(a) Except as provided by Subsection (f), if the commissioners court of a county authorizes a program under this chapter, the commissioners court shall require an annual mandatory payment to be assessed on the net patient revenue of each institutional health care provider located in the county. The commissioners court shall provide for the mandatory payment to be assessed quarterly. In the first year in which the mandatory payment is required, the mandatory payment is assessed on the net patient revenue of an institutional health care provider as determined by the data reported to the Department of State Health Services under Sections 311.032 and 311.033 in the most recent fiscal year for which that data was reported. If the institutional health care provider did not report any data under those sections, the provider's net patient revenue is the amount of that revenue as contained in the provider's Medicare cost report submitted for the most recent fiscal year for which the provider submitted the Medicare cost report. The commissioners court shall update the amount of the mandatory payment on an annual basis.
(b) The commissioners court of a county that requires a mandatory payment under this chapter shall provide each institutional health care provider on which the payment will be assessed written notice of an assessment under this chapter. The institutional health care provider must pay the assessment not later than the 30th day after the date the provider receives the written notice.
(c) The amount of a mandatory payment authorized under this chapter must be uniformly proportionate with the amount of net patient revenue generated by each paying hospital in the county. A program may not hold harmless any institutional health care provider, as required under 42 U.S.C. Section 1396b(w) and 42 C.F.R. Section 433.68.
(d) The commissioners court of a county that requires a mandatory payment under this chapter shall set the amount of the mandatory payment. The aggregate amount of the mandatory payment required of all paying hospitals in the county may not exceed six percent of the aggregate net patient revenue from hospital services provided by all paying hospitals in the county.
(e) Subject to Subsection (d), the commissioners court of a county that requires a mandatory payment under this chapter shall set the mandatory payments in amounts that in the aggregate will generate sufficient revenue to cover the administrative expenses of the county for activities under this chapter and to fund an intergovernmental transfer described by Section 292E.103 (b)(1). The annual amount of revenue from mandatory payments that may be used to pay the administrative expenses of the county for activities under this chapter may not exceed the following amounts, plus the collateralization of deposits, regardless of the actual expenses:
(1) for a county described by Section 292E.002 (2)(A), $20,000;
(2) for a county described by Section 292E.002 (2)(B), $150,000; or
(3) for a county described by Section 292E.002 (2)(C), $300,000.
(f) A paying hospital may not add a mandatory payment required under this section as a surcharge to a patient.
Added by Acts 2025, 89th Leg., R.S., Ch. 621 (H.B. 3348 ), Sec. 1, eff. June 20, 2025.
