SB 1237 — An Act establishing the Pennsylvania Rural Health Redesign Center Authority and the Pennsylvania Rural Health Redesign Center Fund.

PRIOR PRINTER'S NO.

1959 THEPRINTER'S GENERALNO. ASSEMBLY OF PENNSYLVANIA SENATE BILL Session of No.

12372040 2018THE INTRODUCEDGENERAL BYASSEMBLY BAKER,OF SCHWANK,PENNSYLVANIA GORDNER,SENATE MENSCH,BILL ARGALL,Session EICHELBERGER,of BLAKE,No. HUTCHINSON AND BARTOLOTTA, AUGUST 23, 2018 REFERRED TO HEALTH AND HUMAN SERVICES, AUGUST 23, 2018 AN ACT Establishing the Pennsylvania Rural Health Redesign Center Authority and the Pennsylvania Rural Health Redesign Center Fund.

1237 2018 INTRODUCED BY BAKER, SCHWANK, GORDNER, MENSCH, ARGALL, EICHELBERGER, BLAKE, HUTCHINSON, BARTOLOTTA, YAW, STEFANO, WARD AND BROOKS, AUGUST 23, 2018 SENATOR BAKER, HEALTH AND HUMAN SERVICES, AS AMENDED, SEPTEMBER 26, 2018 AN ACT Establishing the Pennsylvania Rural Health Redesign Center Authority and the Pennsylvania Rural Health Redesign Center Fund.

20180SB1237PN2040 - 2 - (1) has a financial AN interest in one or more parties 20180SB1237PN1959<-- - 2 - involved in an action under section 303;

and (2) may have GAIN access to competitively sensitive or <-- strategically relevant information about a participating payer or participant rural hospital.

"Global budget model." An innovative payment and service delivery model that is intended to reduce health care costs while maintaining access to care, improving the quality of care in rural counties and meeting the health needs of participant rural hospitals' local communities, and under which 20180SB1237PN2040 - 3 - participating payers pay participant rural hospitals using a 20180SB1237PN1959 - 3 - global budget methodology established by the authority.

20180SB1237PN2040 - 4 - (3) A professional health service corporation as defined 20180SB1237PN1959 - 4 - in 40 Pa.C.S.

20180SB1237PN2040 - 5 - "Rural hospital." An acute care hospital or critical access 20180SB1237PN1959 - 5 - hospital located in a rural county.

"Rural hospital transformation plan." A description of the health care delivery system transformation that a participant rural hospital will undergo under the global budget model.model, AS <-- APPROVED BY THE BOARD AND THE FEDERAL GOVERNMENT.

20180SB1237PN2040 - 6 - (b) Composition.--The board shall consist of the following members:

20180SB1237PN1959 - 6 - (1) The secretary or a designee, who shall be an employee of the department designated in writing prior to service.

(4) One member selected collectively by each <-- participating payer that is an insurer, together with its parents, affiliates, subsidiaries, other associated entities and the successors of any of them, but excluding any affiliated, subsidiary or otherwise associated Medicaid managed care organizations.

(4) EACH PARTICIPATING PAYER THAT IS AN INSURER SHALL <-- SELECT ONE MEMBER ON BEHALF OF THE PARTICIPATING PAYER AND THE PARTICIPATING PAYER'S PARENTS, AFFILIATES, SUBSIDIARIES, OTHER ASSOCIATED ENTITIES AND SUCCESSORS.

THE SELECTION UNDER THIS PARAGRAPH SHALL EXCLUDE ANY AFFILIATED, SUBSIDIARY OR OTHERWISE ASSOCIATED MEDICAID MANAGED CARE ORGANIZATION.

(5) EACH PARTICIPATING PAYER THAT IS A MEDICAID MANAGED CARE ORGANIZATION SHALL SELECT ONE MEMBER.

This member shall be considered a participant rural hospital 20180SB1237PN2040 - 7 - member on the board.

The participant rural hospital members shall represent the participant rural hospitals and shall be selected from differentdifferent, GEOGRAPHICALLY DIVERSE participant <-- rural hospitals, and appointed as follows:

(i) The President pro tempore of the Senate, the Minority Leader of the Senate, the Speaker of the House of Representatives and the Minority Leader of the House 20180SB1237PN1959 - 7 - of the Representatives shall each appoint one member.

(8) Two members who are nationally recognized experts in RURAL HEALTH CARE DELIVERY OR IN developing and administering <-- global budgets AND who shall be appointed by the Governor.

<-- (c) Terms.--The terms of the members of the board shall be as follows:

If a member leaves the board prior to completing a four-year term due to change in professional status, including, but not limited to, retirement, changing jobsjobs, FAILURE TO QUALIFY or similar <-- reasons, a new member shall be appointed or selected within 60 days of the seat becoming vacant.

20180SB1237PN2040 - 8 - (d) Quorum.--A majority of the appointed members of the <-- board shall constitute a quorum.

7 (relating to 20180SB1237PN1959 - 8 - open meetings).

(2) Make, execute and deliver contracts, grants and 20180SB1237PN2040 - 9 - other instruments necessary or convenient to exercise the powers and duties of the board.

20180SB1237PN1959 - 9 - (4) Apply for, accept and administer grants and loans to carry out the purposes of the authority.

THIS SUBPARAGRAPH IS NOT INTENDED TO <-- 20180SB1237PN2040 - 10 - MEAN THAT THE BOARD MAY ACQUIRE RURAL HOSPITALS OR PARTICIPANT RURAL HOSPITALS.

Any placement of the funds by the State Treasurer in depositories or investments shall be consistent with 20180SB1237PN1959 - 10 - guidelines approved by the board.

20180SB1237PN2040 - 11 - (b) Global budget model.--The board is responsible for administering the global budget model and shall:

20180SB1237PN1959 - 11 - (5) Calculate, approve and administer global budgets.

(7) Review and approve any participant rural hospital <-- investments outside the global budget.

(8) (7) Assist rural hospitals and participant rural <-- hospitals in working with community-based organizations to determine the targeted population health improvement goals.

(9) (8) Evaluate the progress of the implementation of <-- each participant rural hospital's global budget toward population health improvement goals and the cost of achieving health care goals.

20180SB1237PN2040 - 12 - (10) (9) Monitor global budgets and quality metrics for <-- participant rural hospitals.

(11) (10) Provide an annual assessment of each <-- participant rural hospital's compliance with its rural hospital transformation plan and global budget targets.

(12) (11) Require a participant rural hospital to submit <-- a corrective action plan for failure to submit a rural hospital transformation plan, comply with its rural hospital transformation plan or meet its global budget targets.

(13) (12) Terminate a participant rural hospital from <-- the global budget model in accordance with the participant rural hospital's participation agreement.

20180SB1237PN1959 - 12 - (14) (13) Contract with an independent evaluation group <-- to provide the board and executive director with an evaluation of the global budget model's progress in the areas of population health, quality of care and cost targets.

(15) (14) Review and update the definition of "eligible <-- hospital services" by publishing a notice in the Pennsylvania Bulletin, subject to obtaining all necessary Federal approvals.

(2) The authority shall, by December 31 of each year, file a copy of the audit of the preceding Commonwealth fiscal year required under paragraph (1) with the Secretary of the Senate and the Chief Clerk of the House of Representatives 20180SB1237PN2040 - 13 - and provide a copy to the department.