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A BILL TO BE ENTITLED
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AN ACT
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relating to the creation and operations of a health care provider |
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participation program by the Lubbock County Hospital District. |
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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 298C to read as follows: |
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CHAPTER 298C. LUBBOCK COUNTY HOSPITAL DISTRICT HEALTH CARE |
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PROVIDER PARTICIPATION PROGRAM |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 298C.001. PURPOSE. The purpose of this chapter is to |
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authorize the district to administer a health care provider |
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participation program to provide additional compensation to |
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nonpublic hospitals by collecting mandatory payments from each |
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nonpublic hospital in the district 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. 298C.002. DEFINITIONS. In this chapter: |
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(1) "Board" means the board of hospital managers of |
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the district. |
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(2) "Commissioners court" means the Commissioners |
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Court of Lubbock County. |
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(3) "County" means Lubbock County. |
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(4) "District" means the Lubbock County Hospital |
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District of Lubbock County, Texas. |
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(5) "Institutional health care provider" means a |
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nonpublic hospital located in the district that provides inpatient |
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hospital services. |
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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 the health care provider |
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participation program authorized by this chapter. |
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Sec. 298C.003. APPLICABILITY. This chapter applies only to |
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the Lubbock County Hospital District of Lubbock County, Texas. |
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Sec. 298C.004. HEALTH CARE PROVIDER PARTICIPATION PROGRAM; |
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PARTICIPATION IN PROGRAM. The board 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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SUBCHAPTER B. POWERS AND DUTIES |
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Sec. 298C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY |
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PAYMENT. The board may authorize the collection of a mandatory |
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payment authorized under this chapter from an institutional health |
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care provider located in the district only in the manner provided by |
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this chapter. |
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Sec. 298C.052. INSTITUTIONAL HEALTH CARE PROVIDER |
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REPORTING. If the board authorizes the district to participate in a |
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program under this chapter, the board shall require each |
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institutional health care provider to submit to the district a copy |
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of any financial and utilization data required by and reported to |
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the Department of State Health Services under Sections 311.032 and |
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311.033 and any rules adopted by the executive commissioner of the |
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Health and Human Services Commission to implement those sections. |
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Sec. 298C.053. PROGRAM ADMINISTRATION. (a) The board, |
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subject to the approval of the commissioners court, shall delegate |
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all administrative responsibilities of the program, including |
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collection of mandatory payments, expenditures, and audits, to the |
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county. |
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(b) The commissioners court may adopt rules relating to the |
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administration of the program. |
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SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS |
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Sec. 298C.101. HEARING. (a) In each year that the board |
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authorizes a program under this chapter, the board shall hold a |
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public hearing on the amounts of any mandatory payments that the |
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board intends to require during the year and how the revenue derived |
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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 the |
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district and provide written notice of the hearing to the chief |
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operating officer of each institutional health care provider in the |
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district. |
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(c) Determination of the amount of any mandatory payments to |
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be collected during the year shall be shown to be based on |
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reasonable estimates of the amount of revenue necessary to meet and |
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cover the nonfederal share of payments described by Section |
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298C.103(b)(1) that is otherwise unfunded, and is subject to the |
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final approval of the commissioners court. |
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Sec. 298C.102. LOCAL PROVIDER PARTICIPATION FUND; |
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DEPOSITORY. (a) If the board authorizes the collection of a |
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mandatory payment authorized under this chapter, and the |
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commissioners court approves such collection, the commissioners |
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court shall by resolution create a local provider participation |
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fund in one or more banks located in the district that are |
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designated by the commissioners court to serve as the depository |
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for mandatory payments received by the county. |
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(b) All income received by the county under this chapter, |
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including the revenue from mandatory payments remaining after |
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discounts and fees for assessing and collecting the payments are |
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deducted, shall be deposited with the county depository in the |
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county's local provider participation fund and may be withdrawn |
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only as provided by this chapter. |
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(c) All funds collected under this chapter shall be secured |
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in the manner provided by law for securing county funds. |
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Sec. 298C.103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY. |
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(a) The local provider participation fund established under |
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Section 298C.102 consists of: |
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(1) all mandatory payments authorized under this |
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chapter and received by the county; |
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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 provider participation fund to the state as 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 county |
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to the state to provide the nonfederal share of: |
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(A) uncompensated care payments for nonpublic |
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hospitals and delivery system reform incentive payments for |
