Bill Text: TX HB4648 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to the creation and operations of a health care provider participation program by the Lubbock County Hospital District.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2019-04-22 - Committee report sent to Calendars [HB4648 Detail]
Download: Texas-2019-HB4648-Introduced.html
2019S0262-1 02/22/19 | ||
By: Burrows | H.B. No. 4648 |
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relating to the creation and operations of a health care provider | ||
participation program by the Lubbock County Hospital District. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle D, Title 4, Health and Safety Code, is | ||
amended by adding Chapter 298C to read as follows: | ||
CHAPTER 298C. LUBBOCK COUNTY HOSPITAL DISTRICT HEALTH CARE | ||
PROVIDER PARTICIPATION PROGRAM | ||
SUBCHAPTER A. GENERAL PROVISIONS | ||
Sec. 298C.001. PURPOSE. The purpose of this chapter is to | ||
authorize the district to administer a health care provider | ||
participation program to provide additional compensation to | ||
nonpublic hospitals by collecting mandatory payments from each | ||
nonpublic hospital in the district to be used to provide the | ||
nonfederal share of a Medicaid supplemental payment program and for | ||
other purposes as authorized under this chapter. | ||
Sec. 298C.002. DEFINITIONS. In this chapter: | ||
(1) "Board" means the board of hospital managers of | ||
the district. | ||
(2) "Commissioners court" means the Commissioners | ||
Court of Lubbock County. | ||
(3) "County" means Lubbock County. | ||
(4) "District" means the Lubbock County Hospital | ||
District of Lubbock County, Texas. | ||
(5) "Institutional health care provider" means a | ||
nonpublic hospital located in the district that provides inpatient | ||
hospital services. | ||
(6) "Paying hospital" means an institutional health | ||
care provider required to make a mandatory payment under this | ||
chapter. | ||
(7) "Program" means the health care provider | ||
participation program authorized by this chapter. | ||
Sec. 298C.003. APPLICABILITY. This chapter applies only to | ||
the Lubbock County Hospital District of Lubbock County, Texas. | ||
Sec. 298C.004. HEALTH CARE PROVIDER PARTICIPATION PROGRAM; | ||
PARTICIPATION IN PROGRAM. The board may authorize the district to | ||
participate in a health care provider participation program on the | ||
affirmative vote of a majority of the board, subject to the | ||
provisions of this chapter. | ||
SUBCHAPTER B. POWERS AND DUTIES | ||
Sec. 298C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY | ||
PAYMENT. The board may authorize the collection of a mandatory | ||
payment authorized under this chapter from an institutional health | ||
care provider located in the district only in the manner provided by | ||
this chapter. | ||
Sec. 298C.052. INSTITUTIONAL HEALTH CARE PROVIDER | ||
REPORTING. If the board authorizes the district to participate in a | ||
program under this chapter, the board shall require each | ||
institutional health care provider to submit to the district a copy | ||
of any financial and utilization data required by and reported to | ||
the Department of State Health Services under Sections 311.032 and | ||
311.033 and any rules adopted by the executive commissioner of the | ||
Health and Human Services Commission to implement those sections. | ||
Sec. 298C.053. PROGRAM ADMINISTRATION. (a) The board, | ||
subject to the approval of the commissioners court, shall delegate | ||
all administrative responsibilities of the program, including | ||
collection of mandatory payments, expenditures, and audits, to the | ||
county. | ||
(b) The commissioners court may adopt rules relating to the | ||
administration of the program. | ||
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS | ||
Sec. 298C.101. HEARING. (a) In each year that the board | ||
authorizes a program under this chapter, the board shall hold a | ||
public hearing on the amounts of any mandatory payments that the | ||
board intends to require during the year and how the revenue derived | ||
from those payments is to be spent. | ||
(b) Not later than the fifth day before the date of the | ||
hearing required under Subsection (a), the board shall publish | ||
notice of the hearing in a newspaper of general circulation in the | ||
district and provide written notice of the hearing to the chief | ||
operating officer of each institutional health care provider in the | ||
district. | ||
(c) Determination of the amount of any mandatory payments to | ||
