Bill Text: TX SB2286 | 2019-2020 | 86th Legislature | Comm Sub


Bill Title: Relating to the creation and operations of health care provider participation programs in certain counties.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Engrossed) 2019-05-15 - House passage as amended reported [SB2286 Detail]

Download: Texas-2019-SB2286-Comm_Sub.html
  86R24089 JCG-F
 
  By: Fallon S.B. No. 2286
 
  (Frank)
 
  Substitute the following for S.B. No. 2286:  No.
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
 
  relating to the creation and operations of health care provider
  participation programs in certain counties.
         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 292C to read as follows:
  CHAPTER 292C. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN
  CERTAIN COUNTIES WITH HOSPITAL DISTRICT BORDERING OKLAHOMA
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. 292C.001.  DEFINITIONS. In this chapter:
               (1)  "Institutional health care provider" means a
  nonpublic hospital that provides inpatient hospital services and
  that is not located within the boundaries of a hospital district.
               (2)  "Paying hospital" means an institutional health
  care provider required to make a mandatory payment under this
  chapter.
               (3)  "Program" means the county health care provider
  participation program authorized by this chapter.
         Sec. 292C.002.  APPLICABILITY. This chapter applies only to
  a county that:
               (1)  contains a hospital district that is not
  countywide;
               (2)  has a population of more than 125,000; and
               (3)  borders Oklahoma.
         Sec. 292C.003.  COUNTY HEALTH CARE PROVIDER PARTICIPATION
  PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care
  provider participation program authorizes a county to collect a
  mandatory payment from each institutional health care provider
  located in the county to be deposited in a local provider
  participation fund established by the county. Money in the fund may
  be used by the county to fund certain intergovernmental transfers
  as provided by this chapter.
         (b)  The commissioners court of a county may adopt an order
  authorizing the county to participate in the program, subject to
  the limitations provided by this chapter.
         Sec. 292C.004.  EXPIRATION. The authority of a county to
  administer and operate a program under this chapter expires
  December 31, 2023.
  SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
         Sec. 292C.051.  LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
  PAYMENT.  The commissioners court of a county may require a
  mandatory payment authorized under this chapter by an institutional
  health care provider in the county only in the manner provided by
  this chapter.
         Sec. 292C.052.  MAJORITY VOTE REQUIRED. The commissioners
  court of a county may not authorize the county to collect a
  mandatory payment authorized under this chapter without an
  affirmative vote of a majority of the members of the commissioners
  court.
         Sec. 292C.053.  RULES AND PROCEDURES. After the
  commissioners court of a county has voted to require a mandatory
  payment authorized under this chapter, the commissioners court may
  adopt rules relating to the administration of the mandatory
  payment.
         Sec. 292C.054.  INSTITUTIONAL HEALTH CARE PROVIDER
  REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a
  county that collects a mandatory payment authorized under this
  chapter shall require each institutional health care provider
  located in the county to submit to the county 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.
         (b)  The commissioners court of a county that collects a
  mandatory payment authorized under this chapter may inspect the
  records of an institutional health care provider to the extent
  necessary to ensure compliance with the requirements of Subsection
  (a).
  SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
         Sec. 292C.101.  HEARING. (a) Each year, the commissioners
  court of a county that collects a mandatory payment authorized
  under this chapter shall hold a public hearing on the amounts of any
  mandatory payments that the commissioners court intends to require
  during the year.
         (b)  Not later than the fifth day before the date of the
  hearing required under Subsection (a), the commissioners court of
  the county shall publish notice of the hearing in a newspaper of
  general circulation in the county.
         (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. 292C.102.  DEPOSITORY. (a) The commissioners court of
  each county that collects a mandatory payment authorized under this
  chapter by resolution shall designate one or more banks located in
  the county as the depository for mandatory payments received by the
  county.
         (b)  All income received by a county under this chapter,
  including the revenue from mandatory payments remaining after
  discounts and fees for assessing and collecting the payments are
  deducted, shall be deposited with the county depository in the
  county's local provider participation fund and may be withdrawn
  only as provided by this chapter.
         (c)  All funds under this chapter shall be secured in the
  manner provided for securing county funds.
         Sec. 292C.103.  LOCAL PROVIDER PARTICIPATION FUND;
  AUTHORIZED USES OF MONEY. (a)  Each county that collects a
  mandatory payment authorized under this chapter shall create a
  local provider participation fund.
         (b)  The local provider participation fund of a county
  consists of:
