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:

____.  DOGE Recommendation to Elevate and Advance New Efficiency Standards in Medicaid Managed Care in Texas. (a) Past Performance Standards Report: By December 1, 2025, the Health and Human Services Commission shall deliver a report to the governor, lt. governor, speaker of the house and appropriate committees of the legislature, including the Sunset Commission, that streamlines the metrics in the agency's Rider 20 report to the Office of the Governor in 2022. The report shall also demonstrate the following:

(1)  How these metrics can be applied to routine performance of contracts and any procurement method the agency may use or is required to adopt;

(2)  Streamline the volume of Rider 20 metrics, synchronize general performance metrics requirements with contract requirements and identify and remove measures that may be statistically insignificant;

(3)  Conduct a review on the merits of establishing a new acuity adjusted cost efficiency index that assesses the comparative cost performance of all plans;

(4)  Allows a certain number of years for health plans to perform against newly transparent metrics prior to the issuance of any new procurement and likewise proposes a new procurement date;

(5)  Includes recommendations to on-board non-incumbent plans through a parallel but substantially similar procurement process for incumbent health plans using national quality standards.

(b)  Proposed Statutory Changes: HHSC shall propose any needed statutory changes to comply with the reports required in this provision.