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SENATE RESOLUTION
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BE IT RESOLVED by the Senate of the State of Texas, 85th |
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Legislature, Regular Session, 2017, That Senate Rule 12.03 be |
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suspended in part as provided by Senate Rule 12.08 to enable the |
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conference committee appointed to resolve the differences on |
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Senate Bill 1462 (the creation and operation of certain local |
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health care provider participation programs) to consider and |
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take action on the following matter: |
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Senate Rule 12.03(4) is suspended to permit the committee |
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to add text on a matter not included in either the house or senate |
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version of the bill by adding the following SECTIONS to the bill: |
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SECTION 28. Subtitle D, Title 4, Health and Safety Code, |
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is amended by adding Chapter 298B to read as follows: |
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CHAPTER 298B. TARRANT COUNTY HOSPITAL DISTRICT HEALTH CARE |
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PROVIDER PARTICIPATION PROGRAM |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 298B.001. DEFINITIONS. In this chapter: |
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(1) "Board" means the board of hospital managers of |
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the district. |
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(2) "District" means the Tarrant County Hospital |
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District. |
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(3) "Institutional health care provider" means a |
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nonpublic hospital located in the district that provides |
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inpatient hospital services. |
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(4) "Paying provider" means an institutional health |
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care provider required to make a mandatory payment under this |
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chapter. |
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(5) "Program" means the health care provider |
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participation program authorized by this chapter. |
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Sec. 298B.002. APPLICABILITY. This chapter applies only |
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to the Tarrant County Hospital District. |
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Sec. 298B.003. HEALTH CARE PROVIDER PARTICIPATION |
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PROGRAM; PARTICIPATION IN PROGRAM. The board may authorize the |
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district to participate in a health care provider participation |
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program on the affirmative vote of a majority of the board, |
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subject to the provisions of this chapter. |
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Sec. 298B.004. EXPIRATION OF AUTHORITY. (a) Subject to |
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Sections 298B.153(d) and 298B.154, the authority of the district |
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to administer and operate a program under this chapter expires |
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December 31, 2019. |
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(b) Subsection (a) does not affect the authority of the |
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district to require and collect a mandatory payment under Section |
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298B.154 after December 31, 2019, if necessary. |
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SUBCHAPTER B. POWERS AND DUTIES OF BOARD |
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Sec. 298B.051. LIMITATION ON AUTHORITY TO REQUIRE |
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MANDATORY PAYMENT. The board may require a mandatory payment |
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authorized under this chapter by an institutional health care |
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provider in the district only in the manner provided by this |
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chapter. |
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Sec. 298B.052. RULES AND PROCEDURES. The board may adopt |
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rules relating to the administration of the program, including |
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collection of the mandatory payments, expenditures, audits, and |
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any other administrative aspects of the program. |
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Sec. 298B.053. INSTITUTIONAL HEALTH CARE PROVIDER |
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REPORTING. If the board authorizes the district to participate |
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in a program under this chapter, the board shall require each |
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institutional health care provider to submit to the district a |
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copy of any financial and utilization data required by and |
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reported to the Department of State Health Services under |
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Sections 311.032 and 311.033 and any rules adopted by the |
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executive commissioner of the Health and Human Services |
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Commission to implement those sections. |
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SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS |
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Sec. 298B.101. HEARING. (a) In each year that the board |
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authorizes a program under this chapter, the board shall hold a |
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public hearing on the amounts of any mandatory payments that the |
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board intends to require during the year and how the revenue |
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derived from those payments is to be spent. |
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(b) Not later than the fifth day before the date of the |
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hearing required under Subsection (a), the board shall publish |
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notice of the hearing in a newspaper of general circulation in |
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the district and provide written notice of the hearing to each |
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institutional health care provider in the district. |
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Sec. 298B.102. DEPOSITORY. (a) If the board requires a |
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mandatory payment authorized under this chapter, the board shall |
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designate one or more banks as a depository for the district's |
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local provider participation fund. |
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(b) All funds collected under this chapter shall be |
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secured in the manner provided for securing other district funds. |
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Sec. 298B.103. LOCAL PROVIDER PARTICIPATION FUND; |
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AUTHORIZED USES OF MONEY. (a) If the district requires a |
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mandatory payment authorized under this chapter, the district |
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shall create a local provider participation fund. |
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(b) The local provider participation fund consists of: |
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(1) all revenue received by the district |
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attributable to mandatory payments authorized under this |
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chapter; |
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(2) money received from the Health and Human |
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Services Commission as a refund of an intergovernmental transfer |
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under the program, provided that the intergovernmental transfer |
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does not receive a federal matching payment; and |
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(3) the earnings of the fund. |
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(c) Money deposited to the local provider participation |
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fund of the district may be used only to: |
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(1) fund intergovernmental transfers from the |
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district to the state to provide the nonfederal share of Medicaid |
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payments for: |
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(A) uncompensated care payments to nonpublic |
