BILL ANALYSIS

H.B. 2963

By: Coleman

County Affairs

Committee Report (Unamended)

BACKGROUND AND PURPOSE

Texas counties are required by the Indigent Health Care and Treatment Act to provide health care for residents with incomes below 21 percent of the federal poverty threshold. Counties have three options for compliance: hospital districts, public hospitals, and county indigent health care programs. 

Hospital districts, created by voters in 144 counties, provide indigent health care by levying a tax not to exceed 75 cents per $100 in property valuation. In urban counties such as Harris, Bexar, Dallas, Tarrant, Nueces, and El Paso, these hospital districts are major care providers.          

Public hospitals are owned, operated, or leased by a county or municipality in 29 counties.  These hospitals provide indigent health care with local property taxes and sales and use taxes, but are not separate entities from the county or municipality that owns, operates, or leases them. 

Texas counties without hospital districts or public hospitals must operate county indigent health care programs coordinated by the Department of State Health Services, which maintains a state assistance fund to reimburse counties spending more than eight percent of their general revenue tax levy on indigent health care. If a county does not designate and contract with a hospital as a mandated provider of nonemergency health care for its indigent residents, any hospital that provides services to an indigent county resident may claim reimbursement from the county’s indigent health care program as a payer of last resort. Payment is limited to Medicaid rates, with maximum benefits of 30 days of hospitalization or $30,000, whichever occurs first.        

The 76th Legislature, Regular Session, 1999, added provisions for information necessary to determine eligibility to the Health and Safety Code. Section 61.0045(a) authorized any hospital to collect and release information necessary to determine a patient’s residence and eligibility for indigent health care in order to submit to the patient’s county of residence a claim "for payment for the services as described in Section 61.033 or 61.060." Sections 61.033 and 61.060 describe the obligations and exemptions of counties and public hospitals or hospital districts, respectively, to pay for these services. However, Section 61.0045(b) merely states that if the patient is determined to be an eligible resident, the county, public hospital, or hospital district "shall pay the claim made by the provider in accordance with this chapter."  

H.B. 2963 clarifies that the county, hospital district, or public hospital's payment to a provider is limited to its liability for payment for services arising under Sections 61.033 or 61.060.  

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

H.B. 2963 amends the Health and Safety Code to qualify the requirement that a county, a hospital district, or a public hospital that uses certain information to determine whether a patient is an eligible resident of the service area must pay a claim made by a provider, by specifying that the claim is to be paid to the extent that the county, the hospital district, or the public hospital is liable under the applicable provisions of the Indigent Health Care and Treatment Act.

EFFECTIVE DATE

September 1, 2009.