The State Auditor’s Office (SAO) has the responsibility for developing reporting requirements for health related institutions’ practice plans according to Special Provisions Relating Only to State Agencies of Higher Education, Section 20, page III-241, and Section 22, page III-241, the General Appropriations Act (81st Legislature):
Sec. 20. Annual Reports of Health Related Institutions Practice Plans. As a limitation and restriction upon appropriations made by this Act, all agencies that have a public health related institution covered under Article III shall not expend funds after a period of 120 days following the close of the fiscal year, unless there has been filed with the Governor, the State Auditor, the Legislative Budget Board, the Legislative Reference Library, and the Comptroller of Public Accounts an annual report as of August 31 of the preceding fiscal year, showing the use of practice plan funds. The annual report shall conform to a uniform reporting system developed by the State Auditor's Office for all financial data concerning the health related institutions practice plans.
Sec. 22. Uncompensated Care Reporting Requirement. The public health-related institutions shall use the appropriations in this Act to include in their biennial legislative appropriations request information including the actual amount of uncompensated care provided through each institution’s respective physician practice plan, and if applicable, hospital or clinic using the uncompensated care reporting requirement established by the Health and Human Services Commission.
Uncompensated care includes the unreimbursed costs for the uninsured (those with no source of third party insurance) and the underinsured (those with insurance who after contractual adjustment and third party payments have a responsibility to pay for an amount they are unable to pay). Uncompensated care also includes the unreimbursed cost from governmental sponsored health programs. To calculate uncompensated care, charges will be converted to costs by application of a standard, auditable ratio of cost to charge and providers will recognize appropriate patient specific funding and lump sum funding available to offset costs. Any amounts received by the Physician Practice Plan from Upper Payment Limit shall be counted as payments received for uncompensated care.
The required format for reporting practice plans’ financial activity was revised in August 2010. The current format can be obtained here and should be used to report financial activity for all fiscal years ending on or after August 31, 2010.
All practice plan reports submitted to the SAO should be sent electronically to PracticePlanReporting@sao.texas.gov on or prior to the reporting deadline to ensure proper acknowledgement of receipt. This address also may be used to ask questions about the reporting requirements for practice plans.