Bill Text: TX SR935 | 2017-2018 | 85th Legislature | Enrolled

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Bill Title: Suspending limitations on conference committee jurisdiction on SB 1462.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2017-05-28 - Reported enrolled [SR935 Detail]

Download: Texas-2017-SR935-Enrolled.html

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By: Hinojosa S.R. No. 935

SENATE RESOLUTION
BE IT RESOLVED by the Senate of the State of Texas, 85th
Legislature, Regular Session, 2017, That Senate Rule 12.03 be
suspended in part as provided by Senate Rule 12.08 to enable the
conference committee appointed to resolve the differences on
Senate Bill 1462 (the creation and operation of certain local
health care provider participation programs) to consider and
take action on the following matter:
Senate Rule 12.03(4) is suspended to permit the committee
to add text on a matter not included in either the house or senate
version of the bill by adding the following SECTIONS to the bill:
SECTION 28. Subtitle D, Title 4, Health and Safety Code,
is amended by adding Chapter 298B to read as follows:
CHAPTER 298B. TARRANT COUNTY HOSPITAL DISTRICT HEALTH CARE
PROVIDER PARTICIPATION PROGRAM
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 298B.001. DEFINITIONS. In this chapter:
(1) "Board" means the board of hospital managers of
the district.
(2) "District" means the Tarrant County Hospital
District.
(3) "Institutional health care provider" means a
nonpublic hospital located in the district that provides
inpatient hospital services.
(4) "Paying provider" 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. 298B.002. APPLICABILITY. This chapter applies only
to the Tarrant County Hospital District.
Sec. 298B.003. 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.
Sec. 298B.004. EXPIRATION OF AUTHORITY. (a) Subject to
Sections 298B.153(d) and 298B.154, the authority of the district
to administer and operate a program under this chapter expires
December 31, 2019.
(b) Subsection (a) does not affect the authority of the
district to require and collect a mandatory payment under Section
298B.154 after December 31, 2019, if necessary.
SUBCHAPTER B. POWERS AND DUTIES OF BOARD
Sec. 298B.051. LIMITATION ON AUTHORITY TO REQUIRE
MANDATORY PAYMENT. The board may require a mandatory payment
authorized under this chapter by an institutional health care
provider in the district only in the manner provided by this
chapter.
Sec. 298B.052. RULES AND PROCEDURES. The board may adopt
rules relating to the administration of the program, including
collection of the mandatory payments, expenditures, audits, and
any other administrative aspects of the program.
Sec. 298B.053. 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.
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
Sec. 298B.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 each
institutional health care provider in the district.
Sec. 298B.102. DEPOSITORY. (a) If the board requires a
mandatory payment authorized under this chapter, the board shall
designate one or more banks as a depository for the district's
local provider participation fund.
(b) All funds collected under this chapter shall be
secured in the manner provided for securing other district funds.
Sec. 298B.103. LOCAL PROVIDER PARTICIPATION FUND;
AUTHORIZED USES OF MONEY. (a) If the district requires a
mandatory payment authorized under this chapter, the district
shall create a local provider participation fund.
(b) The local provider participation fund consists of:
(1) all revenue received by the district
attributable to mandatory payments authorized under this
chapter;
(2) money received from the Health and Human
Services Commission as a refund of an intergovernmental transfer
under the program, provided that the intergovernmental transfer
does not receive a federal matching payment; and
(3) the earnings of the fund.
(c) Money deposited to the local provider participation
fund of the district 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 payments to nonpublic
hospitals affiliated with the district, 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 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 298B.151(d), pay the
administrative expenses of the district in administering the
program, including collateralization of deposits;
(3) refund a mandatory payment collected in error
from a paying provider;
(4) refund to paying providers 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; or
(B) determines cannot be used to fund the
nonfederal share of Medicaid supplemental payment program
payments;
(5) transfer funds to the Health and Human Services
Commission if the district is legally required to transfer the
funds to address a disallowance of federal matching funds with
respect to programs for which the district made
intergovernmental transfers described by Subdivision (1); and
(6) reimburse the district if the district is
required by the rules governing the uniform rate enhancement
program described by Subdivision (1)(B) to incur an expense or
forego Medicaid reimbursements from the state because the
balance of the local provider participation fund is not
sufficient to fund that rate enhancement program.
(d) Money in the local provider participation fund may
not be commingled with other district funds.
(e) Notwithstanding any other provision of this chapter,
with respect to an intergovernmental transfer of funds described
by Subsection (c)(1) made by the district, any funds received by
the state, district, or other entity as a result of that transfer
may not be used by the state, district, or any other entity to:
(1) 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); or
(2) fund the nonfederal share of payments to
nonpublic hospitals available through the Medicaid
disproportionate share hospital program or the delivery system
reform incentive payment program.
SUBCHAPTER D. MANDATORY PAYMENTS
