Bill Text: TX SB1385 | 2015-2016 | 84th Legislature | Enrolled
Bill Title: Relating to the authorization of the imposition of administrative penalties on providers participating in certain Medicaid waiver programs.
Spectrum: Bipartisan Bill
Status: (Passed) 2015-06-19 - Effective on 9/1/15 [SB1385 Detail]
Download: Texas-2015-SB1385-Enrolled.html
S.B. No. 1385 |
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relating to the authorization of the imposition of administrative | ||
penalties on providers participating in certain Medicaid waiver | ||
programs. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter D, Chapter 161, Human Resources Code, | ||
is amended by adding Section 161.088 to read as follows: | ||
Sec. 161.088. ADMINISTRATIVE PENALTIES. (a) This section | ||
applies to the following waiver programs established under Section | ||
1915(c), Social Security Act (42 U.S.C. Section 1396n(c)), and | ||
administered by the department to serve persons with an | ||
intellectual or developmental disability: | ||
(1) the home and community-based services (HCS) waiver | ||
program; and | ||
(2) the Texas home living (TxHmL) waiver program. | ||
(b) The department may assess and collect an administrative | ||
penalty against a provider who participates in a program to which | ||
this section applies for a violation of a law or rule relating to | ||
the program. If the department assesses an administrative penalty | ||
against a provider for a violation of a law or rule, the department | ||
may not impose a payment hold against or otherwise withhold | ||
contract payments from the provider for the same violation of a law | ||
or rule. | ||
(c) After consulting with appropriate stakeholders, the | ||
executive commissioner shall develop and adopt rules regarding the | ||
imposition of administrative penalties under this section. The | ||
rules must: | ||
(1) specify the types of violations that warrant | ||
imposition of an administrative penalty; | ||
(2) establish a schedule of progressive | ||
administrative penalties in accordance with the relative type, | ||
frequency, and seriousness of a violation; | ||
(3) prescribe reasonable amounts to be imposed for | ||
each violation giving rise to an administrative penalty, subject to | ||
Subdivision (4); | ||
(4) authorize the imposition of an administrative | ||
penalty in an amount not to exceed $5,000 for each violation; | ||
(5) provide that a provider commits a separate | ||
violation each day the provider continues to violate the law or | ||
rule; | ||
(6) ensure standard and consistent application of | ||
administrative penalties throughout the state; and | ||
(7) provide for an administrative appeals process to | ||
adjudicate claims and appeals relating to the imposition of an | ||
administrative penalty under this section that is in accordance | ||
with Chapter 2001, Government Code. | ||
(d) In specifying the types of violations that warrant | ||
imposition of an administrative penalty under Subsection (c), the | ||
executive commissioner shall specify the types of minor violations | ||
that allow a provider an opportunity to take corrective action | ||
before a penalty is imposed. | ||
(e) In establishing the schedule of progressive | ||
administrative penalties and penalty amounts under Subsection (c), | ||
the executive commissioner must consider: | ||
(1) the seriousness of a violation, including: | ||
(A) the nature, circumstances, extent, and | ||
gravity of the violation; and | ||
(B) the hazard to the health or safety of | ||
recipients resulting from the violation; | ||
(2) the provider's history of previous violations; | ||
(3) whether the provider: | ||
(A) had prior knowledge of the violation, | ||
including whether the provider identified the violation through the | ||
provider's internal quality assurance process; and | ||
(B) made any efforts to mitigate or correct the | ||
identified violation; | ||
(4) the penalty amount necessary to deter future | ||
violations; and | ||
(5) any other matter justice may require. | ||
(f) In lieu of imposing an administrative penalty under this | ||
section, the department shall allow a provider found to have | ||
committed a minor violation specified by rule in accordance with | ||
Subsection (d) to have a reasonable period of time that is not less | ||
than 45 days after the date the department sends notice to the | ||
provider of the violation to take corrective action regarding the | ||
violation. The department may not allow time for corrective action | ||
for any violation that is not a minor violation. | ||
SECTION 2. The Department of Aging and Disability Services | ||
may impose an administrative penalty in accordance with Section | ||
161.088, Human Resources Code, as added by this Act, only for | ||
conduct that occurs on or after the effective date of this Act. | ||
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, 2015. | ||
______________________________ | ______________________________ | |
President of the Senate | Speaker of the House | |
I hereby certify that S.B. No. 1385 passed the Senate on | ||
April 20, 2015, by the following vote: Yeas 30, Nays 0; and that | ||
the Senate concurred in House amendment on May 28, 2015, by the | ||
following vote: Yeas 30, Nays 1. | ||
______________________________ | ||
Secretary of the Senate | ||
I hereby certify that S.B. No. 1385 passed the House, with | ||
amendment, on May 22, 2015, by the following vote: Yeas 140, | ||
Nays 0, two present not voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
Approved: | ||
______________________________ | ||
Date | ||
______________________________ | ||
Governor |