Grayson County commissioners will hold a public hearing Tuesday, Nov. 17, on a reworked rate for the payments the county's private hospitals make into its Local Provider Participation Fund, money that helps draw down federal Medicaid dollars.
The fund collects a mandatory payment from each nonpublic hospital in the county. Under a state law written for certain counties along the Red River, that revenue can be sent to the state as intergovernmental transfers that cover the local share of supplemental Medicaid payments.
The court set the 2026 payments on Sept. 22. Since then, the Texas Health and Human Services Commission has said there is good cause for a new rule: payments for tax periods starting Oct. 1, 2026, or later must be charged separately on each hospital's inpatient revenue and its outpatient revenue, both taken from its most recent Medicare cost report.
The proposed order sets the rate at 6% of each. It also creates a new bank account for the fund, which the agency requested. A separate item would add the requirement to the local rules the county has used since August 2017.
Who would pay
A county rate analysis attached to the agenda, built on 2024 net patient revenue of about $577.2 million, lists these totals for the year:
| Hospital | Payment | |---|---| | Texoma Medical Center | $27,784,773 | | Baylor Scott & White Surgical Hospital at Sherman | $3,312,507 | | Sherman Medical Center | $1,411,843 | | Carrus Specialty Hospital | $795,661 | | Carrus Rehabilitation Hospital | $778,473 | | Carrus Behavioral Hospital | $551,351 |
That adds up to $34,634,608, collected in four quarterly installments of about $8.66 million. The same sheet projects $83.5 million in reimbursement, which it calls a 241% return, while noting that figure assumes every dollar collected goes to the non-federal share of supplemental Medicaid programs.
