2025 · Regular session · House bill
HB2402
HB2402 changes the usual-and-customary price rule for “other medical assistance” in Human Resources Code 32.028(c).
Official caption: Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.
Official report lists House author(s): Rose, Simmons, Collier, Gámez. This does not identify sponsors or amendment drafters.
Bill explanation published · Version and amendment review scope is stated below · Individual amendment records may not be separately annotated.
Bill highlights
Selected points from the published explanation. Follow each point to its source-linked context; conditions and limits may matter.
- HB2402 changes the usual-and-customary price rule for “other medical assistance” in Human Resources Code 32.028(c).
- The bill changes one Medicaid payment benchmark, not Medicaid eligibility, a patient’s entitlement to every discounted product, or a guaranteed payment increase for every provider.
- The act took effect September 1, 2025.
What does it do?
HB2402 changes the usual-and-customary price rule for “other medical assistance” in Human Resources Code 32.028(c). The rate remains the usual and customary fee, charge or rate prevailing in the community, unless state or federal law limits payment. The new rule excludes a price offered as part of a monthly fee-based membership discount program. It does not say that every coupon, free discount program or other reduced price must be excluded. Final law, Section 1; rate-setting statute.
The bill changes one Medicaid payment benchmark, not Medicaid eligibility, a patient’s entitlement to every discounted product, or a guaranteed payment increase for every provider. The separate professional-service rule in subsection (b) is not amended. The fiscal analysis identifies prescription-drug payments as a possible area of impact. Final law; engrossed fiscal note.
The act took effect September 1, 2025. If a state agency determines federal permission is needed to implement a provision, it must request that permission and may delay implementation until it is granted. The statute’s effective date alone therefore does not prove that every necessary implementation step occurred that day. Final law, Sections 2–3; official history.
What changed along the way?
The introduced bill would have directed the Health and Human Services Commission (HHSC) to exclude prices from a fee-based membership discount program when determining the benchmark. The House committee substitute instead made the exclusion part of the statutory rate rule itself and added “monthly.” The narrower monthly-fee wording survived into the final law. The engrossed, Senate committee and final versions have no later substantive differences. Introduced text; House substitute; text versions.
The official amendment index lists no amendments; these changes were made in the committee substitute rather than an indexed floor amendment. Amendment index; final law.
For the full amendment record, open the official amendment index.
Official bill versions
Compare the published text versions in the official text index. A change is not attributed to a specific amendment here without a verified record.
Who could benefit—and who could bear the costs?
Pharmacies could receive higher Medicaid payments when excluding a membership-discount price increases the applicable benchmark. That could also raise public spending on prescription drugs. Neither effect is guaranteed for every transaction, and the law does not itself appropriate a specified dollar increase or promise savings to patients. Engrossed fiscal note; final law.
The Legislative Budget Board’s May 13, 2025 engrossed fiscal note says the fiscal impact cannot be determined. HHSC reported that individual pharmacies determine usual-and-customary prices at the point of sale using proprietary discount and coupon information, so the data needed to estimate the effect were unavailable. It anticipated no significant local-government fiscal impact. The April 18 substitute note gives the same explanation. These notes discuss fee-based programs generally, but the enacted text specifically says monthly fee-based programs. Engrossed fiscal note; substitute fiscal note.
The March 31 introduced fiscal note also could not estimate the impact, but for a different reason: HHSC said it was not the entity that determined the usual-and-customary price and could not implement the original direction. The substitute changed that direction into the statutory exclusion described above; it did not turn the uncertain fiscal impact into a finding of no cost. Introduced fiscal note; House substitute.
Official sources
- Bill history and latest recorded action
- Bill versions, analyses and fiscal notes
- Action history and votes
- Amendment index
Catalog report retrieved 2026-10-25. Check the official record for corrections or later changes.
