By Hilderbran H.B. No. 1202
74R4998 CBH-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to clarifying the authority of the Health and Human
1-3 Services Commission to delegate to a health and human services
1-4 agency the authority to operate all or part of the Medicaid program
1-5 and to the powers and duties of that agency.
1-6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-7 SECTION 1. CLARIFICATION OF EFFECT OF LEGISLATION. (a)
1-8 Chapter 15, Acts of the 72nd Legislature, 1st Called Session, 1991
1-9 (H.B. 7), as amended by Chapter 747, Acts of the 73rd Legislature,
1-10 Regular Session, 1993 (H.B. 1510), designated the Health and Human
1-11 Services Commission as the single state agency to administer
1-12 medical assistance (Medicaid) funds and authorized the commission
1-13 to review programs and to implement the transfer of health and
1-14 human services functions, programs, and activities among the
1-15 state's health and human services agencies. In making this
1-16 designation and authorization, the legislature gave the commission
1-17 the authority to delegate to any health and human services agency
1-18 the authority to operate or assist in the operation of any Medicaid
1-19 program.
1-20 (b) Pursuant to this authority, the commission implemented
1-21 the transfer to various health and human services agencies of the
1-22 functions, powers, duties, funds, and obligations related to the
1-23 operation of various Medicaid programs, subject to the
1-24 administrative authority of the commission. Specifically, as that
2-1 authority relates to the Texas Department of Mental Health and
2-2 Mental Retardation, the commission implemented the transfer of the
2-3 functions, powers, duties, funds, and obligations of the following
2-4 Medicaid programs:
2-5 (1) case management for the mentally ill;
2-6 (2) case management for the mentally retarded;
2-7 (3) diagnostic services;
2-8 (4) home and community-based services for persons with
2-9 mental retardation;
2-10 (5) home and community-based services--OBRA;
2-11 (6) rehabilitative services;
2-12 (7) intermediate care facilities for persons with
2-13 mental retardation;
2-14 (8) intermediate care facilities for persons with
2-15 related conditions; and
2-16 (9) intermediate care facilities dental program.
2-17 (c) The legislature declares that:
2-18 (1) the transfer of Medicaid programs and the related
2-19 functions, powers, duties, funds, and obligations to various state
2-20 agencies, including the Texas Department of Mental Health and
2-21 Mental Retardation, were valid transfers;
2-22 (2) all actions taken in reliance on those transfers
2-23 are valid; and
2-24 (3) the transfer of the powers and duties relating to
2-25 the operation of a Medicaid program included a transfer of all
2-26 applicable powers and duties provided by Chapters 21, 22, and 32,
2-27 Human Resources Code, that relate to the operation of the Medicaid
3-1 program, including the power and duty to set rates.
3-2 SECTION 2. CLARIFYING AMENDMENT. Section 32.003, Human
3-3 Resources Code, is amended to read as follows:
3-4 Sec. 32.003. DEFINITIONS <DEFINITION OF MEDICAL ASSISTANCE>.
3-5 In this chapter:
3-6 (1) "Board" means the Health and Human Services
3-7 Commission or the governing body of an agency operating part of the
3-8 medical assistance program, as appropriate.
3-9 (2) "Commissioner" means the Health and Human Services
3-10 Commission or the commissioner or executive director of an agency
3-11 operating part of the medical assistance program, as appropriate.
3-12 (3) "Department" means the Health and Human Services
3-13 Commission or an agency operating part of the medical assistance
3-14 program, as appropriate.
3-15 (4) "Medical <, "medical> assistance" includes all of
3-16 the health care and related services and benefits authorized or
3-17 provided under federal law for needy individuals of this state.
