BILL ANALYSIS

Senate Research Center	H.B. 2402
89R19262 JG-D	By: Rose et al. (Hughes)
	Health & Human Services
	5/13/2025
	Engrossed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

Texas Medicaid sets drug reimbursement rates based on the usual and customary price, the lowest amount a pharmacy charges cash-paying customers on a given day. However, ambiguity regarding the reporting of usual and customary pricing exists for certain membership-based pharmacy discount programs that provide medications at a reduced price as an exclusive benefit to its enrolled members. If Medicaid includes these membership prices in usual and customary calculations, reimbursement rates could be artificially lowered, discouraging pharmacy participation and limiting cost-saving options for consumers.

H.B. 2402 clarifies that membership-based discount programs should be excluded from the Texas Medicaid program's usual and customary price calculations.

H.B. 2402 amends current law relating to the determination of fees, charges, and rates for certain benefits under Medicaid.

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 32.028(c), Human Resources Code, to provide that the fee, charge, or rate for other medical assistance under the medical assistance program excludes any fee, charge, or rate offered as part of a monthly fee-based membership discount program and to make nonsubstantive changes.

SECTION 2. Requires a state agency, if necessary for implementation of a provision of this Act, to request a waiver or authorization from a federal agency, and authorizes a delay of implementation until such a waiver or authorization is granted.

SECTION 3. Effective date: September 1, 2025.