By Moncrief S.B. No. 1592
77R7451 YDB-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the imposition of a quality assurance fee on nursing
1-3 institutions; providing an administrative penalty.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Chapter 242, Health and Safety Code, is amended by
1-6 adding Subchapter Q to read as follows:
1-7 SUBCHAPTER Q. QUALITY ASSURANCE FEE
1-8 Sec. 242.851. DEFINITION. In this subchapter, "gross
1-9 receipts" means money paid as compensation for services provided to
1-10 residents, including client participation. The term does not
1-11 include charitable contributions to an institution.
1-12 Sec. 242.852. COMPUTING QUALITY ASSURANCE FEE. (a) A
1-13 quality assurance fee is imposed on each institution for which a
1-14 license fee must be paid under Section 242.034. The fee is:
1-15 (1) an amount established under Subsection (b)
1-16 multiplied by the number of patient days as determined in
1-17 accordance with Section 242.853;
1-18 (2) payable monthly; and
1-19 (3) in addition to other fees imposed under this
1-20 chapter.
1-21 (b) The Health and Human Services Commission or the
1-22 department at the direction of the commission shall set the quality
1-23 assurance fee for each day in the amount necessary to produce
1-24 annual revenues equal to six percent of the total annual gross
2-1 receipts for institutions in this state. The fee is subject to a
2-2 prospective adjustment as necessary.
2-3 (c) The amount of the quality assurance fee must be
2-4 determined using patient days and gross receipts reported to the
2-5 department and covering a period of at least six months.
2-6 (d) The quality assurance fee is an allowable cost for
2-7 reimbursement under the state Medicaid program.
2-8 Sec. 242.853. PATIENT DAYS. For each calendar day, an
2-9 institution shall determine the number of patient days by adding
2-10 the following:
2-11 (1) the number of patients occupying an institution
2-12 bed immediately before midnight of that day;
2-13 (2) the number of beds that are on hold on that day
2-14 and that have been placed on hold for a period not to exceed five
2-15 consecutive calendar days during which a patient is in the
2-16 hospital; and
2-17 (3) the number of beds that are on hold on that day
2-18 and that have been placed on hold for a period not to exceed 14
2-19 consecutive calendar days during which a patient is on therapeutic
2-20 home leave.
2-21 Sec. 242.854. REPORTING AND COLLECTION. (a) The Health and
2-22 Human Services Commission or the department at the direction of the
2-23 commission shall collect the fee.
2-24 (b) Each institution shall:
2-25 (1) not later than the 10th day after the last day of
2-26 a month file a report with the Health and Human Services Commission
2-27 or department, as appropriate, stating the total patient days for
3-1 the month; and
3-2 (2) not later than the 30th day after the last day of
3-3 the month pay the quality assurance fee.
3-4 Sec. 242.855. RULES; ADMINISTRATIVE PENALTY. (a) The
3-5 Health and Human Services Commission shall adopt rules for the
3-6 administration of this subchapter including rules related to the
3-7 imposition and collection of the quality assurance fee.
3-8 (b) The Health and Human Services Commission may not adopt
3-9 rules granting any exceptions from the quality assurance fee.
3-10 (c) An administrative penalty assessed under this subchapter
3-11 in accordance with Section 242.066, may not exceed one-half of the
3-12 amount of the outstanding quality assurance fee or $20,000,
3-13 whichever is greater.
3-14 Sec. 242.856. QUALITY ASSURANCE FUND. (a) The quality
3-15 assurance fund is a fund outside the state treasury held by the
3-16 Texas Treasury Safekeeping Trust Company. Notwithstanding any other
3-17 law, the comptroller shall deposit fees collected under this
3-18 subchapter to the credit of the fund.
3-19 (b) The fund is composed of:
3-20 (1) fees deposited to the credit of the fund under
3-21 this subchapter; and
3-22 (2) the earnings of the fund.
3-23 (c) Money deposited to the fund remains the property of the
3-24 fund and may be used only for the purposes of this subchapter.
3-25 Sec. 242.857. REIMBURSEMENT OF INSTITUTIONS. (a) The
3-26 Health and Human Services Commission shall use money in the quality
3-27 assurance fund, together with any federal money available to match
4-1 that money, to:
4-2 (1) offset allowable expenses under the state Medicaid
4-3 program; and
4-4 (2) increase reimbursement rates paid under the
4-5 Medicaid program to institutions.
4-6 (b) The Health and Human Services Commission or the
4-7 department at the direction of the commission shall devise the
4-8 formula by which amounts received under this section increase the
4-9 reimbursement rates paid to institutions under the state Medicaid
4-10 program.
4-11 Sec. 242.858. INVALIDITY; FEDERAL FUNDS. If any portion of
4-12 this chapter is held invalid by a final order of a court that is
4-13 not subject to appeal, or if the Health and Human Services
4-14 Commission determines that the imposition of the fee and the
4-15 expenditure as prescribed by this subchapter of amounts collected
4-16 will not entitle the state to receive additional federal funds
4-17 under the Medicaid program, the commission shall stop collection of
4-18 the quality assurance fee and shall return any money collected, but
4-19 not spent, under this subchapter to the institutions that paid the
4-20 fees in proportion to the total amount paid by those institutions.
4-21 SECTION 2. Notwithstanding Section 242.852, Health and Safety
4-22 Code, as added by this Act, the quality assurance fee imposed under
4-23 Subchapter Q, Chapter 242, Health and Safety Code, as added by this
4-24 Act, that is effective for the first month following the effective
4-25 date of this Act is equal to $5.25 multiplied by the number of
4-26 patient days as determined under that subchapter. The quality
4-27 assurance fee established under this section remains in effect
5-1 until the Health and Human Services Commission, or the Texas
5-2 Department of Human Services at the direction of the commission,
5-3 obtains the information necessary to set the fee under Section
5-4 242.852, Health and Safety Code, as added by this Act.
5-5 SECTION 3. As soon as practicable after the effective date of
5-6 this Act, the Health and Human Services Commission shall adopt
5-7 rules as necessary to implement Subchapter Q, Chapter 242, Health
5-8 and Safety Code, as added by this Act.
5-9 SECTION 4. If before implementing any provision of this Act a
5-10 state agency determines a waiver or authorization from a federal
5-11 agency is necessary for implementation of that provision, the
5-12 agency affected by the provision shall request the waiver or
5-13 authorization and may delay implementing that provision until the
5-14 waiver or authorization is granted.
5-15 SECTION 5. This Act takes effect immediately if it receives
5-16 a vote of two-thirds of all the members elected to each house, as
5-17 provided by Section 39, Article III, Texas Constitution. If this
5-18 Act does not receive the vote necessary for immediate effect, this
5-19 Act takes effect September 1, 2001.