be collected during the year shall be shown to be based on | ||
reasonable estimates of the amount of revenue necessary to meet and | ||
cover the nonfederal share of payments described by Section | ||
298C.103(b)(1) that is otherwise unfunded, and is subject to the | ||
final approval of the commissioners court. | ||
Sec. 298C.102. LOCAL PROVIDER PARTICIPATION FUND; | ||
DEPOSITORY. (a) If the board authorizes the collection of a | ||
mandatory payment authorized under this chapter, and the | ||
commissioners court approves such collection, the commissioners | ||
court shall by resolution create a local provider participation | ||
fund in one or more banks located in the district that are | ||
designated by the commissioners court to serve as the depository | ||
for mandatory payments received by the county. | ||
(b) All income received by the county under this chapter, | ||
including the revenue from mandatory payments remaining after | ||
discounts and fees for assessing and collecting the payments are | ||
deducted, shall be deposited with the county depository in the | ||
county's local provider participation fund and may be withdrawn | ||
only as provided by this chapter. | ||
(c) All funds collected under this chapter shall be secured | ||
in the manner provided by law for securing county funds. | ||
Sec. 298C.103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY. | ||
(a) The local provider participation fund established under | ||
Section 298C.102 consists of: | ||
(1) all mandatory payments authorized under this | ||
chapter and received by the county; | ||
(2) money received from the Health and Human Services | ||
Commission as a refund of an intergovernmental transfer from the | ||
local provider participation fund to the state as the nonfederal | ||
share of Medicaid supplemental payment program payments, provided | ||
that the intergovernmental transfer does not receive a federal | ||
matching payment; and | ||
(3) the earnings of the fund. | ||
(b) Money deposited to the local provider participation | ||
fund may be used only to: | ||
(1) fund intergovernmental transfers from the county | ||
to the state to provide the nonfederal share of: | ||
(A) uncompensated care payments for nonpublic | ||
hospitals and delivery system reform incentive payments for | ||
nonpublic hospitals, if those payments are authorized under the | ||
Texas Healthcare Transformation and Quality Improvement Program | ||
waiver issued under Section 1115 of the federal Social Security Act | ||
(42 U.S.C. Section 1315); | ||
(B) uniform rate enhancements for nonpublic | ||
hospitals in the Medicaid managed care service area in which the | ||
district is located; | ||
(C) payments available to nonpublic hospitals | ||
under another waiver program authorizing payments that are | ||
substantially similar to Medicaid payments to nonpublic hospitals | ||
described by Paragraph (A) or (B); or | ||
(D) any reimbursement to nonpublic hospitals for | ||
which federal matching funds are available; | ||
(2) subject to Section 298C.151(d), pay the | ||
administrative expenses of the county in administering the program, | ||
including collateralization of deposits; | ||
(3) refund a portion of a mandatory payment collected | ||
in error from a paying hospital; and | ||
(4) refund to paying hospitals a proportionate share | ||
of the money that the county: | ||
(A) receives from the Health and Human Services | ||
Commission that is not used to fund the nonfederal share of payments | ||
described by Subdivision (1); or | ||
(B) determines cannot be used to fund the | ||
nonfederal share of payments described by Subdivision (1). | ||
(c) Money in the local provider participation fund may not | ||
be commingled with other county funds. | ||
(d) An intergovernmental transfer of funds described by | ||
Subsection (b)(1) and any funds received by the county as a result | ||
of an intergovernmental transfer described by that subsection may | ||
not be used by the county or any other entity to expand Medicaid | ||
eligibility under the Patient Protection and Affordable Care Act | ||
(Pub. L. No. 111-148) as amended by the Health Care and Education | ||
Reconciliation Act of 2010 (Pub. L. No. 111-152). | ||
SUBCHAPTER D. MANDATORY PAYMENTS | ||
Sec. 298C.151. MANDATORY PAYMENTS. (a) If the board | ||
authorizes a program under this chapter, the board, subject to the | ||
approval of the commissioners court, may require an annual | ||
mandatory payment to be assessed on the net patient revenue of each | ||
