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 | |
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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. |