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A BILL TO BE ENTITLED
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AN ACT
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relating to the authority of certain local governments to create |
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and operate health care provider participation programs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle D, Title 4, Health and Safety Code, is |
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amended by adding Chapter 300 to read as follows: |
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CHAPTER 300. HEALTH CARE PROVIDER PARTICIPATION PROGRAMS IN CERTAIN |
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POLITICAL SUBDIVISIONS IN THIS STATE |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 300.0001. PURPOSE. The purpose of this chapter is to |
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authorize a hospital district, county, or municipality in this |
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state to administer a health care provider participation program to |
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provide additional compensation to certain hospitals located in the |
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hospital district, county, or municipality by collecting mandatory |
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payments from each of those hospitals to be used to provide the |
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nonfederal share of a Medicaid supplemental payment program and for |
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other purposes as authorized under this chapter. |
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Sec. 300.0002. DEFINITIONS. In this chapter: |
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(1) "Institutional health care provider" means a |
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nonpublic hospital that provides inpatient hospital services. |
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(2) "Local government" means a hospital district, |
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county, or municipality to which this chapter applies. |
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(3) "Paying hospital" 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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(4) "Program" means a health care provider |
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participation program authorized by this chapter. |
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Sec. 300.0003. APPLICABILITY. This chapter applies only |
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to: |
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(1) a hospital district that is not participating in a |
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health care provider participation program authorized by another |
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chapter of this subtitle; and |
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(2) a county or municipality that: |
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(A) is not participating in a health care |
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provider participation program authorized by another chapter of |
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this subtitle; and |
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(B) is not served by a hospital district or a |
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public hospital. |
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Sec. 300.0004. LOCAL JURISDICTION HEALTH CARE PROVIDER |
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PARTICIPATION PROGRAM; ORDER REQUIRED FOR PARTICIPATION. The |
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governing body of a local government may only adopt an order or |
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ordinance authorizing that local government to participate in a |
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health care provider participation program after an affirmative |
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vote of the majority of the governing body. |
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SUBCHAPTER B. POWERS AND DUTIES OF GOVERNING BODY |
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Sec. 300.0051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY |
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PAYMENT. The governing body of a local government may require a |
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mandatory payment authorized under this chapter by an institutional |
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health care provider located in that hospital district, county, or |
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municipality, as applicable, only in the manner provided by this |
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chapter. |
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Sec. 300.0052. RULES AND PROCEDURES. The governing body of |
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a local government may adopt rules relating to the administration |
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of the health care provider participation program in the local |
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government, including collection of the mandatory payments, |
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expenditures, audits, and any other administrative aspects of the |
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program. |
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Sec. 300.0053. INSTITUTIONAL HEALTH CARE PROVIDER |
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REPORTING. If the governing body of a local government authorizes |
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the local government to participate in a health care provider |
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participation program under this chapter, the governing body shall |
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require each institutional health care provider to submit to the |
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local government a copy of any financial and utilization data |
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required by and reported to the Department of State Health Services |
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under Sections 311.032 and 311.033 and any rules adopted by the |
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executive commissioner of the Health and Human Services Commission |
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to implement those sections. |
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SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS |
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Sec. 300.0101. HEARING. (a) In each year that the |
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governing body of a local government authorizes a health care |
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provider participation program under this chapter, the governing |
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body shall hold a public hearing on the amounts of any mandatory |
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payments that the governing body intends to require during the year |
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and how the revenue 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 governing body shall |
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publish notice of the hearing in a newspaper of general circulation |
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in the hospital district, county, or municipality, as applicable, |
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and provide written notice of the hearing to the chief operating |
