Bill Text: TX SB2423 | 2019-2020 | 86th Legislature | Introduced


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

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2019-03-21 - Referred to Intergovernmental Relations [SB2423 Detail]

Download: Texas-2019-SB2423-Introduced.html
 
 
  By: Birdwell S.B. No. 2423
 
 
 
   
 
 
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 299 to read as follows:
  CHAPTER 299. COUNTY HEALTH CARE PROVIDER PARTICIPATION
  PROGRAM IN CERTAIN COUNTIES
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. 299.001.  DEFINITIONS. In this chapter:
               (1)  "Institutional health care provider" means a
  nonpublic hospital that provides inpatient hospital services.
               (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. 299.002.  APPLICABILITY. This chapter applies only to
  a county that:
               (1)  is adjacent to two counties with a population of
  1,000,000 or more; and
               (2)  borders the Trinity River.
         Sec. 299.003.  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
  and indigent care programs as provided by this chapter.
         (b)  The commissioners court may adopt an order authorizing a
  county to participate in the program, subject to the limitations
  provided by this chapter.
  SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT
         Sec. 299.051.  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. 299.052.  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. 299.053.  RULES AND PROCEDURES. After the
  commissioners court 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. 299.054.  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 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. 299.101.  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 and how the revenue derived from those payments is
  to be spent.
         (b)  Not later than the 10th 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. 299.102.  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. A bank designated as a depository serves for two years or
  until a successor is designated.
         (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. 299.103.  LOCAL PROVIDER PARTICIPATION FUND;
  AUTHORIZED USES OF MONEY. (a) Each county 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
  amounts received attributable to a suit to enforce liability for
  and collect a delinquent mandatory payment;
               (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, 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), or under 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)  subsidize indigent programs;
               (3)  pay the administrative expenses of the county;
               (4)  refund a portion of a mandatory payment collected
  in error from a paying hospital; and
               (5)  refund to paying hospitals the proportionate share
  of money received by the county from the Health and Human Services
  Commission that is not used to fund the nonfederal share of Medicaid
  supplemental payment program payments;
               (6)  refund to paying hospitals the proportionate share
  of money that the county determines cannot be used to fund the
  nonfederal share of Medicaid supplemental payment program payment;
  and
               (7)  pay for any reasonable expenses the county incurs
  in order to collect delinquent mandatory payments, including any
  attorney's fees incurred as a result of contracting with an
  attorney to represent the county in seeking and enforcing the
  collection of delinquent mandatory payments.
         (d)  Money in the local provider participation fund may not
  be commingled with other county funds.
         (e)  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. 299.151.  MANDATORY PAYMENTS BASED ON PAYING HOSPITAL
  NET PATIENT REVENUE. (a) Except as provided by Subsection (e), the
  commission of a county may require an annual mandatory payment to be
  assessed quarterly on the net patient revenue of an institutional
  health care provider located in the county. 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 2010. The county may 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 an amount
  that, when added to the amount of the mandatory payments required
  from all other paying hospitals in the county, equals an amount of
  revenue that exceeds six percent of the aggregate net patient
  revenue of all paying hospitals in the county.
         (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, to fund the nonfederal share of a
  Medicaid supplemental payment program as described by Section
  299.103(c)(1), and to pay for indigent programs, 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 the lesser of four percent of the total revenue
  generated from the mandatory payment or $20,000. Any reasonable
  expenses the commission incurs in order to collect delinquent
  mandatory payments, including any attorney's fees incurred as a
  result of contracting with an attorney to represent the commission
  in seeking and enforcing the collection of delinquent mandatory
  payments, are not subject to the limitation described in this
  subsection.
         (e)  A paying hospital may not add a mandatory payment
  required under this section as a surcharge to a patient.
         Sec. 299.152.  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. 299.153.  INSTALLMENT PAYMENTS; ATTORNEY FOR
  COLLECTION ACTIVITIES; SUIT. (a) A mandatory payment is considered
  to be delinquent if it is not fully paid within 60 days of the due
  date set by the county. The county may enter into an agreement with
  an institutional health care provider that allows payment in
  installments of a delinquent mandatory payment.
         (b)  The commission may contract with any competent attorney
  to represent the county to seek and enforce the collection of
  delinquent mandatory payments. The attorney's compensation is set
  in the contract, but the total amount of compensation provided may
  not exceed the lesser of (1) 20 percent of the amount of delinquent
  mandatory payments collected and (2) $200,000.
         (c)  At any time after a mandatory payment becomes
  delinquent, the county may file suit in a court of competent
  jurisdiction to enforce liability for and collect the mandatory
  payment. The county may recover attorney's fees in a suit to enforce
  liability for and collect a delinquent mandatory payment. Any
  amounts recovered or otherwise received as a result of a suit to
  enforce liability for and collect a delinquent mandatory payment
  shall be deposited into the local provider participation fund.
         Sec. 299.154.  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.  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, 2019.
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