87R6680 KFF-D
 
  By: Buckingham S.B. No. 1533
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the reimbursement of certain urban teaching hospitals
  for the provision of inpatient hospital care under Medicaid.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,
  is amended by adding Section 32.0285 to read as follows:
         Sec. 32.0285.  CALCULATION OF MEDICAL EDUCATION ADD-ON FOR
  REIMBURSEMENT OF CERTAIN URBAN TEACHING HOSPITALS. (a) In this
  section:
               (1)  "Base standard dollar amount" means the
  standardized payment amount calculated by the commission for costs
  incurred by prospectively paid hospitals in this state for
  providing inpatient hospital care under Medicaid.
               (2)  "Children's hospital" means a hospital designated
  by the Centers for Medicare and Medicaid Services as a children's
  hospital.
               (3)  "Medical education add-on" means an adjustment to
  the base standard dollar amount for an urban teaching hospital to
  reflect higher patient care costs relative to nonteaching urban
  hospitals.
               (4)  "Rural hospital" means a hospital enrolled as a
  Medicaid provider that:
                     (A)  is located in a county with a population of
  not more than 60,000;
                     (B)  is designated by the Centers for Medicare and
  Medicaid Services as a critical access hospital, sole community
  hospital, or rural referral center and is not located in an area
  defined by the United States Office of Management and Budget as a
  metropolitan statistical area; or
                     (C)  meets all of the following criteria:
                           (i)  has 100 or fewer beds;
                           (ii)  is designated by the Centers for
  Medicare and Medicaid Services as a critical access hospital, sole
  community hospital, or rural referral center; and
                           (iii)  is located in an area defined by the
  United States Office of Management and Budget as a metropolitan
  statistical area.
               (5)  "State-owned teaching hospital" means:
                     (A)  The University of Texas Medical Branch at
  Galveston;
                     (B)  The University of Texas Health Science Center
  at Tyler; and
                     (C)  The University of Texas M.D. Anderson Cancer
  Center.
               (6)  "Teaching hospital" means a hospital that incurs
  indirect costs for operating graduate medical education programs
  and for which the Centers for Medicare and Medicaid Services has
  calculated and assigned a percentage Medicare education adjustment
  factor under 42 C.F.R. Section 412.105.
               (7)  "Urban hospital" means a hospital that:
                     (A)  is located in an area defined by the United
  States Office of Management and Budget as a metropolitan
  statistical area; and
                     (B)  is not a rural hospital, children's hospital,
  state-owned teaching hospital, or freestanding psychiatric
  facility.
         (b)  To the extent permitted by federal law, in order to
  ensure that urban teaching hospitals are accurately reimbursed for
  the provision of inpatient hospital care to recipients under
  Medicaid, the commission shall, on request from a teaching
  hospital, update on a biannual basis the education adjustment
  factor used to calculate the medical education add-on using the
  most current Medicare education adjustment factor data available
  under 42 C.F.R. Section 412.105 at the time the commission makes the
  update.
         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, 2021.