Bill Text: TX HB3459 | 2019-2020 | 86th Legislature | Enrolled


Bill Title: Relating to the creation and operations of a health care provider participation program by the Harris County Hospital District.

Spectrum: Slight Partisan Bill (Democrat 4-2)

Status: (Enrolled) 2019-05-14 - Sent to the Governor [HB3459 Detail]

Download: Texas-2019-HB3459-Enrolled.html
 
 
  H.B. No. 3459
 
 
 
 
AN ACT
  relating to the creation and operations of a health care provider
  participation program by the Harris 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 299 to read as follows:
  CHAPTER 299. HARRIS COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
  PARTICIPATION PROGRAM
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. 299.001.  DEFINITIONS. In this chapter:
               (1)  "Board" means the board of hospital managers of
  the district.
               (2)  "District" means the Harris 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. 299.002.  APPLICABILITY.  This chapter applies only to
  the Harris County Hospital District.
         Sec. 299.003.  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. 299.004.  EXPIRATION.  (a)  Subject to Section
  299.153(d), the authority of the district to administer and operate
  a program under this chapter expires December 31, 2021.
         (b)  This chapter expires December 31, 2021.
  SUBCHAPTER B. POWERS AND DUTIES OF BOARD
         Sec. 299.051.  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. 299.052.  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. 299.053.  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 as reported 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.
  SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
         Sec. 299.101.  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.
         (c)  A representative of a paying provider is entitled to
  appear at the public hearing and be heard regarding any matter
  related to the mandatory payments authorized under this chapter.
         Sec. 299.102.  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. 299.103.  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, 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 299.151(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 attributable to mandatory payments collected under
  this chapter 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; and
               (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).
         (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 the 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. 299.151.  MANDATORY PAYMENTS BASED ON PAYING PROVIDER
  NET PATIENT REVENUE. (a) If the board authorizes a health care
  provider participation program under this chapter, the board may
  require a mandatory payment to be assessed, either annually or
  periodically throughout the year at the discretion of the board, on
  the net patient revenue of each institutional health care provider
  located in the district.  The board shall provide an institutional
  health care provider written notice of each assessment under this
  subsection, and the provider has 30 calendar days following the
  date of receipt of the notice to pay the assessment. 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 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 and may update the amount on a more frequent 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 four 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 299.103(c)(1).
  The annual amount of revenue from mandatory payments used for
  administrative expenses by the district for activities under this
  chapter is $600,000, 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. 299.152.  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. 299.153.  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:
               (1)  fund the nonfederal share of a Medicaid
  supplemental payment program or Medicaid managed care rate
  enhancements for nonpublic hospitals; and
               (2)  cover the administrative expenses of the district
  associated with activities under this chapter and other uses of the
  fund described by Section 299.103(c).
         (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
  299.103(c)(1) is available to the district.
         SECTION 2.  As soon as practicable after the expiration of
  the authority of the Harris County Hospital District to administer
  and operate a health care provider participation program under
  Chapter 299, Health and Safety Code, as added by this Act, the board
  of hospital managers of the Harris 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 299.103, Health and Safety Code, as added by 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 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. 3459 was passed by the House on April
  17, 2019, by the following vote:  Yeas 122, Nays 17, 2 present, not
  voting.
 
  ______________________________
  Chief Clerk of the House   
 
 
         I certify that H.B. No. 3459 was passed by the Senate on May
  10, 2019, by the following vote:  Yeas 31, Nays 0.
 
  ______________________________
  Secretary of the Senate    
  APPROVED:  _____________________
                     Date          
   
            _____________________
                   Governor       
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