Amend CSSB 1 as follows:

In Article II of the bill, following the appropriations to the Health and Human Services Commission (page II-91), by adding the following appropriately numbered rider:

____.  Medicaid Transformation Waiver. It is the intent of the legislature that the Health and Human Services Commission:

(a)  allow a hospital district established under Health and Safety Code Section 281.002(c) that is in a county with a population of more than 800,000 and that was not included in the boundaries of a hospital district before September 1, 2003, or by a physician practice owned or controlled by such a hospital district to participate in the Uncompensated Care (UC) Pool program authorized under Texas Healthcare Transformation and Quality Improvement Program waiver; and

(b)  increase the amount of UC Pool funds allocated to physician group practices and distribute the allocated funds such that:

(1)  each physician group practice participating in the UC Pool during demonstration year 9 has at least the same percentage of its uncompensated charity care defrayed for future demonstration years as was defrayed for demonstration year 9; and

(2)  each provider made eligible pursuant to Subsection (a) has at least the same percentage of its uncompensated charity care defrayed for future demonstration years as was defrayed for physician group practices receiving funds from the UC Pool in demonstration year 9.

HHSC shall work with the Center for Medicare and Medicaid Services as necessary to implement the provision of this rider.