S.B. No. 1578 proposes the creation of a County Health Care Provider Participation Program for specific Texas counties that lack a hospital district, have populations over 900,000, and border two counties with populations of two million or more. The bill introduces Chapter 292E to the Health and Safety Code, detailing the program's definitions, applicability, and operational framework. It allows these counties to collect mandatory payments from institutional health care providers to establish a local provider participation fund, which can be utilized for various health care expenses, including Medicaid payments and administrative costs. Key provisions require public hearings on the payments, written notices to affected providers, and ensure that payments are proportionate to each provider's net patient revenue, with a cap of six percent on total mandatory payments.

The bill also includes new sections regarding the assessment and collection of these mandatory payments, specifically for funding the nonfederal share of certain Medicaid programs. Under Section 292E.152, counties can collect or contract for these payments, with a provision for a collection fee that must be deposited into the county general fund if collected by a county official. Section 292E.153 outlines the limitations on counties' authority to collect these payments, ensuring they are only for Medicaid-related expenses and not for general revenue. Additionally, the bill allows state agencies to delay implementation until necessary federal waivers are obtained, with an effective date of September 1, 2025.

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