reglab/statecodes huggingface dataset:
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.033. Payment for Services

Sec. 61.033.  PAYMENT FOR SERVICES.  (a)  To the extent prescribed by this chapter, a county is liable for health care services provided under this subchapter by any provider, including a public hospital or hospital district, to an eligible county resident.  A county is not liable for payment for health care services provided:
(1)  by any provider, including a public hospital or hospital district, to a resident of that county who resides in the service area of a public hospital or hospital district;  or
(2)  to an eligible resident of that county who does not reside within the service area of a public hospital or hospital district by a hospital having a Hill-Burton or state-mandated obligation to provide free services and considered to be in noncompliance with the requirements of the Hill-Burton or state-mandated obligation.
(b)  To the extent prescribed by this chapter, if another source of payment does not adequately cover a health care service a county provides to an eligible county resident, the county shall pay for or provide the health care service for which other payment is not available.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.034. Payment Standards for Health Care Services

Sec. 61.034.  PAYMENT STANDARDS FOR HEALTH CARE SERVICES.  (a)  A county is not liable for the cost of a health care service provided under Section 61.028 or 61.0285 that is in excess of the payment standards for that service established by the department under Section 61.006.
(b)  A county may contract with a provider of assistance to provide a health care service at a rate below the payment standard set by department rule.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.12, eff. Sept. 1, 1999.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0182, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.035. Limitation of County Liability

Sec. 61.035.  LIMITATION OF COUNTY LIABILITY.  The maximum county liability for each state fiscal year for health care services provided by all assistance providers, including a hospital and a skilled nursing facility, to each eligible county resident is:
(1)  $30,000;  or
(2)  the payment of 30 days of hospitalization or treatment in a skilled nursing facility, or both, or $30,000, whichever occurs first, if the county provides hospital or skilled nursing facility services to the resident.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.038. Distribution of Assistance Funds

Sec. 61.038.  DISTRIBUTION OF ASSISTANCE FUNDS.  (a)  If the department determines that a county is eligible for assistance, the department shall distribute funds appropriated to the department from the indigent health care assistance fund or any other available fund to the county to assist the county in providing health care services under Sections 61.028 and 61.0285 to its eligible county residents who qualify for assistance as described by Section 61.037.
(b)  State funds provided under this section to a county must be equal to at least 90 percent of the actual payment for the health care services for the county's eligible residents during the remainder of the state fiscal year after the eight percent expenditure level is reached.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 272, Sec. 2, eff. May 28, 1999;  Acts 1999, 76th Leg., ch. 1377, Sec. 1.14, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.039. Failure to Provide State Assistance

Sec. 61.039.  FAILURE TO PROVIDE STATE ASSISTANCE.  If the department fails to provide assistance to an eligible county as prescribed by Section 61.038, the county is not liable for payments for health care services provided to its eligible county residents after the county reaches the eight percent expenditure level.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.14, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.0395. Limited to Appropriated Funds

Sec. 61.0395.  LIMITED TO APPROPRIATED FUNDS.  (a)  The total amount of state assistance provided to counties under this chapter for a fiscal year may not exceed the amount appropriated for that purpose for that fiscal year.
(b)  The executive commissioner may adopt rules governing the distribution of state assistance under this chapter that establish a maximum annual allocation for each county eligible for assistance under this chapter in compliance with Subsection (a).
(c)  The rules adopted under this section:
(1)  may consider the relative populations of the service areas of eligible counties and other appropriate factors;  and
(2)  notwithstanding Subsection (b), may provide for, at the end of each state fiscal year, the reallocation of all money that is allocated to a county under Subsection (b) but that the county is not eligible to receive and the distribution of that money to other eligible counties.
Added by Acts 1999, 76th Leg., ch. 1377, Sec. 1.15, eff. Sept. 1, 1999.  Amended by Acts 2001, 77th Leg., ch. 1128, Sec. 3, eff. Sept. 1, 2001.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0185, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.040. Tax Information

Text of section effective until September 01, 2024
Sec. 61.040.  TAX INFORMATION.  The comptroller shall give the department information relating to:
(1)  the taxable value of property taxable by each county and each county's applicable general revenue tax levy for the relevant period;  and
(2)  the amount of sales and use tax revenue received by each county for the relevant period.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1991, 72nd Leg., 2nd C.S., ch. 6, Sec. 64, eff. Sept. 1, 1991.
Amended by:
Acts 2023, 88th Leg., R.S., Ch. 629 (H.B. 4510), Sec. 3, eff. September 1, 2024.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.040. Tax Information

