S.B. No. 2117

	AN ACT
	relating to the creation and operations of a health care provider
	participation program by the City of Amarillo Hospital District.
	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 295A to read as follows:
	CHAPTER 295A. CITY OF AMARILLO HOSPITAL DISTRICT HEALTH CARE
	PROVIDER PARTICIPATION PROGRAM
	SUBCHAPTER A.  GENERAL PROVISIONS
	Sec. 295A.001.  PURPOSE. The purpose of this chapter is to
	authorize the district to administer a health care provider
	participation program to provide additional compensation to
	hospitals in the district by collecting mandatory payments from
	each hospital in the district to be used to provide the nonfederal
	share of a Medicaid supplemental payment program and for other
	purposes as authorized under this chapter.
	Sec. 295A.002.  DEFINITIONS. In this chapter:
	(1)  "Board" means the board of hospital managers of
	the district.
	(2)  "District" means the City of Amarillo Hospital
	District.
	(3)  "Institutional health care provider" means a
	nonpublic hospital that provides inpatient hospital services.
	(4)  "Paying hospital" means an institutional health
	care provider required to make a mandatory payment under this
	chapter.
	(5)  "Program" means the health care provider
	participation program authorized by this chapter.
	Sec. 295A.003.  APPLICABILITY.  This chapter applies only to
	the City of Amarillo Hospital District.
	Sec. 295A.004.  HEALTH CARE PROVIDER PARTICIPATION PROGRAM;
	PARTICIPATION IN PROGRAM. The board may authorize the district to
	participate in a health care provider participation program on the
	affirmative vote of a majority of the board, subject to the
	provisions of this chapter.
	SUBCHAPTER B. POWERS AND DUTIES OF BOARD
	Sec. 295A.051.  LIMITATION ON AUTHORITY TO REQUIRE MANDATORY
	PAYMENT.  The board may require a mandatory payment authorized
	under this chapter by an institutional health care provider in the
	district only in the manner provided by this chapter.
	Sec. 295A.052.  RULES AND PROCEDURES. The board may adopt
	rules relating to the administration of the health care provider
	participation program, including collection of the mandatory
	payments, expenditures, audits, and any other administrative
	aspects of the program.
	Sec. 295A.053.  INSTITUTIONAL HEALTH CARE PROVIDER
	REPORTING. If the board authorizes the district to participate in a
	health care provider participation program under this chapter, the
	board shall require each institutional health care provider to
	submit to the district 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. 295A.101.  HEARING. (a)  In each year that the board
	authorizes a health care provider participation program under this
	chapter, the board shall hold a public hearing on the amounts of any
	mandatory payments that the board 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 board shall publish
	notice of the hearing in a newspaper of general circulation in the
	district and provide written notice of the hearing to the chief
	operating officer of each institutional health care provider in the
	district.
	Sec. 295A.102.  LOCAL PROVIDER PARTICIPATION FUND;
	DEPOSITORY. (a)  If the board collects a mandatory payment
	authorized under this chapter, the board shall create a local
	provider participation fund in one or more banks designated by the
	district as a depository for public funds.
	(b)  The board may withdraw or use money in the fund only for
	a purpose authorized under this chapter.
	(c)  All funds collected under this chapter shall be secured
	in the manner provided by Chapter 1001, Special District Local Laws
	Code, for securing other public funds of the district.
	Sec. 295A.103.  DEPOSITS TO FUND; AUTHORIZED USES OF MONEY.
	(a)  The local provider participation fund established under
	Section 295A.102 consists of:
	(1)  all mandatory payments authorized under this
	chapter and received by the district;
	(2)  money received from the Health and Human Services
	Commission as a refund of an intergovernmental transfer from the
	district to the state as 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.
	(b)  Money deposited to the local provider participation
	fund may be used only to:
	(1)  fund intergovernmental transfers from the
	district 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)  pay costs associated with indigent care provided
	by institutional health care providers in the district;
	(3)  pay the administrative expenses of the district in
	administering the program, including collateralization of
	deposits;
	(4)  refund a portion of a mandatory payment collected
	in error from a paying hospital; and
	(5)  refund to paying hospitals a proportionate share
	of the money that the district:
	(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.
	(c)  Money in the local provider participation fund may not
	be commingled with other district funds.
	(d)  An intergovernmental transfer of funds described by
	Subsection (b)(1) and any funds received by the district as a result
	of an intergovernmental transfer described by that subsection may
	not be used by the district 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. 295A.151.  MANDATORY PAYMENTS. (a)  Except as provided
	by Subsection (e), if the board authorizes a health care provider
	participation program under this chapter, the board shall require
	an annual mandatory payment to be assessed on the net patient
	revenue of each institutional health care provider located in the
	district.  The board shall provide that the mandatory payment is to
	be collected at least annually, but not more often than 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 previous fiscal
	year or for the closest subsequent fiscal year for which the
	provider submitted the Medicare cost report.  The district 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 a uniform percentage of the amount of net patient
	revenue generated by each paying hospital in the district. 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 aggregate amount of the mandatory payments required
	of all paying hospitals in the district may not exceed six percent
	of the aggregate net patient revenue of all paying hospitals in the
	district.
	(d)  Subject to the maximum amount prescribed by Subsection
	(c), the board shall set the mandatory payments in amounts that in
	the aggregate will generate sufficient revenue to cover the
	administrative expenses of the district for activities under this
	chapter, fund an intergovernmental transfer described by Section
	295A.103(b)(1), or make other payments authorized under this
	chapter. The amount of revenue from mandatory payments that may be
	used for administrative expenses by the district in a year may not
	exceed $25,000, plus the cost of collateralization of deposits. If
	the board demonstrates to the paying hospitals that the costs of
	administering the health care provider participation program under
	this chapter, excluding those costs associated with the
	collateralization of deposits, exceed $25,000 in any year, on
	consent of all of the paying hospitals, the district may use
	additional revenue from mandatory payments received under this
	chapter to compensate the district for its administrative expenses.
	A paying hospital may not unreasonably withhold consent to
	compensate the district for administrative expenses.
	(e)  A paying hospital may not add a mandatory payment
	required under this section as a surcharge to a patient or insurer.
	(f)  A mandatory payment under this chapter is not a tax for
	purposes of Section 5(a), Article IX, Texas Constitution, or
	Chapter 1001, Special District Local Laws Code.
	Sec. 295A.152.  ASSESSMENT AND COLLECTION OF MANDATORY
	PAYMENTS. The district may collect or contract for the assessment
	and collection of mandatory payments authorized under this chapter.
	Sec. 295A.153.  CORRECTION OF INVALID PROVISION OR
	PROCEDURE. 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 board may provide by
	rule for an alternative provision or procedure that conforms to the
	requirements of the federal Centers for Medicare and Medicaid
	Services. A rule adopted under this section may not create, impose,
	or materially expand the legal or financial liability or
	responsibility of the district or an institutional health care
	provider in the district beyond the provisions of this chapter.
	This section does not require the board to adopt a rule.
	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.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I hereby certify that S.B. No. 2117 passed the Senate on
	May 4, 2017, by the following vote:  Yeas 31, Nays 0.
	______________________________
	Secretary of the Senate
	I hereby certify that S.B. No. 2117 passed the House on
	May 21, 2017, by the following vote:  Yeas 137, Nays 2, two
	present not voting.
	______________________________
	Chief Clerk of the House
	Approved:
	______________________________
	Date
	______________________________
	Governor