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officer of each institutional health care provider located in the |
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hospital district, county, or municipality, as applicable. |
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(c) A representative of a paying hospital is entitled to |
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appear at the time and place designated in the public notice and to |
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be heard regarding any matter related to the mandatory payments |
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authorized under this chapter. |
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Sec. 300.0102. LOCAL PROVIDER PARTICIPATION FUND; |
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DEPOSITORY. (a) Each governing body of a local government that |
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collects a mandatory payment authorized under this chapter shall |
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create a local provider participation fund. |
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(b) If a governing body of a local government creates a |
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local provider participation fund, the governing body shall |
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designate one or more banks as a depository for the mandatory |
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payments received by the local government. |
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(c) The governing body of a local government may withdraw or |
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use money in the local provider participation fund of the local |
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government only for a purpose authorized under this chapter. |
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(d) All funds collected under this chapter shall be secured |
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in the manner provided for securing other funds of the local |
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government. |
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Sec. 300.0103. LOCAL PROVIDER PARTICIPATION FUND; |
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AUTHORIZED USES OF MONEY. (a) The local provider participation |
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fund established by a local government under Section 300.0102 |
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consists of: |
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(1) all revenue received by the local government |
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attributable to mandatory payments authorized under this chapter; |
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(2) money received from the Health and Human Services |
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Commission as a refund of an intergovernmental transfer from the |
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local government to the state for the purpose of providing the |
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nonfederal share of Medicaid supplemental payment program |
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payments, provided that the intergovernmental transfer does not |
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receive a federal matching payment; and |
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(3) the earnings of the fund. |
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(b) Money deposited to the local provider participation |
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fund of a local government may be used only to: |
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(1) fund intergovernmental transfers from the local |
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government 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, if those payments are authorized under the Texas |
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Healthcare Transformation and Quality Improvement Program waiver |
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issued under Section 1115 of the federal Social Security Act (42 |
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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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local government 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 (A) |
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or (B); or |
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(D) any reimbursement to nonpublic hospitals for |
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which federal matching funds are available; |
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(2) subject to Section 300.0151(d), pay the |
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administrative expenses of the local government in administering |
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the program, including collateralization of deposits; |
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(3) refund all or a portion of a mandatory payment |
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collected in error from a paying hospital; |
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(4) refund to paying hospitals a proportionate share |
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of the money that the local government: |
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(A) receives from the Health and Human Services |
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Commission that is not used to fund the nonfederal share of Medicaid |
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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 local government is required by law to transfer |
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the funds to address a disallowance of federal matching funds with |
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respect to payments, rate enhancements, and reimbursements for |
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which the local government made intergovernmental transfers |
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described by Subdivision (1); and |
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(6) reimburse the local government if the local |
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government is required by the rules governing the uniform rate |
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enhancement program described by Subdivision (1)(B) to incur an |
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expense or forego Medicaid reimbursements from the state because |
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the balance of the local provider participation fund is not |
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sufficient to fund that rate enhancement program. |
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(c) Money in the local provider participation fund of a |
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local government may not be commingled with other funds of the local |
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government. |
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(d) Notwithstanding any other provision of this chapter, |
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with respect to an intergovernmental transfer of funds described by |
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Subsection (b)(1) made by the local government, any funds received |
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by the state, local government, or other entity as a result of that |
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transfer may not be used by the state, local government, or any |
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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 amended |
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by the Health Care and Education Reconciliation Act of 2010 (Pub. L. |