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hospitals affiliated with the district, if those payments are |
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authorized under the Texas Healthcare Transformation and Quality |
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Improvement Program waiver issued under Section 1115 of the |
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federal Social Security Act (42 U.S.C. Section 1315); |
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(B) uniform rate enhancements for nonpublic |
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hospitals in the Medicaid managed care service area in which the |
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district is located; |
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(C) payments available under another waiver |
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program authorizing payments that are substantially similar to |
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Medicaid payments to nonpublic hospitals described by Paragraph |
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(A) or (B); or |
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(D) any reimbursement to nonpublic hospitals |
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for which federal matching funds are available; |
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(2) subject to Section 298B.151(d), pay the |
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administrative expenses of the district in administering the |
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program, including collateralization of deposits; |
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(3) refund a mandatory payment collected in error |
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from a paying provider; |
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(4) refund to paying providers a proportionate |
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share of the money that the district: |
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(A) receives from the Health and Human |
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Services Commission that is not used to fund the nonfederal share |
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of Medicaid supplemental payment program payments; or |
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(B) determines cannot be used to fund the |
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nonfederal share of Medicaid supplemental payment program |
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payments; |
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(5) transfer funds to the Health and Human Services |
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Commission if the district is legally required to transfer the |
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funds to address a disallowance of federal matching funds with |
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respect to programs for which the district made |
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intergovernmental transfers described by Subdivision (1); and |
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(6) reimburse the district if the district is |
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required by the rules governing the uniform rate enhancement |
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program described by Subdivision (1)(B) to incur an expense or |
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forego Medicaid reimbursements from the state because the |
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balance of the local provider participation fund is not |
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sufficient to fund that rate enhancement program. |
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(d) Money in the local provider participation fund may |
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not be commingled with other district funds. |
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(e) Notwithstanding any other provision of this chapter, |
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with respect to an intergovernmental transfer of funds described |
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by Subsection (c)(1) made by the district, any funds received by |
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the state, district, or other entity as a result of that transfer |
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may not be used by the state, district, or any other entity to: |
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(1) expand Medicaid eligibility under the Patient |
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Protection and Affordable Care Act (Pub. L. No. 111-148) as |
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amended by the Health Care and Education Reconciliation Act of |
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2010 (Pub. L. No. 111-152); or |
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(2) fund the nonfederal share of payments to |
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nonpublic hospitals available through the Medicaid |
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disproportionate share hospital program or the delivery system |
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reform incentive payment program. |
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SUBCHAPTER D. MANDATORY PAYMENTS |
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Sec. 298B.151. MANDATORY PAYMENTS BASED ON PAYING |
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PROVIDER NET PATIENT REVENUE. (a) Except as provided by |
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Subsection (e), if the board authorizes a health care provider |
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participation program under this chapter, the board may require |
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an annual mandatory payment to be assessed on the net patient |
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revenue of each institutional health care provider located in the |
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district. The board may provide for the mandatory payment to be |
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assessed quarterly. In the first year in which the mandatory |
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payment is required, the mandatory payment is assessed on the net |
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patient revenue of an institutional health care provider as |
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determined by the data reported to the Department of State Health |
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Services under Sections 311.032 and 311.033 in the most recent |
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fiscal year for which that data was reported. If the |
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institutional health care provider did not report any data under |
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those sections, the provider's net patient revenue is the amount |
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of that revenue as contained in the provider's Medicare cost |
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report submitted for the previous fiscal year or for the closest |
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subsequent fiscal year for which the provider submitted the |
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Medicare cost report. If the mandatory payment is required, the |
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district shall update the amount of the mandatory payment on an |
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annual basis. |
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(b) The amount of a mandatory payment authorized under |
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this chapter must be uniformly proportionate with the amount of |
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net patient revenue generated by each paying provider in the |
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district as permitted under federal law. A health care provider |
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participation program authorized under this chapter may not hold |
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harmless any institutional health care provider, as required |
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under 42 U.S.C. Section 1396b(w). |
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(c) If the board requires a mandatory payment authorized |
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under this chapter, the board shall set the amount of the |
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mandatory payment, subject to the limitations of this chapter. |
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The aggregate amount of the mandatory payments required of all |
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paying providers in the district may not exceed six percent of |
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the aggregate net patient revenue from hospital services |
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provided by all paying providers in the district. |
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(d) Subject to Subsection (c), if the board requires a |
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mandatory payment authorized under this chapter, the board shall |
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set the mandatory payments in amounts that in the aggregate will |
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generate sufficient revenue to cover the administrative expenses |
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of the district for activities under this chapter and to fund an |
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intergovernmental transfer described by Section 298B.103(c)(1). |
