Relating to clarity and certainty in the administration and operation of Medicaid.

This bill (SB 2457) proposes changes to Texas Medicaid administration to improve clarity and certainty. It requires the state Medicaid commission to use formal rulemaking (not ad-hoc decisions) to exclude or limit benefits unless federal or state law mandates it. Crucially, it prohibits the Inspector General from seeking repayment for Medicaid provider payments discovered more than four years after the payment was made. These provisions directly affect Medicaid providers and state agencies managing Medicaid payments, taking effect September 1, 2025. The bill focuses on procedural changes to prevent retroactive recovery actions beyond a four-year window.