995150                                                     
GENERAL APPROPRIATIONS BILL                          Committee       Amendment
SB2500                                                  AHS              29


Senator(s) Flores moved the following amendment:

Section: 20              EXPLANATION:

On Page: 408             Amends language in Section 20 to add an effective 
                         date, and clarify that managed care payments to 
Spec App:                hospitals, which are based on Enhanced Ambulatory 
                         Patient Groupings, shall be recalculated.

NET IMPACT ON:            Total Funds       General Revenue          Trust Funds
    Recurring -                    0                     0                    0 
Non-Recurring -                    0                     0                    0 
______________________________________________________________________________________

                                               Positions & Amount   Positions & Amount
                                                     DELETE         INSERT

        AGENCY FOR HEALTH CARE ADMINISTRATION  68000000

        In Section 20  On Page 408

In Section 20, on Page 408, DELETE the following:

Within 15 days of this section becoming a law, the Agency for Health 
Care Administration shall calculate a hospital outpatient statewide and 
individual hospital outpatient rates using actual hospital outpatient 
claims with first date of service on or after July 1, 2017 for which 
payment was determined using the Enhanced Ambulatory Patient Grouping 
payment method. The re-calculated rates, in the aggregate, shall be 
equivalent to the average unit cost paid for hospital outpatient claims 
in State Fiscal Year 2016-17.

The Agency for Health Care Administration shall post the re-calculated 
rates within 45 days of this section becoming a law.  The re-calculated 
rates shall be used to make payments for the remainder of the fiscal 
year. These payments shall be sufficient to maintain budget neutrality 
in the aggregate, and must adhere to the Enhanced Ambulatory Patient 
Grouping 5% cap on hospital gains and losses transition period described 
in the State Fiscal Year 2017-18 General Appropriations Act for the 
entire Fiscal Year 2017-2018. 

AND INSERT:

Within 15 days of this section becoming a law, the Agency for Health 

 995150  Log:0045  TMK/TMK           02/05/18 06:34:57 PM  Senate  Page: 1
Care Administration shall calculate a hospital outpatient statewide and 
individual hospital outpatient rates using actual hospital outpatient 
claims with first date of service on or after July 1, 2017, for which 
payment was determined using the Enhanced Ambulatory Patient Grouping 
(EAPG) payment method. The re-calculated rates, in the aggregate, shall 
be equivalent to the average unit cost paid for hospital  outpatient 
claims in Fiscal Year 2016-2017.

The Agency for Health Care Administration shall post the re-calculated  
rates within 45 days of this section becoming a law to be effective 
April 1, 2018.  The re-calculated rates shall be used to make payments 
for the remainder of Fiscal Year 2017-2018.  These payments shall be 
sufficient to maintain budget neutrality in the aggregate, and must 
adhere to the Enhanced Ambulatory Patient Grouping five percent cap on 
hospital gains and losses transition period described in the Fiscal Year 
2017-2018 General Appropriations Act for the Fiscal Year 2017-2018.
               
Managed care payments to hospitals which are based upon EAPG payment 
rates shall be based upon these recalculated rates.  This section shall 
take effect upon becoming a law.































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