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No. 111-152); or |
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(2) fund the nonfederal share of payments to nonpublic |
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hospitals available through the Medicaid disproportionate share |
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hospital program or the delivery system reform incentive payment |
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program. |
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SUBCHAPTER D. MANDATORY PAYMENTS |
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Sec. 300.0151. MANDATORY PAYMENTS. (a) Except as provided |
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by Subsection (e), if the governing body of a local government |
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authorizes a health care provider participation program under this |
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chapter, the governing body shall require an annual mandatory |
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payment to be assessed on the net patient revenue of each |
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institutional health care provider located in the hospital |
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district, county, or municipality, as applicable. The governing |
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body of the local government shall provide that the mandatory |
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payment is to be assessed at least annually, but not more often than |
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quarterly. In the first year in which the mandatory payment is |
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required, the mandatory payment is assessed on the net patient |
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revenue of an institutional health care provider located in the |
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hospital district, county, or municipality, as applicable, 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 institutional |
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health care provider did not report any data under those sections, |
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the provider's net patient revenue is the amount of that revenue as |
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contained in the provider's Medicare cost report submitted for the |
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previous fiscal year or for the closest subsequent fiscal year for |
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which the provider submitted the Medicare cost report. The local |
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government 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 this |
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chapter for a local government must be uniformly proportionate with |
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the amount of net patient revenue generated by each paying hospital |
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in the hospital district, county, or municipality, as applicable, |
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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 under |
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42 U.S.C. Section 1396b(w). |
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(c) The governing body of a local government that authorizes |
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a program under this chapter shall set the amount of the mandatory |
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payment. The aggregate amount of the mandatory payments required |
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of all paying hospitals in the hospital district, county, or |
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municipality, as applicable, may not exceed six percent of the |
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aggregate net patient revenue from hospital services provided by |
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all paying hospitals in the hospital district, county, or |
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municipality, as applicable. |
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(d) Subject to Subsection (c), the governing body of a local |
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government shall set the mandatory payments in amounts that in the |
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aggregate will generate sufficient revenue to cover the |
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administrative expenses of the local government for activities |
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under this chapter and to fund an intergovernmental transfer |
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described by Section 300.0103(b)(1). The annual amount of revenue |
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from mandatory payments that shall be paid for administrative |
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expenses for activities under this chapter by the local government |
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may not exceed $150,000, plus the cost of collateralization of |
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deposits, regardless of actual expenses. |
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(e) A paying hospital 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 required by the governing body of a |
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hospital district under this chapter is not a tax for purposes of |
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the applicable provision of Article IX, Texas Constitution. |
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Sec. 300.0152. ASSESSMENT AND COLLECTION OF MANDATORY |
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PAYMENTS. (a) A hospital district may designate an official of the |
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district or contract with another person to assess and collect the |
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mandatory payments authorized under this chapter. |
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(b) A county or municipality may collect or, using a |
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competitive bidding process, contract for the assessment and |
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collection of mandatory payments authorized under this chapter. |
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(c) The person charged by the local government 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 local |
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government a collection fee in an amount not to exceed the person's |
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usual and customary charges for like services. |
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(d) If the person charged with the assessment and collection |
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of mandatory payments is an official of the local government, any |
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revenue from a collection fee charged under Subsection (c) shall be |
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deposited in the local government general fund and, if appropriate, |
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shall be reported as fees of the local government. |
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Sec. 300.0153. CORRECTION OF INVALID PROVISION OR |
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PROCEDURE. (a) This chapter does not authorize a local government |
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to collect mandatory payments for the purpose of raising general |
