Bill Caption

Relating to the regulation of certain long-term care facilities.

Fiscal Notes

The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.

Bill Analysis

This bill would require the Health and Human Services Commission to collect funds to impose a reinvestment allowance on long term care facilities, excluding those facilities that provide a combination of services on a single campus which may include services covered by this bill, and would prohibit the facility from using the reinvestment allowance as a separate charge on a resident’s billing statement or attempting to charge the reinvestment allowance to a resident.

The money in the reinvestment fund would only be allowed to be used for paying any commission cost to develop and administer systems for managing the reinvestment allowance, reimbursing the Medicaid share of the reinvestment allowance as an allowable cost in the Medicaid daily rate, and increasing reimbursement rates paid under the state Medicaid program to facilities. 50 percent of the funds used to reimburse the rates under the Medicaid program would be allocated to increase reimbursement rate payments based on the total rating of the Centers for Medicare and Medicaid Services five-star quality rating system. 

The commission would be required to, track the scope and severity of violations of the chapter in order to assess administrative penalties, and submit an annual report on the status of the program to the governor, lieutenant governor, and speaker of the house. Not later than November 1, 2020, the commission would be required to submit a program evaluation to the governor, lieutenant governor, and speaker of the house. 

Vote Recommendation Notes

The intent of this bill is to use a draw down of federal dollars in order to increase the base Medicaid reimbursement rate for nursing facilities. An increase in the rate would allow nursing homes to be better able to afford to provide care to patients and would reduce the cost shifting to private pay patients at nursing homes. This bill would provide a necessary change in the reimbursement rates to nursing facilities without increasing appropriations from state revenue. This means that no state dollars would be spent to fund these changes, however, federal programs are subject to change. As it stands on second reading this bill would obligate the state to continue funding the program should the federal funds stop flowing in. For these reasons we oppose this bill unless amended to protect Texas taxpayers from picking up the bill for this program in the absence of federal funding.

We have been in contact with the bill author's office and it is our understanding that amendments are forthcoming to 1) make this program stop should the federal draw down dollars stop, and 2) stipulate that the program would not begin until the federal dollars are approved. Should amendments of this nature be adopted we would withdraw our objection to the bill.