| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
| |
|
|
relating to the creation and operations of a health care provider |
|
|
participation program by the Lubbock County Hospital District of |
|
|
Lubbock County, Texas. |
|
|
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 298C to read as follows: |
|
|
CHAPTER 298C. LUBBOCK COUNTY HOSPITAL DISTRICT OF LUBBOCK COUNTY, |
|
|
TEXAS: HEALTH CARE PROVIDER PARTICIPATION PROGRAM |
|
|
SUBCHAPTER A. GENERAL PROVISIONS |
|
|
Sec. 298C.001. PURPOSE. The purpose of this chapter is to |
|
|
authorize the district to administer a health care provider |
|
|
participation program to provide additional compensation to |
|
|
nonpublic hospitals by collecting mandatory payments from each |
|
|
nonpublic hospital in the district to be used to provide the |
|
|
nonfederal share of a Medicaid supplemental payment program and for |
|
|
other purposes as authorized under this chapter. |
|
|
Sec. 298C.002. DEFINITIONS. In this chapter: |
|
|
(1) "Board" means the board of hospital managers of |
|
|
the district. |
|
|
(2) "District" means the Lubbock County Hospital |
|
|
District of Lubbock County, Texas. |
|
|
(3) "Institutional health care provider" means a |
|
|
nonpublic hospital located in the district that provides inpatient |
|
|
hospital services. |
|
|
(4) "Paying hospital" 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. 298C.003. APPLICABILITY. This chapter applies only to |
|
|
the Lubbock County Hospital District of Lubbock County, Texas. |
|
|
Sec. 298C.004. 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 a majority of the board, subject to the |
|
|
provisions of this chapter. |
|
|
SUBCHAPTER B. POWERS AND DUTIES OF BOARD |
|
|
Sec. 298C.051. LIMITATION ON AUTHORITY TO REQUIRE MANDATORY |
|
|
PAYMENT. The board may require a mandatory payment authorized |
|
|
under this chapter from an institutional health care provider in |
|
|
the district only in the manner provided by this chapter. |
|
|
Sec. 298C.052. INSTITUTIONAL HEALTH CARE PROVIDER |
|
|
REPORTING. If the board authorizes the district to participate in a |
|
|
program under this chapter, the board shall require each |
|
|
institutional health care provider to submit to the district a copy |
|
|
of any financial and utilization data required by and reported to |
|
|
the Department of State Health Services under Sections 311.032 and |
|
|
311.033 and any rules adopted by the executive commissioner of the |
|
|
Health and Human Services Commission to implement those sections. |
|
|
Sec. 298C.053. RULES AND PROCEDURES. The board may adopt |
|
|
rules relating to the administration of the health care provider |
|
|
participation program, including collection of the mandatory |
|
|
payments, expenditures, audits, and any other administrative |
|
|
aspects of the program. |
|
|
SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS |
|
|
Sec. 298C.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 of the hearing to the chief |
|
|
operating officer of each institutional health care provider in the |
|
|
district. |
|
|
(c) The board's determination of the amount of mandatory |
|
|
payments to be collected during the year must be shown to be based |
|
|
on reasonable estimates of the amount of revenue necessary to fund |
|
|
intergovernmental transfers from the district to the state |
|
|
providing the nonfederal share of payments described by Section |
|
|
298C.103(b)(1) that is otherwise unfunded. |
|
|
Sec. 298C.102. LOCAL PROVIDER PARTICIPATION FUND; |
|
|
DEPOSITORY. (a) If the board collects a mandatory payment |
|
|
authorized under this chapter, the board shall create a local |
|
|
provider participation fund in one or more banks located in the |
|
|
district that are designated by the district as a depository for |
|
|
public funds. |
|
|
(b) All money received by the district under this chapter, |
|
|
including the amount of revenue from mandatory payments remaining |
|
|
after deducting any discounts and fees for assessing and collecting |
|
|
the payments, shall be deposited with a depository designated under |
|
|
Subsection (a). |
|
|
(c) The board may withdraw or use money in the fund only for |
|
|
a purpose authorized under this chapter. |
|
|
(d) All funds collected under this chapter shall be secured |
|
|
in the manner provided by Chapter 1053, Special District Local Laws |
|
|
Code, for securing public funds of the district. |
|
|
Sec. 298C.103. DEPOSITS TO FUND; AUTHORIZED USES OF MONEY. |
|
|
(a) The local provider participation fund established under |
|
|
Section 298C.102 consists of: |
|
|
(1) all mandatory payments authorized under this |
|
|
chapter and received by the district; |
|
|
(2) money received from the Health and Human Services |
|
|
Commission as a refund of an intergovernmental transfer from the |
|
|
district to the state as the nonfederal share of Medicaid |
|
|
supplemental payment program payments, provided that the |
|
|
intergovernmental transfer does not receive a federal matching |
|
|
payment; and |
|
|
(3) the earnings of the fund. |
|
|
(b) Money deposited to the local provider participation |
|
|
fund 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 and delivery system |
|
|
reform incentive 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 to nonpublic hospitals |
|
|
under another waiver program authorizing payments that are |