Text of section effective on September 01, 2024
Sec. 61.040.  TAX INFORMATION.  (a)  For the purpose of determining eligibility for state assistance under this chapter, the department may require a county to provide the following information for the relevant period:
(1)  the taxable value of property taxable by the county;
(2)  the county's applicable general revenue tax levy; and
(3)  the amount of sales and use tax revenue received by the county.
(b)  The department shall prescribe the manner in which a county must provide the information described by Subsection (a).
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1991, 72nd Leg., 2nd C.S., ch. 6, Sec. 64, eff. Sept. 1, 1991.
Amended by:
Acts 2023, 88th Leg., R.S., Ch. 629 (H.B. 4510), Sec. 3, eff. September 1, 2024.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.041. County Reporting

Sec. 61.041.  COUNTY REPORTING.  (a)  The department shall establish monthly reporting requirements for a county seeking state assistance and establish procedures necessary to determine if the county is eligible for state assistance.
(b)  The department shall establish requirements relating to:
(1)  documentation required to verify the eligibility of residents to whom the county provides assistance;  and
(2)  county expenditures for health care services under Sections 61.028 and 61.0285.
(c)  The department may audit county records to determine if the county is eligible for state assistance.
(d)  The department shall establish annual reporting requirements for each county that is required to provide indigent health care under this chapter but that is not required to report under Subsection (a).  A county satisfies the annual reporting requirement of this subsection if the county submits information to the department as required by law to obtain an annual distribution under the Agreement Regarding Disposition of Settlement Proceeds filed on July 24, 1998, in the United States District Court, Eastern District of Texas, in the case styled The State of Texas v. The American Tobacco Co., et al., No. 5-96CV-91.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.16, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.042. Employment Services Program

Sec. 61.042.  EMPLOYMENT SERVICES PROGRAM.  (a)  A county may establish procedures consistent with those used by the commission under Chapter 31, Human Resources Code, for administering an employment services program and requiring an applicant or eligible resident to register for work with the Texas Workforce Commission.
(b)  The county shall notify all persons with pending applications and eligible residents of the employment service program requirements not less than 30 days before the program is established.
Added by Acts 1993, 73rd Leg., ch. 880, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 8.122, eff. Sept. 1, 1995.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0186, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.043. Prevention and Detection of Fraud

Sec. 61.043.  PREVENTION AND DETECTION OF FRAUD.  (a)  The county shall adopt reasonable procedures for minimizing the opportunity for fraud, for establishing and maintaining methods for detecting and identifying situations in which a question of fraud may exist, and for administrative hearings to be conducted on disqualifying persons in cases where fraud appears to exist.
(b)  Procedures established by a county for administrative hearings conducted under this section shall provide for appropriate due process, including procedures for appeals.
Added by Acts 1993, 73rd Leg., ch. 880, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter B. County Responsibility for Persons Not Residing in an Area Served by a Public Hospital or Hospital District › Section 61.044. Subrogation

Sec. 61.044.  SUBROGATION.  (a)  The filing of an application for or receipt of services constitutes an assignment of the applicant's or recipient's right of recovery from:
(1)  personal insurance;
(2)  other sources;  or
(3)  another person for personal injury caused by the other person's negligence or wrong.
(b)  A person who applies for or receives services shall inform the county, at the time of application or at any time during eligibility, of any unsettled tort claim that may affect medical needs and of any private accident or sickness insurance coverage that is or may become available.  An applicant or eligible resident shall inform the county of any injury that is caused by the act or failure to act of some other person.  An applicant or eligible resident shall inform the county as required by this subsection within 10 days of the date the person learns of the person's insurance coverage, tort claim, or potential cause of action.
(c)  A claim for damages for personal injury does not constitute grounds for denying or discontinuing services under this chapter.
(d)  A separate and distinct cause of action in favor of the county is hereby created, and the county may, without written consent, take direct civil action in any court of competent jurisdiction.  A suit brought under this section need not be ancillary to or dependent on any other action.
(e)  The county's right of recovery is limited to the amount of the cost of services paid by the county.  Other subrogation rights granted under this section are limited to the cost of the services provided.
(f)  An applicant or eligible resident who knowingly and intentionally fails to disclose the information required by Subsection (b) commits a Class C misdemeanor.
(g)  An applicant or eligible resident is subject to denial of services under this chapter following an administrative hearing.
Added by Acts 1993, 73rd Leg., ch. 880, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.051. Application of Subchapter

