Texas Health & Safety Code - Section 311.031. Definitions
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§ 311.031. DEFINITIONS. In this subchapter:
(1) "Board" means the Texas Board of Health.
(2) "Charity care" means the unreimbursed cost to a
hospital of:
(A) providing, funding, or otherwise financially
supporting health care services on an inpatient or outpatient basis
to a person classified by the hospital as "financially indigent" or
"medically indigent"; and/or
(B) providing, funding, or otherwise financially
supporting health care services provided to financially indigent
persons through other nonprofit or public outpatient clinics,
hospitals, or health care organizations.
(3) "Contractual allowances" means the difference
between revenue at established rates and amounts realizable from
third-party payors under contractual agreements.
(4) "Department" means the Texas Department of Health.
(5) "Donations" means the unreimbursed costs of
providing cash and in-kind services and gifts, including
facilities, equipment, personnel, and programs, to other nonprofit
or public outpatient clinics, hospitals, or health care
organizations.
(6) "Education-related costs" means the unreimbursed
cost to a hospital of providing, funding, or otherwise financially
supporting educational benefits, services, and programs including:
(A) education of physicians, nurses,
technicians, and other medical professionals and health care
providers;
(B) provision of scholarships and funding to
medical schools, colleges, and universities for health professions
education;
(C) education of patients concerning diseases
and home care in response to community needs; and
(D) community health education through
informational programs, publications, and outreach activities in
response to community needs.
(7) "Financially indigent" means an uninsured or
underinsured person who is accepted for care with no obligation or a
discounted obligation to pay for the services rendered based on the
hospital's eligibility system.
(8) "Government-sponsored indigent health care" means
the unreimbursed cost to a hospital of providing health care
services to recipients of Medicaid and other federal, state, or
local indigent health care programs, eligibility for which is based
on financial need.
(9) "Health care organization" means a nonprofit or
public organization that provides, funds, or otherwise financially
supports health care services provided to financially indigent
persons.
(10) "Hospital" means:
(A) a general or special hospital licensed under
Chapter 241;
(B) a private mental hospital licensed under
Chapter 577; and
(C) a treatment facility licensed under Chapter
464.
(11) "Hospital eligibility system" means the
financial criteria and procedure used by a hospital to determine if
a patient is eligible for charity care. The system shall include
income levels and means testing indexed to the federal poverty
guidelines; provided, however, that a hospital may not establish
an eligibility system which sets the income level eligible for
charity care lower than that required by counties under Section
61.023 or higher, in the case of the financially indigent, than 200
percent of the federal poverty guidelines. A hospital may
determine that a person is financially or medically indigent
pursuant to the hospital's eligibility system after health care
services are provided.
(12) "Hospital system" means a system of local
nonprofit hospitals under the common governance of a single
corporate parent that are located within a radius of not more than
125 linear miles of the corporate parent.
(13) "Medically indigent" means a person whose medical
or hospital bills after payment by third-party payors exceed a
specified percentage of the patient's annual gross income,
determined in accordance with the hospital's eligibility system,
and the person is financially unable to pay the remaining bill.
(14) "Research-related costs" means the unreimbursed
cost to a hospital of providing, funding, or otherwise financially
supporting facilities, equipment, and personnel for medical and
clinical research conducted in response to community needs.
(15) "Subsidized health services" means those
services provided by a hospital in response to community needs for
which the reimbursement is less than the hospital's cost for
providing the services and which must be subsidized by other
hospital or nonprofit supporting entity revenue sources.
Subsidized health services may include but are not limited to:
(A) emergency and trauma care;
(B) neonatal intensive care;
(C) free-standing community clinics; and
(D) collaborative efforts with local government
or private agencies in preventive medicine, such as immunization
programs.
(16) "Unreimbursed costs" means the costs a hospital
incurs for providing services after subtracting payments received
from any source for such services including but not limited to the
following: third-party insurance payments; Medicare payments;
Medicaid payments; Medicare education reimbursements; state
reimbursements for education; payments from drug companies to
pursue research; grant funds for research; and disproportionate
share payments. For purposes of this definition, the term "costs"
shall be calculated by applying the cost to charge ratios derived in
accordance with generally accepted accounting principles for
hospitals to billed charges. The calculation of the cost to charge
ratios shall be based on the most recently completed and audited
prior fiscal year of the hospital or hospital system. Prior to
January 1, 1996, for purposes of this definition, charitable
contributions and grants to a hospital, including transfers from
endowment or other funds controlled by the hospital or its
nonprofit supporting entities, shall not be subtracted from the
costs of providing services for purposes of determining
unreimbursed costs. After January 1, 1996, for purposes of this
definition, charitable contributions and grants to a hospital,
including transfers from endowment or other funds controlled by the
hospital or its nonprofit supporting entities, shall not be
subtracted from the costs of providing services for purposes of
determining the unreimbursed costs of charity care and
government-sponsored indigent health care.
Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989. Amended
by Acts 1993, 73rd Leg., ch. 360, § 1, eff. Sept. 1, 1993; Acts
1993, 73rd Leg., ch. 705, § 6.01, eff. Sept. 1, 1993; Acts 1995,
74th Leg., ch. 781, § 1, eff. Sept. 1, 1995.
Section: 311.002 311.0025 311.003 311.021 311.022 311.023 311.024 311.031 311.032 311.033 311.0335 311.035 311.036 311.037 311.039
Last modified: August 11, 2007
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