Tex. Codes » Human Resources Code · TITLE 2. HUMAN SERVICES AND PROTECTIVE SERVICES IN GENERAL · SUBTITLE C. ASSISTANCE PROGRAMS · CHAPTER 32. MEDICAL ASSISTANCE PROGRAM
Texas Codes

Tex. Hum. Res. Code § 32.0281 (2026)

Rules And Notice Relating To Payment Rates

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Sec. 32.0281. RULES AND NOTICE RELATING TO PAYMENT RATES. (a) The executive commissioner shall by rule describe the process used to determine payment rates for medical assistance and shall notify providers, consumers, the Legislative Budget Board, and the Governor's Office of Budget, Planning, and Policy of that process.

(b) The executive commissioner shall adopt rules relating to payment rates that include:

(1) a description of the process used to determine payment rates;

(2) a description of each cost of living index used in calculating inflation rates and the procedure for determining the level of inflation used in the executive commissioner's calculations;

(3) the criteria for desk audits;

(4) the procedure for notifying providers of exclusions and adjustments to reported expenses, if notification is requested; and

(5) a method of adjusting rates if new legislation, regulations, or economic factors affect costs.

(c) The commission shall include in the Title XIX State Medicaid Plan submitted to the federal government for approval the procedures for making available to the public the data and methodology used in establishing payment rates.

(d) The procedures for adopting rules under this section shall be governed by Chapter 2001, Government Code.

(e) An interested party may appeal an action taken by the commission under this section, and an appeal of such action shall be governed by the procedures for a contested case hearing under Chapter 2001, Government Code. The filing of an appeal under this section shall not stay the implementation of payment rates adopted by the executive commissioner in accordance with commission rules.

Added by Acts 1989, 71st Leg., ch. 1085, Sec. 2, eff. Sept. 1, 1989. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 4.097, eff. April 2, 2015.

Notes of Decisions
Cited in 6 cases, 1995–2018 · leading case: S.C. San Antonio, Inc. v. Texas Dep't of Human Servs., 891 S.W.2d 773 (Tex. App.—Austin 1995).
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S.C. San Antonio, Inc. v. Texas Dep't of Human Servs., 891 S.W.2d 773 (Tex. App.—Austin 1995). “” Tex.Hum.Res.Code Ann. § 32.0281(e) (West 1990).”
Chris Traylor v. Diana D., No. 03-15-00657-CV (Tex. App.—Austin Nov. 12, 2015). · cites it 6× “3, 31, 53 TEX. HUM. RES. CODE § 32.028(a)..........”
Dentistry of Brownsville v. Texas Health & Human Servs. Comm'n Charles Smith, No. 03-17-00552-CV (Tex. App.—Austin Dec. 13, 2017). “18 TEX. HUM. RES. CODE § 32.034 ............”
Dentistry of Brownsville v. Texas Health & Human Servs. Comm'n Charles Smith, No. 03-17-00552-CV (Tex. App.—Austin Oct. 18, 2018). “See Tex. Hum. Res. Code §§ 32.0281 (providing requirements for rules relating to “payment rates” that HHSC Executive Commissioner shall adopt), 32.”
Chris Traylor v. Diana D., No. 03-15-00657-CV (Tex. App.—Austin Oct. 27, 2015). “See TEX. HUM. RES. CODE § 32.0281(e). That statute does not apply to the current rate-setting regime, which does not take place through contested-case proceedings.”
S. C. San Antonio, Inc. v. Texas Dep't of Human Servs., No. 03-93-00670-CV (Tex. App.—Austin Jan. 11, 1995). “" Tex. Hum. Res. Code Ann. § 32.0281 (e) (West 1990).”
Tex. Hum. Res. Code § 32.0281(b)(1): 1 case
Chris Traylor v. Diana D., No. 03-15-00657-CV (Tex. App.—Austin Nov. 12, 2015). “3, 31, 53 TEX. HUM. RES. CODE § 32.028(a)..........”
Tex. Hum. Res. Code § 32.0281(d): 1 case
Chris Traylor v. Diana D., No. 03-15-00657-CV (Tex. App.—Austin Nov. 12, 2015). “3, 31, 53 TEX. HUM. RES. CODE § 32.028(a)..........”
Tex. Hum. Res. Code § 32.0281(e): 4 cases
S.C. San Antonio, Inc. v. Texas Dep't of Human Servs., 891 S.W.2d 773 (Tex. App.—Austin 1995). “” Tex.Hum.Res.Code Ann. § 32.0281(e) (West 1990).”
Chris Traylor v. Diana D., No. 03-15-00657-CV (Tex. App.—Austin Nov. 12, 2015). “3, 31, 53 TEX. HUM. RES. CODE § 32.028(a)..........”
Dentistry of Brownsville v. Texas Health & Human Servs. Comm'n Charles Smith, No. 03-17-00552-CV (Tex. App.—Austin Dec. 13, 2017). “18 TEX. HUM. RES. CODE § 32.034 ............”
Chris Traylor v. Diana D., No. 03-15-00657-CV (Tex. App.—Austin Oct. 27, 2015). “See TEX. HUM. RES. CODE § 32.0281(e). That statute does not apply to the current rate-setting regime, which does not take place through contested-case proceedings.”
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