Amend CSHB 2236 by striking page 1, line 7 through page 2,
line 21 and substituting the following:
      (a) In providing health care services through Medicaid
managed care to recipients in a health care service region, the
commission shall contract with a <at least one> managed care
organization in that region that is licensed under the Texas Health
Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance
Code) to provide health care in that region and that is:
      (1) wholly owned and operated by a hospital district in that
region;
      (2) created by a nonprofit corporation that:
            (A) has a contract, agreement, or other arrangement
with a hospital district in that region or with a municipality in
that region that owns a hospital licensed under Chapter 241, Health
and Safety Code, and has an obligation to provide health care to
indigent patients; and
            (B) under the contract, agreement, or other
arrangement, assumes the obligation to provide health care to
indigent patients and leases, manages, or operates a hospital
facility owned by the hospital district or municipality; or
      (3) created by a nonprofit corporation that has a contract,
agreement, or other arrangement with a hospital district in that
region under which the nonprofit corporation acts as an agent of
the district and assumes the district's obligation to arrange for
services under the Medicaid expansion for children as authorized by
Chapter 444, Acts of the 74th Legislature, Regular Session, 1995.
      (e) In providing health care services through Medicaid
managed care to recipients in a health care service region, with
the exception of the Harris service area for the STAR Medicaid
managed care program, as defined by the commission as of the
initial implementation date for that service area, the commission
shall also contract with a managed care organization in that region
that holds a certificate of authority as a health maintenance
organization under Article 20A.05, Insurance Code, and that:
                  (A) is certified under Section 5.01 (a), Medical
Practice Act (Article 4495b, Vernon's Texas Civil Statutes);
                  (B) is created by The University of Texas Medical
Branch at Galveston; and
                  (C) has obtained a certificate of authority as a
health maintenance organization to serve one or more counties in
that region from the Texas Department of Insurance before September
2, 1999.