Relating to certain payment recovery and recoupment efforts under Medicaid and the child health plan program.

HB 159 establishes new rules for Medicaid health plans when recovering overpayments from providers. It requires health plans to provide written notice and a minimum 60-day waiting period after providers exhaust all appeal options before collecting overpayments. The bill also prohibits health plans from re-examining medical necessity decisions or errors not caused by the provider during audits. Additionally, it creates a state program to contract with recovery audit contractors to identify and recover Medicaid overpayments. These changes apply to Texas Medicaid and the child health plan program, effective September 1, 2025.