Notice of Proposed Local Provider Participation Fund for Bexar County Hospital District Through Fiscal Year 2027 Exclusive and separate mandatory participation payments of up to $6.00 per $100.00 of net patient revenue attributable to inpatient hospital services and up to $6.00 per $100.00 of net patient revenue attributable to outpatient hospital services have been proposed for adoption by the governing body of the Bexar County Hospital District d/b/a University Health for the 2027 fiscal year of the fund's assessment(s), beginning January 1, 2027 and ending December 31, 2027. Under State law, only hospitals are required to make this payment, and hospitals are prohibited from passing through the cost of this payment as a surcharge on patients' bills. State law requires that a public hearing be held by the governing body before adopting the mandatory payments. The money deposited to the local provider participation fund may be used to fund the nonfederal share of Medicaid supplemental payments under the Texas Healthcare Transformation and Quality Improvement Program waiver or uniform rate enhancements for nonpublic hospitals in the Bexar Medicaid managed care service area. PROPOSED MAXIMUM ASSESSMENT RATE—REVENUE ATTRIBUTABLE TO INPATIENT HOSPITAL SERVICES: up to $6.00 per $100.00 AND PROPOSED MAXIMUM ASSESSMENT RATE—REVENUE ATTRIBUTABLE TO OUTPATIENT HOSPITAL SERVICES: up to $6.00 per $100.00 THE MANDATORY PAYMENT UNDER THE ABOVE RATE CAN BE CALCULATED AS FOLLOWS: Mandatory Payment Amount = (.060 X Net Patient Revenue Attributable to Inpatient Hospital Services) AND Mandatory Payment Amount = (.060 X Net Patient Revenue Attributable to Outpatient Hospital Services) The net patient revenue values attributable to inpatient and outpatient hospital services will be calculated using the Medicare Cost Report and based on the charge lines from the Medicare Upper Payment Limit Guidelines issued by the Centers for Medicare and Medicaid Services. Mandatory assessment funds attributable to the 2027 fiscal year assessment period will be deposited into a separate depository account from the depository account into which funds from mandatory assessments attributable to prior assessment periods are deposited. You are advised to observe the following public hearing and express your views regarding any matter relating to the proposed mandatory payments. Hearing: October 27, 2026 at 6:00 pm at the Cypress Room, University Hospital, 4502 Medical Drive, San Antonio, Texas 78229. For assistance or detailed information about assessment calculations, please contact: Reed Hurley Chief Financial Officer 4502 Medical Drive San Antonio, TX 78229 Telephone: (210) 358-2101 Email: BCHD.LPPF@uhs-sa.com IPLSAE0168876