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nonpublic hospitals, if those payments are authorized under the |
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Texas Healthcare Transformation and Quality Improvement Program |
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waiver issued under Section 1115 of the federal Social Security Act |
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(42 U.S.C. Section 1315); |
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(B) uniform rate enhancements for nonpublic |
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hospitals in the Medicaid managed care service area in which the |
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district is located; |
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(C) payments available to nonpublic hospitals |
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under another waiver program authorizing payments that are |
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substantially similar to Medicaid payments to nonpublic hospitals |
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described by Paragraph (A) 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 298C.151(d), pay the |
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administrative expenses of the county in administering the program, |
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including collateralization of deposits; |
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(3) refund a portion of a mandatory payment collected |
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in error from a paying hospital; and |
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(4) refund to paying hospitals a proportionate share |
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of the money that the county: |
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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 payments |
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described by Subdivision (1); or |
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(B) determines cannot be used to fund the |
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nonfederal share of payments described by Subdivision (1). |
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(c) Money in the local provider participation fund may not |
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be commingled with other county funds. |
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(d) An intergovernmental transfer of funds described by |
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Subsection (b)(1) and any funds received by the county as a result |
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of an intergovernmental transfer described by that subsection may |
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not be used by the county or any other entity to expand Medicaid |
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eligibility under the Patient Protection and Affordable Care Act |
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(Pub. L. No. 111-148) as amended by the Health Care and Education |
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Reconciliation Act of 2010 (Pub. L. No. 111-152). |
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SUBCHAPTER D. MANDATORY PAYMENTS |
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Sec. 298C.151. MANDATORY PAYMENTS. (a) If the board |
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authorizes a program under this chapter, the board, subject to the |
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approval of the commissioners court, may require an annual |
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mandatory 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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commissioners court may provide that the mandatory payment is to be |
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collected at least annually, but not more often than quarterly. In |
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the first year in which the mandatory payment is required, the |
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mandatory payment is assessed on the net patient revenue of an |
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institutional health care provider as determined by the data |
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reported to the Department of State Health Services under Sections |
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311.032 and 311.033 in the most recent fiscal year for which that |
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data was reported. If the institutional health care provider did |
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not report any data under those sections, the provider's net |
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patient revenue is the amount of that revenue as contained in the |
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provider's Medicare cost report submitted for the previous fiscal |
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year or for the closest subsequent fiscal year for which the |
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provider submitted the Medicare cost report. |
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(b) The amount of a mandatory payment authorized under this |
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chapter must be a uniform percentage of the amount of net patient |
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revenue generated by each paying hospital in the district. A |
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mandatory payment 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 aggregate amount of the mandatory payments required |
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of all paying hospitals in the district may not exceed six percent |
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of the aggregate net patient revenue of all paying hospitals in the |
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district. |
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(d) Subject to the maximum amount prescribed by Subsection |
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(c), the board, with the approval of the commissioners court, shall |
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set the mandatory payments in amounts that in the aggregate will |
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generate sufficient revenue to cover the administrative expenses of |
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the county for activities under this chapter, fund an |
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intergovernmental transfer described by Section 298C.103(b)(1), or |
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make other payments authorized under this chapter. The mandatory |
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payment amounts must be set based on reasonable estimates of the |
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amount of revenue necessary to fully meet and cover authorized |
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expenses under this chapter. The amount of revenue from mandatory |
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payments that may be used for administrative expenses by the county |
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in a year may not exceed $25,000, plus the cost of collateralization |
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of deposits. If the county demonstrates to the paying hospitals |
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that the costs of administering the program under this chapter, |
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excluding those costs associated with the collateralization of |
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deposits, exceed $25,000 in any year, on consent of a majority of |
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all of the paying hospitals, the county may use additional revenue |
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from mandatory payments received under this chapter to compensate |
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the county for its administrative expenses. A paying hospital may |
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not unreasonably withhold consent to compensate the county for |
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administrative 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 or insurer. |
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(f) A mandatory payment under this chapter is not a tax for |
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purposes of Section 4, Article IX, Texas Constitution, or Chapter |
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1053, Special District Local Laws Code. |
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Sec. 298C.152. ASSESSMENT AND COLLECTION OF MANDATORY |
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PAYMENTS. The county may collect or contract for the assessment and |
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collection of mandatory payments authorized under this chapter. |
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Sec. 298C.153. CORRECTION OF INVALID PROVISION OR |
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PROCEDURE. 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 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, |
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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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SECTION 2. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 3. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2019. |