LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
  
                              April 9, 2001
  
  
          TO:  Honorable Patricia Gray, Chair, House Committee on Public
               Health
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB2423  by Hawley (Relating to the designation of a
               hospital as a rural hospital.), Committee Report 1st
               House, Substituted
  
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*  No significant fiscal implication to the State is anticipated.        *
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The bill would direct the Health and Human Services Commission to
establish rules to designate hospitals as rural hospitals in order to
qualify for federal funds under 42 CFR 411-412 (Medicare).  According to
the Texas Department of Health, the Texas Medicaid program reimburses
hospitals, except for in-state children's hospitals, using a prospective
payment system.  Medicaid has no designation for a rural hospital.
Therefore, according to the Texas Department of Health, there should be
little effect on Medicaid expenditures.
  
Local Government Impact
  
No fiscal implication to units of local government is anticipated.
  
  
Source Agencies:   529   Health and Human Services Commission, 501
                   Texas Department of Health
LBB Staff:         JK, HD, KF