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revenue or any amount in excess of the amount reasonably necessary |
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to fund the nonfederal share of a Medicaid supplemental payment |
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program or Medicaid managed care rate enhancements for nonpublic |
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hospitals and to cover the administrative expenses of the local |
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government associated with activities under this chapter and other |
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uses of the fund described by Section 300.0103(b). |
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(b) To the extent any provision or procedure under this |
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chapter causes a mandatory payment authorized under this chapter to |
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be ineligible for federal matching funds, the local government 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 local government or an |
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institutional health care provider in the local hospital district, |
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county, or municipality, as applicable, beyond the provisions of |
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this chapter. This section does not require the governing body of a |
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local government to adopt a rule. |
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(c) The local government may only assess and collect a |
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mandatory payment authorized under this chapter if a waiver |
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program, uniform rate enhancement, or reimbursement described by |
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Section 300.0103(b)(1) is available to the local government. |
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Sec. 300.0154. REPORTING REQUIREMENTS. (a) The governing |
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body of each local government that authorizes a program under this |
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chapter shall report information to the Health and Human Services |
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Commission regarding the program on a schedule determined by the |
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commission. |
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(b) The information must include: |
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(1) the amount of the mandatory payments required and |
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collected in each year the program is authorized; |
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(2) any expenditure of money attributable to mandatory |
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payments collected under this chapter, including: |
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(A) any contract with an entity for the |
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administration or operation of a program authorized by this |
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chapter; or |
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(B) a contract with a person for the assessment |
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and collection of a mandatory payment as authorized under Section |
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300.0152; and |
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(3) the amount of money attributable to mandatory |
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payments collected under this chapter that is used for any other |
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purpose. |
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(c) The executive commissioner of the Health and Human |
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Services Commission shall adopt rules to administer this section. |
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Sec. 300.0155. EXPIRATION OF AUTHORITY. The authority of a |
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local government to administer and operate a program under this |
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chapter expires on September 1 following the second anniversary of |
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the date the governing body of the local government adopted the |
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order or ordinance authorizing the local government to participate |
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in the program as provided by Section 300.0004. |
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Sec. 300.0156. AUTHORITY TO REFUSE FOR VIOLATION. The |
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Health and Human Services Commission may refuse to accept money |
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from a local provider participation fund established under this |
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chapter if the commission determines that doing so may violate |
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federal law. |
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SECTION 2. Subtitle D, Title 4, Health and Safety Code, is |
|
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amended by adding Chapter 300A to read as follows: |
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CHAPTER 300A. HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN |
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DISTRICTS COMPOSED OF CERTAIN LOCAL GOVERNMENTS |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 300A.0001. PURPOSE. The purpose of this chapter is to |
|
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authorize certain local governments to create a district to |
|
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administer a health care provider participation program to provide |
|
|
additional compensation to certain hospitals in the district by |
|
|
collecting mandatory payments from each of those hospitals in the |
|
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district to be used to provide the nonfederal share of a Medicaid |
|
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supplemental payment program and for other purposes as authorized |
|
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under this chapter. |
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Sec. 300A.0002. DEFINITIONS. In this chapter: |
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(1) "Board" means the board of directors of a |
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district. |
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(2) "Director" means a member of the board. |
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(3) "District" means a health care provider |
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participation district created under this chapter. |
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(4) "Institutional health care provider" means a |
|
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nonpublic hospital that provides inpatient hospital services. |
|
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(5) "Local government" means a hospital district, |
|
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county, or municipality to which this chapter applies. |
|
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(6) "Paying hospital" 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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(7) "Program" means a health care provider |
|
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participation program authorized by this chapter. |
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Sec. 300A.0003. APPLICABILITY. This chapter applies only |
|
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to: |
