Since the Texas Legislature authorized the first Local Provider Participation Funds (LPPFs) in 2013, LPPFs have joined public hospital funding to become an integral part of Texas’ Medicaid financing system. In addition to funds from public hospitals, LPPFs help bring $7 billion a year in additional Medicaid funds to Texas hospitals to reduce the shortfall from below-cost Medicaid reimbursement, and in some cases, charity care costs.