Bill Text: TX HB4289 | 2019-2020 | 86th Legislature | Enrolled
Bill Title: Relating to the authority of certain local governments to create and operate health care provider participation programs.
Spectrum: Slight Partisan Bill (Democrat 4-2)
Status: (Passed) 2019-06-10 - Effective immediately [HB4289 Detail]
Download: Texas-2019-HB4289-Enrolled.html
H.B. No. 4289 |
|
||
relating to the authority of certain local governments to create | ||
and operate health care provider participation programs. | ||
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 300 to read as follows: | ||
CHAPTER 300. HEALTH CARE PROVIDER PARTICIPATION PROGRAMS IN CERTAIN | ||
POLITICAL SUBDIVISIONS IN THIS STATE | ||
SUBCHAPTER A. GENERAL PROVISIONS | ||
Sec. 300.0001. PURPOSE. The purpose of this chapter is to | ||
authorize a hospital district, county, or municipality in this | ||
state to administer a health care provider participation program to | ||
provide additional compensation to certain hospitals located in the | ||
hospital district, county, or municipality by collecting mandatory | ||
payments from each of those hospitals to be used to provide the | ||
nonfederal share of a Medicaid supplemental payment program and for | ||
other purposes as authorized under this chapter. | ||
Sec. 300.0002. DEFINITIONS. In this chapter: | ||
(1) "Institutional health care provider" means a | ||
nonpublic hospital that provides inpatient hospital services. | ||
(2) "Local government" means a hospital district, | ||
county, or municipality to which this chapter applies. | ||
(3) "Paying hospital" means an institutional health | ||
care provider required to make a mandatory payment under this | ||
chapter. | ||
(4) "Program" means a health care provider | ||
participation program authorized by this chapter. | ||
Sec. 300.0003. APPLICABILITY. This chapter applies only | ||
to: | ||
(1) a hospital district that is not participating in a | ||
health care provider participation program authorized by another | ||
chapter of this subtitle; and | ||
(2) a county or municipality that: | ||
(A) is not participating in a health care | ||
provider participation program authorized by another chapter of | ||
this subtitle; and | ||
(B) is not served by a hospital district or a | ||
public hospital. | ||
Sec. 300.0004. LOCAL JURISDICTION HEALTH CARE PROVIDER | ||
PARTICIPATION PROGRAM; ORDER REQUIRED FOR PARTICIPATION. The | ||
governing body of a local government may only adopt an order or | ||
ordinance authorizing that local government to participate in a | ||
health care provider participation program after an affirmative | ||
vote of the majority of the governing body. | ||
SUBCHAPTER B. POWERS AND DUTIES OF GOVERNING BODY | ||
Sec. 300.0051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY | ||
PAYMENT. The governing body of a local government may require a | ||
mandatory payment authorized under this chapter by an institutional | ||
health care provider located in that hospital district, county, or | ||
municipality, as applicable, only in the manner provided by this | ||
chapter. | ||
Sec. 300.0052. RULES AND PROCEDURES. The governing body of | ||
a local government may adopt rules relating to the administration | ||
of the health care provider participation program in the local | ||
government, including collection of the mandatory payments, | ||
expenditures, audits, and any other administrative aspects of the | ||
program. | ||
Sec. 300.0053. INSTITUTIONAL HEALTH CARE PROVIDER | ||
REPORTING. If the governing body of a local government authorizes | ||
the local government to participate in a health care provider | ||
participation program under this chapter, the governing body shall | ||
require each institutional health care provider to submit to the | ||
local government 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. 300.0101. HEARING. (a) In each year that the | ||
governing body of a local government authorizes a health care | ||
provider participation program under this chapter, the governing | ||
body shall hold a public hearing on the amounts of any mandatory | ||
payments that the governing body 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 governing body shall | ||
publish notice of the hearing in a newspaper of general circulation | ||
in the hospital district, county, or municipality, as applicable, | ||
and provide written notice of the hearing to the chief operating | ||
officer of each institutional health care provider located in the | ||
hospital district, county, or municipality, as applicable. | ||
(c) A representative of a paying hospital is entitled to | ||
appear at the time and place designated in the public notice and to | ||
be heard regarding any matter related to the mandatory payments | ||
authorized under this chapter. | ||
Sec. 300.0102. LOCAL PROVIDER PARTICIPATION FUND; | ||
DEPOSITORY. (a) Each governing body of a local government that | ||
collects a mandatory payment authorized under this chapter shall | ||
