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County sets hospital provider participation rate at 6% to maintain federal matching funds
Summary
Following a public hearing, the Williamson County Commissioners Court set the local provider participation fee (LPPF) at 6% for FY2026 after hospitals and consultants said the higher rate is needed to draw federal matching funds that support uncompensated care and behavioral-health payments.
The Williamson County Commissioners Court voted Sept. 23 to set the county’s local provider participation fee (LPPF) at 6% for fiscal year 2026 after a public hearing in which hospital representatives described the program’s role in drawing federal matching funds to reimburse uncompensated care and other Medicaid shortfalls.
Commissioner Long moved to set the rate at 6% and Commissioner Covey seconded; the court recorded the motion as carried 5–0. Robin Oldham, a consultant for Adelanto Healthcare Ventures, said the LPPF pools county hospital payments to create the state share that is matched by federal funds “about 2 to 1,” and that in prior years the program drew more than $540 million into the community. Oldham said the program now encompasses several subprograms (examples used in the hearing included CHIRP, ATLAS and a behavioral-health program) and that expanding the pool and program types supports drawing additional federal dollars.
Hospital representatives told the court they support the 6% rate. Bill Galinski of Baylor Scott & White said the funds are “invaluable” in caring for vulnerable patients and described how uncompensated-care claims and Medicaid shortfalls factor into hospitals’ finances. A hospital representative described the uncompensated-care reimbursement process as an aggregate claim covering uncompensated-costs after payments and charity care are applied, rather than an individual claim-by-claim reimbursement.
Members of the public spoke during the hearing. Some, including Bill Kelberlaw and Jim Dillon, criticized the LPPF process on policy grounds; others commended the hospitals’ community work. After public testimony the court set the rate by formal motion.
Under the LPPF, participating hospitals are assessed the rate set by the court and the pool created is used to fund the local share for state Medicaid matching programs that reimburse uncompensated care, behavioral-health services and other targeted payments. The county will publish administrative materials and the rate order for FY2026 as required by state rules.
The county recorded the action in the minutes; staff said participating hospitals will use the county-set rate to complete state reporting and matching procedures.
