| (a) Purpose. As required by federal and state law,
the Health and Human Services Commission (HHSC) requires a local jurisdiction
that operates a local provider participation fund (LPPF) to report
mandatory payments.
(b) Definitions.
(1) Institutional health care provider--A non-public
hospital that provides inpatient hospital services.
(2) Local jurisdiction--A non-state governmental entity
that operates an LPPF.
(3) Mandatory payment--A payment required to be made
to an LPPF based on the net patient revenue of a paying hospital.
(4) Paying hospital--An institutional health care provider
required to make a mandatory payment.
(5) Rate--The amount calculated for each paying hospital
to submit to the LPPF.
(c) A local jurisdiction that operates an LPPF must
report information to HHSC in a form and format to be determined by
HHSC as described in subsection (e) of this section.
(d) The information must be reported for each federal
fiscal quarter, no later than ten calendar days after the end of the
federal fiscal quarter. HHSC will open the information reporting system
prior to the end of the federal fiscal quarter.
(e) The report for each federal fiscal quarter must
include:
(1) the rate used to determine the mandatory payment;
(2) a list of all paying hospitals;
(3) the amount of the mandatory payment required of
each paying hospital;
(4) the amount of the mandatory payment received by
the LPPF from each paying hospital;
(5) the sum of the mandatory payments received by the
LPPF; and
(6) the purpose for which the LPPF funds were expended
or transferred and the amount and date for each transfer or expenditure.
(f) If a local jurisdiction that created an LPPF fails
to submit the required information, HHSC will not accept a transfer
of LPPF funds for any Medicaid program from the local jurisdiction
until the reporting requirement is satisfied.
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