create a local provider participation fund. | ||
(b) If a governing body of a local government creates a | ||
local provider participation fund, the governing body shall | ||
designate one or more banks as a depository for the mandatory | ||
payments received by the local government. | ||
(c) The governing body of a local government may withdraw or | ||
use money in the local provider participation fund of the local | ||
government only for a purpose authorized under this chapter. | ||
(d) All funds collected under this chapter shall be secured | ||
in the manner provided for securing other funds of the local | ||
government. | ||
Sec. 300.0103. LOCAL PROVIDER PARTICIPATION FUND; | ||
AUTHORIZED USES OF MONEY. (a) The local provider participation | ||
fund established by a local government under Section 300.0102 | ||
consists of: | ||
(1) all revenue received by the local government | ||
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 from the | ||
local government to the state for the purpose of providing 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 of a local government may be used only to: | ||
(1) fund intergovernmental transfers from the local | ||
government 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 | ||
local government 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 300.0151(d), pay the | ||
administrative expenses of the local government in administering | ||
the program, including collateralization of deposits; | ||
(3) refund all or a portion of a mandatory payment | ||
collected in error from a paying hospital; | ||
(4) refund to paying hospitals a proportionate share | ||
of the money that the local government: | ||
(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 local government is required by law to transfer | ||
the funds to address a disallowance of federal matching funds with | ||
respect to payments, rate enhancements, and reimbursements for | ||
which the local government made intergovernmental transfers | ||
described by Subdivision (1); and | ||
(6) reimburse the local government if the local | ||
government 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. | ||
(c) Money in the local provider participation fund of a | ||
local government may not be commingled with other funds of the local | ||
government. | ||
(d) Notwithstanding any other provision of this chapter, | ||
with respect to an intergovernmental transfer of funds described by | ||
Subsection (b)(1) made by the local government, any funds received | ||
by the state, local government, or other entity as a result of that | ||
transfer may not be used by the state, local government, 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. 300.0151. MANDATORY PAYMENTS. (a) Except as provided | ||
by Subsection (e), if the governing body of a local government | ||
authorizes a health care provider participation program under this | ||
chapter, the governing body shall require an annual mandatory | ||
payment to be assessed on the net patient revenue of each | ||
institutional health care provider located in the hospital | ||
district, county, or municipality, as applicable. The governing | ||
body of the local government shall provide that the mandatory | ||
payment is to be assessed 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 located in the | ||
hospital district, county, or municipality, as applicable, 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 local | ||
government shall update the amount of the mandatory payment on an | ||
annual basis. | ||
(b) The amount of a mandatory payment authorized under this | ||
chapter for a local government must be uniformly proportionate with | ||
the amount of net patient revenue generated by each paying hospital | ||
in the hospital district, county, or municipality, as applicable, | ||
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) The governing body of a local government that authorizes | ||
a program under this chapter shall set the amount of the mandatory | ||
payment. The aggregate amount of the mandatory payments required | ||
of all paying hospitals in the hospital district, county, or | ||
municipality, as applicable, may not exceed six percent of the | ||
aggregate net patient revenue from hospital services provided by | ||
all paying hospitals in the hospital district, county, or | ||
municipality, as applicable. | ||
(d) Subject to Subsection (c), the governing body of a local | ||
government shall set the mandatory payments in amounts that in the | ||
aggregate will generate sufficient revenue to cover the | ||
administrative expenses of the local government for activities | ||
under this chapter and to fund an intergovernmental transfer | ||
described by Section 300.0103(b)(1). The annual amount of revenue | ||
from mandatory payments that shall be paid for administrative | ||
expenses for activities under this chapter by the local government | ||
may not exceed $150,000, plus the cost of collateralization of | ||
deposits, regardless of actual expenses. | ||
