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