H.B. No. 3348 establishes a County Health Care Provider Participation Program in certain Texas counties that lack a hospital district, specifically targeting those with populations between 46,000 and 50,000 adjacent to the state capital, counties with populations of 900,000 or more bordering two counties with populations of two million or more, and counties with populations of one million or more next to a county with a population of 2.5 million or more. The bill introduces Chapter 292E to the Health and Safety Code, which outlines the program's definitions, applicability, and operational framework, allowing counties to collect mandatory payments from institutional health care providers to fund local health care services.

The bill delineates the powers and duties of the county commissioners court, requiring a majority vote to authorize mandatory payments and to establish a local provider participation fund. It specifies that collected funds can be utilized for Medicaid payments for uncompensated care and administrative expenses, while also mandating public hearings for transparency. Additionally, the bill sets annual revenue limits for administrative expenses based on county classification, prohibits hospitals from passing mandatory payments onto patients, and allows counties to contract for payment collection with a fee cap. It also includes provisions for compliance with federal requirements, reporting to the Health and Human Services Commission, and the imposition of interest and penalties on delinquent payments. The bill will take effect immediately upon a two-thirds vote or on September 1, 2025, if that threshold is not met.

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