Sec. 61.051.  APPLICATION OF SUBCHAPTER.  (a)  This subchapter applies to health care services and assistance provided to a person who resides in the service area of a public hospital or hospital district.
(b)  For the purposes of this subchapter, a hospital is not considered to be a public hospital and is not responsible for providing care under this subchapter if the hospital:
(1)  is owned, operated, or leased by a municipality with a population of less than 5,500;
(2)  was leased before January 1, 1981, by a municipality that at the time of the lease did not have a legal obligation to provide indigent health care;  or
(3)  was established under Section 265.031.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 16, eff. Sept. 1, 1991.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.052. General Eligibility Provisions

Sec. 61.052.  GENERAL ELIGIBILITY PROVISIONS.  (a)  A public hospital or hospital district shall provide health care assistance to each eligible resident in its service area who meets:
(1)  the basic income and resources requirements established by the department under Sections 61.006 and 61.008 and in effect when the assistance is requested;  or
(2)  a less restrictive income and resources standard adopted by the hospital or hospital district serving the area in which the person resides.
(b)  If a public hospital used an income and resources standard during the operating year that ended before January 1, 1985, that was less restrictive than the income and resources requirements established by the department under Section 61.006, the hospital shall adopt that standard to determine eligibility under this subchapter.
(c)  If a public hospital did not use an income and resources standard during the operating year that ended before January 1, 1985, but had a Hill-Burton obligation during part of that year, the hospital shall adopt the standard the hospital used to meet the Hill-Burton obligation to determine eligibility under this subchapter.
(d)  A public hospital established after September 1, 1985, shall provide health care services to each resident who meets the income and resources requirements established by the department under Sections 61.006 and 61.008, or the hospital may adopt a less restrictive income and resources standard.  The hospital may adopt a less restrictive income and resources standard at any time.
(e)  If because of a change in the income and resources requirements established by the department under Sections 61.006 and 61.008 the standard adopted by a public hospital or hospital district becomes stricter than the requirements established by the department, the hospital or hospital district shall change its standard to at least comply with the requirements established by the department.
(f)  A public hospital or hospital district may contract with the department to perform eligibility determination services.
(g)  A county that provides health care services to its eligible residents through a hospital established by a board of managers jointly appointed by a county and a municipality under Section 265.011 and that establishes an income and resources standard in accordance with Subsection (a)(2) may credit the services provided to all persons who are eligible under that standard toward eligibility for state assistance as described by Section 61.037(e).
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.17, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.053. Application Procedure

Sec. 61.053.  APPLICATION PROCEDURE.  (a)  A public hospital or hospital district shall adopt an application procedure.
(b)  Not later than the beginning of a public hospital's or hospital district's operating year, the hospital or district shall specify the procedure it will use during the operating year to determine eligibility and the documentation required to support a request for assistance and shall make a reasonable effort to notify the public of the procedure.
(c)  The public hospital or hospital district shall furnish an applicant with written application forms.
(d)  On request of an applicant, the public hospital or hospital district shall assist an applicant in filling out forms and completing the application process.  The hospital or district shall inform an applicant of the availability of assistance.
(e)  The public hospital or hospital district shall require an applicant to sign a written statement in which the applicant swears to the truth of the information supplied.
(f)  The public hospital or hospital district shall explain to the applicant that if the application is approved, the applicant must report to the hospital or district any change in income or resources that might affect the applicant's eligibility.  The report must be made not later than the 14th day after the date on which the change occurs.  The hospital or district shall explain the possible penalties for failure to report a change.
(g)  The public hospital or hospital district shall review each application and shall accept or deny the application not later than the 14th day after the date on which the hospital or district receives the completed application.
(h)  The public hospital or hospital district shall provide a procedure for reviewing applications and for allowing an applicant to appeal a denial of assistance.
(i)  The public hospital or hospital district shall provide an applicant written notification of the hospital's or district's decision.  If the hospital or district denies assistance, the written notification shall include the reason for the denial and an explanation of the procedure for appealing the denial.
(j)  The public hospital or hospital district shall maintain the records relating to an application for at least three years after the date on which the application is submitted.
(k)  If an applicant is denied assistance, the applicant may resubmit an application at any time circumstances justify a redetermination of eligibility.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.054. Basic Health Care Services Provided by a Public Hospital

