Bill Text: TX HB3459 | 2019-2020 | 86th Legislature | Introduced
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 Harris County Hospital District.
Spectrum: Slight Partisan Bill (Democrat 4-2)
Status: (Passed) 2019-05-24 - Effective immediately [HB3459 Detail]
Download: Texas-2019-HB3459-Introduced.html
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: (Passed) 2019-05-24 - Effective immediately [HB3459 Detail]
Download: Texas-2019-HB3459-Introduced.html
By: Coleman | H.B. No. 3459 |
|
||
|
||
relating to the creation and operations of health care provider | ||
participation programs in 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 trustees 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. 2999.003 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 the majority of the board, subject to the | ||
provisions of this chapter. | ||
Sec. 299.004 EXPIRATION. | ||
(a) 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 PAYING PROVIDER REPORTING. If the board | ||
authorizes the district to participate in a program under this | ||
chapter, the board shall require each paying provider to submit to | ||
the district a copy of any financial and utilization data as | ||
reported in the paying provider's Medicare cost report for the | ||
previous fiscal year or for the closest subsequent fiscal year for | ||
which the paying 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. | ||
(c) A representative of a paying provider is entitled to | ||
appear at the public hearing and to 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 Subdivision | ||
(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 a mandatory payment 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 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 on the net patient revenue of each | ||
paying provider located in the district. The board may provide for | ||
the mandatory payment to be assessed incrementally throughout the | ||
year; provided, however, that paying providers shall have thirty | ||
(30) calendar days upon receipt of written notice from the district | ||
to make any mandatory payment. In the first year in which the | ||
mandatory payment is required, the mandatory payment is assessed on | ||
the net patient revenue of a paying provider as determined by the | ||
paying provider's copy of its Medicare cost report for the previous | ||
fiscal year or for the closest subsequent fiscal year for which the | ||
paying provider submitted the Medicare cost report. | ||
(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 .103(c)(1). Of the | ||
annual amount of revenue received by the district attributable to | ||
mandatory payments authorized under this chapter, 0.25% shall be | ||
paid to the district for administrative 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 fund the | ||
uses described in Section 299.103(c) 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 | ||
299.103(c)(1) is available to the district. | ||
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. |