Floor Packet Page No. 65 Amend CSSB 1 (House Committee Printing) in Article II of the bill, following the appropriations to the Health and Human Services Commission, by adding the following appropriately numbered rider: . GRADUATE MEDICAL EDUCATION IN CERTAIN BORDER AREAS. a. From amounts appropriated by this Act to the Health and Human Services Commission to support Graduate Medical Education, the commission shall formulate and implement a Medicaid reimbursement methodology for graduate medical education that promotes and encourages residency training programs along the Texas-Mexico border. The methodology shall provide that eligible residency training programs shall be reimbursed for direct medical education (DME) costs in addition to indirect medical education (IME) costs to the same extent as allowed for reimbursement under the Medicare program. An eligible residency training program is not limited with respect to the number of residency training slots for which the program may receive funding. b. To be eligible for reimbursement under the methodology implemented under this rider, a residency training program must: (1) be sponsored by or affiliated with a public university; (2) include clinical training of resident physicians: (A) in a federally qualified health center, as defined by 42 U.S.C. Section 1395x (aa) (4); and (B) in a hospital that is located within 20 miles of the international border with Mexico; (3) serve a patient population that includes patients residing in a rural area, as defined by 42 U.S.C. Section 1395ww (d) (2) (D); and (4) operate in a county in which at least one-third of the population lives in households with incomes at or below federal poverty guidelines, or in a county contiguous to such a county.