Texas 2025 - 89th Regular

Texas House Bill HB2402

Filed
2/4/25  
Out of House Committee
4/23/25  
Voted on by House
5/2/25  
Out of Senate Committee
5/22/25  
Voted on by Senate
5/23/25  
Governor Action
6/20/25  

Caption

Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.

Impact

If enacted, HB2402 is expected to streamline the fee determination process for Medicaid services in Texas. This bill mandates that any fees charged must align with what is customary in the local community, potentially leading to better predictability in budgeting for both healthcare providers and recipients. Furthermore, it acknowledges that the implementation of this act might require waivers or authorizations from federal agencies, highlighting a necessary aspect of compliance with overarching federal laws governing Medicaid.

Summary

House Bill 2402 focuses on the determination of fees, charges, and rates for certain benefits under the Medicaid program in Texas. The proposed changes amend existing provisions to clarify that the fee or charge is the usual and customary fee prevailing in the community, unless restricted by state or federal law. This clarification is significant as it aims to standardize reimbursements for services under Medicaid, which could positively impact healthcare providers and beneficiaries by promoting fair billing practices.

Sentiment

The sentiment surrounding HB2402 appears to be generally supportive among stakeholders who focus on Medicaid services, particularly among healthcare providers who advocate for consistency and clarity in billing. Proponents argue that this bill helps ensure that providers receive fair compensation, while patients can be assured of accessing services that are billed at standard rates. However, there may also be concerns regarding the impact on Medicaid funding and the sufficiency of reimbursements for certain specialized services.

Contention

Notable points of contention may arise around how fees are determined and the local interpretation of 'usual and customary' charges. Healthcare advocates might push for a more nuanced understanding of community-specific needs, suggesting that the bill could inadvertently favor larger healthcare entities over smaller practices, which may struggle with the implications of the revised fee structure. The requirement for federal waivers could also lead to delays and complications in implementing the bill's provisions.

Companion Bills

TX SB1112

Identical Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.

Previously Filed As

TX SB1112

Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.

TX A1909

Requires DHS to disregard certain federal pension benefits for veterans in making Medicaid eligibility determinations.

TX S3802

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

TX A4265

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

TX HB4273

Relating to fraud prevention and verifying eligibility for benefits under Medicaid.

TX SB961

Relating to fraud prevention and verifying eligibility for benefits under Medicaid.

TX A4342

Establishes program for certain individuals to become certified homemaker-home health aides and provide services to certain Medicaid and Medicaid-Medicare dually eligible enrollees under increased reimbursement rates.

TX S3905

Establishes program for certain individuals to become certified homemaker-home health aides and provide services to certain Medicaid and Medicaid-Medicare dually eligible enrollees under increased reimbursement rates.

TX LB197

Change provisions relating to disqualification for benefits, claim determinations, and claim redeterminations under the Employment Security Law

TX HB455

Medical records; persons seeking disability benefits may obtain at no charge until determination of disability.

Similar Bills

No similar bills found.