H.B. No. 4799 proposes the creation of a County Health Care Provider Participation Program in Texas for counties that are unserved by a hospital district or public hospital, have a population between 46,000 and 50,000, and are adjacent to the state capital. The bill introduces Chapter 292E to the Health and Safety Code, which establishes the framework for the program, allowing counties to collect mandatory payments from institutional health care providers to fund a local provider participation fund. This fund can be utilized for various health care-related expenses, including Medicaid payments and administrative costs. The bill outlines the powers and duties of the county commissioners court, requiring a majority vote to authorize the collection of these payments and mandating public hearings to ensure transparency.

Furthermore, the bill clarifies that the mandatory payments collected are not classified as taxes under the Texas Constitution and details the procedures for their assessment and collection, including potential collection fees. It allows counties to adopt alternative provisions to maintain eligibility for federal matching funds and prohibits the use of these payments for general revenue purposes. The legislation also includes a provision for delaying implementation if federal authorization is needed and specifies that it will take effect immediately upon a two-thirds vote from both houses or on September 1, 2025, if such a vote is not achieved.

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