Texas HB5231 amends Medicaid rules to clarify benefit exclusions and limit recovery of payments after four years.

Texas HB5231 amends the Human Resources Code to require the commission to prospectively determine benefit exclusions or limitations in Medicaid, unless mandated by law. It also modifies the Government Code to prohibit the office of the inspector general from recovering payments from Medicaid providers for waste or abuse discovered more than four years after the payment. The Act applies to payments for which recovery is sought after its effective date, regardless of the payment date.

Texas HB5231 amends Medicaid rules to clarify benefit exclusions and limit recovery of payments after four years.

Texas HB5231 amends the Human Resources Code to require the commission to prospectively determine benefit exclusions or limitations in Medicaid, unless mandated by law. It also modifies the Government Code to prohibit the office of the inspector general from recovering payments from Medicaid providers for waste or abuse discovered more than four years after the payment. The Act applies to payments for which recovery is sought after its effective date, regardless of the payment date.