Sec. 61.054.  BASIC HEALTH CARE SERVICES PROVIDED BY A PUBLIC HOSPITAL.  (a)  Except as provided by Subsection (c), a public hospital shall endeavor to provide the basic health care services a county is required to provide under Section 61.028.
(b)  If a public hospital provided additional health care services to eligible residents during the operating year that ended before January 1, 1985, the hospital shall continue to provide those services.
(c)  A public hospital shall coordinate the delivery of basic health care services to eligible residents and may provide any basic health care services the hospital was not providing on January 1, 1999, but only to the extent the hospital is financially able to do so.
(d)  A public hospital may provide health care services in addition to basic health care services.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.18, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.055. Basic Health Care Services Provided by Hospital Districts

Sec. 61.055.  BASIC HEALTH CARE SERVICES PROVIDED BY HOSPITAL DISTRICTS.  (a)  Except as provided by Subsection (b), a hospital district shall endeavor to provide the basic health care services a county is required to provide under Section 61.028, together with any other services required under the Texas Constitution and the statute creating the district.
(b)  A hospital district shall coordinate the delivery of basic health care services to eligible residents and may provide any basic health care services the district was not providing on January 1, 1999, but only to the extent the district is financially able to do so.
(c)  This section may not be construed to discharge a hospital district from its obligation to provide the health care services required under the Texas Constitution and the statute creating the district.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.19, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.056. Provision of Health Care Services

Sec. 61.056.  PROVISION OF HEALTH CARE SERVICES.  (a)  A public hospital or hospital district may arrange to provide health care services through a local health department, a publicly owned facility, or a contract with a private provider regardless of the provider's location, or through the purchase of insurance for eligible residents.
(b)  The public hospital or hospital district may affiliate with other public hospitals or hospital districts or with a governmental entity to provide regional administration and delivery of health care services.
(c)  A hospital district created in a county with a population of more than 1.2 million that was not included in the boundaries of a hospital district before September 1, 2003, may affiliate with any public or private entity to provide regional administration and delivery of health care services.  The regional affiliation, in accordance with the affiliation agreement, shall use money contributed by an affiliated governmental entity to provide health care services to an eligible resident of that governmental entity.
Text of subsection as added by Acts 2009, 81st Leg., R.S., Ch. 916 (H.B. 2963), Sec. 3
(d)  A public hospital or hospital district may provide or arrange to provide health care services for eligible residents through the purchase of health coverage or other health benefits, including benefits described by Chapter 75.  For purposes of this subsection, the board of directors or managers of the hospital or district have the powers and duties provided to the commissioners court of a county under Chapter 75.
Text of subsection as added by Acts 2009, 81st Leg., R.S., Ch. 217 (S.B. 1063), Sec. 3
(d)  A hospital district created in a county with a population of more than 1.2 million that was not included in the boundaries of a hospital district before September 1, 2003, may provide or arrange to provide health care services for eligible residents through the purchase of health coverage or other health benefits, including benefits described by Chapter 75.  For purposes of this subsection, the board of managers of the district has the powers and duties provided to the commissioners court of a county under Chapter 75.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 164 (S.B. 1107), Sec. 3, eff. September 1, 2007.
Acts 2009, 81st Leg., R.S., Ch. 217 (S.B. 1063), Sec. 3, eff. May 27, 2009.
Acts 2009, 81st Leg., R.S., Ch. 916 (H.B. 2963), Sec. 3, eff. September 1, 2009.
Acts 2023, 88th Leg., R.S., Ch. 644 (H.B. 4559), Sec. 67, eff. September 1, 2023.
Acts 2023, 88th Leg., R.S., Ch. 644 (H.B. 4559), Sec. 68, eff. September 1, 2023.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.057. Mandated Provider

Sec. 61.057.  MANDATED PROVIDER.  A public hospital may select one or more providers of health care services.  A public hospital may require eligible residents to obtain care from a mandated provider except:
(1)  in an emergency;
(2)  when medically inappropriate;  or
(3)  when care is not available.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.058. Notification of Provision of Nonemergency Services