|
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(1) a hospital district that: |
|
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(A) is not participating in a health care |
|
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provider participation program authorized by another chapter of |
|
|
this subtitle; and |
|
|
(B) has only one institutional health care |
|
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provider located in the district; and |
|
|
(2) a county or municipality that: |
|
|
(A) is not participating in a health care |
|
|
provider participation program authorized by another chapter of |
|
|
this subtitle; |
|
|
(B) is not served by a hospital district or a |
|
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public hospital; and |
|
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(C) has only one institutional health care |
|
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provider located in the county or municipality. |
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SUBCHAPTER B. CREATION, OPERATION, AND DISSOLUTION OF DISTRICT |
|
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Sec. 300A.0021. CREATION BY CONCURRENT ORDERS. (a) A local |
|
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government and one or more other local governments may create a |
|
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district by adopting concurrent orders. |
|
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(b) A concurrent order to create a district must: |
|
|
(1) be approved by the governing body of each creating |
|
|
local government; |
|
|
(2) contain identical provisions; and |
|
|
(3) define the boundaries of the district to be |
|
|
coextensive with the combined boundaries of each creating local |
|
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government. |
|
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Sec. 300A.0022. POWERS. A district may authorize and |
|
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administer a health care provider participation program in |
|
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accordance with this chapter. |
|
|
Sec. 300A.0023. BOARD OF DIRECTORS. (a) If three or more |
|
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local governments create a district, the presiding officer of the |
|
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governing body of each local government that creates the district |
|
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shall appoint one director. |
|
|
(b) If two local governments create a district: |
|
|
(1) the presiding officer of the governing body of the |
|
|
most populous local government shall appoint two directors; and |
|
|
(2) the presiding officer of the governing body of the |
|
|
other local government shall appoint one director. |
|
|
(c) Directors serve staggered two-year terms, with as near |
|
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as possible to one-half of the directors' terms expiring each year. |
|
|
(d) A vacancy in the office of director shall be filled for |
|
|
the unexpired term in the same manner as the original appointment. |
|
|
(e) The board shall elect from among its members a |
|
|
president. The president may vote and may cast an additional vote |
|
|
to break a tie. |
|
|
(f) The board shall also elect from among its members a vice |
|
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president. |
|
|
(g) The board shall appoint a secretary, who need not be a |
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director. |
|
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(h) Each officer of the board serves for a term of one year. |
|
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(i) The board shall fill a vacancy in a board office for the |
|
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unexpired term. |
|
|
(j) A majority of the members of the board voting must |
|
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concur in a matter relating to the business of the district. |
|
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Sec. 300A.0024. QUALIFICATIONS FOR OFFICE. (a) To be |
|
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eligible to serve as a director, a person must be a resident of the |
|
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local government that appoints the person under Section 300A.0023. |
|
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(b) An employee of the district may not serve as a director. |
|
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Sec. 300A.0025. COMPENSATION. (a) Directors and officers |
|
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serve without compensation but may be reimbursed for actual |
|
|
expenses incurred in the performance of official duties. |
|
|
(b) Expenses reimbursed under this section must be: |
|
|
(1) reported in the district's minute book or other |
|
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district records; and |
|
|
(2) approved by the board. |
|
|
Sec. 300A.0026. AUTHORITY TO SUE AND BE SUED. The board may |
|
|
sue and be sued on behalf of the district. |
|
|
Sec. 300A.0027. DISTRICT FINANCES. Subchapter F, Chapter |
|
|
287, other than Sections 287.129 and 287.130, applies to the |
|
|
district in the same manner that those provisions apply to a health |
|
|
services district created under Chapter 287. This section does not |
|
|
authorize the district to issue bonds. |
|
|
Sec. 300A.0028. DISSOLUTION. A district shall be dissolved |
|
|
if the local governments that created the district adopt concurrent |
|
|
orders to dissolve the district and the concurrent orders contain |
|
|
identical provisions. |
|
|
Sec. 300A.0029. ADMINISTRATION OF PROPERTY, DEBTS, AND |
|
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ASSETS AFTER DISSOLUTION. (a) After dissolution of a district |
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under Section 300A.0028, the board shall continue to control and |
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administer any property, debts, and assets of the district until |
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all funds have been disposed of and all district debts have been |
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paid or settled. |
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(b) As soon as practicable after the dissolution of the |
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district, the board shall transfer to each institutional health |
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care provider in the district the provider's proportionate share of |
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any remaining funds in any local provider participation fund |
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created by the district under Section 300A.0102. |
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(c) If, after administering any property and assets, the |
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board determines that the district's property and assets are |
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insufficient to pay the debts of the district, the district shall |
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transfer the remaining debts to the local governments that created |
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the district in proportion to the funds contributed to the district |
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by each local government, including a paying hospital in the local |
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government. |
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(d) If, after complying with Subsections (b) and (c) and |
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administering the property and assets, the board determines that |
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unused funds remain, the board shall transfer the unused funds to |
