Bill Text: TX SB1130 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to the creation and administration of a reinvestment allowance for certain long-term care facilities.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2017-03-27 - Left pending in committee [SB1130 Detail]
Download: Texas-2017-SB1130-Introduced.html
85R7658 LED-F | ||
By: Hinojosa | S.B. No. 1130 |
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relating to the creation and administration of a reinvestment | ||
allowance for certain long-term care facilities. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Chapter 242, Health and Safety Code, is amended | ||
by adding Subchapter P to read as follows: | ||
SUBCHAPTER P. REINVESTMENT ALLOWANCE | ||
Sec. 242.701. DEFINITION. In this subchapter, "gross | ||
receipts" means the gross inpatient revenue received by a facility | ||
from services provided to facility residents. Gross receipts | ||
exclude revenue from nonresident care, including beauty and barber | ||
services, vending facilities, interest, charitable contributions, | ||
the sale of meals, and outpatient services. | ||
Sec. 242.702. REINVESTMENT ALLOWANCE; COMPUTATION. (a) | ||
The commission shall impose a reinvestment allowance on each | ||
facility licensed under this chapter. The reinvestment allowance | ||
is: | ||
(1) the product of the amount established under | ||
Subsection (b) multiplied by the number of a facility's | ||
non-Medicare patient days calculated under Section 242.703; | ||
(2) payable monthly; and | ||
(3) in addition to other amounts imposed under this | ||
chapter. | ||
(b) The executive commissioner shall establish for each | ||
non-Medicare patient day an amount for use in calculating the | ||
reinvestment allowance sufficient to produce annual revenues from | ||
all facilities not to exceed the maximum amount that may be assessed | ||
within the indirect guarantee threshold provided under 42 C.F.R. | ||
Section 433.68(f)(3)(i). | ||
(c) The commission shall determine the amount described by | ||
Subsection (b) using non-Medicare patient days and gross receipts: | ||
(1) reported to the commission; and | ||
(2) covering a period of at least six months. | ||
(d) A facility may not list the reinvestment allowance as a | ||
separate charge on a resident's billing statement or otherwise | ||
directly or indirectly attempt to charge the reinvestment allowance | ||
to a resident. | ||
Sec. 242.703. PATIENT DAYS. For each calendar day, a | ||
facility shall determine the number of non-Medicare patient days by | ||
adding: | ||
(1) the number of non-Medicare residents occupying a | ||
bed in the facility immediately before midnight of that day plus the | ||
number of residents admitted that day, less the number of residents | ||
discharged that day, except a resident is included in the count | ||
under this subdivision if: | ||
(A) the resident is admitted and discharged on | ||
the same day; or | ||
(B) the resident is discharged that day because | ||
of the resident's death; and | ||
(2) the number of beds that are on hold that day and | ||
that have been placed on hold for a period not to exceed three | ||
consecutive calendar days during which a resident is: | ||
(A) in the hospital; or | ||
(B) on therapeutic home leave. | ||
Sec. 242.704. COLLECTION AND REPORTING. (a) The | ||
commission shall collect the reinvestment allowance. | ||
(b) Not later than the 25th day after the last day of a | ||
month, each facility shall: | ||
(1) file with the commission a report stating the | ||
total non-Medicare resident days for the month; and | ||
(2) pay the reinvestment allowance. | ||
Sec. 242.705. RULES; ADMINISTRATIVE PENALTY. (a) The | ||
executive commissioner shall adopt rules to administer this | ||
subchapter, including rules related to imposing and collecting the | ||
reinvestment allowance. | ||
(b) Notwithstanding Section 242.066, an administrative | ||
penalty assessed under that section for a violation of this | ||
subchapter may not exceed the greater of: | ||
(1) one-half of the amount of the facility's | ||
outstanding reinvestment allowance; or | ||
(2) $20,000. | ||
Sec. 242.706. NURSING FACILITY REINVESTMENT ALLOWANCE | ||
TRUST FUND. (a) The nursing facility reinvestment allowance trust | ||
fund is established as a trust fund to be held by the comptroller | ||
outside of the state treasury and administered by the commission as | ||
trustee. Interest and income from the assets of the trust fund | ||
shall be credited to and deposited in the trust fund. The commission | ||
may use money in the fund only as provided by Section 242.707. | ||
(b) The commission shall remit the reinvestment allowance | ||
