80R12913 KFF-F
 
  By: Isett H.B. No. 2540
 
Substitute the following for H.B. No. 2540:
 
  By:  Rose C.S.H.B. No. 2540
 
A BILL TO BE ENTITLED
AN ACT
relating to implementing a pilot project to simplify, streamline,
and reduce costs associated with the Medicaid cost reporting and
auditing process for certain providers.
       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
       SECTION 1.  Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.02114 to read as follows:
       Sec. 531.02114. PILOT PROJECT TO SIMPLIFY, STREAMLINE, AND
REDUCE COSTS ASSOCIATED WITH MEDICAID COST REPORTING AND AUDITING
PROCESS FOR CERTAIN PROVIDERS. (a) In this section:
             (1)  "Pilot project" means the pilot project to
simplify, streamline, and reduce costs associated with the Medicaid
cost reporting and auditing process for providers implemented by
the commission under this section.
             (2)  "Provider" means a private ICF-MR facility or home
and community-based services waiver program provider.
       (b)  The commission shall develop and implement a pilot
project to simplify, streamline, and reduce costs associated with
the Medicaid cost reporting and auditing process for private ICF-MR
facilities and home and community-based services waiver program
providers.
       (c)  The executive commissioner by rule shall, with the
assistance of the work group established under Subsection (d),
adopt cost reporting and auditing processes and guidelines similar
to standard business financial reporting processes and guidelines.
The rules must:
             (1)  require that cost report forms:
                   (A)  not exceed 20 letter-size pages in length,
including any appendices; and
                   (B)  be distributed to providers at least one
month before the beginning of the applicable reporting period;
             (2)  require that a provider summarize information
regarding program revenue, administrative costs, central office
costs, facility costs, and direct-care costs, including the hourly
wage detail of direct-care staff;
             (3)  allow a provider to electronically submit cost
reports;
             (4)  require the filing of cost reports in alternating
years as follows:
                   (A)  in even-numbered years, private ICF-MR
facility providers; and
                   (B)  in odd-numbered years, home and
community-based services waiver program providers;
             (5)  allow a provider to request and receive from the
commission information, including reports, relating to the
services provided by the provider that is maintained by the
commission in a database or under another program or system to
facilitate the cost reporting process; and
             (6)  require that each provider receive a full audit by
the commission's office of inspector general at least once during
the period the pilot project is in operation.
       (d)  In developing the pilot project, the commission shall
establish a work group that reports to the executive commissioner
and is responsible for:
             (1)  developing and proposing cost report forms and
processes, audit processes, and rules necessary to implement the
pilot project;
             (2)  developing:
                   (A)  a plan for monitoring the pilot project's
implementation; and
                   (B)  recommendations for improving and expanding
the pilot project to other Medicaid programs;
             (3)  establishing an implementation date for the pilot
project that allows the commission to have sufficient information
related to the pilot project for purposes of preparing the
commission's legislative appropriations request for the state
fiscal biennium beginning September 1, 2009;
             (4)  monitoring wage levels of the direct-care staff of
providers to assess the value and need for minimum spending levels;
and
             (5)  submitting a quarterly report to the lieutenant
governor, the speaker of the house of representatives, the senate
finance committee, and the house appropriations committee
regarding the status of the pilot project.
       (e)  The executive commissioner shall determine the number
of members of the work group described by Subsection (d). The
executive commissioner shall ensure that the work group includes
members who represent:
             (1)  public and private providers of ICF-MR services
and home and community-based waiver program services;
             (2)  experienced cost report preparers who have
received cost report training from the commission;
             (3)  accounting firms licensed under Chapter 901,
Occupations Code, that are familiar with the provision of program
services described by Subdivision (1);
             (4)  commission staff; and
             (5)  other interested stakeholders, as determined by
the executive commissioner.
       (f)  Not later than September 1, 2012, the commission shall
submit a report to the legislature that:
             (1)  evaluates the operation of the pilot project; and
             (2)  makes recommendations regarding the continuation
or expansion of the pilot project.
       (g)  This section expires September 1, 2013.
       SECTION 2.  If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
       SECTION 3.  This Act takes effect September 1, 2007.