By Hawley                                             H.B. No. 2424
         77R6551 JAT-D                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to payment for services provided by rural hospitals and
 1-3     physicians under the state child health plan.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1. Subchapter D, Chapter 62, Health and Safety Code,
 1-6     is amended by adding Section 62.157 to read as follows:
 1-7           Sec. 62.157.  PAYMENTS TO RURAL HEALTH CARE PROVIDERS.  (a)
 1-8     In this section:
 1-9                 (1)  "Rural hospital" means a hospital that:
1-10                       (A)  has 100 or fewer beds; and
1-11                       (B)  is located in a county with a population of
1-12     100,000 or less.
1-13                 (2)  "Rural physician" means a physician who practices
1-14     in a county with a population of 100,000 or less.
1-15           (b)  The commission shall ensure that a health plan provider
1-16     pays a rural hospital for services provided under this chapter the
1-17     state Medicaid program prospective payment system rate.
1-18           (c)  At the end of a rural hospital's fiscal year, the health
1-19     plan provider or the commission shall determine what the amount of
1-20     reimbursement to the hospital would have been if the health plan
1-21     provider had reimbursed the hospital for costs using a method
1-22     similar to a method authorized under the Tax Equity and Fiscal
1-23     Responsibility Act of 1982, Pub. L. No. 97-248, without the
1-24     imposition of a cap on costs.
 2-1           (d)  If the commission or the health plan provider determines
 2-2     under Subsection (c) that the amount that would have been
 2-3     reimbursed to the hospital is greater than the amount actually
 2-4     received by the hospital under the prospective payment system under
 2-5     Subsection (b), the health plan provider shall pay the difference
 2-6     to the hospital.
 2-7           (e)  The commission shall ensure that a health plan provider
 2-8     reimburses a rural physician for services provided by the physician
 2-9     under this chapter using the state Medicaid program fee schedule
2-10     for physicians.
2-11           SECTION 2. (a)  The Health and Human Services Commission
2-12     shall, not later than September 15, 2001, submit for approval a
2-13     plan amendment relating to the state child health plan under 42
2-14     U.S.C. Section 1397ff, as amended, as necessary to comply with the
2-15     change in law made by this Act.
2-16           (b)  The Health and Human Services Commission may delay,
2-17     until approval of the amended state child health plan,
2-18     implementation of the changes to rural hospital and physician
2-19     payment rates under Section 62.157, Health and Safety Code, as
2-20     added by this Act.
2-21           SECTION 3. This Act takes effect September 1, 2001.