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A BILL TO BE ENTITLED
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AN ACT
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relating to imposing an uncompensated care fee on certain hospitals |
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to provide state funding for the Medicaid program. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 32, Human Resources Code, is amended by |
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adding Subchapter G to read as follows: |
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SUBCHAPTER G. HOSPITAL UNCOMPENSATED CARE FEE |
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Sec. 32.301. DEFINITIONS. In this subchapter: |
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(1) "Commission" means the Health and Human Services |
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Commission. |
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(2) "Executive commissioner" means the executive |
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commissioner of the Health and Human Services Commission. |
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(3) "Gross receipts" means money paid to a hospital as |
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compensation for services provided to patients. The term does not |
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include charitable contributions to a hospital. |
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Sec. 32.302. UNCOMPENSATED CARE FEE REQUIRED. (a) A |
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uncompensated care fee is imposed on each hospital in this state |
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that is required to obtain a license under Chapter 241, Health and |
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Safety Code. The fee is: |
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(1) equal to the daily uncompensated care fee amount |
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established under Subsection (b) multiplied by the number of |
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patient days for a month as determined in accordance with Section |
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32.303; and |
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(2) payable monthly. |
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(b) The commission shall set the daily uncompensated care |
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fee in the amount necessary to produce annual revenues equal to an |
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amount that is not more than six percent of the hospital's total |
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annual gross receipts in this state. The amount of the daily fee: |
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(1) must be determined using patient days and gross |
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receipts reported to the commission and covering a period of at |
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least six months; and |
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(2) is subject to a prospective adjustment as |
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necessary. |
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(c) The uncompensated care fee is an allowable cost for |
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reimbursement under the Medicaid program. |
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Sec. 32.303. PATIENT DAYS. A hospital shall determine the |
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number of patient days for each calendar day. The number of patient |
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days for a calendar day is equal to the number of patients occupying |
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a bed at the hospital immediately before midnight of that day. |
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Sec. 32.304. REPORTING AND COLLECTION. (a) The commission |
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shall collect the uncompensated care fee. |
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(b) Each hospital shall: |
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(1) not later than the 20th day after the last day of |
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each month file a report with the commission stating the total |
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patient days for the month; and |
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(2) not later than the 30th day after the last day of |
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the month pay the uncompensated care fee. |
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Sec. 32.305. ALLOCATION. (a) The commission shall remit |
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to the comptroller the uncompensated care fees paid to the |
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commission under this subchapter. The comptroller shall deposit |
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the remittances to the credit of the hospital uncompensated care |
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account. |
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(b) The hospital uncompensated care account is an account in |
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the general revenue fund. Money in the account may be appropriated |
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only for expenditures that are allowable costs for purposes of |
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obtaining federal matching money under the medical assistance |
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program, including expenditures for increased medical assistance |
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reimbursements to hospitals that provide high-quality inpatient |
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services under the medical assistance program. |
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(c) The hospital uncompensated care account is exempt from |
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the application of Section 403.095, Government Code. Interest |
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earned on money in the account shall be credited to the account. |
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Sec. 32.306. RULES. (a) The executive commissioner shall |
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adopt rules for the administration of this subchapter, including |
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rules related to the imposition and collection of the uncompensated |
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care fee. |
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(b) The executive commissioner may not adopt rules granting |
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exceptions from the uncompensated care fee. |
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Sec. 32.307. ENFORCEMENT. A hospital that fails to pay the |
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uncompensated care fee is ineligible to participate as a medical |
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assistance provider or receive medical assistance reimbursement |
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for the provision of services. |
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SECTION 2. The executive commissioner of the Health and |
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Human Services Commission shall adopt rules for the administration |
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of Subchapter G, Chapter 32, Human Resources Code, as added by this |
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Act, not later than November 1, 2013. The rules must specify the |
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month for which the initial uncompensated care fee will be imposed |
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under that subchapter. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect September 1, 2013. |