By Maxey                                               H.B. No. 867
       74R2352 KLL-D
                                 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 REIMBURSEMENT SYSTEM
    1-8        Sec. 242.201.  AUTOMATED SYSTEM FOR MEDICAID REIMBURSEMENT.
    1-9  (a)  The department shall acquire and develop an automated system
   1-10  for providing reimbursements to nursing homes under the state
   1-11  Medicaid program.
   1-12        (b)  The department shall select an automated system that
   1-13  will allow the addition of other components of the state Medicaid
   1-14  program, including components administered by other state agencies.
   1-15        (c)  The department and the Health and Human Services
   1-16  Commission shall work together to apply for all available federal
   1-17  funds to help pay for the automated system.
   1-18        Sec. 242.202.  DATA USED BY SYSTEM.  The automated
   1-19  reimbursement system must use the data on the MDS+ form designed by
   1-20  the United States Health Care Financing Administration for nursing
   1-21  home use.
   1-22        Sec. 242.203.  ELECTRONIC CLAIMS FOR REIMBURSEMENT.  (a)  The
   1-23  automated reimbursement system must be able to link the department
   1-24  electronically with nursing homes making claims for reimbursement.
    2-1  When the system is operational, each nursing home shall make claims
    2-2  electronically.
    2-3        (b)  The department shall charge a fee to nursing homes that
    2-4  do not make their claims for reimbursement electronically.  The
    2-5  department shall set the fee in an amount necessary to cover the
    2-6  costs of manually processing the claims.
    2-7        Sec. 242.204.  DATE OF REIMBURSEMENT.  The department shall
    2-8  pay nursing home reimbursement claims under the state Medicaid
    2-9  program that are made electronically not later than the 30th day
   2-10  after the date the claim is made.
   2-11        Sec. 242.205.  RULES.  The department shall adopt rules and
   2-12  make policy changes as necessary to improve the efficiency of the
   2-13  reimbursement process and to maximize the automated reimbursement
   2-14  system's capabilities.
   2-15        SECTION 2.  (a)  The Texas Department of Human Services shall
   2-16  implement the nursing home reimbursement component of the automated
   2-17  reimbursement system required under Subchapter H, Chapter 242,
   2-18  Health and Safety Code, as added by this Act, not later than
   2-19  September 1, 1996.  The Health and Human Services Commission shall
   2-20  evaluate and determine deadlines for using the system for other
   2-21  components of the state Medicaid program and shall work with health
   2-22  and human services agencies to allocate costs.
   2-23        (b)  The department shall give priority to developing and
   2-24  implementing the automated reimbursement system under this section
   2-25  over any other equipment and automation upgrades.
   2-26        (c)  The department shall reduce staff and purchases as
   2-27  savings and efficiency from implementing the automated
    3-1  reimbursement system are realized.
    3-2        SECTION 3.  The importance of this legislation and the
    3-3  crowded condition of the calendars in both houses create an
    3-4  emergency and an imperative public necessity that the
    3-5  constitutional rule requiring bills to be read on three several
    3-6  days in each house be suspended, and this rule is hereby suspended,
    3-7  and that this Act take effect and be in force from and after its
    3-8  passage, and it is so enacted.