Bill > SB1112

This bill modifies the Texas Human Resources Code by changing how Medicaid fees, charges, and rates are determined. Specifically, the bill clarifies that when calculating the usual and customary fee for medical assistance, the state commission must exclude any fee or rate that is part of a fee-based membership discount program. This means that rates offered through membership programs will not be considered when setting Medicaid reimbursement rates, potentially preventing those discounted rates from artificially lowering the standard rates. The bill includes a standard provision allowing state agencies to delay implementation if they determine a federal waiver is necessary, and it is set to take effect on September 1, 2025. This change appears aimed at ensuring more accurate and fair compensation rates for medical services under the Medicaid program by preventing potential rate manipulations through membership discount programs.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=SB1112