H.B. No. 867
    1-1                                AN ACT
    1-2  relating to an automated system for providing reimbursements to
    1-3  nursing homes under the state Medicaid program.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Chapter 242, Health and Safety Code, is amended
    1-6  by adding Subchapter H to read as follows:
    1-7            SUBCHAPTER H.  AUTOMATED MEDICAID PATIENT CARE
    1-8                       AND REIMBURSEMENT SYSTEM
    1-9        Sec. 242.201.  AUTOMATED SYSTEM FOR MEDICAID PATIENT CARE AND
   1-10  REIMBURSEMENT.  (a)  The department shall acquire and develop an
   1-11  automated system for providing reimbursements to nursing homes
   1-12  under the state Medicaid program, subject to the availability of
   1-13  funds appropriated for that purpose.
   1-14        (b)  The department shall select an automated system that
   1-15  will allow the addition of other components of the state Medicaid
   1-16  program, including components administered by other state agencies.
   1-17        (c)  The department and the Health and Human Services
   1-18  Commission shall work together to apply for all available federal
   1-19  funds to help pay for the automated system.
   1-20        (d)  To the extent possible, the department shall assist
   1-21  nursing homes to make systems compatible with the automated system
   1-22  selected by the department.
   1-23        Sec. 242.202.  DATA USED BY SYSTEM.  The automated patient
   1-24  care and reimbursement system must use a form designed by the
    2-1  United States Health Care Financing Administration for nursing home
    2-2  use.
    2-3        Sec. 242.203.  ELECTRONIC CLAIMS FOR REIMBURSEMENT.  (a)  The
    2-4  automated reimbursement system must be able to link the department
    2-5  electronically with nursing homes making claims for reimbursement.
    2-6  When the system is operational, each nursing home shall make claims
    2-7  electronically.
    2-8        (b)  The department shall charge a fee to nursing homes that
    2-9  do not make their claims for reimbursement electronically.  The
   2-10  department shall set the fee in an amount necessary to cover the
   2-11  costs of manually processing the claims.
   2-12        Sec. 242.204.  DATE OF REIMBURSEMENT.  The department shall
   2-13  pay nursing home reimbursement claims under the state Medicaid
   2-14  program that are made electronically not later than the 30th day
   2-15  after the date the claim is made.
   2-16        Sec. 242.205.  RULES.  The department shall adopt rules and
   2-17  make policy changes as necessary to improve the efficiency of the
   2-18  reimbursement process and to maximize the automated reimbursement
   2-19  system's capabilities.
   2-20        SECTION 2.  (a)  The Texas Department of Human Services shall
   2-21  implement the nursing home reimbursement component of the automated
   2-22  reimbursement system required under Subchapter H, Chapter 242,
   2-23  Health and Safety Code, as added by this Act, not later than
   2-24  January 1, 1997.  The Health and Human Services Commission shall
   2-25  evaluate and determine deadlines for using the system for other
   2-26  components of the state Medicaid program and shall work with health
   2-27  and human services agencies to allocate costs.
    3-1        (b)  The department shall reduce staff and purchases as
    3-2  savings and efficiency from implementing the automated
    3-3  reimbursement system are realized.
    3-4        SECTION 3.  The importance of this legislation and the
    3-5  crowded condition of the calendars in both houses create an
    3-6  emergency and an imperative public necessity that the
    3-7  constitutional rule requiring bills to be read on three several
    3-8  days in each house be suspended, and this rule is hereby suspended,
    3-9  and that this Act take effect and be in force from and after its
   3-10  passage, and it is so enacted.