BG C.S.H.B. 2932 75(R)BILL ANALYSIS


PUBLIC HEALTH
C.S.H.B. 2932
By: Coleman
4-24-97
Committee Report (Substituted)

BACKGROUND 

For over 25 years, hospitals have been authorized and encouraged to file
liens on services provided to Medicaid recipients when certain liable
third party sources of payment are available, such as an automobile
liability insurance policy.  Each year, Texas hospitals refund more than
$6 million to the Medicaid program once they receive payment from the
settlement of a liability claim. 

In 1995, the rights of hospitals to pursue their hospital liens on
services provided to Medicaid recipients began to be challenged.  These
challenges are grounded in a creative re-interpretation of the existing
law and an ambiguous provision which exists in the Medicaid provider
agreements.  

This legislation is consistent with Comptroller Sharp's TPR recommendation
to increase thirdparty subrogation collection efforts for medical payments
and the state's policy that Medicaid be the "payor of last resort." 

PURPOSE

CSHB 2932 allows a hospital provider to recover funds from a third party
in the amount of hospital charges for services provided to a recipient.  

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any
additional rulemaking authority to a state officer, department, agency or
institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 32.033, Human Resources Code, by adding
Subsection (i) to allow a hospital provider to recover from a third party
any funds the department has a right of recovery under Subsection (a)(3)
regarding the assumption by a third party of another's legal right to
collect a debt or damages (subrogation).  Allows a hospital provider to
file a lien under Chapter 55, Property Code, regarding Hospital Liens,
and to recover the full amount of hospital charges for services provided
to a recipient.  Requires a hospital provider, upon recovery from a third
party, to reimburse DHS for any amount previously paid to the hospital
provider by DHS. Establishes that the combined amounts received by the
hospital provider from DHS and the third party may not exceed the amount
charged by the hospital for the first 100 days of the injured recipient's
hospitalization. 

SECTION 2.  Establishes the effective date of this Act to be September 1,
1997. 

SECTION 3.  Emergency Clause.

COMPARISON OF ORIGINAL TO SUBSTITUTE

The original bill made reference to a Sec. 55.004, Property Code, which is
obsolete under federal law. The substitute removes this and specifies the
amount to be not more than the first hundred day charges.