85R8764 KFF-F     By: Klick, et al. H.B. No. 2454       A BILL TO BE ENTITLED   AN ACT   relating to the provision of a nursing facility quality-based   payment incentives program and a program to increase direct care   staff and wages under Medicaid.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Sections 32.028(g) and (i), Human Resources   Code, are amended to read as follows:          (g)  Subject to Subsection (i), the executive commissioner   shall ensure that the rules governing the determination of rates   paid for nursing facility services improve the quality of care by:                (1)  providing a program offering nursing facility   quality-based payment incentives and a program for increasing   direct care staff and direct care wages and benefits[, but only to   the extent that appropriated funds are available after money is   allocated to base rate reimbursements as determined by the   commission's nursing facility rate setting methodologies]; and                (2)  if appropriated funds are available after money is   allocated for payment of incentive-based rates under Subdivision   (1), providing incentives that incorporate the use of a quality of   care index, a customer satisfaction index, and a resolved   complaints index developed by the commission.          (i)  The executive commissioner shall ensure that rules   governing an [the] incentives program described by Subsection   (g)(1):                (1)  provide that participation in the program by a   nursing facility is voluntary;                (2)  do not impose on a nursing facility not   participating in the program a minimum spending requirement for   direct care staff wages and benefits;                (3)  do not set a base rate for a nursing facility   participating in the program that is more than the base rate for a   nursing facility not participating in the program; and                (4)  establish a funding process to provide incentives   for increasing direct care staff and direct care wages and benefits   in accordance with appropriations provided.          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.