Bill Text: TX HB651 | 2019-2020 | 86th Legislature | Enrolled
Bill Title: Relating to the creation and operations of health care provider participation programs in counties not served by a hospital district or a public hospital.
Spectrum: Moderate Partisan Bill (Republican 4-1)
Status: (Vetoed) 2019-06-15 - Vetoed by the Governor [HB651 Detail]
Download: Texas-2019-HB651-Enrolled.html
H.B. No. 651 |
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relating to the creation and operations of health care provider | ||
participation programs in counties not served by a hospital | ||
district or a public hospital. | ||
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 299 to read as follows: | ||
CHAPTER 299. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN | ||
COUNTY NOT SERVED BY HOSPITAL DISTRICT OR PUBLIC HOSPITAL | ||
SUBCHAPTER A. GENERAL PROVISIONS | ||
Sec. 299.0001. PURPOSE. The purpose of this chapter is to | ||
authorize a county not served by a hospital district or a public | ||
hospital to administer a county health care provider participation | ||
program to provide additional compensation to hospitals in the | ||
county by collecting mandatory payments from each hospital in the | ||
county to be used to provide the nonfederal share of a Medicaid | ||
supplemental payment program and for other purposes as authorized | ||
under this chapter. | ||
Sec. 299.0002. DEFINITIONS. In this chapter: | ||
(1) "Institutional health care provider" means a | ||
nonpublic hospital that provides inpatient hospital services. | ||
(2) "Paying hospital" means an institutional health | ||
care provider required to make a mandatory payment under this | ||
chapter. | ||
(3) "Program" means a county health care provider | ||
participation program authorized by this chapter. | ||
Sec. 299.0003. APPLICABILITY. This chapter applies only to | ||
a county that is not served by a hospital district or a public | ||
hospital. | ||
Sec. 299.0004. COUNTY HEALTH CARE PROVIDER PARTICIPATION | ||
PROGRAM; COUNTY ORDER REQUIRED FOR PARTICIPATION. The | ||
commissioners court of a county may adopt an order authorizing the | ||
county to participate in a health care provider participation | ||
program, subject to the limitations provided by this chapter. | ||
SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT | ||
Sec. 299.0051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY | ||
PAYMENT. The commissioners court of a county may require a | ||
mandatory payment authorized under this chapter by an institutional | ||
health care provider in the county only in the manner provided by | ||
this chapter. | ||
Sec. 299.0052. RULES AND PROCEDURES. The commissioners | ||
court of a county may adopt rules relating to the administration of | ||
the health care provider participation program in the county, | ||
including collection of the mandatory payments, expenditures, | ||
audits, and any other administrative aspects of the program. | ||
Sec. 299.0053. INSTITUTIONAL HEALTH CARE PROVIDER | ||
REPORTING. If the commissioners court of a county authorizes the | ||
county to participate in a health care provider participation | ||
program under this chapter, the commissioners court shall require | ||
each institutional health care provider to submit to the county 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. | ||
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS | ||
Sec. 299.0101. HEARING. (a) In each year that the | ||
commissioners court of a county authorizes a health care provider | ||
participation program under this chapter, the commissioners court | ||
shall hold a public hearing on the amounts of any mandatory payments | ||
that the commissioners court 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 commissioners court | ||
shall publish notice of the hearing in a newspaper of general | ||
circulation in the county and provide written notice of the hearing | ||
to the chief operating officer of each institutional health care | ||
provider in the county. | ||
Sec. 299.0102. LOCAL PROVIDER PARTICIPATION FUND; | ||
DEPOSITORY. (a) Each commissioners court of a county that collects | ||
a mandatory payment authorized under this chapter shall create a | ||
local provider participation fund in one or more banks designated | ||
by the county as a depository for the mandatory payments received by | ||
the county. | ||
(b) The commissioners court of a county may withdraw or use | ||
money in the local provider participation fund of the county only | ||
for a purpose authorized under this chapter. | ||
(c) All funds collected under this chapter shall be secured | ||
in the manner provided for securing other county funds. | ||
Sec. 299.0103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY. | ||
(a) The local provider participation fund established by a county | ||
under Section 299.0102 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 | ||
county to the state for the purpose of providing 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 of a county may be used only to: | ||
(1) fund intergovernmental transfers from the county | ||
to the state to provide: | ||
(A) the nonfederal share of a Medicaid | ||
supplemental payment program authorized under the state Medicaid | ||
plan, 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), or a successor waiver | ||
program authorizing similar Medicaid supplemental payment | ||
programs; or | ||
(B) payments to Medicaid managed care | ||
organizations that are dedicated for payment to hospitals; | ||
(2) pay costs associated with indigent care provided | ||
by institutional health care providers in the county; | ||
(3) pay the administrative expenses of the county in | ||
administering the program, including collateralization of | ||
deposits; | ||
(4) refund a portion of a mandatory payment collected | ||
in error from a paying hospital; and | ||
(5) 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 Medicaid | ||
supplemental payment program payments; or | ||
(B) determines cannot be used to fund the | ||
nonfederal share of Medicaid supplemental payment program | ||
payments. | ||
(c) Money in the local provider participation fund of a | ||
county 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. 299.0151. MANDATORY PAYMENTS. (a) Except as provided | ||
by Subsection (e), if the commissioners court of a county | ||
authorizes a health care provider participation program under this | ||
chapter, the commissioners court shall require an annual mandatory | ||
payment to be assessed on the net patient revenue of each | ||
institutional health care provider located in the county. The | ||
commissioners court shall 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 located in the county 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. The county | ||
shall update the amount of the mandatory payment on an annual basis. | ||
(b) The amount of a mandatory payment authorized under this | ||
chapter for a county must be uniformly proportionate with the | ||
amount of net patient revenue generated by each paying hospital in | ||
the county. 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 commissioners court of a county that authorizes a | ||
program under this chapter shall set the amount of the mandatory | ||
payment. The amount of the mandatory payment required of each | ||
paying hospital in the county may not exceed six percent of the | ||
hospital's net patient revenue. | ||
(d) Subject to the maximum amount prescribed by Subsection | ||
(c), the commissioners court of a county that authorizes a program | ||
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 299.0103(b)(1), or | ||
make other payments authorized 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 commissioners court | ||
demonstrates to the paying hospitals in the county that the costs of | ||
administering the health care provider participation program under | ||
this chapter, excluding those costs associated with the | ||
collateralization of deposits, exceed $25,000 in any year, on | ||
consent of all of the paying hospitals in the county, 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 5(a), Article IX, Texas Constitution. | ||
Sec. 299.0152. ASSESSMENT AND COLLECTION OF MANDATORY | ||
PAYMENTS. A county may collect or contract for the assessment and | ||
collection of mandatory payments authorized under this chapter. | ||
Sec. 299.0153. 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 county 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 county or an institutional health care | ||
provider in the county beyond the provisions of this chapter. This | ||
section does not require the commissioners court of a county 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. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I certify that H.B. No. 651 was passed by the House on April | ||
10, 2019, by the following vote: Yeas 135, Nays 9, 1 present, not | ||
voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
I certify that H.B. No. 651 was passed by the Senate on May | ||
22, 2019, by the following vote: Yeas 30, Nays 1. | ||
______________________________ | ||
Secretary of the Senate | ||
APPROVED: _____________________ | ||
Date | ||
_____________________ | ||
Governor |