|
|
substantially similar to Medicaid payments to nonpublic hospitals |
|
|
described by Paragraph (A) or (B); or |
|
|
(D) any reimbursement to nonpublic hospitals for |
|
|
which federal matching funds are available; |
|
|
(2) subject to Section 298C.151(d), pay the |
|
|
administrative expenses of the district in administering the |
|
|
program, including collateralization of deposits; |
|
|
(3) refund a portion of a mandatory payment collected |
|
|
in error from a paying hospital; and |
|
|
(4) refund to paying hospitals a proportionate share |
|
|
of the money 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 described by Subdivision |
|
|
(1); or |
|
|
(B) determines cannot be used to fund the |
|
|
nonfederal share of Medicaid supplemental payment program payments |
|
|
described by Subdivision (1). |
|
|
(c) Money in the local provider participation fund may not |
|
|
be commingled with other district funds. |
|
|
(d) An intergovernmental transfer of funds described by |
|
|
Subsection (b)(1) and any funds received by the district as a result |
|
|
of an intergovernmental transfer described by that subsection may |
|
|
not be used by the district or any other entity to 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). |
|
|
SUBCHAPTER D. MANDATORY PAYMENTS |
|
|
Sec. 298C.151. MANDATORY PAYMENTS. (a) If the board |
|
|
authorizes a program under this chapter, the board shall require an |
|
|
annual mandatory payment to be assessed on the net patient revenue |
|
|
of each institutional health care provider located in the district. |
|
|
The board may provide that the mandatory payment is to be collected |
|
|
at least annually, but not more often than quarterly. In the first |
|
|
year in which the mandatory payment is required, the mandatory |
|
|
payment is assessed on the net patient revenue of an institutional |
|
|
health care provider as determined by the data reported to the |
|
|
Department of State Health Services under Sections 311.032 and |
|
|
311.033 in the most recent fiscal year for which that data was |
|
|
reported. If the institutional health care provider did not report |
|
|
any data under those sections, the provider's net patient revenue |
|
|
is the amount of that revenue as contained in the provider's |
|
|
Medicare cost report submitted for the previous fiscal year or for |
|
|
the closest subsequent fiscal year for which the provider submitted |
|
|
the Medicare cost report. The district shall update the amount of |
|
|
the mandatory payment on an annual basis and may update the amount |
|
|
on a more frequent basis. |
|
|
(b) The amount of a mandatory payment authorized under this |
|
|
chapter must be a uniform percentage of the amount of net patient |
|
|
revenue generated by each paying hospital in the district. A |
|
|
mandatory payment authorized under this chapter may not hold |
|
|
harmless any institutional health care provider, as required under |
|
|
42 U.S.C. Section 1396b(w). |
|
|
(c) The aggregate amount of the mandatory payments required |
|
|
of all paying hospitals in the district may not exceed six percent |
|
|
of the aggregate net patient revenue of all paying hospitals in the |
|
|
district. |
|
|
(d) Subject to the maximum amount prescribed by Subsection |
|
|
(c) and this subsection, 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, fund an intergovernmental transfer described by |
|
|
Section 298C.103(b)(1), or make other payments authorized under |
|
|
this chapter. The amount of the mandatory payments must be based on |
|
|
reasonable estimates of the amount of revenue necessary to cover |
|
|
the administrative expenses, intergovernmental transfers, and |
|
|
other payments described by this subsection as authorized under |
|
|
this chapter. The amount of revenue from mandatory payments that |
|
|
may be used for administrative expenses by the district in a year |
|
|
may not exceed $25,000, plus the cost of collateralization of |
|
|
deposits. If the board demonstrates to the paying hospitals that |
|
|
the costs of administering the program under this chapter, |
|
|
excluding those costs associated with the collateralization of |
|
|
deposits, exceed $25,000 in any year, on consent of all of the |
|
|
paying hospitals, the district may use additional revenue from |
|
|
mandatory payments received under this chapter to compensate the |
|
|
district for its administrative expenses. A paying hospital may |
|
|
not unreasonably withhold consent to compensate the district for |
|
|
administrative expenses. |
|
|
(e) A paying hospital may not add a mandatory payment |
|
|
required under this section as a surcharge to a patient or insurer. |
|
|
(f) A mandatory payment under this chapter is not a tax for |
|
|
purposes of Section 9, Article IX, Texas Constitution, or Chapter |
|
|
1053, Special District Local Laws Code. |
|
|
Sec. 298C.152. ASSESSMENT AND COLLECTION OF MANDATORY |
|
|
PAYMENTS. The district may collect or contract for the assessment |
|
|
and collection of mandatory payments authorized under this chapter. |
|
|
Sec. 298C.153. CORRECTION OF INVALID PROVISION OR |
|
|
PROCEDURE. 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. |
|
|
SECTION 2. 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 3. 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. |
|
|
|
|
|
* * * * * |