Sec. 61.058.  NOTIFICATION OF PROVISION OF NONEMERGENCY SERVICES.  (a)  A public hospital may require any provider, including a mandated provider, to obtain approval from the hospital before providing nonemergency health care services to an eligible resident in the hospital's service area.
(b)  If the public hospital does not require prior approval and a provider delivers or will deliver nonemergency health care services to a patient who the provider suspects might be eligible for assistance under this subchapter, the provider shall notify the hospital that health care services have been or will be provided to the patient.  The notice shall be made:
(1)  by telephone not later than the 72nd hour after the provider determines that the patient resides in the hospital's service area;  and
(2)  by mail postmarked not later than the fifth working day after the date on which the provider determines that the patient resides in the hospital's service area.
(c)  If the provider knows that the public hospital serving the area in which the patient resides has selected a mandated provider or if, after contacting the hospital, the hospital requests that the patient be transferred to a mandated provider, the provider shall transfer the patient to the mandated provider unless it is medically inappropriate to do so.
(d)  Not later than the 14th day after the date on which the public hospital receives sufficient information to determine eligibility, the hospital shall determine if the patient is eligible for assistance from the hospital.  If the hospital does not determine the patient's eligibility within that period, the patient is considered to be eligible.  The hospital shall notify the provider of its decision.
(e)  If a provider delivers nonemergency health care services to a patient who is eligible for assistance under this subchapter and fails to comply with this section, the provider is not eligible for payment for the services from the public hospital serving the area in which the patient resides.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.20, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.059. Notification of Provision of Emergency Services

Sec. 61.059.  NOTIFICATION OF PROVISION OF EMERGENCY SERVICES.  (a)  If a nonmandated provider delivers emergency services to a patient who the provider suspects might be eligible for assistance under this subchapter, the provider shall notify the hospital that emergency services have been or will be provided to the patient.  The notice shall be made:
(1)  by telephone not later than the 72nd hour after the provider determines that the patient resides in the hospital's service area;  and
(2)  by mail postmarked not later than the fifth working day after the date on which the provider determines that the patient resides in the hospital's service area.
(b)  The provider shall attempt to determine if the patient resides in a public hospital's service area when the patient first receives services.
(c)  The provider, the patient, and the patient's family shall cooperate with the public hospital in determining if the patient is an eligible resident of the hospital's service area.
(d)  Not later than the 14th day after the date on which the public hospital receives sufficient information to determine eligibility, the hospital shall determine if the patient is eligible for assistance from the hospital. If the hospital does not determine the patient's eligibility within that period, the patient is considered to be eligible.  The hospital shall notify the provider of its decision.
(e)  If the public hospital and the provider disagree on the patient's residence or eligibility, the hospital or the provider may submit the matter to the department as provided by Section 61.004.
(f)  If a provider delivers emergency services to a patient who is eligible for assistance under this subchapter and fails to comply with this section, the provider is not eligible for payment for the services from the public hospital serving the area in which the patient resides.
(g)  If emergency services are customarily available at a facility operated by a public hospital, that hospital is not liable for emergency services furnished to an eligible resident by another provider in the area the hospital has a legal obligation to serve.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.21, eff. Sept. 1, 1999;  Acts 2001, 77th Leg., ch. 1128, Sec. 4, eff. Sept. 1, 2001.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.060. Payment for Services

Sec. 61.060.  PAYMENT FOR SERVICES.  (a)  To the extent prescribed by this chapter, a public hospital is liable for health care services provided under this subchapter by any provider, including another public hospital, to an eligible resident in the hospital's service area.  A public hospital is not liable for payment for health care services provided to:
(1)  a person who does not reside in the hospital's service area;  or
(2)  an eligible resident of the hospital's service area by a hospital having a Hill-Burton or state-mandated obligation to provide free services and considered to be in noncompliance with the requirements of the Hill-Burton or state-mandated obligation.
(b)  A hospital district is liable for health care services as provided by the Texas Constitution and the statute creating the district.
(c)  A public hospital is the payor of last resort under this subchapter and is not liable for payment or assistance to an eligible resident in the hospital's service area if any other public or private source of payment is available.
(d)  If another source of payment does not adequately cover a health care service a public hospital provides to an eligible resident of the hospital's service area, the hospital shall pay for or provide the health care service for which other payment is not available.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.061. Payment Rates and Limits

