TX SB2655

Creates a county health care provider participation program for counties with population between 46,000 and 50,000 that are adjacent to Travis County (state capital) and not served by a hospital district or public hospital

Authorizes eligible counties to collect mandatory payments from nonpublic hospitals based on net patient revenue, assessed quarterly, with aggregate payments capped at 6% of total net patient revenue from hospital services

Establishes a local provider participation fund to deposit collected payments, which can only be used for intergovernmental transfers to fund the nonfederal share of Medicaid payments, including uncompensated care payments and directed payment programs for nonpublic hospitals

Requires commissioners court approval by majority vote, annual public hearings on payment amounts, and caps county administrative expenses at $20,000 annually plus collateralization costs

Prohibits hospitals from passing mandatory payments to patients as surcharges and explicitly bars using program funds to expand Medicaid eligibility under the Affordable Care Act