(a) Each county that collects a mandatory payment authorized under this chapter shall create a local provider participation fund.
(b) The local provider participation fund of a county consists of:
(1) all revenue received by the county attributable to mandatory payments authorized under this chapter, including any penalties and interest attributable to delinquent payments;
(2) money received from the Health and Human Services Commission as a refund of an intergovernmental transfer from the county to the state for the purpose of providing the nonfederal share of Medicaid supplemental payment program payments, provided that the intergovernmental transfer does not receive a federal matching payment; and
(3) the earnings of the fund.
(c) Money deposited to the local provider participation fund may be used only to:
(1) fund intergovernmental transfers from the county to the state to provide the nonfederal share of Medicaid payments for:
(A) uncompensated care payments to nonpublic hospitals, if those payments are authorized under the Texas Healthcare Transformation and Quality Improvement Program waiver issued under Section 1115 of the federal Social Security Act (42 U.S.C. Section 1315), or a successor waiver program authorizing similar Medicaid supplemental payment programs;
(B) uniform rate enhancements for nonpublic hospitals in the Medicaid managed care service area in which the county is located;
(C) payments available under another waiver program authorizing payments that are substantially similar to Medicaid payments to nonpublic hospitals described by Paragraph (A) or (B);
(D) payments to Medicaid managed care organizations that are dedicated for payment to hospitals; or
(E) any reimbursement to nonpublic hospitals for which federal matching funds are available;
(2) subject to Section 292D.151 (d), pay the administrative expenses of the county in administering the program, including collateralization of deposits;
(3) refund all or a portion of a mandatory payment collected in error from a paying hospital;
(4) refund to paying hospitals a proportionate share of the money attributable to mandatory payments collected under this chapter that the county:
(A) receives from the Health and Human Services Commission that is not used to fund the nonfederal share of Medicaid supplemental payment program payments; or
(B) determines cannot be used to fund the nonfederal share of Medicaid supplemental payment program payments;
(5) transfer funds to the Health and Human Services Commission if the county is legally required to transfer the funds to address a disallowance of federal matching funds with respect to payments, rate enhancements, and reimbursements for which the county made intergovernmental transfers described by Subdivision (1); and
(6) reimburse the county if the county is required by the rules governing the uniform rate enhancement program described by Subdivision (1)(B) to incur an expense or forego Medicaid reimbursements from the state because the balance of the local provider participation fund is not sufficient to fund that rate enhancement program.
(d) Money in the local provider participation fund may not be commingled with other county funds.
(e) Notwithstanding any other provision of this chapter, with respect to an intergovernmental transfer of funds described by Subsection (c)(1) made by the county, any funds received by the state or county as a result of the transfer may not be used by the state, county, or any other entity to:
(1) expand Medicaid eligibility under the Patient Protection and Affordable Care Act (Pub. L. No. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. No. 111-152); or
(2) fund the nonfederal share of payments to nonpublic hospitals available through the Medicaid disproportionate share hospital program.
Added by Acts 2023, 88th Leg., R.S., Ch. 632 (H.B. 4835 ), Sec. 1, eff. September 1, 2025.
SUBCHAPTER D. MANDATORY PAYMENTS
