TX SB1578

Authorizes counties with populations over 900,000 that border two counties each with 2 million+ residents and are not served by a hospital district to establish a health care provider participation program

Allows commissioners courts to require mandatory payments from nonpublic hospitals providing inpatient services, assessed on net patient revenue and capped at 6% of aggregate net patient revenue from all paying providers

Creates a local provider participation fund to collect mandatory payments, which can only be used for intergovernmental transfers to fund the nonfederal share of Medicaid supplemental payments, uncompensated care, and directed payment programs for nonpublic hospitals

Limits annual administrative expenses paid from mandatory payment revenue to $150,000 plus collateralization costs, and prohibits hospitals from passing mandatory payments to patients as surcharges

Prohibits funds from being used to expand Medicaid eligibility under the Affordable Care Act or to fund the Medicaid disproportionate share hospital program, with an effective date of September 1, 2025