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the local governments that created the district in proportion to |
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the funds contributed to the district by each local government, |
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including a paying hospital in the local government. |
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Sec. 300A.0030. ACCOUNTING AFTER DISSOLUTION. After the |
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district has paid all its debts and has disposed of all its assets |
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and funds as prescribed by Section 300A.0029, the board shall |
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provide an accounting to each local government that created the |
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district. The accounting must show the manner in which the assets |
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and debts of the district were distributed. |
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SUBCHAPTER C. HEALTH CARE PROVIDER PARTICIPATION PROGRAM; POWERS |
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AND DUTIES OF DISTRICT BOARD |
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Sec. 300A.0051. HEALTH CARE PROVIDER PARTICIPATION |
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PROGRAM. The board of a district may authorize the district to |
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participate in a health care provider participation program on the |
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affirmative vote of a majority of the board, subject to the |
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provisions of this chapter. |
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Sec. 300A.0052. 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. 300A.0053. RULES AND PROCEDURES. The board may adopt |
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rules relating to the administration of the health care provider |
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participation program in the district, including collection of the |
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mandatory payments, expenditures, audits, and any other |
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administrative aspects of the program. |
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Sec. 300A.0054. INSTITUTIONAL HEALTH CARE PROVIDER |
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REPORTING. If the board authorizes the district to participate in a |
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health care provider participation program under this chapter, the |
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board shall require each institutional health care provider located |
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in the district to submit to the district a copy of any financial |
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and utilization data required by and reported to the Department of |
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State Health Services under Sections 311.032 and 311.033 and any |
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rules adopted by the executive commissioner of the Health and Human |
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Services Commission to implement those sections. |
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SUBCHAPTER D. GENERAL FINANCIAL PROVISIONS |
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Sec. 300A.0101. HEARING. (a) In each year that the board |
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authorizes a health care provider participation program under this |
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chapter, the board shall hold a public hearing on the amounts of any |
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mandatory payments that the board intends to require during the |
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year and how the revenue 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 each |
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local government that creates the district and provide written |
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notice of the hearing to the chief operating officer of each |
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institutional health care provider in the district. |
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(c) A representative of a paying hospital is entitled to |
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appear at the time and place designated in the public notice and be |
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heard regarding any matter related to the mandatory payments |
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authorized under this chapter. |
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Sec. 300A.0102. LOCAL PROVIDER PARTICIPATION FUND; |
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DEPOSITORY. (a) If the board collects a mandatory payment |
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authorized under this chapter, the board shall create a local |
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provider participation fund in one or more banks designated by the |
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district as a depository for the mandatory payments received by the |
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district. |
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(b) The board may withdraw or use money in the local |
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provider participation fund of the district only for a purpose |
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authorized under this chapter. |
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(c) All funds collected under this chapter shall be secured |
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in the manner provided for securing public funds. |
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Sec. 300A.0103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY. |
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(a) The local provider participation fund established under |
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Section 300A.0102 consists of: |
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(1) all revenue received by the district attributable |
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to mandatory payments authorized under this chapter; |
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(2) money received from the Health and Human Services |
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Commission as a refund of an intergovernmental transfer from the |
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district to the state for the purpose of providing the nonfederal |
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share of Medicaid supplemental payment program payments, provided |
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that the intergovernmental transfer does not receive a federal |
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matching payment; and |
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(3) the earnings of the fund. |
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(b) Money deposited to the local provider participation |
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fund 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, if those payments are authorized under the Texas |
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Healthcare Transformation and Quality Improvement Program waiver |
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issued under Section 1115 of the federal Social Security Act (42 |
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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 (A) |
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or (B); or |