collected under this subchapter and federal matching funds received | ||
by this state to the comptroller for deposit in the trust fund. | ||
Sec. 242.707. REIMBURSEMENT OF FACILITIES. (a) The | ||
commission may use money in the nursing facility reinvestment | ||
allowance trust fund, including any federal matching funds, only | ||
for the following purposes: | ||
(1) reimbursing the federal share of the reinvestment | ||
allowance as a pass-through in the rate; | ||
(2) increasing reimbursement rates paid under the | ||
state Medicaid program to facilities; and | ||
(3) with any money remaining after funding | ||
Subdivisions (1) and (2), providing direct care staff programs | ||
related to quality incentives and quality metrics. | ||
(b) The commission shall devise a formula by which amounts | ||
received under this subchapter increase the reimbursement rates | ||
paid to facilities under the state Medicaid program. | ||
(c) Money in the nursing facility reinvestment allowance | ||
trust fund may not be used 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). | ||
Sec. 242.708. INVALIDITY; FEDERAL FUNDS. If any provision | ||
of or procedure under this subchapter is held invalid by a final | ||
court order that is not subject to appeal, or if the commission | ||
determines that the imposition of the reinvestment allowance and | ||
the expenditure of amounts collected as prescribed by this | ||
subchapter will not entitle the state to receive federal matching | ||
funds under the Medicaid program, the commission shall: | ||
(1) stop collection of the reinvestment allowance; and | ||
(2) not later than the 30th day after the date | ||
collection is stopped, return to each facility, in proportion to | ||
the total amount paid by the facility, any money deposited to the | ||
credit of the nursing facility reinvestment allowance trust fund | ||
but not spent. | ||
Sec. 242.709. AUTHORITY TO ACCOMPLISH PURPOSES OF | ||
SUBCHAPTER. The executive commissioner by rule may adopt a | ||
definition, a method of computation, or a rate that differs from | ||
those expressly provided by or expressly authorized by this | ||
subchapter to the extent the difference is necessary to accomplish | ||
the purposes of this subchapter. | ||
Sec. 242.710. EXPIRATION. This subchapter expires August | ||
31, 2021. | ||
SECTION 2. (a) As soon as practicable after the effective | ||
date of this Act, the executive commissioner of the Health and Human | ||
Services Commission shall: | ||
(1) adopt the rules necessary to implement Subchapter | ||
P, Chapter 242, Health and Safety Code, as added by this Act; and | ||
(2) notwithstanding Section 242.702, Health and | ||
Safety Code, as added by this Act, establish the amount of the | ||
initial reinvestment allowance imposed under Subchapter P, Chapter | ||
242, Health and Safety Code, as added by this Act, based on | ||
available revenue and patient day information. | ||
(b) The amount of the initial reinvestment allowance | ||
established under Subsection (a) of this section remains in effect | ||
until the Health and Human Services Commission obtains the | ||
information necessary to set the amount of the reinvestment | ||
allowance under Section 242.702, 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. Notwithstanding any other law, a reinvestment | ||
allowance may not be imposed under Section 242.702, Health and | ||
Safety Code, as added by this Act, or collected under Section | ||
242.704, Health and Safety Code, as added by this Act, until: | ||
(1) an amendment to the state Medicaid plan that | ||
increases the rates paid to long-term care facilities licensed | ||
under Chapter 242, Health and Safety Code, for providing services | ||
under the state Medicaid program is approved by the Centers for | ||
Medicare and Medicaid Services or another applicable federal | ||
government agency; and | ||
(2) long-term care facilities licensed under Chapter | ||
242, Health and Safety Code, have been compensated retroactively at | ||
the increased rate for services provided under the state Medicaid | ||
program for the period beginning with the effective date of this | ||
Act. | ||
SECTION 5. The Health and Human Services Commission shall | ||
discontinue the reinvestment allowance imposed under Subchapter P, | ||
Chapter 242, Health and Safety Code, as added by this Act, if the | ||
commission reduces Medicaid reimbursement rates, including rates | ||
that increased due to funds from the nursing facility reinvestment | ||
allowance trust fund or federal matching funds, below the rates in | ||
effect on September 1, 2017. | ||
SECTION 6. 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, 2017. |