BILL ANALYSIS

Senate Research Center	S.B. 1156
88R6237 SRA-F	By: Men�ndez
	Health & Human Services
	4/29/2023
	As Filed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

Many hospitals and health systems have been using the federal Acute Hospital Care at Home (AHCAH) waiver to provide safe, high quality, hospital-level services in patients' homes. The Centers for Medicare and Medicaid Services (CMS) implemented the AHCAH waiver program to allow Medicare beneficiaries to receive acute-level health care services in their home during the COVID-19 public health emergency. So far, more than 200 hospitals across 34 states are approved to participate in this program, with more applying for the waiver.

Hospital at home programs have existed since the early 1990s and studies have proven that this model of care is safe, cost-effective, and valued by patients. Hospital at home programs have led to fewer readmissions and returns to the emergency department, higher patient-reported outcomes and patient satisfaction, and significantly lower use of skilled nursing facility care. These results were the case for patients of both high and low socioeconomic statuses.

S.B. 1156 would permit hospitals in Texas to apply for an AHCAH license by submitting an application to the Health and Human Services Commisison plus an application fee. This legislation is needed, as Texas hospitals could be excluded from the AHCAH program until at least 2025.

As proposed, S.B. 1156 amends current law relating to the operation of a hospital at home program by certain hospitals and authorizes a fee.

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the executive commissioner of the Health and Human Service Commission in SECTION 1 (Section. 241.403, Health and Safety Code) of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 241, Health and Safety Code, by adding Subchapter M, as follows:

SUBCHAPTER M. HOSPITAL AT HOME PROGRAM

Sec. 241.401. DEFINITIONS. Defines "acute hospital care at home waiver program" and "hospital at home program."

Sec. 241.402. APPROVAL AND LICENSE REQUIRED. (a) Prohibits a hospital from operating a hospital at home program unless the hospital:

(1) is approved by the Centers for Medicare and Medicaid Services (CMS) to operate the program and;

(2) holds a license issued by the Health and Human Services Commission (HHSC) under this subchapter.

Sec. 241.403. MINIMUM STANDARDS. (a) Requires the executive commissioner of HHSC (executive commissioner) to adopt rules establishing minimum standards for the operation of a hospital at home program by a hospital.

(b) Requires that the standards established under Subsection (a) be at least as stringent as the standards established by CMS under the acute hospital care at home waiver program.

Sec. 241.404. APPLICATION; ISSUANCE OF LICENSE. (a) Requires an applicant for a license under this subchapter to:

(1) submit an application to HHSC in the form and manner prescribed by HHSC; and

(2) pay a fee in the amount set HHSC under Section 241.405.

(b) Requires HHSC to issue a license to an applicant to operate a hospital at home program under this subchapter if the applicant meets the standards established under Section 241.403 and satisfies the requirements of this section.

(c) Authorizes HHSC to request that an applicant provide additional information necessary to determine whether the applicant meets the standards established under Section 241.403 after the applicant has submitted an application.

Sec. 241.405. FEES. (a) Authorizes HHSC to establish a fee to be assessed for the issuance of a license under this subchapter.

(b) Requires HHSC to set the fee in an amount that is reasonable and necessary to cover the costs of administering this subchapter.

Sec. 241.406. WAIVER OF REQUIREMENTS. (a) Authorizes HHSC by order to waive or modify the requirement of a particular provision of this subchapter or a standard established under this subchapter if HHSC determines that the waiver or modification:

(1) will facilitate a hospital's creation or operation of a hospital at home program; and

(2) is in the best interests of the individuals who are or will be served by the hospital's hospital at home program.

(b) Provides that Sections 241.026(d) (relating to requiring the executive commissioner to adopt rules to establish procedures and criteria for the issuance of the waiver or modification order) and (e) (relating requiring that a licensing record of a hospital granted the waiver or modification if ordered by the Department of State Health Services to contain certain information) apply to a waiver or modification under this section.

SECTION 2. Effective date: September 1, 2023.