H.B. No. 5231 aims to enhance clarity and certainty in the administration and operation of Medicaid in Texas. The bill introduces new provisions to the Human Resources Code and the Government Code. Specifically, it adds a new subsection to Section 32.0231, which mandates that the commission must determine, through the rulemaking process, whether to exclude or limit any benefits under the medical assistance program on a prospective basis, unless such actions are required by state or federal law. Additionally, it amends Section 544.0502 to prevent the office of the inspector general from recovering payments made to Medicaid providers for waste or abuse discovered after four years from the payment date.

The bill also stipulates that any recovery efforts for payments sought after the effective date of the Act will apply regardless of when the payment was made. Furthermore, it allows state agencies to delay the implementation of any provision of the Act if a waiver or authorization from a federal agency is necessary. The provisions of this Act are set to take effect on September 1, 2025.

Statutes affected:
Introduced: Human Resources Code 32.0231 (Human Resources Code 32)