By: Miles, Alvarado, Taylor S.B. No. 2022
 
 
 
   
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the creation and operations of health care provider
  participation programs in Harris County Hospital District.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle D, Title 4, Health and Safety Code, is
  amended by adding Chapter ___ to read as follows:
  CHAPTER ___. HARRIS COUNTY HOSPITAL DISTRICT HEALTH CARE PROVIDER
  PARTICIPATION PROGRAM.
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. ___.001 DEFINITIONS. In this chapter:
               (1)  "Board" means the board of trustees of the
  district.
               (2)  "District" means the Harris County Hospital
  District.
               (3)  "Institutional health care provider" means a
  nonpublic hospital located in the district that provides inpatient
  hospital services.
               (4)  "Paying provider" means an institutional health
  care provider required to make a mandatory payment under this
  chapter.
               (5)  "Program" means the health care provider
  participation program authorized by this chapter.
         Sec. ___.002 APPLICABILITY. This chapter applies only to the
  Harris County Hospital District.
         Sec. ___.003 HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
  PARTICIPATION IN PROGRAM. The board may authorize the district to
  participate in a health care provider participation program on the
  affirmative vote of the majority of the board, subject to the
  provisions of this chapter.
         Sec. ___.004 EXPIRATION.
         (a)  The authority of the district to administer and operate
  a program under this chapter expires December 31, 2021.
         (b)  This chapter expires December 31, 2021.
  SUBCHAPTER B. POWERS AND DUTIES OF BOARD
         Sec. ___.051 LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
  PAYMENT. The board may require a mandatory payment authorized
  under this chapter by an institutional health care provider in the
  district only in the manner provided by this chapter.
         Sec. ___.052 RULES AND PROCEDURES. The board may adopt rules
  relating to the administration of the program, including collection
  of the mandatory payments, expenditures, audits, and any other
  administrative aspects of the program.
         Sec. ___.053 PAYING PROVIDER REPORTING. If the board
  authorizes the district to participate in a program under this
  chapter, the board shall require each paying provider to submit to
  the district a copy of any financial and utilization data as
  reported in the paying provider's Medicare cost report for the
  previous fiscal year or for the closest subsequent fiscal year for
  which the paying provider submitted the Medicare cost report.
  SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS
         Sec. ___.101 HEARING.
         (a)  In each year that the board authorizes a program under
  this chapter, the board shall hold a public hearing on the amounts
  of any mandatory payments that the board intends to require during
  the year and how the revenue derived from those payments is to be
  spent.
         (b)  Not later than the fifth day before the date of the
  hearing required under Subsection (a), the board shall publish
  notice of the hearing in a newspaper of general circulation in the
  district and provide written notice.
         (c)  A representative of a paying provider is entitled to
  appear at the public hearing and to be heard regarding any matter
  related to the mandatory payments authorized under this chapter.
         Sec. ___.102 DEPOSITORY.
         (a)  If the board requires a mandatory payment authorized
  under this chapter, the board shall designate one or more banks as a
  depository for the district's local provider participation fund.
         (b)  All funds collected under this chapter shall be secured
  in the manner provided for securing other district funds.
         Sec. ___.103 LOCAL PROVIDER PARTICIPATION FUND; AUTHORIZED
  USES OF MONEY.
         (a)  If the district requires a mandatory payment authorized
  under this chapter, the district shall create a local provider
  participation fund.
         (b)  The local provider participation fund consists of:
               (1)  all revenue received by the district attributable
  to mandatory payments authorized under this chapter;
               (2)  money received from the Health and Human Services
  Commission as a refund of an intergovernmental transfer under the
  program, provided that the intergovernmental transfer does not
  receive a federal matching payment; and
               (3)  the earnings of the fund.
         (c)  Money deposited to the local provider participation
  fund of the district may be used only to:
               (1)  fund intergovernmental transfers from the
  district to the state to provide the nonfederal share of Medicaid
  payments for:
                     (A)  uncompensated care payments to nonpublic
  hospitals, if those payments are authorized under the Texas
  Healthcare Transformation and Quality Improvement Program waiver
  issued under Section 1115 of the federal Social Security Act (42
  U.S.C. Section 1315);
                     (B)  uniform rate enhancements for nonpublic
  hospitals in the Medicaid managed care service area in which the
  district is located;
                     (C)  payments available under another waiver
  program authorizing payments that are substantially similar to
  Medicaid payments to nonpublic hospitals described by Subdivision
  (A) or (B); or
                     (D)  any reimbursement to nonpublic hospitals for
  which federal matching funds are available;
               (2)  subject to Section ___.151(d), pay the
  administrative expenses of the district in administering the
  program, including collateralization of deposits;
               (3)  refund a mandatory payment collected in error from
  a paying provider;
               (4)  refund to paying providers a proportionate share
  of a mandatory payment that the district:
                     (A)  receives from the Health and Human Services
  Commission that is not used to fund the nonfederal share of Medicaid
  supplemental payment program payments; or
                     (B)  determines cannot be used to fund the
  nonfederal share of Medicaid supplemental payment program
  payments; and
               (5)  transfer funds to the Health and Human Services
  Commission if the district is legally required to transfer funds to
  address a disallowance of federal matching funds with respect to
  programs for which the district made intergovernmental transfers
  described by Subdivision (1).
