By: Guerra H.B. No. 3711

A BILL TO BE ENTITLED

AN ACT

relating to imposing an uncompensated care fee on certain hospitals to provide state funding for the Medicaid program.

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

SECTION 1. Chapter 32, Human Resources Code, is amended by adding Subchapter G to read as follows:

SUBCHAPTER G. HOSPITAL UNCOMPENSATED CARE FEE

Sec. 32.301. DEFINITIONS. In this subchapter:

(1) "Commission" means the Health and Human Services Commission.

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

(3) "Gross receipts" means money paid to a hospital as compensation for services provided to patients. The term does not include charitable contributions to a hospital.

Sec. 32.302. UNCOMPENSATED CARE FEE REQUIRED. (a) A uncompensated care fee is imposed on each hospital in this state that is required to obtain a license under Chapter 241, Health and Safety Code. The fee is:

(1) equal to the daily uncompensated care fee amount established under Subsection (b) multiplied by the number of patient days for a month as determined in accordance with Section 32.303; and

(2) payable monthly.

(b) The commission shall set the daily uncompensated care fee in the amount necessary to produce annual revenues equal to an amount that is not more than six percent of the hospital's total annual gross receipts in this state. The amount of the daily fee:

(1) must be determined using patient days and gross receipts reported to the commission and covering a period of at least six months; and

(2) is subject to a prospective adjustment as necessary.

(c) The uncompensated care fee is an allowable cost for reimbursement under the Medicaid program.

Sec. 32.303. PATIENT DAYS. A hospital shall determine the number of patient days for each calendar day. The number of patient days for a calendar day is equal to the number of patients occupying a bed at the hospital immediately before midnight of that day.

Sec. 32.304. REPORTING AND COLLECTION. (a) The commission shall collect the uncompensated care fee.

(b) Each hospital shall:

(1) not later than the 20th day after the last day of each month file a report with the commission stating the total patient days for the month; and

(2) not later than the 30th day after the last day of the month pay the uncompensated care fee.

Sec. 32.305. ALLOCATION. (a) The commission shall remit to the comptroller the uncompensated care fees paid to the commission under this subchapter. The comptroller shall deposit the remittances to the credit of the hospital uncompensated care account.

(b) The hospital uncompensated care account is an account in the general revenue fund. Money in the account may be appropriated only for expenditures that are allowable costs for purposes of obtaining federal matching money under the medical assistance program, including expenditures for increased medical assistance reimbursements to hospitals that provide high-quality inpatient services under the medical assistance program.

(c) The hospital uncompensated care account is exempt from the application of Section 403.095, Government Code. Interest earned on money in the account shall be credited to the account.

Sec. 32.306. RULES. (a) The executive commissioner shall adopt rules for the administration of this subchapter, including rules related to the imposition and collection of the uncompensated care fee.

(b) The executive commissioner may not adopt rules granting exceptions from the uncompensated care fee.

Sec. 32.307. ENFORCEMENT. A hospital that fails to pay the uncompensated care fee is ineligible to participate as a medical assistance provider or receive medical assistance reimbursement for the provision of services.

SECTION 2. The executive commissioner of the Health and Human Services Commission shall adopt rules for the administration of Subchapter G, Chapter 32, Human Resources Code, as added by this Act, not later than November 1, 2013. The rules must specify the month for which the initial uncompensated care fee will be imposed under that subchapter.

SECTION 3. 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 4. This Act takes effect September 1, 2013.