Amend CSSB 1 (house committee report) as follows:

(1)  In Article II of the bill, in the appropriations to the Health and Human Services Commission, increase the general revenue appropriations for Strategy A.1.1, Medicaid Client Services (page II-34), by $4,000,000 for each state fiscal year of the state fiscal biennium ending August 31, 2027.

(2)  In Article II of the bill, following the appropriations to the Health and Human Services Commission (page II-38), add the following appropriately numbered rider:

____.  Reimbursement Rate Increase for Nutritional Formula. (a) Out of amounts appropriated above to the Health and Human Services Commission for Strategy A.1.1, Medicaid Client Services, the commission shall allocate $4,000,000 in general revenue and $6,000,000 in federal funds for each state fiscal year of the state fiscal biennium ending August 31, 2027, for the purpose of increasing the Medicaid reimbursement rate for nutritional formula by 10 percent.

(b)  For purposes of this rider, nutritional formula means the following Healthcare Common Procedure Coding System (HCPCS) coded items:

(1)  B4149 (blenderized whole food tube feeding formula);

(2)  B4150 (age 15+ tube feeding formula);

(3)  B4153 (age 15+ formula for patients that lack the ability to break down proteins);

(4)  B4160 (pediatric tube feeding formula); and

(5)  B4161 (pediatric formula for patients that lack the ability to break down proteins).

(3)  In Article VII of the bill, in the appropriations to the Texas Lottery Commission (pages VII-8 and 9), proportionately reduce the general revenue appropriation for each strategy under Goal A, Operate Lottery, by a total of $8,000,000 for the state fiscal biennium ending August 31, 2027.

(4)  In Article XI of the bill, in the Article II items for the Health and Human Services Commission (page XI-7), strike "Rate Increase for Nutritional Formula" and the associated amount for the biennium.

(5)  Adjust totals and methods of financing accordingly.