Sec. 298B.151. MANDATORY PAYMENTS BASED ON PAYING
PROVIDER NET PATIENT REVENUE. (a) Except as provided by
Subsection (e), if the board authorizes a health care provider
participation program under this chapter, the board 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 board may provide for the mandatory payment to be
assessed 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. If the mandatory payment is required, the
district shall update the amount of the mandatory payment on an
annual basis.
(b) The amount of a mandatory payment authorized under
this chapter must be uniformly proportionate with the amount of
net patient revenue generated by each paying provider in the
district as permitted under federal law. A health care provider
participation program authorized under this chapter may not hold
harmless any institutional health care provider, as required
under 42 U.S.C. Section 1396b(w).
(c) If the board requires a mandatory payment authorized
under this chapter, the board shall set the amount of the
mandatory payment, subject to the limitations of this chapter.
The aggregate amount of the mandatory payments required of all
paying providers in the district may not exceed six percent of
the aggregate net patient revenue from hospital services
provided by all paying providers in the district.
(d) Subject to Subsection (c), if the board requires a
mandatory payment authorized under this chapter, 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 and to fund an
intergovernmental transfer described by Section 298B.103(c)(1).
The annual amount of revenue from mandatory payments that shall
be paid for administrative expenses by the district is $150,000,
plus the cost of collateralization of deposits, regardless of
actual expenses.
(e) A paying provider may not add a mandatory payment
required under this section as a surcharge to a patient.
(f) A mandatory payment assessed under this chapter is
not a tax for hospital purposes for purposes of Section 4,
Article IX, Texas Constitution, or Section 281.045.
Sec. 298B.152. ASSESSMENT AND COLLECTION OF MANDATORY
PAYMENTS. (a) The district may designate an official of the
district or contract with another person to assess and collect
the mandatory payments authorized under this chapter.
(b) The person charged by the district with the
assessment and collection of mandatory payments shall charge and
deduct from the mandatory payments collected for the district a
collection fee in an amount not to exceed the person's usual and
customary charges for like services.
(c) If the person charged with the assessment and
collection of mandatory payments is an official of the district,
any revenue from a collection fee charged under Subsection (b)
shall be deposited in the district general fund and, if
appropriate, shall be reported as fees of the district.
Sec. 298B.153. PURPOSE; CORRECTION OF INVALID PROVISION
OR PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this
chapter is to authorize the district to establish a program to
enable the district to collect mandatory payments from
institutional health care providers to fund the nonfederal share
of a Medicaid supplemental payment program or the Medicaid
managed care rate enhancements for nonpublic hospitals to
support the provision of health care by institutional health care
providers to district residents in need of health care.
(b) This chapter does not authorize the district to
collect mandatory payments for the purpose of raising general
revenue or any amount in excess of the amount reasonably
necessary to fund the nonfederal share of a Medicaid supplemental
payment program or Medicaid managed care rate enhancements for
nonpublic hospitals and to cover the administrative expenses of
the district associated with activities under this chapter.
(c) 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.
(d) The district may only assess and collect a mandatory
payment authorized under this chapter if a waiver program,
uniform rate enhancement, or reimbursement described by Section
298B.103(c)(1) is available to the district.
Sec. 298B.154. FEDERAL DISALLOWANCE. Notwithstanding
any other provision of this chapter, if the Centers for Medicare
and Medicaid Services issues a disallowance of federal matching
funds for a purpose for which intergovernmental transfers
described by Section 298B.103(c)(1) were made and the Health and
Human Services Commission demands repayment from the district of
federal funds paid to the district for that purpose, the district
may require and collect mandatory payments from each paying
provider that received those federal funds in an amount
sufficient to satisfy the repayment demand made by the
commission. The percentage limitation prescribed by Section
298B.151(c) does not apply to a mandatory payment required under
this section.
SECTION 29. As soon as practicable after the expiration
of the authority of the Tarrant County Hospital District to
administer and operate a health care provider participation
program under Chapter 298B, Health and Safety Code, as added by
this Act, the board of hospital managers of the Tarrant County
Hospital District shall transfer to each institutional health
care provider in the district that provider's proportionate
share of any remaining funds in any local provider participation
fund created by the district under Section 298B.103, Health and
Safety Code, as added by this Act.
SECTION 30. If before implementing any provision of
Chapter 298B, Health and Safety Code, as added by 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.
Explanation: The added language is necessary to allow the
Tarrant County Hospital District to create and operate a health
care provider participation program in Tarrant County.
_______________________________
President of the Senate
I hereby certify that the
above Resolution was adopted by
the Senate on May 28, 2017, by the
following vote: Yeas 30, Nays 0.
_______________________________
Secretary of the Senate