Bill Text: TX HB4700 | 2023-2024 | 88th 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 Nacogdoches County Hospital District.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Passed) 2023-06-17 - Effective immediately [HB4700 Detail]
Download: Texas-2023-HB4700-Introduced.html
Bill Title: Relating to the creation and operations of a health care provider participation program by the Nacogdoches County Hospital District.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Passed) 2023-06-17 - Effective immediately [HB4700 Detail]
Download: Texas-2023-HB4700-Introduced.html
88R11248 MPF-F | ||
By: Clardy | H.B. No. 4700 |
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relating to the creation and operations of a health care provider | ||
participation program by the Nacogdoches 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 298H to read as follows: | ||
CHAPTER 298H. NACOGDOCHES COUNTY HOSPITAL DISTRICT HEALTH CARE | ||
PROVIDER PARTICIPATION PROGRAM | ||
SUBCHAPTER A. GENERAL PROVISIONS | ||
Sec. 298H.001. DEFINITIONS. In this chapter: | ||
(1) "Board" means the board of directors of the | ||
district. | ||
(2) "District" means the Nacogdoches 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. | ||
(6) "Qualifying assessment basis" means any basis | ||
consistent with 42 U.S.C. Section 1396b(w) on which the board | ||
requires mandatory payments to be assessed under this chapter. | ||
Sec. 298H.002. APPLICABILITY. This chapter applies only to | ||
the Nacogdoches County Hospital District. | ||
Sec. 298H.003. HEALTH CARE PROVIDER PARTICIPATION PROGRAM; | ||
PARTICIPATION IN PROGRAM. (a) 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. | ||
(b) The board may not authorize the district to participate | ||
in a health care provider participation program under Chapter 300 | ||
or 300A. | ||
Sec. 298H.004. EXPIRATION. (a) Subject to Section | ||
298H.153(d), the authority of the district to administer and | ||
operate a program under this chapter expires December 31, 2027. | ||
(b) This chapter expires December 31, 2027. | ||
SUBCHAPTER B. POWERS AND DUTIES OF BOARD | ||
Sec. 298H.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 located | ||
in the district only in the manner provided by this chapter. | ||
Sec. 298H.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 | ||
other administrative aspects of the program. | ||
Sec. 298H.053. INSTITUTIONAL HEALTH CARE PROVIDER | ||
REPORTING. If the board authorizes the district to participate in a | ||
program under this chapter, the board may require each | ||
institutional health care provider to submit to the district a copy | ||
of any financial and utilization data reported in: | ||
(1) the provider's Medicare cost report submitted for | ||
the most recent fiscal year for which the provider submitted the | ||
Medicare cost report; or | ||
(2) a report other than the report described by | ||
Subdivision (1) that the board considers reliable and is submitted | ||
by or to the provider for the most recent fiscal year. | ||
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS | ||
Sec. 298H.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. | ||
(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. 298H.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. 298H.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 the 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 | ||
supplemental 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) 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 298H.151(f), 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 the 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 payments described by Subdivision (1); or | ||
(B) determines cannot be used to fund the | ||
nonfederal share of Medicaid supplemental payments or rate | ||
enhancements described by Subdivision (1); 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 Medicaid supplemental payments 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 that transfer may | ||
not be used by the state, district, or other entity to 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). | ||
SUBCHAPTER D. MANDATORY PAYMENTS | ||
Sec. 298H.151. MANDATORY PAYMENTS. (a) If the board | ||
authorizes a health care provider participation program under this | ||
chapter, the board may require a mandatory payment to be assessed | ||
against each institutional health care provider located in the | ||
district, either annually or periodically throughout the year at | ||
the discretion of the board, on a qualifying assessment basis. The | ||
qualifying assessment basis must be the same for each institutional | ||
health care provider in the district. The board shall provide an | ||
institutional health care provider written notice of each | ||
assessment under this section, and the provider has 30 calendar | ||
days following the date of receipt of the notice to make the | ||
assessed mandatory payment. | ||
(b) Except as otherwise provided by this subsection, the | ||
qualifying assessment basis must be determined by the board using | ||
information contained in an institutional health care provider's | ||
Medicare cost report for the most recent fiscal year for which the | ||
provider submitted the report. If the provider is not required to | ||
submit a Medicare cost report, or if the Medicare cost report | ||
submitted by the provider does not contain information necessary to | ||
determine the qualifying assessment basis, the qualifying | ||
assessment basis may be determined by the board using information | ||
contained in another report the board considers reliable that is | ||
submitted by or to the provider for the most recent fiscal year. To | ||
the extent practicable, the board shall use the same type of report | ||
to determine the qualifying assessment basis for each paying | ||
provider in the district. | ||
(c) If a mandatory payment is required, the district shall | ||
periodically update the amount of the mandatory payment. | ||
(d) 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 42 U.S.C. Section 1396b(w). | ||
(e) 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 in the district. | ||
(f) Subject to Subsection (e), 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 298H.103(c)(1). | ||
The annual amount of revenue from the mandatory payments used by the | ||
district may not exceed $150,000, plus the cost of | ||
collateralization of deposits, regardless of actual expenses. | ||
(g) A paying provider may not add a mandatory payment | ||
required under this section as a surcharge to a patient. | ||
(h) 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 of this code. | ||
Sec. 298H.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 the 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 the 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. 298H.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 the 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 | ||
the 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 the 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 298H.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, rate | ||
enhancement, or reimbursement described by Section 298H.103(c)(1) | ||
is available for nonpublic hospitals located in 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, 2023. |