Sec. 61.061.  PAYMENT RATES AND LIMITS.  The payment rates and limits prescribed by Sections 61.034 and 61.035 that relate to county services apply to inpatient and outpatient hospital services a public hospital is required to provide if:
(1)  the hospital cannot provide the services or emergency services that are required;  and
(2)  the services are provided by an entity other than the hospital.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.062. Responsibility of Governmental Entity

Sec. 61.062.  RESPONSIBILITY OF GOVERNMENTAL ENTITY.  A governmental entity that owns, operates, or leases a public hospital shall provide sufficient funding to the hospital to provide basic health care services.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.22, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.063. Procedure to Change Eligibility Standards or Services Provided

Sec. 61.063.  PROCEDURE TO CHANGE ELIGIBILITY STANDARDS OR SERVICES PROVIDED.  (a)  A public hospital may not change its eligibility standards to make the standards more restrictive and may not reduce the health care services it offers unless it complies with the requirements of this section.
(b)  Not later than the 90th day before the date on which a change would take effect, the public hospital must publish notice of the proposed change in a newspaper of general circulation in the hospital's service area and set a date for a public hearing on the change.  The published notice must include the date, time, and place of the public meeting.  The notice is in addition to the notice required by Chapter 551, Government Code.
(c)  Not later than the 30th day before the date on which the change would take effect, the public hospital must conduct a public meeting to discuss the change.  The meeting must be held at a convenient time in a convenient location in the hospital's service area.  Members of the public may testify at the meeting.
(d)  If, based on the public testimony and on other relevant information, the governing body of the hospital finds that the change would not have a detrimental effect on access to health care for the residents the hospital serves, the hospital may adopt the change.  That finding must be formally adopted.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(82), eff. Sept. 1, 1995.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.064. Transfer of a Public Hospital

Sec. 61.064.  TRANSFER OF A PUBLIC HOSPITAL.  (a)  A governmental entity that owns, operates, or leases a public hospital and that closes, sells, or leases the hospital:
(1)  has the obligation to provide basic health care services under this chapter;
(2)  shall adopt the eligibility standards that the hospital was or would have been required to adopt;  and
(3)  shall provide the same services the hospital was or would have been required to provide under this chapter on the date of the closing, sale, or lease.
(b)  If the governmental entity owned, operated, or leased the public hospital before January 1, 1985, and sold or leased the hospital on or after that date but before September 1, 1986, the obligation retained is the obligation the hospital would have had on September 1, 1986.
(c)  Notwithstanding Subsections (a) and (b), if a hospital district that owns, operates, or leases a public hospital dissolves, the district has no responsibility under this chapter.  If on or before dissolution the district sold or transferred its hospital to another governmental entity, that governmental entity assumes the district's responsibility to provide health care services in accordance with this subchapter.  If the district did not sell or transfer the hospital to another governmental entity, the county shall provide health care services to the residents of the district's service area in accordance with Subchapter B.
(d)  This section does not apply to a governmental entity that sold or leased a public hospital to a hospital district or a hospital authority on or after January 1, 1985, but before September 1, 1986.  If a governmental entity sold or leased a hospital as provided by this subsection, the hospital ceased being a public hospital for the purposes of this chapter on the date it was sold or leased, and neither the governmental entity nor the hospital district or hospital authority has any responsibility under this chapter.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1999, 76th Leg., ch. 1377, Sec. 1.23, eff. Sept. 1, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.065. County Responsibility for Hospital Sold on or After January 1, 1988

Sec. 61.065.  COUNTY RESPONSIBILITY FOR HOSPITAL SOLD ON OR AFTER JANUARY 1, 1988.  (a)  This section applies to a county that, on or after January 1, 1988, sells to a purchaser that is not a governmental entity a county hospital that was leased at the time of the sale to a person who is not a governmental entity.
(b)  On the date the hospital is sold, the hospital ceases being a public hospital for the purposes of this chapter, and the county shall provide health care services to county residents in accordance with Subchapter B.
(c)  If the contract for the sale of the hospital provides for the provision by the hospital of health care services to county residents, the value of the health care services credited or paid in a state fiscal year under the contract is included as part of the computation of a county expenditure under Section 61.037 to the extent that the value of the services does not exceed the payment standard established by department rule for allowed inpatient and outpatient services.
Added by Acts 1989, 71st Leg., ch. 1100, Sec. 5.10(c), eff. Sept. 1, 1989.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0187, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.066. Prevention and Detection of Fraud

