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A BILL TO BE ENTITLED
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AN ACT
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relating to health care provider participation programs in this |
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State. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Title 4, Health and Safety Code, is amended by |
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adding Subtitle D-1 before Chapter 288 as follows: |
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Subtitle D-1. PROVIDER PARTICIPATION PROGRAMS |
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SECTION 2. Chapter 289, Health and Safety Code, is deleted |
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and replaced by the following new Chapter 289 to read as follows: |
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CHAPTER 289. PROVISIONS OF GENERAL APPLICABILITY TO PROVIDER |
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PARTICIPATION PROGRAMS |
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Sec. 289.0001 PURPOSE. This chapter provides provisions |
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that apply to all provider participation programs in this Subtitle |
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D-1, including those operated by a county health care funding |
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district under Chapter 288. |
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Sec. 289.0101. BASIS FOR MANDATORY PAYMENTS. |
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Notwithstanding language elsewhere in this Subtitle D-1, a local |
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government administering a program under this subtitle may utilize |
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a basis other than the net patient revenue of each institutional |
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health care provider to compute the mandatory payments. |
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Specifically, a local government entity administering a program |
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under this subtitle may utilize any basis permitted by federal law |
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at 42 U.S.C. Section 1396b(w) and 42 C.F.R. Section 433.68. |
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Sec. 289.0102. DOCUMENTATION. If the documentation, that |
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is to be submitted by institutional health care providers to the |
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local government as specified elsewhere in this Subtitle D-1, is |
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insufficient for a local government to assure that all |
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institutional health care providers are assessed a mandatory |
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payment that is consistent with this subtitle and federal law at 42 |
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U.S.C. Section 1396b(w) and 42 C.F.R. Section 433.68, a local |
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government may require and use additional documentation to |
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effectuate that purpose. |
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Sec. 289.0103. AUTHORITY TO REQUEST WAIVER. If federal law |
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at 42 U.S.C. Section 1396b(w) or 42 C.F.R. Part 433 Subpart B is |
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revised, or interpreted by the Centers for Medicare & Medicaid |
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Services, in ways that impede the operation of local provider |
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participation programs, and a local government administering a |
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program under this subtitle determines that it would be beneficial |
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for the Health and Human Services Commission to obtain a waiver from |
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the Centers for Medicare & Medicaid Services as permitted by 42 |
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U.S.C. Section 1396b(w)(3) and 42 C.F.R. Section 433.68(e), then |
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the local government may request that the Commission submit such |
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waiver request. If a request is submitted to the Commission, the |
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Commission shall submit such waiver request to the Centers for |
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Medicare & Medicaid Services on behalf of the local government, |
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along with documentation justifying that waiver request provided by |
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the local government. If the waiver request is granted, then the |
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local government, consistent with the terms of the waiver granted, |
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need not comply with requirements elsewhere in this subtitle that |
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mandatory payments be assessed on each provider and that the amount |
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of the mandatory payment be uniformly proportionate with the amount |
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of net patient revenue. |
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SECTION 3. Chapter 290, Health and Safety Code, is deleted. |
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SECTION 4. Section 298C.004, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 298C.004. EXPIRATION. (a) Subject to Section |
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298C.153(d), the authority of the district to administer and |
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operate a program under this chapter expires December 31, 2023 |
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[2021]. |
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(b) This chapter expires December 31, 2023 [2021]. |
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SECTION 5. Section 298E.103(e)(2), Health and Safety Code, |
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is amended to read as follows: |
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(2) fund the nonfederal share of payments to hospitals |
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available through [the Medicaid disproportionate share hospital |
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program or] the delivery system reform incentive payment program. |
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SECTION 6. Section 299.004, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 299.004. EXPIRATION. (a) Subject to Section |
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299.153(d), the authority of the district to administer and operate |
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a program under this chapter expires December 31, 2023 [2021]. |
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(b) This chapter expires December 31, 2023 [2021]. |
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SECTION 7. Section 299.151(c), Health and Safety Code, is |
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amended to read as follows: |
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(c) If the board requires a mandatory payment authorized |
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under this chapter, the board shall set the amount of the mandatory |
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payment, subject to the limitations of this chapter. The aggregate |
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amount of the mandatory payments required of all paying providers |
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in the district may not exceed six [four] percent of the aggregate |
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net patient revenue from hospital services provided by all paying |
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providers in the district. |
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SECTION 8. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2021. |