Monitoring the Session

HB 2402

bill changes how Medicaid sets its ‘usual and customary’ price

Became law, effective Sep 1, 2025

Verdict: No flags

No flagsInitial review
Rep. Toni RoseDHouse 110

Initial review · graded Oct 20, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade

Caption

relating to the determination of fees, charges, and rates for certain benefits under Medicaid.

Caption from analyzed text · version I.

Summary

Membership discount program prices stay out of the benchmark.

The bill changes how Texas Medicaid figures the 'usual and customary' price it pays for certain medical services. It tells the state health commission to leave out prices offered through fee-based membership discount programs when it sets that benchmark. Providers who offer cheap membership-plan prices to cash customers will not see those discounts drag down what Medicaid pays them, starting September 1, 2025.

Labels

Labels: CROSS-PARTY HANDOFF. Lead author Toni Rose (D) in the House. Lead sponsor Bryan Hughes (R) in the Senate. Party as the Legislative Reference Library lists it for the 89th Legislature.

Receipt

The receipt

89R-HB2402 · 2025-02-04

SOLD BY

Rep. Toni RoseDHouse 110 Rep. Lauren Ashley SimmonsDHouse 146 Rep. Nicole CollierDHouse 95

+ 1 more author

ITEM

relating to the determination of fees, charges, and rates for certain benefits under Medicaid.

WHAT IT DOES

Membership discount program prices stay out of the benchmark.

The bill changes how Texas Medicaid figures the 'usual and customary' price it pays for certain medical services. It tells the state health commission to leave out prices offered through fee-based membership discount programs when it sets that benchmark. Providers who offer cheap membership-plan prices to cash customers will not see those discounts drag down what Medicaid pays them, starting September 1, 2025.

CHARGES

[ ] NONE FOUND

TOTAL

No first-year general revenue figure available here.

LBB estimate · fiscal note version E · source

Sources

Fiscal note · version E · May 13, 2025

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.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

HISTORY

  1. Filed
  2. Read first time
  3. Referred to Human Services
  4. Scheduled for public hearing on . . .
  5. Considered in public hearing
  6. Committee substitute considered in committee
  7. Testimony taken/registration(s) recorded in committee
  8. Left pending in committee
  9. Considered in public hearing
  10. Committee substitute considered in committee
  11. Reported favorably as substituted
  12. Comte report filed with Committee Coordinator
  13. Committee report distributed
  14. Committee report sent to Calendars
  15. Considered in Calendars
  16. Placed on General State Calendar
  17. Read 2nd time
  18. Passed to engrossment
  19. Record vote RV#1162
  20. Statement(s) of vote recorded in Journal
  21. Read 3rd time
  22. Passed
  23. Record vote RV#1271
  24. Statement(s) of vote recorded in Journal
  25. Reported engrossed
  26. Received from the House
  27. Read first time
  28. Referred to Health & Human Services
  29. Scheduled for public hearing on . . .
  30. Considered in public hearing
  31. Testimony taken in committee
  32. Left pending in committee
  33. Considered in public hearing
  34. Vote taken in committee
  35. Reported favorably w/o amendments
  36. Committee report printed and distributed
  37. Placed on intent calendar
  38. Rules suspended-Regular order of business
  39. Vote recorded in Journal
  40. Read 2nd time & passed to 3rd reading
  41. Vote recorded in Journal
  42. Three day rule suspended
  43. Record vote
  44. Read 3rd time
  45. Passed
  46. Record vote
  47. Senate passage reported
  48. Reported enrolled
  49. Signed in the House
  50. Signed in the Senate
  51. Sent to the Governor
  52. Signed by the Governor
  53. Effective on 9/1/25
ALSO NOTED · NOT CHARGED (1)

CARVE-OUT · analysis confidence 40%

THE TEXT

…“the commission shall exclude any fee, charge, or rate offered as part of a fee-based membership discount program”

Bill text, introduced version (I)

The rule protects one kind of pricing arrangement, fee-based membership discount programs, from counting against providers' Medicaid rates. The caption honestly says the bill is about rate determination, so this is a narrow, disclosed favor rather than a hidden one.

FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 110 yea · 26 nay

Senate · 30 yea · 1 nay

Sources

House: Final passage · May 2, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

Senate: Final passage · May 23, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

All floor motions and other positions below.

No flags

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

CAMPAIGN PAID FOR BY

Toni Rose

Donors

Texas Trial Lawyers Association PAC$23KTexas Sands PAC$14KTexans for Truth and Liberty PAC$10K

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Jul 12, 2024 to Jun 27, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Texas Trial Lawyers Association PAC$22,500.00

Texas Trial Lawyers Association PAC

$22,500.00

Cash
$22,500.00
Paid by others
$0.00
Total
$22,500.00

Also funds 137 other sitting lawmakers.

Derived recipient stock · Jul 24, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Oct 15, 2024 to Jun 22, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100989331, 101032423, 101061700.

Texas Sands PAC$14,000.00

Texas Sands PAC

$14,000.00

Cash
$14,000.00
Paid by others
$0.00
Total
$14,000.00

Also funds 121 other sitting lawmakers.

Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Sep 24, 2024 to May 18, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100989331, 101061700.

Texans for Truth and Liberty PAC$10,000.00

Texans for Truth and Liberty PAC

$10,000.00

Cash
$10,000.00
Paid by others
$0.00
Total
$10,000.00

Also funds 44 other sitting lawmakers.

Derived recipient stock · Jun 24, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · on Jun 24, 2025. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101010994.

Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texas Trial Lawyers Association PAC

$22,500.00

Cash
$22,500.00
Paid by others
$0.00
Total
$22,500.00

Also funds 137 other sitting lawmakers.

Derived recipient stock · Jul 24, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Oct 15, 2024 to Jun 22, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100989331, 101032423, 101061700.

×

Texas Sands PAC

$14,000.00

Cash
$14,000.00
Paid by others
$0.00
Total
$14,000.00

Also funds 121 other sitting lawmakers.

Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Sep 24, 2024 to May 18, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 100989331, 101061700.

×

Texans for Truth and Liberty PAC

$10,000.00

Cash
$10,000.00
Paid by others
$0.00
Total
$10,000.00

Also funds 44 other sitting lawmakers.

Derived recipient stock · Jun 24, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · on Jun 24, 2025. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101010994.

Votes5

Senate May 23, 2025

Yea
30
Nay
1
Present, not voting
Not printed
Absent
Not printed
Excused
Not printed
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Sources

The bill was read third time and was passed by the following vote: Yeas 30, Nays 1. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

  • Yea: 30 (published)
  • Nay: 1 (published)
  • Present, not voting: Not printed
  • Absent: Not printed
  • Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 23, 2025

Yea
30
Nay
1
Present, not voting
Not printed
Absent
Not printed
Excused
Not printed
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Sources

Senator Hughes moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that HB 2402 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 30, Nays 1.

Published stock of positions for this vote, except where marked derived.

  • Yea: 30 (published)
  • Nay: 1 (published)
  • Present, not voting: Not printed
  • Absent: Not printed
  • Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 23, 2025

Yea
Not printed
Nay
Not printed
Present, not voting
Not printed
Absent
Not printed
Excused
Not printed
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Voice vote. No numeric tally or individual yeas are inferred.

Sources

Senator Hughes moved to suspend the regular order of business to take up for consideration HB 2402 at this time on its second reading: HB 2402, Relating to the determination of fees, charges, and rates for certain benefits under Medicaid. The motion prevailed. Senator Hagenbuch asked to be recorded as voting "Nay" on suspension of the regular order of business. The bill was read second time and was passed to third reading by a viva voce vote.

Published stock of positions for this vote, except where marked derived.

  • Yea: Not printed
  • Nay: Not printed
  • Present, not voting: Not printed
  • Absent: Not printed
  • Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

House May 2, 2025

Yea
110
Nay
26
Present, not voting
1
Absent
6
Excused
7
Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 1271

HB 2402 was passed by (Record 1271): 110 Yeas, 26 Nays, 1 Present, not voting.

Published stock of positions for this vote, except where marked derived.

  • Yea: 110 (published)
  • Nay: 26 (published)
  • Present, not voting: 1 (published)
  • Absent: 6 (derived from named list)
  • Excused: 7 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

House May 1, 2025

Yea
121
Nay
13
Present, not voting
2
Absent
4
Excused
10
Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 1162

CSHB 2402 was passed to engrossment by (Record 1162): 121 Yeas, 13 Nays, 2 Present, not voting.

Published stock of positions for this vote, except where marked derived.

  • Yea: 121 (published)
  • Nay: 13 (published)
  • Present, not voting: 2 (published)
  • Absent: 4 (derived from named list)
  • Excused: 10 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

Witnesses9
For
7
Against
0
On
2
Names

For

  • AARP Texas2 registrations
  • Amazon Pharmacy2 registrations
  • Self1 registration
  • Texas Council of Community Centers2 registrations

On

  • Health and Human Services Commission2 registrations
Sources

9 parsed registrations across the loaded witness lists.

Derived stock of witness registrations. Repeated appearances count separately. Organizations and self-representation appear as printed.

House witness list. Source snapshot 2026-10-20, Central time.

Senate witness list. Source snapshot 2026-10-20, Central time.

Fiscal

No first-year general revenue figure available here.

LBB estimate · fiscal note version E · source

Sources

Fiscal note · version E · May 13, 2025

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.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

Sources

Texas House · Filed Feb 4, 2025

06/20/2025 E Effective on 9/1/25

Texas Legislature Online · Introduced · House Committee Report · Engrossed · Senate Committee Report · Enrolled

Data snapshot Oct 26, 2026 at 4:20 AM CDT. Grades, charges, quotes and corrections follow the published record.

Sponsors
Bryan HughesRSenate 1

House committee · Human Services · Committee vote 10 aye, 1 nay · Out of committee

Senate committee · Health & Human Services · Committee vote 9 aye, 0 nay · Out of committee

Companion

SB 1112 by Hughes (identical)

Subjects

Human Services--Medical Assistance

MEDICAID

HEALTH & HUMAN SERVICES COMMISSION

Text

The text as introduced · 181 words

89R4233 JG-D

By: Rose
H.B. No. 2402

A BILL TO BE ENTITLED

AN ACT

relating to the determination of fees, charges, and rates for

certain benefits under Medicaid.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 32.028(c), Human Resources Code, is

amended to read as follows:

(c) The fee, charge, or rate for other medical assistance is

the usual and customary fee, charge, or rate that prevails in the

community unless the payment is limited by state or federal law. In

determining the usual and customary fee, charge, or rate under this

subsection, the commission shall exclude any fee, charge, or rate

offered as part of a fee-based membership discount program.

SECTION 2. If before implementing any provision of this Act

a state agency determines that a waiver or authorization from a

federal agency is necessary for implementation of that provision,

the agency affected by the provision shall request the waiver or

authorization and may delay implementing that provision until the

waiver or authorization is granted.

SECTION 3. This Act takes effect September 1, 2025.