Bill Text: TX HB4143 | 2023-2024 | 88th Legislature | Introduced

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Bill Title: Relating to the operations of certain local health care provider participation programs.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2023-03-21 - Referred to County Affairs [HB4143 Detail]

Download: Texas-2023-HB4143-Introduced.html

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88R5623 SRA-F
By: Lambert H.B. No. 4143

A BILL TO BE ENTITLED
AN ACT
relating to the operations of certain local health care provider
participation programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 293C.001, Health and Safety Code, is
amended by adding Subdivision (4) to read as follows:
(4) "Qualifying assessment basis" means the health
care item, health care service, or other health care-related basis
consistent with 42 U.S.C. Section 1396b(w) on which the
commissioners court of a county requires mandatory payments to be
assessed under this chapter.
SECTION 2. Section 293C.002, Health and Safety Code, is
amended to read as follows:
Sec. 293C.002. APPLICABILITY. This chapter applies only to
a county that:
(1) is not served by a hospital district or a public
hospital;
(2) has a population of more than 140,000 [125,000]
and less than 155,000 [140,000]; and
(3) is not adjacent to a county with a population of
1.2 [one] million or more.
SECTION 3. Section 293C.054(a), Health and Safety Code, is
amended to read as follows:
(a) The commissioners court of a county that collects a
mandatory payment authorized under this chapter may [shall] require
each institutional health care provider located in the county to
submit to the county a copy of any financial and utilization data as
reported in:
(1) a report 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;
(2) the provider's Medicare cost report for the most
recent fiscal year for which the provider submitted the Medicare
cost report; or
(3) a report other than a report described by
Subdivision (1) or (2) that the commissioners court considers
reliable and is submitted by or to the provider for the most recent
fiscal year.
SECTION 4. Subchapter B, Chapter 293C, Health and Safety
Code, is amended by adding Section 293C.055 to read as follows:
Sec. 293C.055. REQUEST FOR CERTAIN RELIEF. (a) The
commissioners court of a county may request that the Health and
Human Services Commission submit a request to the Centers for
Medicare and Medicaid Services for relief under 42 C.F.R. Section
433.72 for purposes of assuring the program is administered
efficiently, transparently, and in a manner that complies with
federal law.
(b) If the request for relief under Subsection (a) is
granted, the commissioners court of a county may act in compliance
with the terms of the relief. To the extent of a conflict between
the terms of the relief and any law, including a provision of this
subtitle, requiring mandatory payments be assessed in a uniform or
broad-based manner, the terms of the relief prevail.
SECTION 5. The heading to Section 293C.151, Health and
Safety Code, is amended to read as follows:
Sec. 293C.151. MANDATORY PAYMENTS [BASED ON PAYING HOSPITAL
NET PATIENT REVENUE].
SECTION 6. Section 293C.151, Health and Safety Code, is
amended by amending Subsections (a) and (b) and adding Subsections
(a-1), (a-2), and (f) to read as follows:
(a) Except as provided by Subsection (e), the commissioners
court of a county that collects a mandatory payment authorized
under this chapter may require an annual mandatory payment to be
assessed against each institutional health care provider located in
the county on a qualifying assessment basis [the net patient
revenue of each institutional health care provider located in the
county]. The qualifying assessment basis must be the same for each
institutional health care provider located in the county. The
commissioners court may provide for the mandatory payment to be
assessed quarterly.
(a-1) Except as otherwise provided by this subsection, the
qualifying assessment basis must be determined by the commissioners
court using data reported to the Department of State Health
Services under Sections 311.032 and 311.033 by an institutional
health care provider for the most recent fiscal year the provider
reported the data, or if the provider did not report any data under
those sections, the provider's Medicare cost report for the most
recent fiscal year for which the provider submitted the report. If
neither the data reported under Sections 311.032 and 311.033 nor
the Medicare cost report contain information necessary to determine
the qualifying assessment basis, the qualifying assessment basis
may be determined by the commissioners court using information
contained in another report the commissioners court considers
reliable that is submitted by or to the provider for the most recent
fiscal year. To the extent practicable, the commissioners court
shall use the same type of report to determine the qualifying
assessment basis for each paying hospital in the county.
(a-2) [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 fiscal year ending in 2017 or,
if the institutional health care provider did not report any data
under those sections in that fiscal year, as determined by the
institutional health care provider's Medicare cost report
submitted for the 2017 fiscal year or for the closest subsequent
fiscal year for which the provider submitted the Medicare cost
report.] The county 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 determined in a manner that ensures the revenue
generated qualifies for federal matching funds under federal law,
consistent with [uniformly proportionate with the amount of net
patient revenue generated by each paying hospital in the county. 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).
(f) This section does not authorize the commissioners court
of a county to assess a mandatory payment that would qualify as a
bed tax or any other tax under the laws of this state.
SECTION 7. 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, 2023.