S.B. No. 1385
 
 
 
 
AN ACT
  relating to the authorization of the imposition of administrative
  penalties on providers participating in certain Medicaid waiver
  programs.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter D, Chapter 161, Human Resources Code,
  is amended by adding Section 161.088 to read as follows:
         Sec. 161.088.  ADMINISTRATIVE PENALTIES. (a)  This section
  applies to the following waiver programs established under Section
  1915(c), Social Security Act (42 U.S.C. Section 1396n(c)), and
  administered by the department to serve persons with an
  intellectual or developmental disability:
               (1)  the home and community-based services (HCS) waiver
  program; and
               (2)  the Texas home living (TxHmL) waiver program.
         (b)  The department 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.  If the department assesses an administrative penalty
  against a provider for a violation of a law or rule, the department
  may not impose a payment hold against or otherwise withhold
  contract payments from the provider for the same violation of a law
  or rule.
         (c)  After consulting with appropriate stakeholders, the
  executive commissioner shall develop and adopt rules regarding the
  imposition of administrative penalties under this section.  The
  rules must:
               (1)  specify the types of violations that warrant
  imposition of an administrative penalty;
               (2)  establish a schedule of progressive
  administrative penalties in accordance with the relative type,
  frequency, and seriousness of a violation;
               (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;
               (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.
         (d)  In specifying the types of violations that warrant
  imposition of an administrative penalty under Subsection (c), the
  executive commissioner shall specify the types of minor violations
  that allow a provider an opportunity to take corrective action
  before a penalty is imposed.
         (e)  In establishing the schedule of progressive
  administrative penalties and penalty amounts under Subsection (c),
  the executive commissioner must consider:
               (1)  the seriousness of a violation, including:
                     (A)  the nature, circumstances, extent, and
  gravity of the violation; and
                     (B)  the hazard to the health or safety of
  recipients resulting from the violation;
               (2)  the provider's history of previous violations;
               (3)  whether the provider:
                     (A)  had prior knowledge of the violation,
  including whether the provider identified the violation through the
  provider's internal quality assurance process; and
                     (B)  made any efforts to mitigate or correct the
  identified violation;
               (4)  the penalty amount necessary to deter future
  violations; and
               (5)  any other matter justice may require.
         (f)  In lieu of imposing an administrative penalty under this
  section, the department shall allow a provider found to have
  committed a minor violation specified by rule in accordance with
  Subsection (d) to have a reasonable period of time that is not less
  than 45 days after the date the department sends notice to the
  provider of the violation to take corrective action regarding the
  violation.  The department may not allow time for corrective action
  for any violation that is not a minor violation.
         SECTION 2.  The Department of Aging and Disability Services
  may impose an administrative penalty in accordance with Section
  161.088, Human Resources Code, as added by this Act, only for
  conduct that occurs on or after the effective date of this Act.
         SECTION 3.  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 4.  This Act takes effect September 1, 2015.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 1385 passed the Senate on
  April 20, 2015, by the following vote: Yeas 30, Nays 0; and that
  the Senate concurred in House amendment on May 28, 2015, by the
  following vote: Yeas 30, Nays 1.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 1385 passed the House, with
  amendment, on May 22, 2015, by the following vote: Yeas 140,
  Nays 0, two present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor