Texas House Rep. Rose authors bill on Medicaid fees reflecting community rates

Passed bill authored by State Rep. Toni Rose aims to ensure Medicaid fees reflect customary community rates and requires agencies to seek federal approval if needed, following its approval in both chambers, according to the Texas Legislature website.

In the House, 56 Democrats and 54 Republicans voted in favor of the bill, while 26 Republicans opposed it.

Meanwhile, in the Senate, 10 Democrats and 20 Republicans voted in favor, while one Democrat voted against it.

Toni Rose introduced the bill in the Texas House on Tuesday, Feb. 4, during the 89th regular legislative session.

Rose, a Democrat, was elected to the Texas State House in 2013 to represent the state’s 110th House district, replacing previous state representative Barbara Mallory Caraway.

According to the Texas Legislature, the bill’s official text was summarized as follows: ‘Relating to the determination of fees, charges, and rates for certain benefits under Medicaid’.

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, the bill amends Section 32.028(c) of the Human Resources Code to specify that fees, charges, or rates for other medical assistance under Medicaid are to reflect the usual and customary amounts that prevail in the community, provided they comply with state or federal law. It requires the commission to exclude fees associated with membership discount programs when determining these customary amounts. Additionally, if a state agency deems that a federal waiver or authorization is needed to implement any part of the bill, the agency must seek such permission and can delay implementation until approval is obtained. The bill is set to take effect Sept. 1, 2025.

The bill was co-authored by Rep. Nicole Collier (Democrat – District 95), Rep. Erin Gamez (Democrat – District 38), and Rep. Lauren Ashley Simmons (Democrat – District 146).

The bill received its final legislative approval on Friday, May 23, and was signed into law by Gov. Greg Abbott on Friday, June 20.

Bills in Texas go through a multi-step legislative process, including committee review, debates, and votes in both chambers before reaching a final decision. Each session, there are typically thousands of bills introduced, but only a portion successfully navigate the process to become law.

You can read more about the bills and other measures here.