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AN ACT
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relating to the authorization of the imposition of administrative |
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penalties on providers participating in certain Medicaid waiver |
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programs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter D, Chapter 161, Human Resources Code, |
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is amended by adding Section 161.088 to read as follows: |
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Sec. 161.088. ADMINISTRATIVE PENALTIES. (a) This section |
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applies to the following waiver programs established under Section |
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1915(c), Social Security Act (42 U.S.C. Section 1396n(c)), and |
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administered by the department to serve persons with an |
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intellectual or developmental disability: |
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(1) the home and community-based services (HCS) waiver |
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program; and |
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(2) the Texas home living (TxHmL) waiver program. |
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(b) The department may assess and collect an administrative |
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penalty against a provider who participates in a program to which |
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this section applies for a violation of a law or rule relating to |
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the program. If the department assesses an administrative penalty |
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against a provider for a violation of a law or rule, the department |
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may not impose a payment hold against or otherwise withhold |
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contract payments from the provider for the same violation of a law |
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or rule. |
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(c) After consulting with appropriate stakeholders, the |
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executive commissioner shall develop and adopt rules regarding the |
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imposition of administrative penalties under this section. The |
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rules must: |
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(1) specify the types of violations that warrant |
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imposition of an administrative penalty; |
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(2) establish a schedule of progressive |
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administrative penalties in accordance with the relative type, |
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frequency, and seriousness of a violation; |
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(3) prescribe reasonable amounts to be imposed for |
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each violation giving rise to an administrative penalty, subject to |
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Subdivision (4); |
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(4) authorize the imposition of an administrative |
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penalty in an amount not to exceed $5,000 for each violation; |
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(5) provide that a provider commits a separate |
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violation each day the provider continues to violate the law or |
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rule; |
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(6) ensure standard and consistent application of |
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administrative penalties throughout the state; and |
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(7) provide for an administrative appeals process to |
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adjudicate claims and appeals relating to the imposition of an |
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administrative penalty under this section that is in accordance |
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with Chapter 2001, Government Code. |
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(d) In specifying the types of violations that warrant |
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imposition of an administrative penalty under Subsection (c), the |
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executive commissioner shall specify the types of minor violations |
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that allow a provider an opportunity to take corrective action |
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before a penalty is imposed. |
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(e) In establishing the schedule of progressive |
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administrative penalties and penalty amounts under Subsection (c), |
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the executive commissioner must consider: |
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(1) the seriousness of a violation, including: |
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(A) the nature, circumstances, extent, and |
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gravity of the violation; and |
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(B) the hazard to the health or safety of |
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recipients resulting from the violation; |
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(2) the provider's history of previous violations; |
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(3) whether the provider: |
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(A) had prior knowledge of the violation, |
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including whether the provider identified the violation through the |
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provider's internal quality assurance process; and |
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(B) made any efforts to mitigate or correct the |
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identified violation; |
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(4) the penalty amount necessary to deter future |
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violations; and |
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(5) any other matter justice may require. |
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(f) In lieu of imposing an administrative penalty under this |
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section, the department shall allow a provider found to have |
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committed a minor violation specified by rule in accordance with |
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Subsection (d) to have a reasonable period of time that is not less |
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than 45 days after the date the department sends notice to the |
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provider of the violation to take corrective action regarding the |
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violation. The department may not allow time for corrective action |
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for any violation that is not a minor violation. |
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SECTION 2. The Department of Aging and Disability Services |
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may impose an administrative penalty in accordance with Section |
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161.088, Human Resources Code, as added by this Act, only for |
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conduct that occurs on or after the effective date of this Act. |
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SECTION 3. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 4. This Act takes effect September 1, 2015. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I hereby certify that S.B. No. 1385 passed the Senate on |
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April 20, 2015, by the following vote: Yeas 30, Nays 0; and that |
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the Senate concurred in House amendment on May 28, 2015, by the |
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following vote: Yeas 30, Nays 1. |
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______________________________ |
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Secretary of the Senate |
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I hereby certify that S.B. No. 1385 passed the House, with |
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amendment, on May 22, 2015, by the following vote: Yeas 140, |
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Nays 0, two present not voting. |
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______________________________ |
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Chief Clerk of the House |
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Approved: |
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______________________________ |
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Date |
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______________________________ |
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Governor |