Bill > HB5231

This bill introduces two key changes to Medicaid administration in Texas. First, it requires the state health commission to use a formal rulemaking process to determine whether to exclude or limit medical assistance program benefits on a prospective basis, unless such exclusions are mandated by state or federal law. Second, the bill places a four-year statute of limitations on the state's Office of the Inspector General's ability to recover payments from Medicaid providers for waste or abuse, meaning that after four years from the original payment date, the office cannot seek recovery. The bill includes a provision allowing state agencies to delay implementation if they determine federal waivers or authorizations are necessary, and it is set to take effect on September 1, 2025. These changes aim to provide more clarity and certainty in Medicaid administration by establishing clear guidelines for benefit determinations and limiting the timeframe for payment recoveries.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB5231