(e) A paying hospital may not add a mandatory payment | ||
required under this section as a surcharge to a patient. | ||
(f) A mandatory payment required by the governing body of a | ||
hospital district under this chapter is not a tax for purposes of | ||
the applicable provision of Article IX, Texas Constitution. | ||
Sec. 300.0152. ASSESSMENT AND COLLECTION OF MANDATORY | ||
PAYMENTS. (a) A hospital 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) A county or municipality may collect or, using a | ||
competitive bidding process, contract for the assessment and | ||
collection of mandatory payments authorized under this chapter. | ||
(c) The person charged by the local government with the | ||
assessment and collection of mandatory payments shall charge and | ||
deduct from the mandatory payments collected for the local | ||
government a collection fee in an amount not to exceed the person's | ||
usual and customary charges for like services. | ||
(d) If the person charged with the assessment and collection | ||
of mandatory payments is an official of the local government, any | ||
revenue from a collection fee charged under Subsection (c) shall be | ||
deposited in the local government general fund and, if appropriate, | ||
shall be reported as fees of the local government. | ||
Sec. 300.0153. CORRECTION OF INVALID PROVISION OR | ||
PROCEDURE. (a) This chapter does not authorize a local government | ||
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 local | ||
government associated with activities under this chapter and other | ||
uses of the fund described by Section 300.0103(b). | ||
(b) 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 local government 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 local government or an | ||
institutional health care provider in the local hospital district, | ||
county, or municipality, as applicable, beyond the provisions of | ||
this chapter. This section does not require the governing body of a | ||
local government to adopt a rule. | ||
(c) The local government may only assess and collect a | ||
mandatory payment authorized under this chapter if a waiver | ||
program, uniform rate enhancement, or reimbursement described by | ||
Section 300.0103(b)(1) is available to the local government. | ||
Sec. 300.0154. REPORTING REQUIREMENTS. (a) The governing | ||
body of each local government that authorizes a program under this | ||
chapter shall report information to the Health and Human Services | ||
Commission regarding the program on a schedule determined by the | ||
commission. | ||
(b) The information must include: | ||
(1) the amount of the mandatory payments required and | ||
collected in each year the program is authorized; | ||
(2) any expenditure of money attributable to mandatory | ||
payments collected under this chapter, including: | ||
(A) any contract with an entity for the | ||
administration or operation of a program authorized by this | ||
chapter; or | ||
(B) a contract with a person for the assessment | ||
and collection of a mandatory payment as authorized under Section | ||
300.0152; and | ||
(3) the amount of money attributable to mandatory | ||
payments collected under this chapter that is used for any other | ||
purpose. | ||
(c) The executive commissioner of the Health and Human | ||
Services Commission shall adopt rules to administer this section. | ||
Sec. 300.0155. EXPIRATION OF AUTHORITY. The authority of a | ||
local government to administer and operate a program under this | ||
chapter expires on September 1 following the second anniversary of | ||
the date the governing body of the local government adopted the | ||
order or ordinance authorizing the local government to participate | ||
in the program as provided by Section 300.0004. | ||
Sec. 300.0156. AUTHORITY TO REFUSE FOR VIOLATION. The | ||
Health and Human Services Commission may refuse to accept money | ||
from a local provider participation fund established under this | ||
chapter if the commission determines that doing so may violate | ||
federal law. | ||
SECTION 2. Subtitle D, Title 4, Health and Safety Code, is | ||
amended by adding Chapter 300A to read as follows: | ||
CHAPTER 300A. HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN | ||
DISTRICTS COMPOSED OF CERTAIN LOCAL GOVERNMENTS | ||
SUBCHAPTER A. GENERAL PROVISIONS | ||
Sec. 300A.0001. PURPOSE. The purpose of this chapter is to | ||
authorize certain local governments to create a district to | ||
administer a health care provider participation program to provide | ||
additional compensation to certain hospitals in the district by | ||
collecting mandatory payments from each of those hospitals 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. 300A.0002. DEFINITIONS. In this chapter: | ||
(1) "Board" means the board of directors of a | ||
district. | ||
(2) "Director" means a member of the board. | ||
(3) "District" means a health care provider | ||
participation district created under this chapter. | ||
(4) "Institutional health care provider" means a | ||
