87R17270 JCG-D
 
  By: Coleman H.B. No. 1338
 
  Substitute the following for H.B. No. 1338:
 
  By:  Anderson C.S.H.B. No. 1338
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the continuation and operations of a health care
  provider participation program by the Harris County Hospital
  District.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 299.001, Health and Safety Code, is
  amended by adding Subdivision (6) to read as follows:
               (6)  "Qualifying assessment basis" means the health
  care item, health care service, or other health care-related basis
  consistent with 42 U.S.C. Section 1396b(w) on which the board
  requires mandatory payments to be assessed under this chapter.
         SECTION 2.  Section 299.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 299.004.  EXPIRATION. (a) Subject to Section
  299.153(d), the authority of the district to administer and operate
  a program under this chapter expires December 31, 2023 [2021].
         (b)  This chapter expires December 31, 2023 [2021].
         SECTION 3.  Section 299.053, Health and Safety Code, is
  amended to read as follows:
         Sec. 299.053.  INSTITUTIONAL HEALTH CARE PROVIDER
  REPORTING. If the board authorizes the district to participate in a
  program under this chapter, the board may [shall] require each
  institutional health care provider to submit to the district a copy
  of any financial and utilization data as reported in:
               (1)  the provider's Medicare cost report [submitted]
  for the most recent [previous fiscal year or for the closest
  subsequent] 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.
         SECTION 4.  Section 299.103(c), Health and Safety Code, is
  amended to read as follows:
         (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
  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)  uniform 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 299.151(d), 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 a paying provider, in an amount that is
  proportionate to the mandatory payments made under this chapter by
  the provider during the 12 months preceding the date of the refund,
  [providers a proportionate share of] the money attributable to
  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 payment program payments; or
                     (B)  determines cannot be used to fund the
  nonfederal share of Medicaid supplemental payment program
  payments; 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 programs for which the district made intergovernmental
  transfers described by Subdivision (1).
         SECTION 5.  The heading to Section 299.151, Health and
  Safety Code, is amended to read as follows:
         Sec. 299.151.  MANDATORY PAYMENTS [BASED ON PAYING PROVIDER
  NET PATIENT REVENUE].
         SECTION 6.  Section 299.151, Health and Safety Code, is
  amended by amending Subsections (a), (b), and (c) and adding
  Subsections (a-1) and (a-2) to read as follows:
         (a)  If the board authorizes a health care provider
  participation program under this chapter, the board may require [a]
  mandatory payments [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 the basis of a health care item, health care service,
  or other health care-related basis that is consistent with the
  requirements of 42 U.S.C. Section 1396b(w) [the net patient revenue
  of each institutional health care provider located in the
  district]. 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 [subsection], and the
  provider has 30 calendar days following the date of receipt of the
  notice to pay the assessment.
         (a-1)  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.
         (a-2)  [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 provider's Medicare cost report submitted for the previous
  fiscal year or for the closest subsequent fiscal year for which the
  provider submitted the Medicare cost report.] If [the] mandatory
  payments are [payment is] required, the district shall update the
  amount of the mandatory payments [payment] on an annual basis and
  may update the amount on a more frequent basis.
         (b)  The amount of a mandatory payment authorized under this
  chapter must be uniformly proportionate with the qualifying
  assessment basis for [amount of net patient revenue generated by]
  each paying provider in the district as permitted under federal
  law. A health care provider participation program authorized under
  this chapter may not hold harmless any institutional health care
  provider, as required under 42 U.S.C. Section 1396b(w).
         (c)  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 [four] percent of the aggregate
  net patient revenue from hospital services provided by all paying
  providers in the district.
         SECTION 7.  Subchapter D, Chapter 299, Health and Safety
  Code, is amended by adding Section 299.154 to read as follows:
         Sec. 299.154.  REQUEST FOR CERTAIN RELIEF. If 42 U.S.C.
  Section 1396b(w) or 42 C.F.R. Part 433 Subpart B is revised or
  interpreted in a manner that impedes the operations of a program
  under this chapter, and the operations may be improved by a request
  for relief under 42 C.F.R. Section 433.72, the board may request the
  Health and Human Services Commission to submit, and if requested
  the commission shall submit, a request to the Centers for Medicare
  and Medicaid Services for relief under 42 C.F.R. Section 433.72.
         SECTION 8.  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, 2021.