Bill Text: TX SB2448 | 2019-2020 | 86th Legislature | Comm Sub

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the creation and operations of a health care provider participation program by the Lubbock County Hospital District of Lubbock County, Texas.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Passed) 2019-06-04 - Effective immediately [SB2448 Detail]

Download: Texas-2019-SB2448-Comm_Sub.html
 
 
  By: Perry S.B. No. 2448
 
  (Burrows)
 
   
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the creation and operations of a health care provider
  participation program by the Lubbock County Hospital District of
  Lubbock County, Texas.
         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 OF LUBBOCK COUNTY,
  TEXAS:  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)  "District" means the Lubbock County Hospital
  District of Lubbock County, Texas.
               (3)  "Institutional health care provider" means a
  nonpublic hospital located in the district that provides inpatient
  hospital services.
               (4)  "Paying hospital" means an institutional health
  care provider required to make a mandatory payment under this
  chapter.
               (5)  "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 OF BOARD
         Sec. 298C.051.  LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
  PAYMENT. The board may require a mandatory payment authorized
  under this chapter from an institutional health care provider 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.  RULES AND PROCEDURES. The board may adopt
  rules relating to the administration of the health care provider
  participation program, including collection of the mandatory
  payments, expenditures, audits, and any other administrative
  aspects 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)  The board's determination of the amount of mandatory
  payments to be collected during the year must be shown to be based
  on reasonable estimates of the amount of revenue necessary to fund
  intergovernmental transfers from the district to the state
  providing the nonfederal share of payments described by Section
  298C.103(b)(1) that is otherwise unfunded.
         Sec. 298C.102.  LOCAL PROVIDER PARTICIPATION FUND;
  DEPOSITORY. (a)  If the board collects a mandatory payment
  authorized under this chapter, the board shall create a local
  provider participation fund in one or more banks located in the
  district that are designated by the district as a depository for
  public funds.
         (b)  All money received by the district under this chapter,
  including the amount of revenue from mandatory payments remaining
  after deducting any discounts and fees for assessing and collecting
  the payments, shall be deposited with a depository designated under
  Subsection (a).
         (c)  The board may withdraw or use money in the fund only for
  a purpose authorized under this chapter.
         (d)  All funds collected under this chapter shall be secured
  in the manner provided by Chapter 1053, Special District Local Laws
  Code, for securing public funds of the district.
         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 district;
               (2)  money received from the Health and Human Services
  Commission as a refund of an intergovernmental transfer from the
  district 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
  district to the state to provide the nonfederal share of Medicaid
  payments for:
                     (A)  uncompensated care and delivery system
  reform incentive payments to 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 district 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 district:
                     (A)  receives from the Health and Human Services
  Commission that is not used to fund the nonfederal share of Medicaid
  supplemental payment program payments described by Subdivision
  (1); or
                     (B)  determines cannot be used to fund the
  nonfederal share of Medicaid supplemental payment program payments
  described by Subdivision (1).
         (c)  Money in the local provider participation fund may not
  be commingled with other district funds.
         (d)  An intergovernmental transfer of funds described by
  Subsection (b)(1) and any funds received by the district as a result
  of an intergovernmental transfer described by that subsection may
  not be used by the district 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 shall require an
  annual mandatory payment to be assessed on the net patient revenue
  of each institutional health care provider located in the district.  
  The board 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.  The district shall update the amount of
  the mandatory payment on an annual basis and may update the amount
  on a more frequent basis.
         (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) and this subsection, the board shall set the mandatory payments
  in amounts that in the aggregate will generate sufficient revenue
  to cover the administrative expenses of the district 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 amount of the mandatory payments must be based on
  reasonable estimates of the amount of revenue necessary to cover
  the administrative expenses, intergovernmental transfers, and
  other payments described by this subsection as authorized under
  this chapter.  The amount of revenue from mandatory payments that
  may be used for administrative expenses by the district in a year
  may not exceed $25,000, plus the cost of collateralization of
  deposits. If the board 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 all of the
  paying hospitals, the district may use additional revenue from
  mandatory payments received under this chapter to compensate the
  district for its administrative expenses.  A paying hospital may
  not unreasonably withhold consent to compensate the district 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 9, Article IX, Texas Constitution, or Chapter
  1053, Special District Local Laws Code.
         Sec. 298C.152.  ASSESSMENT AND COLLECTION OF MANDATORY
  PAYMENTS. The district 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.
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