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A BILL TO BE ENTITLED
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AN ACT
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relating to rural hospitals and similar facilities; requiring a |
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license; authorizing fees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 531, Government Code, is amended by |
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adding Subchapter G to read as follows: |
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SUBCHAPTER G. RURAL HOSPITALS |
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Sec. 531.201. STRATEGIC PLAN; REPORT. (a) The commission |
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shall develop and implement a strategic plan to ensure that the |
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citizens of this state residing in rural areas have access to |
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hospital services. |
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(b) The strategic plan must include: |
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(1) a proposal for using at least one of the following |
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methods to ensure access to hospital services in the rural areas of |
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this state: |
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(A) an enhanced cost reimbursement methodology |
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for the payment of rural hospitals participating in the Medicaid |
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managed care program in conjunction with a supplemental payment |
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program for rural hospitals to cover costs incurred in providing |
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services to recipients; |
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(B) a hospital rate enhancement program that |
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applies only to rural hospitals; |
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(C) a reduction of punitive actions under the |
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Medicaid program that require reimbursement for Medicaid payments |
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made to the provider, if the provider is a rural hospital, a |
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reduction of the frequency of payment reductions under the Medicaid |
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program made to rural hospitals, and an enhancement of payments |
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made under merit-based programs or similar programs for rural |
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hospitals; |
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(D) a reduction of state regulatory-related |
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costs related to the commission's review of rural hospitals; or |
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(E) in accordance with rules adopted by the |
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Centers for Medicare and Medicaid Services, the establishment of a |
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minimum fee schedule that applies to payments made by managed care |
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organizations to rural hospitals; and |
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(2) target dates for achieving goals related to the |
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proposal described by Subdivision (1). |
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(c) Not later than January 1, 2020, the commission shall |
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submit the strategic plan developed under Subsection (b) to the |
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Legislative Budget Board for comment and review. The commission |
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may not begin implementation of the proposal contained in the |
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strategic plan until the strategic plan is approved by the |
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Legislative Budget Board. |
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(d) Not later than November 1 of each even-numbered year, |
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the commission shall submit a report regarding the commission's |
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development and implementation of the strategic plan described by |
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Subsection (b) to: |
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(1) the legislature; |
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(2) the governor; and |
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(3) the Legislative Budget Board. |
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Sec. 531.202. ADVISORY COMMITTEE ON RURAL HOSPITALS. (a) |
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The commission shall establish the Rural Hospital Advisory |
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Committee, either as another advisory committee or as a |
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subcommittee of the Hospital Payment Advisory Committee, to advise |
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the commission on issues relating specifically to rural hospitals. |
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(b) The Rural Hospital Advisory Committee is composed of |
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interested persons appointed by the executive commissioner. |
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Section 2110.002 does not apply to the advisory committee. |
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(c) A member of the advisory committee serves without |
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compensation. |
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Sec. 531.203. COLLABORATION WITH OFFICE OF RURAL AFFAIRS. |
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The commission shall collaborate with the Office of Rural Affairs |
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to ensure that this state is pursuing to the fullest extent possible |
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federal grants, funding opportunities, and support programs |
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available to rural hospitals as administered by the Health |
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Resources and Services Administration and the Office of Minority |
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Health in the United States Department of Health and Human |
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Services. |
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SECTION 2. Subchapter A, Chapter 533, Government Code, is |
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amended by adding Section 533.0041 to read as follows: |
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Sec. 533.0041. REIMBURSEMENT METHODOLOGY FOR RURAL |
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HOSPITALS. To the extent allowed by federal law and |
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notwithstanding any state law, the executive commissioner shall by |
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rule adopt a reimbursement methodology for the payment of rural |
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hospitals participating in the Medicaid managed care program that |
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ensures the rural hospitals are reimbursed on an individual basis |
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that allows the rural hospitals to fully recover allowable costs |
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incurred in providing services to recipients. In adopting rules |
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under this section, the executive commissioner: |
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(1) may adopt a methodology that requires: |
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(A) the commission to directly reimburse rural |
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hospitals for allowable costs; or |
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(B) a managed care organization to reimburse |
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rural hospitals; and |
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(2) shall define "allowable costs" and "rural |
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hospital" for purposes of this section. |
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SECTION 3. Chapter 241, Health and Safety Code, is amended |
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by adding Subchapter K to read as follows: |
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SUBCHAPTER K. LIMITED SERVICES RURAL HOSPITAL |
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Sec. 241.301. DEFINITION. In this subchapter, "limited |
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services rural hospital" means a general or special hospital that |
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is or was licensed under this chapter and that: |
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(1) is: |
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(A) located in a rural area, as defined by: |
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(i) commission rule; or |
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(ii) 42 U.S.C. Section 1395ww(d)(2)(D); or |
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(B) designated by the Centers for Medicare and |
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Medicaid Services as a critical access hospital, rural referral |
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center, or sole community hospital; and |
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(2) otherwise meets the requirements to be designated |
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as a limited services rural hospital or a similarly designated |
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hospital under federal law. |
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Sec. 241.302. LICENSE REQUIRED; FEES. (a) A person may not |
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establish, conduct, or maintain a limited services rural hospital |
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unless: |
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(1) the United States Congress passes a bill creating |
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a payment program specifically for limited services rural hospitals |
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or similarly designated hospitals that becomes law; and |
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(2) the commission issues a license to the person to |
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establish, conduct, or maintain a limited services rural hospital |
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under this subchapter. |
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(b) If the United States Congress enacts a bill described by |
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Subsection (a)(1) that becomes law, the commission shall adopt |
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rules: |
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(1) establishing minimum standards for the |
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facilities; and |
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(2) implementing this section. |
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(c) The standards adopted under Subsection (b) must be at |
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least as stringent as the standards established in the law |
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described by Subsection (a) for eligibility to qualify for a |
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payment program established by the law. |
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(d) An applicant for a license under this section must: |
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(1) submit an application for the license to the |
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commission in a form and manner prescribed by the commission; and |
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(2) pay any required fee. |
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(e) The commission shall issue a license to act as a limited |
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services rural hospital under this subchapter if the applicant |
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complies with the rules and standards adopted under this section. |
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(f) The commission by order may waive or modify the |
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requirement of a particular provision of this chapter or a standard |
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adopted under this section if the commission determines that the |
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waiver or modification will facilitate the creation or operation of |
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the facility and that the waiver or modification is in the best |
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interests of the individuals served or to be served by the facility. |
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Sections 241.026(d) and (e) apply to a waiver or modification under |
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this section for a limited services rural hospital in the same |
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manner as the subsections apply to a waiver or modification for a |
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hospital. |
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(g) A provision of this chapter related to the enforcement |
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authority of the commission applies to a limited services rural |
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hospital. |
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SECTION 4. This Act takes effect September 1, 2019. |