TO:	Honorable Garnet Coleman, Chair, House Committee on County Affairs
FROM:	John McGeady, Assistant Director     Sarah Keyton, Assistant Director Legislative Budget Board
IN RE:	HB4548 by Wray (Relating to the creation and operations of health care provider participation programs in certain counties.), As Introduced

The bill amends the Health and Safety Code to add Chapter 299, which authorizes a health care provider participation program in a certain county. The provisions of this bill apply to a county that 1) is adjacent to two counties with a population of 1,000,000 or more and 2) borders the Trinity River. A health care provider participation program would allow a county to collect a mandatory payment from non-public hospitals to fund intergovernmental transfers, subsidize indigent programs and for payments to Medicaid managed care organizations that are dedicated for payment to hospitals. Intergovernmental transfers are used by the Health and Human Services Commission (HHSC) as the nonfederal share to draw down Medicaid supplemental payments.

The nonfederal share of Texas Medicaid supplemental payments is provided largely by local public funds provided to HHSC by intergovernmental transfer. The bill's provisions do not contain any implications for state General Revenue funds. HHSC reports that there would be no significant fiscal impact to the agency resulting from implementation of the bill. It is assumed that HHSC would absorb any administrative costs using existing resources.

The bill would take effect on September 1, 2019, or immediately with a vote of two-thirds of all members in both houses.

Local Government Impact

Because the bill would not have statewide impact on units of local government of the same type or class, no comment from this office is required by the rules of the House as to its probable fiscal implication on units of local government.