nonpublic hospital that provides inpatient hospital services. | ||
(5) "Local government" means a hospital district, | ||
county, or municipality to which this chapter applies. | ||
(6) "Paying hospital" means an institutional health | ||
care provider required to make a mandatory payment under this | ||
chapter. | ||
(7) "Program" means a health care provider | ||
participation program authorized by this chapter. | ||
Sec. 300A.0003. APPLICABILITY. This chapter applies only | ||
to: | ||
(1) a hospital district that: | ||
(A) is not participating in a health care | ||
provider participation program authorized by another chapter of | ||
this subtitle; and | ||
(B) has only one institutional health care | ||
provider located in the district; and | ||
(2) a county or municipality that: | ||
(A) is not participating in a health care | ||
provider participation program authorized by another chapter of | ||
this subtitle; | ||
(B) is not served by a hospital district or a | ||
public hospital; and | ||
(C) has only one institutional health care | ||
provider located in the county or municipality. | ||
SUBCHAPTER B. CREATION, OPERATION, AND DISSOLUTION OF DISTRICT | ||
Sec. 300A.0021. CREATION BY CONCURRENT ORDERS. (a) A local | ||
government and one or more other local governments may create a | ||
district by adopting concurrent orders. | ||
(b) A concurrent order to create a district must: | ||
(1) be approved by the governing body of each creating | ||
local government; | ||
(2) contain identical provisions; and | ||
(3) define the boundaries of the district to be | ||
coextensive with the combined boundaries of each creating local | ||
government. | ||
Sec. 300A.0022. POWERS. A district may authorize and | ||
administer a health care provider participation program in | ||
accordance with this chapter. | ||
Sec. 300A.0023. BOARD OF DIRECTORS. (a) If three or more | ||
local governments create a district, the presiding officer of the | ||
governing body of each local government that creates the district | ||
shall appoint one director. | ||
(b) If two local governments create a district: | ||
(1) the presiding officer of the governing body of the | ||
most populous local government shall appoint two directors; and | ||
(2) the presiding officer of the governing body of the | ||
other local government shall appoint one director. | ||
(c) Directors serve staggered two-year terms, with as near | ||
as possible to one-half of the directors' terms expiring each year. | ||
(d) A vacancy in the office of director shall be filled for | ||
the unexpired term in the same manner as the original appointment. | ||
(e) The board shall elect from among its members a | ||
president. The president may vote and may cast an additional vote | ||
to break a tie. | ||
(f) The board shall also elect from among its members a vice | ||
president. | ||
(g) The board shall appoint a secretary, who need not be a | ||
director. | ||
(h) Each officer of the board serves for a term of one year. | ||
(i) The board shall fill a vacancy in a board office for the | ||
unexpired term. | ||
(j) A majority of the members of the board voting must | ||
concur in a matter relating to the business of the district. | ||
Sec. 300A.0024. QUALIFICATIONS FOR OFFICE. (a) To be | ||
eligible to serve as a director, a person must be a resident of the | ||
local government that appoints the person under Section 300A.0023. | ||
(b) An employee of the district may not serve as a director. | ||
Sec. 300A.0025. COMPENSATION. (a) Directors and officers | ||
serve without compensation but may be reimbursed for actual | ||
expenses incurred in the performance of official duties. | ||
(b) Expenses reimbursed under this section must be: | ||
(1) reported in the district's minute book or other | ||
district records; and | ||
(2) approved by the board. | ||
Sec. 300A.0026. AUTHORITY TO SUE AND BE SUED. The board may | ||
sue and be sued on behalf of the district. | ||
Sec. 300A.0027. DISTRICT FINANCES. Subchapter F, Chapter | ||
287, other than Sections 287.129 and 287.130, applies to the | ||
district in the same manner that those provisions apply to a health | ||
services district created under Chapter 287. This section does not | ||
authorize the district to issue bonds. | ||
Sec. 300A.0028. DISSOLUTION. A district shall be dissolved | ||
if the local governments that created the district adopt concurrent | ||
orders to dissolve the district and the concurrent orders contain | ||
identical provisions. | ||
Sec. 300A.0029. ADMINISTRATION OF PROPERTY, DEBTS, AND | ||
ASSETS AFTER DISSOLUTION. (a) After dissolution of a district | ||
under Section 300A.0028, the board shall continue to control and | ||
administer any property, debts, and assets of the district until | ||
all funds have been disposed of and all district debts have been | ||
paid or settled. | ||
(b) As soon as practicable after the dissolution of the | ||
district, the board shall transfer to each institutional health | ||
