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A BILL TO BE ENTITLED
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AN ACT
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relating to cost reporting requirements for certain facilities and |
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providers participating in medical assistance programs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter B, Chapter 32, Human Resources Code, |
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is amended by adding Section 32.0285 to read as follows: |
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Sec. 32.0285. STREAMLINED COST REPORTING AND COST |
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VALIDATION FOR CERTAIN PROVIDERS. (a) This section applies to a |
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facility providing services under the ICF-IID program, as defined |
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by Section 534.001, Government Code, or a home and community-based |
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services (HCS) waiver program provider. |
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(b) The executive commissioner shall develop and implement |
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a streamlined cost reporting system for facilities and providers to |
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which this section applies. The streamlined cost reporting system |
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must: |
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(1) be organized by program type; and |
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(2) not later than December 1 of each odd-numbered |
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year, require each facility and provider to submit a financial |
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statement detailing the applicable program's costs that complies |
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with generally accepted accounting principles and contains the |
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following cost categories: |
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(A) total income for each program; |
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(B) total costs for each program, reported by |
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specific expense categories to be determined by commission rule; |
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(C) total costs for each service unit; and |
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(D) average payment rates for each program. |
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(c) The commission shall review the financial statement |
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required under Subsection (b) and use the financial statement to |
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evaluate a facility's or provider's compliance with any obligations |
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or requirements for participating in an incentive program |
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established under Section 32.028(g). |
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(d) In developing and implementing the streamlined cost |
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reporting system, the commission shall: |
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(1) consult with appropriate advisory committees to |
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obtain recommendations for the specific expense categories to be |
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included in the financial statement; |
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(2) ensure that any recommendations or rules adopted |
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based on recommendations provided under Subdivision (1): |
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(A) reduce administrative burdens and costs on |
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facilities and providers; and |
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(B) are consistent with: |
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(i) economic efficiency; |
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(ii) available resources and capacity of |
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small businesses; and |
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(iii) allowable and unallowable program |
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costs under Medicaid; and |
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(3) ensure that the streamlined cost reporting system: |
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(A) is implemented in a way that eases the |
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administrative burden on facilities and providers; |
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(B) establishes the relevant cost baselines and |
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framework for the cost determination and rate-setting processes; |
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and |
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(C) provides current and accurate data for |
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legislative reporting and budgeting. |
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(e) Not later than January 1 of each even-numbered year, the |
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commission shall randomly select 10 facilities and providers whose |
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financial reports the commission will use to validate program costs |
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reported in the financial statements for the preceding state fiscal |
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biennium required under Subsection (b). The executive commissioner |
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by rule shall designate small, medium, and large classes of |
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providers. The facilities and providers selected under this |
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subsection must include three facilities or providers from the |
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small providers class, four facilities or providers from the medium |
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providers class, and three facilities or providers from the large |
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providers class. The commission shall notify the facilities and |
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providers selected under this subsection not later than 120 days |
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before the date validation is scheduled to begin. |
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(f) A facility or provider that is selected under Subsection |
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(e) shall: |
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(1) cooperate with all reasonable requests from the |
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commission for necessary information and data to validate program |
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costs; |
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(2) hire additional staff as necessary to ensure |
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accurate and timely compliance with this section and rules adopted |
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under this section; |
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(3) contract with a certified public accountant to |
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audit the information and data collected by the facility or |
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provider; and |
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(4) submit detailed information and data of program |
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costs along with the report of the audit required under Subdivision |
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(3) in the form and manner prescribed by the commission. |
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(g) The commission shall review and analyze the report of |
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each audit required under Subsection (f) not later than August 31 of |
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each even-numbered year and prepare and submit a report to the |
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legislature based on those audits. |
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SECTION 2. 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 3. Not later than November 1, 2017, the executive |
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commissioner of the Health and Human Services Commission shall |
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adopt rules necessary to implement the changes in law made by this |
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Act. |
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SECTION 4. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2017. |