83R4298 JSC-D

By: Kolkhorst H.B. No. 15

A BILL TO BE ENTITLED

AN ACT

relating to level of care designations for hospitals that provide neonatal and maternal services.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Chapter 241, Health and Safety Code, is amended by adding Subchapter H to read as follows:

SUBCHAPTER H. HOSPITAL LEVEL OF CARE DESIGNATIONS FOR NEONATAL AND

MATERNAL CARE

Sec. 241.181. DEFINITIONS. In this subchapter:

(1) "Department" means the Department of State Health Services.

(2) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.

Sec. 241.182. LEVEL OF CARE DESIGNATIONS. (a) The executive commissioner shall assign level of care designations to each hospital based on the neonatal and maternal services provided at the hospital.

(b) A hospital may receive different level designations for neonatal and maternal care, respectively.

Sec. 241.183. RULES. (a) The executive commissioner shall adopt rules:

(1) establishing the levels of care for neonatal and maternal care to be assigned to hospitals;

(2) prescribing criteria for designating levels of neonatal and maternal care, respectively, including specifying the minimum requirements to qualify for each level designation;

(3) establishing a process for the assignment of levels of care to a hospital for neonatal and maternal care, respectively;

(4) dividing the state into neonatal and maternal care regions;

(5) establishing neonatal and maternal care regional advisory councils and prescribing processes for the councils; and

(6) detailing confidential reporting requirements.

(b) Each level of care designation must require the hospital to:

(1) actively participate in the appropriate neonatal and maternal care regional advisory council; and

(2) regularly submit outcome and other data to the department as required or requested.

(c) The criteria a hospital must achieve to receive each level of care designation must be posted on the department's Internet website.

Sec. 241.184. ASSIGNMENT OF LEVEL OF CARE DESIGNATION. (a) The executive commissioner in consultation with the department shall assign the appropriate level of care designation to each hospital that meets the minimum standards for that level of care. The executive commissioner shall evaluate separately the neonatal and maternal services provided at the hospital and assign the respective level of care designations accordingly.

(b) Biennially, the executive commissioner and the department shall review the levels of care designations assigned to each hospital and, as necessary, assign a hospital a different level of care designation or remove the hospital's level of care designation.

Sec. 241.185. HOSPITAL FAILING TO ACHIEVE MINIMUM LEVELS OF CARE. A hospital that does not meet the minimum requirements for any level of care designation for neonatal or maternal services:

(1) may not receive a level of care designation for those services; and

(2) is not eligible to receive reimbursement through the Medicaid program for neonatal or maternal services, as applicable.

SECTION 2. (a) In this section:

(1) "Department" means the Department of State Health Services.

(2) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.

(3) "Task force" means the Perinatal Facility Designation Implementation Task Force established under this section.

(b) The task force consists of 14 members appointed by the executive commissioner as follows:

(1) four neonatologists, at least two of whom must practice in a Level IIIC neonatal intensive care unit;

(2) one general pediatrician;

(3) two general obstetrician-gynecologists;

(4) two maternal fetal medicine specialists;

(5) one family practice physician who provides obstetrical care and practices in a rural community;

(6) one representative from a children's hospital;

(7) one representative from a hospital with a Level II neonatal intensive care unit;

(8) one representative from a rural hospital; and

(9) one representative from a general hospital.

(c) To the extent possible, the executive commissioner shall appoint members to the task force who previously served on the Neonatal Intensive Care Unit Council established under Chapter 818 (H.B. 2636), Acts of the 82nd Legislature, Regular Session, 2011.

(d) A member of the task force serves without compensation but is entitled to reimbursement for actual and necessary travel expenses related to the performance of task force duties.

(e) The Health and Human Services Commission, the department, and the task force shall work together to develop a process for the designation of levels of neonatal and maternal care at hospitals in accordance with Subchapter H, Chapter 241, Health and Safety Code, as added by this Act.

(f) The task force shall:

(1) develop criteria for designating levels of neonatal and maternal care, respectively, including specifying the minimum requirements to qualify for each level designation;

(2) develop a process for the assignment of levels of care to a hospital for neonatal and maternal care, respectively;

(3) make recommendations for the division of the state into neonatal and maternal care regions;

(4) develop processes for neonatal and maternal care regional advisory councils; and

(5) develop confidential reporting requirements.

(g) In developing the criteria for the levels of neonatal and maternal care, the task force shall consider:

(1) any recommendations or publications of the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists, including the Guidelines for Perinatal Care; and

(2) the geographic and varied needs of citizens of this state.

(h) Each level of care designation must comply with Section 241.183(b), Health and Safety Code, as added by this Act.

(i) The task force shall submit a report detailing the task force's determinations and recommendations to the department and the executive commissioner not later than September 1, 2015.

(j) The task force is abolished August 31, 2016.

SECTION 3. (a) Not later than December 1, 2013, the executive commissioner of the Health and Human Services Commission shall appoint the members of the Perinatal Facility Designation Implementation Task Force as required by Section 2 of this Act.

(b) Not later than March 1, 2016, after consideration of the report of the Perinatal Facility Designation Implementation Task Force, the executive commissioner of the Health and Human Services Commission shall adopt the initial rules required by Section 241.183, Health and Safety Code, as added by this Act.

(c) Not later than August 31, 2016, the executive commissioner of the Health and Human Services Commission shall complete the neonatal and maternal level of care designation assignments for each hospital in this state.

(d) Notwithstanding Section 241.185, Health and Safety Code, as added by this Act, a hospital is not required to have a level of care designation as a condition of reimbursement through the Medicaid program before September 1, 2016.

SECTION 4. 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 5. This Act takes effect September 1, 2013.