         (d)  Money in the local provider participation fund may not
  be commingled with other district funds.
         (e)  Notwithstanding any other provision of this chapter,
  with respect to an intergovernmental transfer of funds described by
  Subsection (c)(1) made by the district, any funds received by the
  state, district, or other entity as a result of the transfer may not
  be used by the state, district, or any other entity to:
               (1)  expand Medicaid eligibility under the Patient
  Protection and Affordable Care Act (Pub. L. No. 111-148) as amended
  by the Health Care and Education Reconciliation Act of 2010 (Pub. L.
  No. 111-152); or
               (2)  fund the nonfederal share of payments to nonpublic
  hospitals available through the Medicaid disproportionate share
  hospital program or the delivery system reform incentive payment
  program.
  SUBCHAPTER D. MANDATORY PAYMENTS
         Sec. ___.151 MANDATORY PAYMENTS BASED ON PAYING PROVIDER NET
  PATIENT REVENUE.
         (a)  If the board authorizes a health care provider
  participation program under this chapter, the board may require a
  mandatory payment to be assessed on the net patient revenue of each
  paying provider located in the district. The board may provide for
  the mandatory payment to be assessed incrementally throughout the
  year; provided, however, that paying providers shall have thirty
  (30) calendar days upon receipt of written notice from the district
  to make any mandatory payment. In the first year in which the
  mandatory payment is required, the mandatory payment is assessed on
  the net patient revenue of a paying provider as determined by the
  paying provider's copy of its Medicare cost report for the previous
  fiscal year or for the closest subsequent fiscal year for which the
  paying provider submitted the Medicare cost report.
         (b)  The amount of a mandatory payment authorized under this
  chapter must be uniformly proportionate with the amount of net
  patient revenue generated by each paying provider in the district
  as permitted under federal law. A health care provider
  participation program authorized under this chapter may not hold
  harmless any institutional health care provider, as required under
  42 U.S.C. Section 1396b(w).
         (c)  If the board requires a mandatory payment authorized
  under this chapter, the board shall set the amount of the mandatory
  payment, subject to the limitations of this chapter. The aggregate
  amount of the mandatory payments required of all paying providers
  in the district may not exceed four percent of the aggregate net
  patient revenue from hospital services provided by all paying
  providers in the district.
         (d)  Subject to Subsection (c), if the board requires a
  mandatory payment authorized under this chapter, the board shall
  set the mandatory payments in amounts that in the aggregate will
  generate sufficient revenue to cover the administrative expenses of
  the district for activities under this chapter and to fund an
  intergovernmental transfer described by Section ___.103(c)(1). Of
  the annual amount of revenue received by the district attributable
  to mandatory payments authorized under this chapter, 0.25% shall be
  paid to the district for administrative expenses.
         (e)  A paying provider may not add a mandatory payment
  required under this section as a surcharge to a patient.
         (f)  A mandatory payment assessed under this chapter is not a
  tax for hospital purposes for purposes of Section 4, Article IX,
  Texas Constitution, or Section 281.045.
         Sec. ___.152 ASSESSMENT AND COLLECTION OF MANDATORY
  PAYMENTS.
         (a)  The district may designate an official of the district
  or contract with another person to assess and collect the mandatory
  payments authorized under this chapter.
         (b)  The person charged by the district with the assessment
  and collection of mandatory payments shall charge and deduct from
  the mandatory payments collected for the district a collection fee
  in an amount not to exceed the person's usual and customary charges
  for like services.
         (c)  If the person charged with the assessment and collection
  of mandatory payments is an official of the district, any revenue
  from a collection fee charged under Subsection (b) shall be
  deposited in the district general fund and, if appropriate, shall
  be reported as fees of the district.
         Sec. ___.153 PURPOSE; CORRECTION OF INVALID PROVISION OR
  PROCEDURE; LIMITATION OF AUTHORITY.
         (a)  The purpose of this chapter is to authorize the district
  to establish a program to enable the district to collect mandatory
  payments from institutional health care providers to fund the
  nonfederal share of a Medicaid supplemental payment program or the
  Medicaid managed care rate enhancements for nonpublic hospitals to
  support the provision of health care by institutional health care
  providers to district residents in need of health care.
         (b)  This chapter does not authorize the district to collect
  mandatory payments for the purpose of raising general revenue or
  any amount in excess of the amount reasonably necessary to fund the
  uses described in Section _____.103(c) to cover the administrative
  expenses of the district associated with activities under this
  chapter.
         (c)  To the extent any provision or procedure under this
  chapter causes a mandatory payment authorized under this chapter to
  be ineligible for federal matching funds, the board may provide by
  rule for an alternative provision or procedure that conforms to the
  requirements of the federal Centers for Medicare and Medicaid
  Services. A rule adopted under this section may not create, impose,
  or materially expand the legal or financial liability or
  responsibility of the district or an institutional health care
  provider in the district beyond the provisions of this chapter.
  This section does not require the board to adopt a rule.
         (d)  The district may only assess and collect a mandatory
  payment authorized under this chapter if a waiver program, uniform
  rate enhancement, or reimbursement described by Section
  ___.103(c)(1) is available to the district.