for implementation of that provision, | ||
the agency affected by the provision shall request the waiver or | ||
authorization and may delay implementing that provision until the | ||
waiver or authorization is granted. | ||
SECTION 4. This Act takes effect September 1, 2013. |