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A BILL TO BE ENTITLED
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AN ACT
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relating to indigent health care. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 61.002, Health and Safety Code, is |
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amended by amending Subdivision (1) and adding Subdivision (4-a) to |
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read as follows: |
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(1) "Department" means the [Texas] Department of State |
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Health Services. |
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(4-a) "Executive commissioner" means the executive |
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commissioner of the Health and Human Services Commission. |
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SECTION 2. Subsection (f), Section 61.003, Health and |
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Safety Code, is amended to read as follows: |
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(f) For purposes of this chapter, a person who is an inmate |
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or resident of a state school or institution operated by the |
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department, the Texas Department of Criminal Justice |
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[Corrections], the [Texas] Department of Aging and Disability |
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Services [Mental Health and Mental Retardation], the Texas Youth |
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Commission, the Texas School for the Blind and Visually Impaired, |
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the Texas School for the Deaf, or any other state agency or who is an |
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inmate, patient, or resident of a school or institution operated by |
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a federal agency is not considered a resident of a hospital district |
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or of any governmental entity except the state or federal |
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government. |
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SECTION 3. The heading to Section 61.004, Health and Safety |
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Code, is amended to read as follows: |
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Sec. 61.004. [RESIDENCE OR] ELIGIBILITY DISPUTE. |
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SECTION 4. Subsections (a) and (d), Section 61.004, Health |
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and Safety Code, are amended to read as follows: |
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(a) If a provider of assistance and a governmental entity or |
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hospital district cannot agree on [a person's residence or] whether |
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a person is eligible for assistance under this chapter, the |
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provider or the governmental entity or hospital district may submit |
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the matter to the department. |
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(d) From the information submitted, the department shall |
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determine [the person's residence or] whether the person is |
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eligible for assistance under this chapter[, as appropriate,] and |
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shall notify each governmental entity or hospital district and the |
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provider of assistance of the decision and the reasons for the |
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decision. |
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SECTION 5. Subsection (b), Section 61.0045, Health and |
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Safety Code, is amended to read as follows: |
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(b) A county, hospital district, or public hospital that |
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receives information obtained under Subsection (a) shall use the |
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information to determine whether the patient to whom services were |
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provided is an eligible resident of the service area of the county, |
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hospital district, or public hospital and, if so, shall pay the |
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claim made by the provider in accordance with its liability for |
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payment for the services as described by Section 61.033 or 61.060 |
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[this chapter]. |
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SECTION 6. Subsection (c), Section 61.006, Health and |
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Safety Code, is amended to read as follows: |
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(c) The department shall also define the services and |
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establish the payment standards for the categories of services |
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listed in Sections 61.028(a) and 61.0285 in accordance with Health |
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and Human Services Commission [Texas Department of Human Services] |
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rules relating to the Temporary Assistance for Needy |
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Families-Medicaid program. |
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SECTION 7. Section 61.007, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 61.007. INFORMATION PROVIDED BY APPLICANT. The |
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department by rule shall require each applicant to provide at least |
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the following information: |
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(1) the applicant's full name and address; |
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(2) the applicant's social security number, if |
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available; |
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(3) the number of persons in the applicant's |
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household, excluding persons receiving Temporary Assistance for |
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Needy Families, Supplemental Security Income, or Medicaid |
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benefits; |
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(4) the applicant's county of residence; |
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(5) the existence of insurance coverage or other |
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hospital or health care benefits for which the applicant is |
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eligible; |
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(6) any transfer of title to real property by [that] |
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the applicant [has made in the preceding 24 months]; |
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(7) the applicant's annual household income, excluding |
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the income of any household member receiving Temporary Assistance |
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for Needy Families, Supplemental Security Income, or Medicaid |
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benefits; and |
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(8) the value [amount] of the applicant's liquid |
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resources, vehicles, [assets and the equity value of the
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applicant's car] and real property. |
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SECTION 8. Subsection (a), Section 61.008, Health and |
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Safety Code, is amended to read as follows: |
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(a) The executive commissioner [department] by rule shall |
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provide that in determining eligibility: |
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(1) a county may not consider the value of the |
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applicant's homestead; |
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(2) a county must consider the [equity] value of a |
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vehicle [car] that is in excess of the amount exempted under |
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department guidelines as a resource; |
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(3) a county must subtract the work-related and |
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dependent [child] care expense [allowance] allowed under |
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department guidelines; |
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(4) a county must consider as a resource real property |
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other than a homestead and, except as provided by Subsection (b), |
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must count that property in determining eligibility; and |
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(5) transferral of countable resources may not be more |
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restrictive than the resource requirements for the Temporary |