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(D) any reimbursement to nonpublic hospitals for |
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which federal matching funds are available; |
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(2) subject to Section 300A.0151(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 all or a portion of a mandatory payment |
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collected in error from a paying hospital; |
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(4) refund to paying hospitals a proportionate share |
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of the money that the district: |
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(A) receives from the Health and Human Services |
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Commission that is not used to fund the nonfederal share of Medicaid |
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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 required by law to transfer the funds |
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to address a disallowance of federal matching funds with respect to |
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payments, rate enhancements, and reimbursements for which the |
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district made intergovernmental transfers described by Subdivision |
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(1); and |
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(6) reimburse the district if the district is required |
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by the rules governing the uniform rate enhancement program |
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described by Subdivision (1)(B) to incur an expense or forego |
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Medicaid reimbursements from the state because the balance of the |
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local provider participation fund is not sufficient to fund that |
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rate enhancement program. |
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(c) Money in the local provider participation fund may not |
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be commingled with other district funds or other funds of a local |
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government that creates the district. |
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(d) Notwithstanding any other provision of this chapter, |
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with respect to an intergovernmental transfer of funds described by |
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Subsection (b)(1) made by the district, any funds received by the |
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state, district, or other entity as a result of the transfer may not |
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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 amended |
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by the Health Care and Education Reconciliation Act of 2010 (Pub. L. |
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No. 111-152); or |
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(2) fund the nonfederal share of payments to nonpublic |
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hospitals available through the Medicaid disproportionate share |
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hospital program or the delivery system reform incentive payment |
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program. |
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Sec. 300A.0104. ACCOUNTING OF FUNDS. The district shall |
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maintain an accounting of the funds received from each local |
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government that creates the district, including a paying hospital |
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located in a hospital district, county, or municipality that |
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created the district, as applicable. |
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SUBCHAPTER E. MANDATORY PAYMENTS |
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Sec. 300A.0151. MANDATORY PAYMENTS BASED ON PAYING HOSPITAL |
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NET PATIENT REVENUE. (a) Except as provided by Subsection (e), if |
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the board authorizes a health care provider participation program |
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under this chapter, the district shall require an annual mandatory |
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payment to be assessed on the net patient revenue of each |
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institutional health care provider located in the district. The |
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board shall provide that the mandatory payment is to be assessed at |
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least annually, but not more often than quarterly. In the first |
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year in which the mandatory payment is required, the mandatory |
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payment is assessed on the net patient revenue of an institutional |
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health care provider located in the district as determined by the |
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data reported to the Department of State Health Services under |
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Sections 311.032 and 311.033 in the most recent fiscal year for |
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which that data was reported. If the institutional health care |
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provider did not report any data under those sections, the |
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provider's net patient revenue is the amount of that revenue as |
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contained in the provider's Medicare cost report submitted for the |
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previous fiscal year or for the closest subsequent fiscal year for |
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|
which the provider submitted the Medicare cost report. 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 this |
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chapter must be uniformly proportionate with the amount of net |
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patient revenue generated by each paying hospital in the district |
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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 under |
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42 U.S.C. Section 1396b(w). |
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(c) The board shall set the amount of a mandatory payment |
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authorized under this chapter. The aggregate amount of the |
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mandatory payments required of all paying hospitals in the district |
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may not exceed six percent of the aggregate net patient revenue from |
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hospital services provided by all paying hospitals in the district. |
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(d) Subject to Subsection (c), the board shall set the |
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mandatory payments in amounts that in the aggregate will generate |
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sufficient revenue to cover the administrative expenses of the |
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district for activities under this chapter and to fund an |
