By Eiland, Naishtat, Madden, Coleman                  H.B. No. 2906
         77R1615 JRD-D                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the imposition of an additional fee on nursing and
 1-3     convalescent homes for the purpose of allowing the state to
 1-4     increase reimbursement rates to the homes under the state Medicaid
 1-5     program and to qualify for more federal Medicaid funds.
 1-6           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-7           SECTION 1. Subchapter B, Chapter 242, Health and Safety Code,
 1-8     is amended by adding Section 242.0341 to read as follows:
 1-9           Sec. 242.0341.  QUALITY ASSURANCE FEE. (a)  A quality
1-10     assurance fee is imposed on each institution for which a license
1-11     fee must be paid under Section 242.034.  The fee is:
1-12                 (1)  equal to six percent of the institution's gross
1-13     receipts from its operations in this state;
1-14                 (2)  payable monthly;
1-15                 (3)  in addition to other fees imposed under this
1-16     chapter; and
1-17                 (4)  an allowable cost for reimbursement under the
1-18     state Medicaid program.
1-19           (b)  The Health and Human Services Commission or the
1-20     department at the direction of the commission shall collect the
1-21     fee.  Each institution shall send to the commission or department,
1-22     as appropriate, the information that the commission or department
1-23     requires to collect the fee from the institution, including
1-24     information necessary to verify the amount of the fee for the
 2-1     institution.  The commission or the department at the direction of
 2-2     the commission shall prescribe the time by which an institution
 2-3     must pay the monthly fee.
 2-4           (c)  Amounts received under this section may be appropriated
 2-5     only for the purposes of paying the cost of administering this
 2-6     section and increasing the rate of reimbursement paid to
 2-7     institutions under the state Medicaid program.  The commission or
 2-8     the department at the direction of the commission shall devise the
 2-9     formula by which amounts received under this section increase the
2-10     rate of reimbursement paid to institutions under the state Medicaid
2-11     program.
2-12           (d)  The department, taking into account the direct and
2-13     indirect effects that a higher rate of reimbursement paid to
2-14     institutions under the state Medicaid program should have on the
2-15     ability of the nursing and convalescent home industry in this state
2-16     generally to increase the quality of care, shall adopt rules
2-17     consistent with the department's powers under this chapter designed
2-18     to require a commensurately higher quality of care for residents in
2-19     institutions in this state.
2-20           (e)  The quality assurance fee may not be imposed and
2-21     collected, and the department is not required to adopt rules under
2-22     Subsection (d) or enforce rules already adopted under that
2-23     subsection, if the commission determines that the imposition of the
2-24     fee and the expenditure as prescribed by this section of amounts
2-25     collected will not entitle the state to receive additional federal
2-26     funds under the Medicaid program.
2-27           SECTION 2. If before implementing any provision of this Act a
 3-1     state agency determines that a waiver or authorization from a
 3-2     federal agency is necessary for implementation of that provision,
 3-3     the agency affected by the provision shall request the waiver or
 3-4     authorization and may delay implementing that provision until the
 3-5     waiver or authorization is granted.
 3-6           SECTION 3. This Act takes effect September 1, 2001.