H.B. No. 3348 establishes a County Health Care Provider Participation Program in certain Texas counties that lack a hospital district, introducing Chapter 292E to the Health and Safety Code. The program targets counties with specific population criteria, allowing them to collect mandatory payments from institutional health care providers to support local health initiatives. The bill outlines the responsibilities of the county commissioners court, including the need for a majority vote to authorize these payments and the creation of a local provider participation fund. Funds raised can be allocated for Medicaid payments for uncompensated care and related administrative expenses, with public hearings mandated to ensure transparency regarding the payment amounts and their intended uses.

Additionally, the bill sets forth new provisions for the assessment and collection of mandatory payments, establishing annual revenue limits for administrative expenses based on county classification, with caps ranging from $20,000 to $300,000. It prohibits hospitals from passing these mandatory payments onto patients and allows counties to contract for payment collection, with any fees directed to the county's general fund. The program aims to comply with federal requirements while minimizing financial liabilities for counties and health care providers. It includes reporting obligations to the Health and Human Services Commission and provisions for imposing interest and penalties on late payments. The act will take effect immediately upon a two-thirds vote from both legislative houses or on September 1, 2025, if that threshold is not achieved.

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