Relating to the creation and operations of a health care provider participation program in certain counties.

New Chapter 292F creates a comprehensive county health care provider participation program with detailed provisions for mandatory payments, fund management, and expiration dates.

Eligibility criteria for counties were updated to include counties with 900,000+ population that border two 2-million+ population counties, expanding beyond the original 1-million+ population threshold.

New definitions for 'institutional health care provider' and 'paying provider' clarify which entities are subject to mandatory payments.

New requirements include public hearings before setting payment amounts, majority vote approval by commissioners court, and annual updates to payment amounts based on provider revenue data.

Mandatory payments are capped at 6% of aggregate net patient revenue from all paying providers in the county, with administrative expenses limited to $150,000 plus collateralization costs.

Program authority expires December 31, 2030, replacing the previous September 1, 2030 expiration date, with immediate effect requiring a two-thirds legislative vote or September 1, 2025 if not achieved.

New provisions require written notice to providers before assessments, prohibit adding payments as patient surcharges, and mandate transfer of remaining funds to providers when the program expires.