care provider in the district the provider's proportionate share of | ||
any remaining funds in any local provider participation fund | ||
created by the district under Section 300A.0102. | ||
(c) If, after administering any property and assets, the | ||
board determines that the district's property and assets are | ||
insufficient to pay the debts of the district, the district shall | ||
transfer the remaining debts to the local governments that created | ||
the district in proportion to the funds contributed to the district | ||
by each local government, including a paying hospital in the local | ||
government. | ||
(d) If, after complying with Subsections (b) and (c) and | ||
administering the property and assets, the board determines that | ||
unused funds remain, the board shall transfer the unused funds to | ||
the local governments that created the district in proportion to | ||
the funds contributed to the district by each local government, | ||
including a paying hospital in the local government. | ||
Sec. 300A.0030. ACCOUNTING AFTER DISSOLUTION. After the | ||
district has paid all its debts and has disposed of all its assets | ||
and funds as prescribed by Section 300A.0029, the board shall | ||
provide an accounting to each local government that created the | ||
district. The accounting must show the manner in which the assets | ||
and debts of the district were distributed. | ||
SUBCHAPTER C. HEALTH CARE PROVIDER PARTICIPATION PROGRAM; POWERS | ||
AND DUTIES OF DISTRICT BOARD | ||
Sec. 300A.0051. HEALTH CARE PROVIDER PARTICIPATION | ||
PROGRAM. The board of a district 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. 300A.0052. 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. 300A.0053. RULES AND PROCEDURES. The board may adopt | ||
rules relating to the administration of the health care provider | ||
participation program in the district, including collection of the | ||
mandatory payments, expenditures, audits, and any other | ||
administrative aspects of the program. | ||
Sec. 300A.0054. INSTITUTIONAL HEALTH CARE PROVIDER | ||
REPORTING. If the board authorizes the district to participate in a | ||
health care provider participation program under this chapter, the | ||
board shall require each institutional health care provider located | ||
in the district 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 D. GENERAL FINANCIAL PROVISIONS | ||
Sec. 300A.0101. HEARING. (a) In each year that the board | ||
authorizes a health care provider participation 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 each | ||
local government that creates the district and provide written | ||
notice of the hearing to the chief operating officer of each | ||
institutional health care provider in the district. | ||
(c) A representative of a paying hospital is entitled to | ||
appear at the time and place designated in the public notice and be | ||
heard regarding any matter related to the mandatory payments | ||
authorized under this chapter. | ||
Sec. 300A.0102. 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 designated by the | ||
district as a depository for the mandatory payments received by the | ||
district. | ||
(b) The board may withdraw or use money in the local | ||
provider participation fund of the district only for a purpose | ||
authorized under this chapter. | ||
(c) All funds collected under this chapter shall be secured | ||
in the manner provided for securing public funds. | ||
Sec. 300A.0103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY. | ||
(a) The local provider participation fund established under | ||
Section 300A.0102 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 from the | ||
district to the state for the purpose of providing 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 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 300A.0151(d), pay the | ||
administrative expenses of the district in administering the | ||
program, including collateralization of deposits; | ||
(3) refund all or a portion of a mandatory payment | ||
collected in error from a paying hospital; | ||
(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; 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 required by law to transfer the funds | ||
to address a disallowance of federal matching funds with respect to | ||
payments, rate enhancements, and reimbursements 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. | ||
(c) Money in the local provider participation fund may not | ||
be commingled with other district funds or other funds of a local | ||
government that creates the district. | ||
(d) Notwithstanding any other provision of this chapter, | ||
with respect to an intergovernmental transfer of funds described by | ||
Subsection (b)(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. | ||
Sec. 300A.0104. ACCOUNTING OF FUNDS. The district shall | ||
maintain an accounting of the funds received from each local | ||
government that creates the district, including a paying hospital | ||