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The annual amount of revenue from mandatory payments that shall |
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be paid for administrative expenses by the district is $150,000, |
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plus the cost of collateralization of deposits, regardless of |
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actual expenses. |
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(e) A paying provider may not add a mandatory payment |
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required under this section as a surcharge to a patient. |
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(f) A mandatory payment assessed under this chapter is |
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not a tax for hospital purposes for purposes of Section 4, |
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Article IX, Texas Constitution, or Section 281.045. |
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Sec. 298B.152. ASSESSMENT AND COLLECTION OF MANDATORY |
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PAYMENTS. (a) The district may designate an official of the |
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district or contract with another person to assess and collect |
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the mandatory payments authorized under this chapter. |
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(b) The person charged by the district with the |
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assessment and collection of mandatory payments shall charge and |
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deduct from the mandatory payments collected for the district a |
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collection fee in an amount not to exceed the person's usual and |
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customary charges for like services. |
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(c) If the person charged with the assessment and |
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collection of mandatory payments is an official of the district, |
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any revenue from a collection fee charged under Subsection (b) |
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shall be deposited in the district general fund and, if |
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appropriate, shall be reported as fees of the district. |
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Sec. 298B.153. PURPOSE; CORRECTION OF INVALID PROVISION |
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OR PROCEDURE; LIMITATION OF AUTHORITY. (a) The purpose of this |
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chapter is to authorize the district to establish a program to |
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enable the district to collect mandatory payments from |
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institutional health care providers to fund the nonfederal share |
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of a Medicaid supplemental payment program or the Medicaid |
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managed care rate enhancements for nonpublic hospitals to |
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support the provision of health care by institutional health care |
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providers to district residents in need of health care. |
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(b) This chapter does not authorize the district to |
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collect mandatory payments for the purpose of raising general |
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revenue or any amount in excess of the amount reasonably |
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necessary to fund the nonfederal share of a Medicaid supplemental |
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payment program or Medicaid managed care rate enhancements for |
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nonpublic hospitals and to cover the administrative expenses of |
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the district associated with activities under this chapter. |
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(c) To the extent any provision or procedure under this |
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chapter causes a mandatory payment authorized under this chapter |
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to be ineligible for federal matching funds, the board may |
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provide by rule for an alternative provision or procedure that |
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conforms to the requirements of the federal Centers for Medicare |
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and Medicaid Services. A rule adopted under this section may not |
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create, impose, or materially expand the legal or financial |
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liability or responsibility of the district or an institutional |
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health care provider in the district beyond the provisions of |
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this chapter. This section does not require the board to adopt a |
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rule. |
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(d) The district may only assess and collect a mandatory |
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payment authorized under this chapter if a waiver program, |
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uniform rate enhancement, or reimbursement described by Section |
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298B.103(c)(1) is available to the district. |
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Sec. 298B.154. FEDERAL DISALLOWANCE. Notwithstanding |
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any other provision of this chapter, if the Centers for Medicare |
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and Medicaid Services issues a disallowance of federal matching |
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funds for a purpose for which intergovernmental transfers |
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described by Section 298B.103(c)(1) were made and the Health and |
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Human Services Commission demands repayment from the district of |
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federal funds paid to the district for that purpose, the district |
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may require and collect mandatory payments from each paying |
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provider that received those federal funds in an amount |
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sufficient to satisfy the repayment demand made by the |
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commission. The percentage limitation prescribed by Section |
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298B.151(c) does not apply to a mandatory payment required under |
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this section. |
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SECTION 29. As soon as practicable after the expiration |
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of the authority of the Tarrant County Hospital District to |
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administer and operate a health care provider participation |
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program under Chapter 298B, Health and Safety Code, as added by |
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this Act, the board of hospital managers of the Tarrant County |
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Hospital District shall transfer to each institutional health |
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care provider in the district that provider's proportionate |
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share of any remaining funds in any local provider participation |
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fund created by the district under Section 298B.103, Health and |
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Safety Code, as added by this Act. |
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SECTION 30. If before implementing any provision of |
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Chapter 298B, Health and Safety Code, as added by this Act, a |
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state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that |
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provision, the agency affected by the provision shall request the |
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waiver or authorization and may delay implementing that |
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provision until the waiver or authorization is granted. |
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Explanation: The added language is necessary to allow the |
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Tarrant County Hospital District to create and operate a health |
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care provider participation program in Tarrant County. |
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_______________________________ |
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President of the Senate |
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I hereby certify that the |
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above Resolution was adopted by |
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the Senate on May 28, 2017, by the |
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following vote: Yeas 30, Nays 0. |
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_______________________________ |
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Secretary of the Senate |