Amend CSSB 1 (house committee printing) as follows:

(1)  In Article I of the bill, in the appropriations to the Trusteed Programs within the Office of the Governor (page I-58), reduce the appropriations to Strategy C.1.1, Promote Texas, by $10,000,000 from general revenue funds and by $15,000,000 from General Revenue Fund 5003, Hotel Occupancy Tax for Economic Development, in each fiscal year of the biennium;

(2)  In Article II of the bill, in the appropriations to the Health and Human Services Commission (II-34), increase the appropriations from the general revenue fund to Strategy A.1.1, Medicaid Client Services, by $25,000,000 in each fiscal year of the biennium and appropriate the increased associated federal funds by the appropriate amount for each of those state fiscal years;

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

____.  Rates: Improving Access to Pediatric Services and Women's Health Services. (a)  Included in amounts appropriated above to the Health and Human Services Commission (HHSC) in Strategy A.1.5, Children, is $12,000,000 in general revenue in each fiscal year to increase the Medicaid reimbursement rates to improve access by children to physician and clinic services, especially well-child visits.

(b)  Included in amounts appropriated above in Strategy A.1.3, Pregnant Women, is $12,000,000 in general revenue in each fiscal year to increase the Medicaid reimbursement rates for birth and women's health-related services.

(c)  It is the intent of the legislature that HHSC allocate the funding identified in Subsection (a) among evaluation and management procedure codes to improve access to care for clients served under Medicaid fee-for-service and managed care models.

(d)  It is the intent of the legislature that HHSC shall ensure all funds allocated through this rider are fully reflected in reimbursement rates paid for physician services in Medicaid fee-for-service and managed care models.

(e)  HHSC shall evaluate, with the input of interested stakeholders, the impact the current Medicaid reimbursement rates have on provider participation and access to care. The Commission shall also evaluate how Texas' reimbursement rates compare to those of other states and provide an analysis of the cost to increase reimbursement rates. HHSC shall submit a report to the governor's office and the Legislative Budget Board by September 1, 2026.