located in a hospital district, county, or municipality that | ||
created the district, as applicable. | ||
SUBCHAPTER E. MANDATORY PAYMENTS | ||
Sec. 300A.0151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL | ||
NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if | ||
the board authorizes a health care provider participation program | ||
under this chapter, the district 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 shall provide that the mandatory payment is to be assessed 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 located in the district 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. | ||
(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 hospital 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) The board shall set the amount of a mandatory payment | ||
authorized under this chapter. 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 from | ||
hospital services provided by all paying hospitals in the district. | ||
(d) Subject to Subsection (c), 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 300A.0103(b)(1). | ||
The annual amount of revenue from mandatory payments that shall be | ||
paid for administrative expenses by the district for activities | ||
under this chapter may not exceed $150,000, plus the cost of | ||
collateralization of deposits, regardless of actual expenses. | ||
(e) A paying hospital may not add a mandatory payment | ||
required under this section as a surcharge to a patient. | ||
(f) For purposes of any hospital district that creates a | ||
district under this chapter, a mandatory payment assessed under | ||
this chapter is not a tax for hospital purposes for purposes of the | ||
applicable provision of Article IX, Texas Constitution. | ||
Sec. 300A.0152. 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. 300A.0153. CORRECTION OF INVALID PROVISION OR | ||
PROCEDURE; LIMITATION OF AUTHORITY. (a) 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 300A.0103(b). | ||
(b) 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. | ||
(c) 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 | ||
300A.0103(b)(1) is available to the district. | ||
Sec. 300A.0154. REPORTING REQUIREMENTS. (a) The board of a | ||
district that authorizes a program under this chapter shall report | ||
information to the Health and Human Services Commission regarding | ||
the program on a schedule determined by the commission. | ||
(b) The information must include: | ||
(1) the amount of the mandatory payments required and | ||
collected in each year the program is authorized; | ||
(2) any expenditure of money attributable to mandatory | ||
payments collected under this chapter, including: | ||
(A) any contract with an entity for the | ||
administration or operation of a program authorized by this | ||
chapter; or | ||
(B) a contract with a person for the assessment | ||
and collection of a mandatory payment as authorized under Section | ||
300A.0152; and | ||
(3) the amount of money attributable to mandatory | ||
payments collected under this chapter that is used for any other | ||
purpose. | ||
(c) The executive commissioner of the Health and Human | ||
Services Commission shall adopt rules to administer this section. | ||
Sec. 300A.0155. EXPIRATION OF AUTHORITY. The authority of | ||
a district to administer and operate a program under this chapter | ||
expires on September 1 following the second anniversary of the date | ||
the board of the district authorized the district to participate in | ||
the program as provided by Section 300A.0051. | ||
Sec. 300A.0156. AUTHORITY TO REFUSE FOR VIOLATION. The | ||
Health and Human Services Commission may refuse to accept money | ||
from a local provider participation fund established under this | ||
chapter if the commission determines that doing so may violate | ||
federal law. | ||
SECTION 3. As soon as practicable after the expiration of | ||
the authority of a local government to administer and operate a | ||
health care provider participation program under Chapter 300 or | ||
300A, Health and Safety Code, as added by this Act, the governing | ||
body of the local government shall transfer to each institutional | ||
health care provider in the boundaries of the local government that | ||
provider's proportionate share of any remaining funds in any local | ||
provider participation fund created by the local government under | ||
Chapter 300 or 300A, Health and Safety Code, as added by this Act. | ||
SECTION 4. 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 5. 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. 4289 was passed by the House on May 8, | ||
2019, by the following vote: Yeas 101, Nays 40, 1 present, not | ||
voting. | ||
______________________________ | ||
Chief Clerk of the House | ||
I certify that H.B. No. 4289 was passed by the Senate on May | ||
22, 2019, by the following vote: Yeas 31, Nays 0. | ||
______________________________ | ||
Secretary of the Senate | ||
APPROVED: _____________________ | ||
Date | ||
_____________________ | ||
Governor |