institutional health care provider located in the district. The | ||
commissioners court may provide that the mandatory payment is to be | ||
collected at least annually, but not more often than quarterly. In | ||
the first year in which the mandatory payment is required, the | ||
mandatory payment is assessed on the net patient revenue of an | ||
institutional health care provider as determined by the data | ||
reported to the Department of State Health Services under Sections | ||
311.032 and 311.033 in the most recent fiscal year for which that | ||
data was reported. If the institutional health care provider did | ||
not report any data under those sections, the provider's net | ||
patient revenue is the amount of that revenue as contained in the | ||
provider's Medicare cost report submitted for the previous fiscal | ||
year or for the closest subsequent fiscal year for which the | ||
provider submitted the Medicare cost report. | ||
(b) The amount of a mandatory payment authorized under this | ||
chapter must be a uniform percentage of the amount of net patient | ||
revenue generated by each paying hospital in the district. A | ||
mandatory payment authorized under this chapter may not hold | ||
harmless any institutional health care provider, as required under | ||
42 U.S.C. Section 1396b(w). | ||
(c) The aggregate amount of the mandatory payments required | ||
of all paying hospitals in the district may not exceed six percent | ||
of the aggregate net patient revenue of all paying hospitals in the | ||
district. | ||
(d) Subject to the maximum amount prescribed by Subsection | ||
(c), the board, with the approval of the commissioners court, shall | ||
set the mandatory payments in amounts that in the aggregate will | ||
generate sufficient revenue to cover the administrative expenses of | ||
the county for activities under this chapter, fund an | ||
intergovernmental transfer described by Section 298C.103(b)(1), or | ||
make other payments authorized under this chapter. The mandatory | ||
payment amounts must be set based on reasonable estimates of the | ||
amount of revenue necessary to fully meet and cover authorized | ||
expenses under this chapter. The amount of revenue from mandatory | ||
payments that may be used for administrative expenses by the county | ||
in a year may not exceed $25,000, plus the cost of collateralization | ||
of deposits. If the county demonstrates to the paying hospitals | ||
that the costs of administering the program under this chapter, | ||
excluding those costs associated with the collateralization of | ||
deposits, exceed $25,000 in any year, on consent of a majority of | ||
all of the paying hospitals, the county may use additional revenue | ||
from mandatory payments received under this chapter to compensate | ||
the county for its administrative expenses. A paying hospital may | ||
not unreasonably withhold consent to compensate the county for | ||
administrative expenses. | ||
(e) A paying hospital may not add a mandatory payment | ||
required under this section as a surcharge to a patient or insurer. | ||
(f) A mandatory payment under this chapter is not a tax for | ||
purposes of Section 4, Article IX, Texas Constitution, or Chapter | ||
1053, Special District Local Laws Code. | ||
Sec. 298C.152. ASSESSMENT AND COLLECTION OF MANDATORY | ||
PAYMENTS. The county may collect or contract for the assessment and | ||
collection of mandatory payments authorized under this chapter. | ||
Sec. 298C.153. CORRECTION OF INVALID PROVISION OR | ||
PROCEDURE. To the extent any provision or procedure under this | ||
chapter causes a mandatory payment authorized under this chapter to | ||
be ineligible for federal matching funds, the board may provide by | ||
rule for an alternative provision or procedure that conforms to the | ||
requirements of the federal Centers for Medicare and Medicaid | ||
Services. A rule adopted under this section may not create, impose, | ||
or materially expand the legal or financial liability or | ||
responsibility of the district or an institutional health care | ||
provider in the district beyond the provisions of this chapter. | ||
This section does not require the board to adopt a rule. | ||
SECTION 2. 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 3. This Act takes effect immediately if it receives | ||
a vote of two-thirds of all the members elected to each house, as | ||
provided by Section 39, Article III, Texas Constitution. If this | ||
Act does not receive the vote necessary for immediate effect, this | ||
Act takes effect September 1, 2019. |