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intergovernmental transfer described by Section 300A.0103(b)(1). |
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The annual amount of revenue from mandatory payments that shall be |
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paid for administrative expenses by the district for activities |
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under this chapter may not exceed $150,000, plus the cost of |
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collateralization of deposits, regardless of actual expenses. |
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(e) A paying hospital 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) For purposes of any hospital district that creates a |
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district under this chapter, a mandatory payment assessed under |
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this chapter is not a tax for hospital purposes for purposes of the |
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applicable provision of Article IX, Texas Constitution. |
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Sec. 300A.0152. 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 the |
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|
mandatory payments authorized under this chapter. |
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|
(b) The person charged by the district with the assessment |
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|
and collection of mandatory payments shall charge and deduct from |
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the mandatory payments collected for the district a collection fee |
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in an amount not to exceed the person's usual and customary charges |
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for like services. |
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(c) If the person charged with the assessment and collection |
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of mandatory payments is an official of the district, any revenue |
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from a collection fee charged under Subsection (b) shall be |
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deposited in the district general fund and, if appropriate, shall |
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be reported as fees of the district. |
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Sec. 300A.0153. CORRECTION OF INVALID PROVISION OR |
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PROCEDURE; LIMITATION OF AUTHORITY. (a) This chapter does not |
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authorize the district to collect mandatory payments for the |
|
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purpose of raising general revenue or any amount in excess of the |
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|
amount reasonably necessary to: |
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(1) fund the nonfederal share of a Medicaid |
|
|
supplemental payment program or Medicaid managed care rate |
|
|
enhancements for nonpublic hospitals; and |
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(2) cover the administrative expenses of the district |
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associated with activities under this chapter and other uses of the |
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fund described by Section 300A.0103(b). |
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(b) To the extent any provision or procedure under this |
|
|
chapter causes a mandatory payment authorized under this chapter to |
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be ineligible for federal matching funds, the board may provide by |
|
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rule for an alternative provision or procedure that conforms to the |
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requirements of the federal Centers for Medicare and Medicaid |
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Services. A rule adopted under this section may not create, impose, |
|
|
or materially expand the legal or financial liability or |
|
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responsibility of the district or an institutional health care |
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provider in the district beyond the provisions of this chapter. |
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|
This section does not require the board to adopt a rule. |
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(c) The district may only assess and collect a mandatory |
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payment authorized under this chapter if a waiver program, uniform |
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rate enhancement, or reimbursement described by Section |
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300A.0103(b)(1) is available to the district. |
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Sec. 300A.0154. REPORTING REQUIREMENTS. (a) The board of a |
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district that authorizes a program under this chapter shall report |
|
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information to the Health and Human Services Commission regarding |
|
|
the program on a schedule determined by the commission. |
|
|
(b) The information must include: |
|
|
(1) the amount of the mandatory payments required and |
|
|
collected in each year the program is authorized; |
|
|
(2) any expenditure of money attributable to mandatory |
|
|
payments collected under this chapter, including: |
|
|
(A) any contract with an entity for the |
|
|
administration or operation of a program authorized by this |
|
|
chapter; or |
|
|
(B) a contract with a person for the assessment |
|
|
and collection of a mandatory payment as authorized under Section |
|
|
300A.0152; and |
|
|
(3) the amount of money attributable to mandatory |
|
|
payments collected under this chapter that is used for any other |
|
|
purpose. |
|
|
(c) The executive commissioner of the Health and Human |
|
|
Services Commission shall adopt rules to administer this section. |
|
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Sec. 300A.0155. EXPIRATION OF AUTHORITY. The authority of |
|
|
a district to administer and operate a program under this chapter |
|
|
expires on September 1 following the second anniversary of the date |
|
|
the board of the district authorized the district to participate in |
|
|
the program as provided by Section 300A.0051. |
|
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Sec. 300A.0156. AUTHORITY TO REFUSE FOR VIOLATION. The |
|
|
Health and Human Services Commission may refuse to accept money |
|
|
from a local provider participation fund established under this |
|
|
chapter if the commission determines that doing so may violate |
|
|
federal law. |
|
|
SECTION 3. As soon as practicable after the expiration of |
|
|
the authority of a local government to administer and operate a |
|
|
health care provider participation program under Chapter 300 or |
|
|
300A, Health and Safety Code, as added by this Act, the governing |
|
|
body of the local government shall transfer to each institutional |
|
|
health care provider in the boundaries of the local government that |
|
|
provider's proportionate share of any remaining funds in any local |
|
|
provider participation fund created by the local government under |
|
|
Chapter 300 or 300A, Health and Safety Code, as added by this Act. |
|
|
SECTION 4. 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 5. This Act takes effect immediately if it receives |
|
|
a vote of two-thirds of all the members elected to each house, as |
|
|
provided by Section 39, Article III, Texas Constitution. If this |
|
|
Act does not receive the vote necessary for immediate effect, this |
|
|
Act takes effect September 1, 2019. |
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* * * * * |