TX HB5231

Requires the Health and Human Services Commission to use formal rulemaking procedures to prospectively determine whether to exclude or limit any Medicaid benefit, unless the exclusion or limitation is mandated by state or federal law

Establishes a 4-year statute of limitations for the Office of Inspector General to recover Medicaid payments from providers due to waste or abuse, prohibiting recovery attempts after the fourth anniversary of the payment date

The 4-year recovery limitation applies to all payments for which recovery is sought on or after the effective date, regardless of when the original payment was made

Authorizes state agencies to delay implementation of any provision requiring federal waiver or authorization until such approval is obtained

Takes effect September 1, 2025