By: Guillen H.B. No. 4110
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to certain administrative penalties and procedures
  associated with aging, community-based, and long-term care service
  providers.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 161.089, Human Resources Code, is
  amended by amending Subsections (b), (c), (c-1), (e), (f). (g), and
  (h) and adding Subsections (g-1) and (g-2) to read as follows:
         (b)  The commission may assess and collect an administrative
  penalty against a provider who participates in a program to which
  this section applies for a violation of a law or rule relating to
  the program, except that an administrative penalty may not be
  assessed for minor violations unless those violations are of a
  continuing nature or are not corrected by the provider. If the
  commission assesses an administrative penalty against a provider
  for a violation of a law or rule, the commission may not impose a
  payment hold against, recoup past payments from, or otherwise
  withhold contract payments from the provider for the same violation
  of a law or rule unless the provider has committed fraud, waste, or
  abuse. The commission may impose a referral hold in lieu of an
  administrative penalty assessed under this section.
         (c)  The [After consulting with appropriate stakeholders,
  the] executive commissioner by rule shall [develop and adopt rules
  regarding the imposition of administrative penalties under this
  section. The rules must]:
               (1)  specify each violation that warrants [the types of
  violations that warrant] imposition of an administrative penalty
  after consideration of:
                     (A)  the seriousness of the violation, including
  the nature, circumstances, extent, and gravity of the violation and
  the hazard of the violation to the health and safety of an
  individual; and
                     (B)  whether the provider previously identified
  the violation as part of their internal quality assurance process
  and made appropriate progress on correction;
               (2)  establish a schedule of appropriate and graduated
  penalties for each [progressive administrative penalties in
  accordance with the relative type, frequency, and seriousness of a]
  violation based on:
                     (A)  the seriousness of the violation, including
  the nature, circumstances, extent, and gravity of the violation and
  the hazard of the violation to the health and safety of an
  individual;
                     (B)  any history of previous violations by the
  provider;
                     (C)  whether the provider previously identified
  the violation as part of its internal quality assurance process and
  made appropriate progress on correction;
                     (D)  the amount necessary to deter future
  violations;
                     (E)  efforts made by the provider to correct the
  violation; and
                     (F)  any other matters that justice may require;
               (3)  prescribe reasonable amounts to be imposed for
  each violation giving rise to an administrative penalty, subject to
  Subdivision (4);
               (4)  authorize the imposition of an administrative
  penalty in an amount not to exceed $5,000 for each violation;
               (5)  provide that a provider commits a separate
  violation each day the provider continues to violate the law or
  rule, except that each day of a violation occurring before the day
  on which the provider receives written notice of the violation from
  the commission does not constitute a separate violation and shall
  be considered by the commission to be one violation;
               (6)  ensure standard and consistent application of
  administrative penalties throughout the state; and
               (7)  provide for an administrative appeals process to
  adjudicate claims and appeals relating to the imposition of an
  administrative penalty under this section that is in accordance
  with Chapter 2001, Government Code [; and]
               [(8)  ensure standard and consistent interpretation of
  service delivery rules and consistent application of
  administrative penalties throughout this state].
         (c-1)  The [On adoption of the rules under Subsection (c),
  the] executive commissioner shall maintain [develop]
  interpretative guidelines for regulatory staff and providers
  regarding the imposition of administrative penalties under this
  section.
         (e)  Except as provided by Subsection (f), the executive
  commissioner by rule shall provide to a provider who has
  implemented a plan of correction a reasonable period of time
  following the date the commission sends written notice to the
  provider of the violation to correct the violation before the
  commission may assess an administrative penalty. The period may
  not be less than 45 days.
         (f)  The commission may assess an administrative penalty on
  providing written notice of a violation to a provider without
  providing a reasonable period of time to a provider to correct the
  violation if the violation:
               (1)  results in [represents a pattern of violation that
  results in] actual harm or death;
               (2)  constitutes a serious threat to health or safety
  and was not corrected by the provider or the provider has not made
  demonstrable progress toward correcting the violation prior to
  receiving notice of the violation from the commission [is
  widespread in scope and results in actual harm]; or
               (3)  [is widespread in scope and constitutes a
  potential for actual harm;
               [(4)  constitutes an immediate threat to the health or
  safety of a recipient;
               [(5)  substantially limits the provider's ability to
  provide care; or
               [(6)]  is a violation in which a provider:
                     (A)  wilfully interferes with the work of a
  representative of the commission or the enforcement of a law
  relating to a program to which this section applies;
                     (B)  fails to pay a penalty assessed by the
  commission under this section not later than the 10th day after the
  date the assessment of the penalty becomes final, subject to
  Section 161.0891; or
                     (C)  fails to submit a plan of correction not
  later than the 10th day after the date the provider receives a
  statement of the violation.
         (g)  Notwithstanding any other provision of this section, an
  administrative penalty ceases to be incurred on the date a
  violation is corrected. For purposes of this section, the date of
  correction is the date identified by the provider and submitted to
  the commission with evidence of correction. Penalties do not
  accrue for a violation until a provider receives written notice of
  the violation and of all elements of the violation that must be
  corrected by the provider to achieve compliance.
         (g-1)  Notwithstanding provider requirements to notify the
  service planning team of a significant change in condition, if the
  commission identifies a violation caused by deficiency of services
  authorized on a service plan, including potential hazards to the
  health and safety of the individual, the commission shall allow
  sufficient time for the service planning team to modify the service
  plan before imposing an administrative penalty.
         (g-2)  Notwithstanding any other provision of law, the
  commission may waive or reduce any applicable penalty if the
  commission determines that strict enforcement of the rule or law
  would impose a hardship or otherwise not be in the best interest of
  persons supported by the provider.
         SECTION 2.  Section 161.0891(g), Human Resources Code, is
  amended to read as follows:
         (g)  The commission may not offer amelioration to a provider:
               (1)  more than three times in a two-year period;
               (2)  more than one time in a two-year period for the
  same or similar violation; or
               (3)  for a violation that resulted in [hazard to the
  health or safety of a recipient, including] serious harm to or death
  of a recipient [, or that substantially limits the provider's
  ability to provide care].
         SECTION 5.  Subchapter D, Chapter 161, Human Resources Code,
  is amended by adding Section 161.08915 to read as follows:
         Sec. 161.08915.  HOME AND COMMUNITY-BASED SERVICES WAIVER
  REGULATIONS TASKFORCE. (a) Not later than December 1, 2023, the
  executive commissioner shall establish a Home and Community-Based
  Services Waiver Regulations Taskforce. The taskforce must be
  composed of:
               (1)  representatives of providers of services in the
  1915(c) Home and Community-Based Services and Texas Home Living
  waivers; and
               (2)  representatives of appropriate health and human
  service agency functions, including regulatory, waiver, and
  billing functions.
         (b)  The taskforce shall review all rules, regulations, and
  policies applicable to home and community-based services and make
  recommendations to the executive commissioner designed to provide
  clarity of regulations, reduced administrative burdens, and
  removal of duplicative or conflicting regulations that are not
  required by state or federal law.
         (c)  Not later than December 1, 2024, the commission shall
  submit a report to the legislature detailing recommendations made
  by the taskforce and the administrative changes made as a result of
  those recommendations.
         (d)  This section expires January 1, 2026.
         SECTION 4.  Sections 161.089(h) and 161.0891(h), Human
  Resources Code, are repealed.
         SECTION 5.  This Act takes effect immediately if it receives
  a vote of two-thirds of all 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, 2023.