               (1)  all revenue received by the county attributable to
  mandatory payments authorized under this chapter, including any
  penalties and interest attributable to delinquent payments;
               (2)  money received from the Health and Human Services
  Commission as a refund of an intergovernmental transfer from the
  county 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.
         (c)  Money deposited to the local provider participation
  fund may be used only to:
               (1)  fund intergovernmental transfers from the county
  to the state to provide:
                     (A)  the nonfederal share of a Medicaid
  supplemental payment program authorized under the state Medicaid
  plan, 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), or a successor waiver
  program authorizing similar Medicaid supplemental payment
  programs; or
                     (B)  payments to Medicaid managed care
  organizations that are dedicated for payment to hospitals;
               (2)  pay the administrative expenses of the county
  solely for activities under this chapter;
               (3)  refund a portion of a mandatory payment collected
  in error from a paying hospital; and
               (4)  refund to paying hospitals the proportionate share
  of money received by the county that is not used to fund the
  nonfederal share of Medicaid supplemental payment program
  payments.
         (d)  Money deposited to the local provider participation
  fund may not be used to pay for the services of a consultant or a
  person required to register under Chapter 305, Government Code.
         (e)  Money in the local provider participation fund may not
  be commingled with other county funds.
         (f)  An intergovernmental transfer of funds described by
  Subsection (c)(1) and any funds received by the county as a result
  of an intergovernmental transfer described by that subsection may
  not be used by the county or any 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. 292C.151.  MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
  NET PATIENT REVENUE. (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 on the net patient revenue of each
  institutional health care provider located in the county.  The
  commissioners court may provide for the mandatory payment to be
  assessed 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 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 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).
         (c)  The commissioners court of a county that collects a
  mandatory payment authorized under this chapter shall set the
  amount of the mandatory payment.  The amount of the mandatory
  payment required of each paying hospital may not exceed six percent
  of the paying hospital's net patient revenue.
         (d)  Subject to the maximum amount prescribed by Subsection
  (c), the commissioners court of a county that collects a mandatory
  payment authorized under this chapter shall set the mandatory
  payments in amounts that in the aggregate will generate sufficient
  revenue to cover the administrative expenses of the county for
  activities under this chapter and to fund an intergovernmental
  transfer described by Section 292C.103(c)(1), except that the
  amount of revenue from mandatory payments used for administrative
  expenses of the county for activities under this chapter in a year
  may not exceed $20,000, plus the cost of collateralization of
  deposits.  If the county demonstrates to the paying hospitals that
  the costs of administering the program under this chapter,
  excluding those costs associated with the collateralization of
  deposits, exceed $20,000 in any year, on consent of a majority of
  the paying hospitals, the county may use additional revenue from
  mandatory payments received under this chapter to compensate the
  county for its administrative expenses.  A paying hospital may not
  unreasonably withhold consent to compensate the county for
  administrative expenses.
         (e)  A paying hospital may not add a mandatory payment
  required under this section as a surcharge to a patient.
         Sec. 292C.152.  ASSESSMENT AND COLLECTION OF MANDATORY
  PAYMENTS. The county may collect or contract for the assessment and
  collection of mandatory payments authorized under this chapter.
         Sec. 292C.153.  INTEREST, PENALTIES, AND DISCOUNTS.  
  Interest, penalties, and discounts on mandatory payments required
  under this chapter are governed by the law applicable to county ad
  valorem taxes.
         Sec. 292C.154.  PURPOSE; CORRECTION OF INVALID PROVISION OR
  PROCEDURE. (a)  The purpose of this chapter is to generate revenue
  by collecting from institutional health care providers a mandatory
  payment to be used to provide the nonfederal share of a Medicaid
  supplemental payment program.
         (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 county may provide by
  rule for an alternative provision or procedure that conforms to the
  requirements of the federal Centers for Medicare and Medicaid
  Services.
         SECTION 2.  As soon as practicable after the expiration of
  the authority of a county to administer and operate a health care
  provider participation program under Chapter 292C, Health and
  Safety Code, as added by this Act, the commissioners court of the
  county shall transfer to the institutional health care providers in
  the county a proportionate share of any remaining funds in any local
  provider participation fund created by the county under Section
  292C.103, 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.  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.
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