By: Phillips (Senate Sponsor - Estes) H.B. No. 2062          (In the Senate - Received from the House May 1, 2017;   May 5, 2017, read first time and referred to Committee on Health &   Human Services; May 16, 2017, reported adversely, with favorable   Committee Substitute by the following vote:  Yeas 8, Nays 0, 1   present not voting; May 16, 2017, sent to printer.)Click here to see the committee vote    COMMITTEE SUBSTITUTE FOR H.B. No. 2062 By:  Buckingham     A BILL TO BE ENTITLED   AN ACT     relating to the creation and operations of health care provider   participation programs 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 292A to read as follows:   CHAPTER 292A. COUNTY HEALTH CARE PROVIDER PARTICIPATION PROGRAM IN   CERTAIN COUNTIES BORDERING RED RIVER   SUBCHAPTER A. GENERAL PROVISIONS          Sec. 292A.001.  DEFINITIONS. In this chapter:                (1)  "Institutional health care provider" means a   nonpublic hospital that provides inpatient hospital services.                (2)  "Paying hospital" means an institutional health   care provider required to make a mandatory payment under this   chapter.                (3)  "Program" means the county health care provider   participation program authorized by this chapter.          Sec. 292A.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 100,000;                (3)  contains at least two municipalities, each of   which has a population of more than 15,000; and                (4)  borders the Red River.          Sec. 292A.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 to fund certain intergovernmental transfers   and indigent care programs as provided by this chapter.          (b)  The commissioners court may adopt an order authorizing a   county to participate in the program, subject to the limitations   provided by this chapter.   SUBCHAPTER B. POWERS AND DUTIES OF COMMISSIONERS COURT          Sec. 292A.051.  LIMITATION ON AUTHORITY TO REQUIRE MANDATORY   PAYMENT.  The commissioners court of a county may require a   mandatory payment authorized under this chapter by an institutional   health care provider in the county only in the manner provided by   this chapter.          Sec. 292A.052.  MAJORITY VOTE REQUIRED. The commissioners   court of a county may not authorize the county to collect a   mandatory payment authorized under this chapter without an   affirmative vote of a majority of the members of the commissioners   court.          Sec. 292A.053.  RULES AND PROCEDURES. After the   commissioners court has voted to require a mandatory payment   authorized under this chapter, the commissioners court may adopt   rules relating to the administration of the mandatory payment.          Sec. 292A.054.  INSTITUTIONAL HEALTH CARE PROVIDER   REPORTING; INSPECTION OF RECORDS. (a) The commissioners court of a   county that collects a mandatory payment authorized under this   chapter 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.          (b)  The commissioners court of a county that collects a   mandatory payment authorized under this chapter may inspect the   records of an institutional health care provider to the extent   necessary to ensure compliance with the requirements of Subsection   (a).   SUBCHAPTER C. GENERAL FINANCIAL PROVISIONS          Sec. 292A.101.  HEARING. (a) Each year, the commissioners   court of a county that collects a mandatory payment authorized   under this chapter shall hold a public hearing on the amounts of any   mandatory payments that the commissioners court intends to require   during the year.          (b)  Not later than the fifth day before the date of the   hearing required under Subsection (a), the commissioners court of   the county shall publish notice of the hearing in a newspaper of   general circulation in the county.          (c)  A representative of a paying hospital is entitled to   appear at the time and place designated in the public notice and to   be heard regarding any matter related to the mandatory payments   authorized under this chapter.          Sec. 292A.102.  DEPOSITORY. (a) The commissioners court of   each county that collects a mandatory payment authorized under this   chapter by resolution shall designate one or more banks located in   the county as the depository for mandatory payments received by the   county.          (b)  All income received by a county under this chapter,   including the revenue from mandatory payments remaining after   discounts and fees for assessing and collecting the payments are   deducted, shall be deposited with the county depository in the   county's local provider participation fund and may be withdrawn   only as provided by this chapter.          (c)  All funds under this chapter shall be secured in the   manner provided for securing county funds.          Sec. 292A.103.  LOCAL PROVIDER PARTICIPATION FUND;   AUTHORIZED USES OF MONEY. (a)  Each county that collects a   mandatory payment authorized 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, including any   penalties and interest attributable to delinquent payments;                (2)  money received from the Health and Human Services   Commission as a refund of an intergovernmental transfer from the   county to the state for the purpose of providing 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.          (c)  Money deposited to the local provider participation   fund may be used only to:                (1)  fund intergovernmental transfers from the county   to the state to provide:                      (A)  the nonfederal share of a Medicaid   supplemental payment program authorized under the state Medicaid   plan, 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; or                      (B)  payments to Medicaid managed care   organizations that are dedicated for payment to hospitals;                (2)  subsidize indigent programs;                (3)  pay the administrative expenses of the county   solely for activities under this chapter;                (4)  refund a portion of a mandatory payment collected   in error from a paying hospital; and                (5)  refund to paying hospitals the proportionate share   of money received by the county that is not used to fund the   nonfederal share of Medicaid supplemental payment program   payments.          (d)  Money in the local provider participation fund may not   be commingled with other county funds.          (e)  An intergovernmental transfer of funds described by   Subsection (c)(1) and any funds received by the county as a result   of an intergovernmental transfer described by that subsection may   not be used by the county 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. 292A.151.  MANDATORY PAYMENTS BASED ON PAYING HOSPITAL   NET PATIENT REVENUE. (a)  Except as provided by Subsection (e), the   commissioners court of a county that collects a mandatory payment   authorized under this chapter 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 fiscal year   ending in 2015 or, if the institutional health care provider did not   report any data under those sections in that fiscal year, as   determined by the institutional health care provider's Medicare   cost report submitted for the 2015 fiscal year or for the closest   subsequent fiscal year for which the provider submitted the   Medicare cost report.  The county shall update the amount of the   mandatory payment on an annual basis.          (b)  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 hospital in the county. 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 commissioners court of a county that collects a   mandatory payment authorized under this chapter shall set the   amount of the mandatory payment.  The amount of the mandatory   payment required of each paying hospital may not exceed six percent   of the paying hospital's net patient revenue.          (d)  Subject to the maximum amount prescribed by Subsection   (c), the commissioners court of a county that collects a mandatory   payment authorized under this chapter shall set the mandatory   payments in amounts that in the aggregate will generate sufficient   revenue to cover the administrative expenses of the county for   activities under this chapter, to fund an intergovernmental   transfer described by Section 292A.103(c)(1), and to pay for   indigent programs, except that the amount of revenue from mandatory   payments used for administrative expenses of the county for   activities under this chapter in a year may not exceed the lesser of   four percent of the total revenue generated from the mandatory   payment or $20,000.          (e)  A paying hospital may not add a mandatory payment   required under this section as a surcharge to a patient.          Sec. 292A.152.  ASSESSMENT AND COLLECTION OF MANDATORY   PAYMENTS. The county may collect or contract for the assessment and   collection of mandatory payments authorized under this chapter.          Sec. 292A.153.  INTEREST, PENALTIES, AND DISCOUNTS.     Interest, penalties, and discounts on mandatory payments required   under this chapter are governed by the law applicable to county ad   valorem taxes.          Sec. 292A.154.  PURPOSE; CORRECTION OF INVALID PROVISION OR   PROCEDURE. (a)  The purpose of this chapter is to generate revenue   by collecting from institutional health care providers a mandatory   payment to be used to provide the nonfederal share of a Medicaid   supplemental payment program.          (b)  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 county may provide by   rule for an alternative provision or procedure that conforms to the   requirements of the federal Centers for Medicare and Medicaid   Services.          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, 2017.     * * * * *