SRC-PNG H.B. 2573 76(R)   BILL ANALYSIS


Senate Research Center   H.B. 2573
By: Wolens (Nelson)
Health Services
5/10/1999
Engrossed


DIGEST 

The Indigent Health Care and Treatment Act, enacted in 1985, has not
addressed all out-of-country issues impacting reimbursement of facilities
for care provided to indigent patients.  Tertiary medical centers, which
provide and coordinate care for trauma and seriously ill patients, as well
as injury prevention, research, public education, and continuing education
for rural providers, have experienced increased costs for care provided to
out-of-country indigent residents.  Currently, taxpayers of the county bear
the added costs incurred by the centers which provide health care to these
indigent residents.  This bill would require the Texas Board of Health to
adopt minimum standards and objectives to implement a system that
encourages hospitals to provide tertiary medical services and increases the
availability of these services, as well as providing funding for those
services. 

PURPOSE

As proposed, H.B. 2573 requires the Texas Board of Health to adopt minimum
standards and objectives to implement a system that encourages hospitals to
provide tertiary medical services and increases the availability of these
services, and provides funding for those services. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the Texas Board of Heath in SECTION 1
(Sections 46.003 and 46.006, Health and Safety Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Title 2B, Health And Safety Code, by adding Chapter 46,
as follows: 

CHAPTER 46.  TERTIARY MEDICAL CARE

Sec.  46.001.  DEFINITIONS.  Defines "tertiary care facility" and "tertiary
medical services."  

Sec.  46.002.  DESIGNATION OF FACILITIES.  Requires the Texas Department of
Health (TDH) to designate tertiary care facilities (facilities) that meet
this chapter's requirements to provide tertiary medical services. 

Sec.  46.003.  DUTIES OF BOARD; RULES.  (a) Requires the Texas Board of
Health (board), by rule, to adopt minimum standards and objectives to
implement a system that encourages hospitals to provide tertiary medical
services and increases the availability of these services. 

(b) Requires that the rules make certain provisions with respect to
geographic areas, services by facilities, and the patients they serve. 

(c) Requires the rules to include certain guidelines, criteria,
requirements, standards, and assurances regarding facilities and the
population they service. 

Sec.  46.004.  DENIAL, SUSPENSION, OR REVOCATION OF DESIGNATION. Authorizes
TDH to deny, suspend, or revoke a designation as a facility if the facility
does not  comply with rules adopted under this chapter.  Provides that the
denial, suspension, or revocation of a designation by TDH and the appeal
from that action are governed by the board's rules for a contested case
hearing and by Chapter 2001, Government Code. 

Sec.  46.005.  TERTIARY CARE FACILITY ACCOUNT.  Provides that the facility
account is an account in the state treasury.  Authorizes money in the
account to be appropriated only to TDH for the purposes of this chapter.
Provides that the account is composed of money appropriated to the account
and any other funds required to be put in the account.  Authorizes TDH to
seek and accept gifts, grants, and donations from any public or private
entity on behalf of the account.  Provides that Section 403.095, Government
Code, is inapplicable to the account.  Requires five percent of the total
amount in the account to be held in reserve for each fiscal year and
authorizes it to be used only for reimbursement of unpaid tertiary medical
services provided as a result of extraordinary emergencies occurring during
that year. Provides that of the amount remaining, no more than five percent
may be used for the costs of administering the account. 

Sec.  46.006.  COLLECTION OF INFORMATION.  (a) Requires each facility to
submit to TDH, in the manner and time required, information relating to
unreimbursed tertiary medical services provided to persons residing outside
the service area of the county, public hospital, or hospital district
responsible for indigent health care under Chapter 61, Health and Safety
Code, in the area where the facility is located.  Requires the board to
adopt rules governing the collection of this information. 

Sec.  46.007.  CERTIFICATION TO COMPTROLLER.  (a) Requires TDH to certify
to the comptroller of public accounts (comptroller) for each facility the
cost of unreimbursed tertiary medical services it provides to persons
residing outside the service area of the county, public hospital, or
hospital district responsible for indigent health care under Chapter 61,
Health and Safety Code, in the area where the facility is located.   

(b) Requires TDH, on a yearly basis, to make for a facility that was
designated as a tertiary care facility during the previous year, an initial
certification to the comptroller under Subsection (a) in an amount equaling
80 percent of that certified under this section for a facility in the
previous year.  Requires TDH to make a subsequent certification of the cost
of additional unreimbursed tertiary medical services provided by the
facility on receipt from the facility of the required information under
Section 46.006, Health and Safety Code. 

(c) Requires TDH to allocate the amount available under Section 46.005,
Health and Safety Code, to each facility based on the percentages computed
by dividing the cost of the facility's unreimbursed tertiary medical
services , if in any year, the cost of services certified under Subsection
(a) for all designated facilities exceeds the amount available for payment
to the facilities under that section. 

(d) Provides that the cost of each service provided is the average amount
payable under Medicare for services for the Medicare diagnosis related
groups that must be provided by a facility to qualify for designation under
the minimum standards adopted under this chapter for the purposes of this
section and Section 46.008, Health and Safety Code. 

Sec.  46.008.  CERTIFICATION OF EMERGENCIES.  Requires TDH, for the
purposes of reimbursement under this chapter, to certify an extraordinary
emergency under certain conditions.  Requires TDH to certify to the
comptroller the amount of unreimbursed tertiary medical services incurred
by a facility during an emergency if one is declared under Subsection (a). 

SECTION 2. Effective date: September 1, 1999.

SECTION 3. Emergency clause.