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A BILL TO BE ENTITLED
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AN ACT
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relating to implementing a pilot project to simplify, streamline, |
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and reduce costs associated with the Medicaid cost reporting and |
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auditing process for certain providers. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 531, Government Code, is |
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amended by adding Section 531.02114 to read as follows: |
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Sec. 531.02114. PILOT PROJECT TO SIMPLIFY, STREAMLINE, AND |
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REDUCE COSTS ASSOCIATED WITH MEDICAID COST REPORTING AND AUDITING |
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PROCESS FOR CERTAIN PROVIDERS. (a) In this section: |
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(1) "Pilot project" means the pilot project to |
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simplify, streamline, and reduce costs associated with the Medicaid |
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cost reporting and auditing process for providers implemented by |
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the commission under this section. |
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(2) "Provider" means a private ICF-MR facility or home |
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and community-based services waiver program provider. |
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(b) The commission shall develop and implement a pilot |
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project to simplify, streamline, and reduce costs associated with |
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the Medicaid cost reporting and auditing process for private ICF-MR |
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facilities and home and community-based services waiver program |
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providers. |
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(c) The executive commissioner by rule shall, with the |
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assistance of the work group established under Subsection (d), |
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adopt cost reporting and auditing processes and guidelines similar |
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to standard business financial reporting processes and guidelines. |
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The rules must: |
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(1) require that cost report forms: |
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(A) not exceed 20 letter-size pages in length, |
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including any appendices; and |
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(B) be distributed to providers at least one |
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month before the beginning of the applicable reporting period; |
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(2) require that a provider summarize information |
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regarding program revenue, administrative costs, central office |
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costs, facility costs, and direct-care costs, including the hourly |
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wage detail of direct-care staff; |
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(3) allow a provider to electronically submit cost |
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reports; |
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(4) require the filing of cost reports in alternating |
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years as follows: |
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(A) in even-numbered years, private ICF-MR |
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facility providers; and |
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(B) in odd-numbered years, home and |
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community-based services waiver program providers; |
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(5) allow a provider to request and receive from the |
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commission information, including reports, relating to the |
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services provided by the provider that is maintained by the |
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commission in a database or under another program or system to |
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facilitate the cost reporting process; and |
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(6) require that each provider receive a full audit by |
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the commission's office of inspector general at least once during |
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the period the pilot project is in operation. |
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(d) In developing the pilot project, the commission shall |
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establish a work group that reports to the executive commissioner |
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and is responsible for: |
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(1) developing and proposing cost report forms and |
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processes, audit processes, and rules necessary to implement the |
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pilot project; |
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(2) developing: |
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(A) a plan for monitoring the pilot project's |
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implementation; and |
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(B) recommendations for improving and expanding |
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the pilot project to other Medicaid programs; |
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(3) establishing an implementation date for the pilot |
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project that allows the commission to have sufficient information |
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related to the pilot project for purposes of preparing the |
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commission's legislative appropriations request for the state |
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fiscal biennium beginning September 1, 2009; |
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(4) monitoring wage levels of the direct-care staff of |
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providers to assess the value and need for minimum spending levels; |
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and |
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(5) submitting a quarterly report to the lieutenant |
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governor, the speaker of the house of representatives, the senate |
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finance committee, and the house appropriations committee |
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regarding the status of the pilot project. |
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(e) The executive commissioner shall determine the number |
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of members of the work group described by Subsection (d). The |
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executive commissioner shall ensure that the work group includes |
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members who represent: |
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(1) public and private providers of ICF-MR services |
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and home and community-based waiver program services; |
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(2) experienced cost report preparers who have |
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received cost report training from the commission; |
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(3) accounting firms licensed under Chapter 901, |
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Occupations Code, that are familiar with the provision of program |
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services described by Subdivision (1); |
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(4) commission staff; and |
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(5) other interested stakeholders, as determined by |
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the executive commissioner. |
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(f) Not later than September 1, 2012, the commission shall |
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submit a report to the legislature that: |
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(1) evaluates the operation of the pilot project; and |
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(2) makes recommendations regarding the continuation |
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or expansion of the pilot project. |
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(g) This section expires September 1, 2013. |
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SECTION 2. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 3. This Act takes effect September 1, 2007. |