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.