Amend CSSB 385 as follows:
      (1)  In the recital of SECTION 12 of the bill (page 38, line
7, House committee printing), strike "is amended by adding
Subsections (i)-(m)" and substitute "is amended by adding
Subsections (i)-(n)".
      (2)  Following Section 14(m), Texas Health Maintenance
Organization Act (Article 20A.14, Vernon's Texas Insurance Code),
as added by SECTION 12 of the bill (page 40, between lines 6 and 7,
House committee printing), insert the following:
      (n)  A health maintenance organization that uses a drug
formulary in providing a prescription drug benefit shall provide
the benefit to the enrollee for a drug not included in the
formulary if:
            (1)  the drug not included in the formulary is in a
class of drugs covered under the prescription drug benefit;
            (2)  a physician treating the enrollee under the health
care plan determines that prescription of the drug not included in
the formulary, rather than a drug included in the formulary, is in
the best interest of the enrollee; and
            (3)  the enrollee pays the difference between the costs
of the drugs, if the drug that is not included in the formulary is
more expensive than the drug that is included in the formulary.