3-18 SECTION 3. CLARIFYING AMENDMENT. Section 32.024(o), Human
3-19 Resources Code, is amended to read as follows:
3-20 (o) The department, in its rules and standards governing the
3-21 scope of hospital and long-term services, shall establish a swing
3-22 bed program in accordance with federal regulations to provide
3-23 reimbursement for skilled nursing patients who are served in
3-24 hospital settings provided that the length of stay is limited to 30
3-25 days per year and the hospital is located in a county with a
3-26 population of 100,000 or less. If the swing beds are used for more
3-27 than one 30-day length of stay per year, per patient, the hospital
4-1 must comply with the Minimum Licensing Standards as mandated by
4-2 Chapter 242, Health and Safety Code <413, Acts of the 53rd
4-3 Legislature, Regular Session, 1953 (Article 4442(c), Vernon's Texas
4-4 Civil Statutes)>, and the Medicaid standards for nursing home
4-5 certification, as promulgated by the department <Texas Department
4-6 of Human Services>.
4-7 SECTION 4. CLARIFYING AMENDMENT. Section 32.029(c), Human
4-8 Resources Code, is amended to read as follows:
4-9 (c) If the department elects to make direct vendor payments,
4-10 the payments shall be made by vouchers and warrants drawn by the
4-11 comptroller on the proper account <of the Texas Department of Human
4-12 Services fund>. The department shall furnish the comptroller with
4-13 a list of those vendors entitled to payments and the amounts to
4-14 which each is entitled. When the warrants are drawn, they must be
4-15 delivered to the department, which <commissioner, who> shall
4-16 supervise the delivery to vendors.
4-17 SECTION 5. CLARIFYING AMENDMENT. Sections 32.030(a) and
4-18 (c), Human Resources Code, are amended to read as follows:
4-19 (a) The medical assistance fund is a special fund in the
4-20 treasury and constitutes a separate account <in the Texas
4-21 Department of Human Services fund>. The fund may be expended only
4-22 for the purpose of carrying out the provisions of this chapter.
4-23 (c) The disproportionate share fund is a <special fund and>
4-24 separate account <in the Texas Department of Human Services fund>
4-25 that provides reimbursement each year to hospitals that render a
4-26 high volume of services to medically indigent persons in the state.
4-27 Payments from the fund shall be not less than $5 million annually
5-1 in state funds in excess of the amounts contained in the general
5-2 appropriations bill as introduced for the 1990-1991 biennium.
5-3 SECTION 6. CLARIFYING AMENDMENT. Section 32.031(e), Human
5-4 Resources Code, is amended to read as follows:
5-5 (e) Public hospitals, including hospitals owned, operated,
5-6 or leased by a governmental entity, including a municipality,
5-7 county, hospital district, or this state, and specifically
5-8 including a state teaching hospital, may transfer funds to the
5-9 department <Texas Department of Human Services> for use as state
5-10 share under the Medicaid disproportionate share program.
5-11 SECTION 7. CLARIFYING AMENDMENT. Section 32.041(a), Human
5-12 Resources Code, is amended to read as follows:
5-13 (a) Beginning September 1, 1991, the department <Texas
5-14 Department of Human Services> in consultation with the Medicaid
5-15 analysis and cost control unit of the Legislative Budget Board
5-16 shall initiate the planning for a Medicaid managed care
5-17 demonstration project.
5-18 SECTION 8. APPLICATION TO FUND OR ACCOUNT. (a) A fund or
5-19 account, the existence of which is derived from a statute amended
5-20 by this Act and which is abolished under Section 403.094,
5-21 Government Code, before the effective date of this Act, is not
5-22 revived or reenacted by this Act.
5-23 (b) The application of Sections 403.094 and 403.095,
5-24 Government Code, to a fund or account or to the permissible uses of
5-25 revenue of fund balances is not affected by this Act.
5-26 SECTION 9. EMERGENCY. The importance of this legislation
5-27 and the crowded condition of the calendars in both houses create an
6-1 emergency and an imperative public necessity that the
6-2 constitutional rule requiring bills to be read on three several
6-3 days in each house be suspended, and this rule is hereby suspended,
6-4 and that this Act take effect and be in force from and after its
6-5 passage, and it is so enacted.