HB4799 - Relating to the creation and operations of a health care provider participation program in certain counties.

  89R15305 SRA-F     By: Troxclair H.B. No. 4799       A BILL TO BE ENTITLED   AN ACT   relating to the creation and operations of a health care provider   participation program in certain counties.          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 292E to read as follows:   CHAPTER 292E. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN   CERTAIN COUNTIES   SUBCHAPTER A. GENERAL PROVISIONS           Sec. 292E.001.  DEFINITIONS. In this chapter:                 (1)     "Institutional health care provider" means a   nonpublic hospital that provides inpatient hospital services.                 (2)     "Paying provider" means an institutional health   care provider required to make a mandatory payment under this   chapter.                 (3)     "Program" means a county health care provider   participation program authorized by this chapter.           Sec.   292E.002.     APPLICABILITY. This chapter applies only to   a county that:                 (1)     is not served by a hospital district or a public   hospital;                 (2)     has a population of more than 46,000 and less than   50,000; and                 (3)     is adjacent to the county containing the state   capital.           Sec.   292E.003.     COUNTY HEALTH CARE PROVIDER PARTICIPATION   PROGRAM; PARTICIPATION IN PROGRAM. (a) A county health care   provider participation program authorizes a county to collect a   mandatory payment from each institutional health care provider   located in the county to be deposited in a local provider   participation fund established by the county. Money in the fund may   be used by the county as provided by Section 292E.103(c).           (b)     The commissioners court of a county may adopt an order   authorizing the county to participate in the program, subject to   the limitations provided by this chapter.   SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT           Sec.   292E.051.     LIMITATION ON AUTHORITY TO REQUIRE MANDATORY   PAYMENTS. The commissioners court of a county may require a   mandatory payment under this chapter by an institutional health   care provider in the county only in the manner provided by this   chapter.           Sec.   292E.052.     MAJORITY VOTE REQUIRED.     The commissioners   court of a county may not authorize the county to collect a   mandatory payment under this chapter without an affirmative vote of   a majority of the members of the commissioners court.           Sec.   292E.053.     RULES AND PROCEDURES.   After the   commissioners court of a county has voted to require a mandatory   payment authorized under this chapter, the commissioners court may   adopt rules relating to the administration of the program,   including the collection of a mandatory payment, expenditures, an   audit, and any other administrative aspect of the program.           Sec.   292E.054.     INSTITUTIONAL HEALTH CARE PROVIDER   REPORTING.     If the commissioners court of a county authorizes the   county to participate in a program under this chapter, the   commissioners court shall require each institutional health care   provider to submit to the county 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.   SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS           Sec.   292E.101.     HEARING.     (a)     In each year that the   commissioners court of a county authorizes a mandatory payment   under this chapter, the commissioners court shall hold a public   hearing on the amounts of any mandatory payments that the county   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 commissioners court   shall publish notice of the hearing in a newspaper of general   circulation in the county and provide written notice of the hearing   to each institutional health care provider located in the county.           (c)     A representative of a paying provider is entitled to   appear at the public hearing and be heard regarding any matter   related to the mandatory payments authorized under this chapter.           Sec.   292E.102.     DEPOSITORY. (a)     The commissioners court of   a county that requires a mandatory payment under this chapter shall   designate one or more banks as the depository for the county's local   provider participation fund.           (b)     All income received by a county under this chapter shall   be deposited with the depository designated under Subsection (a) in   the county's local provider participation fund and may be withdrawn   only as provided by this chapter.           (c)     All money collected under this chapter shall be secured   in the manner provided for securing other county money.           Sec.   292E.103.     LOCAL PROVIDER PARTICIPATION FUND;   AUTHORIZED USES OF MONEY.     (a)     A county that requires a mandatory   payment under this chapter shall create a local provider   participation fund.           (b)     The local provider participation fund of a county   consists of:                 (1)     all revenue received by the county 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 described   by Subsection (c)(1), provided that the intergovernmental transfer   does not receive a federal matching payment; and                 (3)  the earnings of the fund.           (c)     Money deposited to a county's local provider   participation fund may be used only to:                 (1)     fund intergovernmental transfers from the county   to the state to provide the nonfederal share of Medicaid payments   for:                       (A)     uncompensated care payments to nonpublic   hospitals 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), or a   successor waiver program authorizing similar Medicaid supplemental   payment programs;                       (B)     uniform rate enhancements or other directed   payment programs for nonpublic hospitals;                       (C)     payments available 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, or   that may benefit nonpublic hospitals as determined by the   commissioners court, for which federal matching funds are   available;                 (2)     subject to Section 292E.151(e), pay the   administrative expenses of the county in administering the program,   including collateralization of deposits;                 (3)     refund all or a portion of a mandatory payment   collected in error from a paying provider;                 (4)     refund to paying providers a proportionate share   of the money that the county:                       (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 county is legally required to transfer the funds   to address a disallowance of federal matching funds with respect to   any program for which intergovernmental transfers described by   Subdivision (1) were made.           (d)     Money in the local provider participation fund may not   be commingled with other county money.           (e)     Notwithstanding any other provision of this chapter,   with respect to an intergovernmental transfer of funds described by   Subsection (c)(1) made by the county, any funds received by the   state, county, or other entity as a result of the transfer may not   be used by the state, county, or 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.   292E.151.     MANDATORY PAYMENTS BASED ON PAYING PROVIDER   NET PATIENT REVENUE. (a)     Except as provided by Subsection (f), if   the commissioners court of a county authorizes a program under this   chapter, the commissioners court may require an annual mandatory   payment to be assessed on the net patient revenue of each   institutional health care provider located in the county.   The   commissioners court may provide for the mandatory payment to be   assessed 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   most recent fiscal year for which the provider submitted the   Medicare cost report.   If the mandatory payment is required, the   commissioners court shall update the amount of the mandatory   payment on an annual basis.           (b)     The commissioners court of a county that requires a   mandatory payment under this chapter shall provide each   institutional health care provider on which the payment will be   assessed written notice of an assessment under this chapter.   The   institutional health care provider must pay the assessment not   later than the 30th day after the date the provider receives the   written notice.           (c)     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   administering county.   A program may not hold harmless any   institutional health care provider, as required under 42 U.S.C.   Section 1396b(w) and 42 C.F.R. Section 433.68.           (d)     The commissioners court of a county that requires a   mandatory payment under this chapter shall set the amount of the   mandatory payment.   The aggregate amount of the mandatory payment &# [Text truncated for display. Full text available on Congress.gov.]