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Assistance for Needy Families-Medicaid program [if an applicant
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transferred title to real property for less than market value to
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become eligible for assistance under this chapter, the county may
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not credit toward eligibility for state assistance an expenditure
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for that applicant made during a two-year period beginning on the
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date on which the property is transferred]. |
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SECTION 9. Section 61.009, Health and Safety Code, is |
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amended by amending Subsection (a) and adding Subsection (c) to |
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read as follows: |
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(a) The department shall establish uniform reporting |
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requirements for governmental entities that own, operate, or lease |
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public hospitals providing assistance under this chapter and for |
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counties and hospital districts. |
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(c) The reports must be sent to the department at least |
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annually. |
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SECTION 10. Subsection (b), Section 61.025, Health and |
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Safety Code, is amended to read as follows: |
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(b) The transfer agreement may transfer partial |
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responsibility to the county under which the municipal hospital |
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continues to provide health care services to eligible residents of |
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the municipality, but the county agrees to assume the hospital's |
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responsibility to reimburse other providers who provide: |
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(1) basic [mandatory] inpatient or outpatient |
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services to eligible residents that the municipal hospital cannot |
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provide; or |
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(2) emergency services to eligible residents. |
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SECTION 11. Subsections (a) and (b), Section 61.0285, |
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Health and Safety Code, are amended to read as follows: |
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(a) In addition to basic health care services provided under |
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Section 61.028, a county may, in accordance with [department] rules |
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adopted by the executive commissioner under Section 61.006, provide |
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other medically necessary services or supplies that the county |
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determines to be cost-effective, including: |
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(1) freestanding ambulatory surgical center services; |
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(2) diabetic and colostomy medical supplies and |
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equipment; |
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(3) durable medical equipment; |
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(4) home and community health care services; |
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(5) social work services; |
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(6) psychological counseling services; |
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(7) services provided by physician assistants, nurse |
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practitioners, certified nurse midwives, clinical nurse |
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specialists, and certified registered nurse anesthetists; |
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(8) dental care; |
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(9) vision care, including eyeglasses; |
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(10) services provided by federally qualified health |
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centers, as defined by 42 U.S.C. Section 1396d(l)(2)(B); |
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(11) emergency medical services; and |
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(12) any other appropriate health care service |
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identified by [board] rule that may be determined to be |
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cost-effective. |
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(b) A county must notify the department of the county's |
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intent to provide services specified by Subsection (a). The [If the
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services are approved by the department under Section 61.006, or if
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the department fails to notify the county of the department's
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disapproval before the 31st day after the date the county notifies
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the department of its intent to provide the services, the] county |
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may credit the services toward eligibility for state assistance |
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under this subchapter. |
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SECTION 12. Subsection (e), Section 61.032, Health and |
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Safety Code, is amended to read as follows: |
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(e) If the county and the provider disagree on the patient's |
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[residence or] eligibility, the county or the provider may submit |
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the matter to the department as provided by Section 61.004. |
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SECTION 13. Subsection (a), Section 61.042, Health and |
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Safety Code, is amended to read as follows: |
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(a) A county may establish procedures consistent with those |
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used by the Health and Human Services Commission [Texas Department
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of Human Services] under Chapter 31, Human Resources Code, for |
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administering an employment services program and requiring an |
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applicant or eligible resident to register for work with the Texas |
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Workforce [Employment] Commission. |
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SECTION 14. Section 61.066, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 61.066. PREVENTION AND DETECTION OF FRAUD. (a) A |
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hospital district or public hospital may adopt reasonable |
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procedures for minimizing the opportunity for fraud, for |
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establishing and maintaining methods for detecting and identifying |
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situations in which a question of fraud may exist, and for |
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administrative hearings to be conducted on disqualifying persons in |
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cases where fraud appears to exist. |
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(b) Procedures established by a hospital district or public |
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hospital for administrative hearings conducted under this section |
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shall provide for appropriate due process, including procedures for |
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appeals. |
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SECTION 15. Subsection (c), Section 61.023, Health and |
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Safety Code, is repealed. |
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SECTION 16. Notwithstanding Subsection (e), Section |
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61.025, Health and Safety Code, a county and municipality may amend |
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an agreement under Section 61.025, Health and Safety Code, to |
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conform to changes in law made by this Act to Subsection (b), |
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Section 61.025, Health and Safety Code. |
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SECTION 17. This Act takes effect immediately if it |
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receives a vote of two-thirds of all the members elected to each |
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house, as provided by Section 39, Article III, Texas Constitution. |
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If this Act does not receive the vote necessary for immediate |
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effect, this Act takes effect September 1, 2007. |
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* * * * * |