LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION April 18, 2025 TO: Honorable Lacey Hull, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB2402 by Rose (Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.), Committee Report 1st House, Substituted The fiscal implications of the bill cannot be determined due to the lack of data necessary to estimate the degree to which fee-based membership discount programs impact the usual and customary fee, charge, or rate. The bill would establish that the usual and customary fee, charge, or rate for certain medical assistance excludes any fee, charge, or rate offered as part of a fee-based membership discount program.The bill would take effect September 1, 2025.According to the Health and Human Services Commission (HHSC), excluding fees, charges, or rates offered as part of a fee-based membership discount program may result in the Medicaid program paying a higher rate for prescription drugs than if such discounts were included. However, because the usual and customary fee, charge, or rate is determined by individual pharmacies at the point of sale and because this determination relies on proprietary discount and coupon information, the potential impact is unclear. The fiscal implications of the bill cannot be determined due to the lack of data necessary to estimate the degree to which fee-based membership discount programs impact the usual and customary fee, charge, or rate. Local Government ImpactNo significant fiscal implication to units of local government is anticipated. Source Agencies: b > td > 529 Health and Human Services Commission LBB Staff: b > td > JMc, NPe, ER, ESch, NV
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION
April 18, 2025
TO: Honorable Lacey Hull, Chair, House Committee on Human Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB2402 by Rose (Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.), Committee Report 1st House, Substituted
TO: Honorable Lacey Hull, Chair, House Committee on Human Services
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB2402 by Rose (Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.), Committee Report 1st House, Substituted
Honorable Lacey Hull, Chair, House Committee on Human Services
Honorable Lacey Hull, Chair, House Committee on Human Services
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB2402 by Rose (Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.), Committee Report 1st House, Substituted
HB2402 by Rose (Relating to the determination of fees, charges, and rates for certain benefits under Medicaid.), Committee Report 1st House, Substituted
The fiscal implications of the bill cannot be determined due to the lack of data necessary to estimate the degree to which fee-based membership discount programs impact the usual and customary fee, charge, or rate.
The fiscal implications of the bill cannot be determined due to the lack of data necessary to estimate the degree to which fee-based membership discount programs impact the usual and customary fee, charge, or rate.
The bill would establish that the usual and customary fee, charge, or rate for certain medical assistance excludes any fee, charge, or rate offered as part of a fee-based membership discount program.The bill would take effect September 1, 2025.According to the Health and Human Services Commission (HHSC), excluding fees, charges, or rates offered as part of a fee-based membership discount program may result in the Medicaid program paying a higher rate for prescription drugs than if such discounts were included. However, because the usual and customary fee, charge, or rate is determined by individual pharmacies at the point of sale and because this determination relies on proprietary discount and coupon information, the potential impact is unclear. The fiscal implications of the bill cannot be determined due to the lack of data necessary to estimate the degree to which fee-based membership discount programs impact the usual and customary fee, charge, or rate.
The bill would establish that the usual and customary fee, charge, or rate for certain medical assistance excludes any fee, charge, or rate offered as part of a fee-based membership discount program.
The bill would take effect September 1, 2025.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 529 Health and Human Services Commission
529 Health and Human Services Commission
LBB Staff: b > td > JMc, NPe, ER, ESch, NV
JMc, NPe, ER, ESch, NV