Sec. 61.066.  PREVENTION AND DETECTION OF FRAUD.  (a)  A hospital district may adopt reasonable procedures for minimizing the opportunity for fraud, for establishing and maintaining methods for detecting and identifying situations in which a question of fraud may exist, and for administrative hearings to be conducted on disqualifying persons in cases where fraud appears to exist.
(b)  Procedures established by a hospital district for administrative hearings conducted under this section shall provide for appropriate due process, including procedures for appeals.
(c)  A hospital district may recover, from the eligible resident perpetrating a fraud, an amount equal to the value of any fraudulently obtained health care services provided to the eligible resident disqualified under this section.
Added by Acts 2001, 77th Leg., ch. 563, Sec. 1, eff. Aug. 27, 2001.
Amended by:
Acts 2011, 82nd Leg., R.S., Ch. 1320 (S.B. 303), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 61 - Indigent Health Care and Treatment Act › Subchapter C. Persons Who Reside in an Area Served by a Public Hospital or Hospital District › Section 61.068. Employment Services Program

Sec. 61.068.  EMPLOYMENT SERVICES PROGRAM.  (a)  A public hospital or hospital district may establish procedures consistent with those used by the commission under Chapter 31, Human Resources Code, for administering an employment services program and requiring an applicant or eligible resident to register for work with the Texas Workforce Commission.
(b)  The public hospital or hospital district shall notify each person with a pending application and all eligible residents of the requirements of the employment services program not less than 30 days before the program is established.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1206 (S.B. 304), Sec. 1, eff. June 17, 2011.
Redesignated from Health and Safety Code, Section 61.067 by Acts 2013, 83rd Leg., R.S., Ch. 161 (S.B. 1093), Sec. 22.001(24), eff. September 1, 2013.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0189, eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 62 - Child Health Plan for Certain Low-Income Children › Subchapter A. General Provisions › Section 62.001. Objective of the State Child Health Plan

Sec. 62.001.  OBJECTIVE OF THE STATE CHILD HEALTH PLAN.  The principal objective of the state child health plan is to provide primary and preventative health care to low-income, uninsured children of this state, including children with special health care needs, who are not served by or eligible for other state assisted health insurance programs.
Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30, 1999.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 62 - Child Health Plan for Certain Low-Income Children › Subchapter A. General Provisions › Section 62.002. Definitions

Sec. 62.002.  DEFINITIONS.  In this chapter:
(1)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 3.1639(22), eff. April 2, 2015.
(2)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 3.1639(22), eff. April 2, 2015.
(3)  "Health plan provider" means an insurance company, health maintenance organization, or other entity that provides health benefits coverage under the child health plan program.  The term includes a primary care case management provider network.
(4)  "Household income" means the sum of the individual incomes of each individual in an applicant's or enrollee's household, minus the standard income disregard prescribed by federal law.
Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30, 1999.  Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.45, eff. Sept. 1, 2003.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1353 (H.B. 109), Sec. 1, eff. June 15, 2007.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0190, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1639(22), eff. April 2, 2015.
2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle C - Programs Providing Health Care Benefits and Services › Chapter 62 - Child Health Plan for Certain Low-Income Children › Subchapter A. General Provisions › Section 62.003. Not an Entitlement; Termination of Program

Sec. 62.003.  NOT AN ENTITLEMENT;  TERMINATION OF PROGRAM.  (a)  This chapter does not establish an entitlement to assistance in obtaining health benefits for a child.
(b)  The program established under this chapter terminates at the time that federal funding terminates under Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended, unless a successor program providing federal funding for a state-designed child health plan program is created.
(c)  Unless the legislature authorizes the expenditure of other revenue for the program established under this chapter, the program terminates on the date that money obtained by the state as a result of the Comprehensive Settlement Agreement and Release filed in the case styled The State of Texas v. The American Tobacco Co., et al., No. 5-96CV-91, in the United States District Court, Eastern District of Texas, is no longer available to provide state funding for the program.
Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30, 1999.