Texas Register Table of Contents
- 1 State Board of Dental Examiners
- 1.0.1 Proposed Rules Re:
- 1.0.1.1 Amending 22 TAC §104.1, to amend continuing education requirements by reducing dentists and dental hygienists 24-hour continuing education requirement by 2 hours if they attest they read all newsletters issued by the Texas State Board of Dental Examiners during their renewal period.
- 1.0.1.2 Amending 22 TAC §108.42, to remove the requirement that a mobile dental facility or portable dental unit have a lead apron with thyroid shields when x-rays are made.
- 1.0.1.3 Amending 22 TAC §111.1, to remove unnecessary subsections no longer in effect.
- 1.0.1.4 Amending 22 TAC §113.2, to remove the requirement that dental patients must be protected by a lead apron with thyroid collar.
- 1.0.1.5 Amending 22 TAC §114.12, to require a biennial renewal cycle for dental assistant registrations.
- 1.0.2 Proposed Rule Reviews Re:
- 1.0.1 Proposed Rules Re:
- 2 Texas Department of State Health Services
- 2.0.1 Proposed Rules Re:
- 2.0.2 Withdrawn Rules Re:
- 2.0.2.1 Withdrawing 25 TAC §§135.21, 135.24, 135.25, to repeal the Inspections, Enforcement, and Complaints sections because the content of the rule has been added to proposed new §135.62, §135.67, and §135.63.
- 2.0.2.2 Amending 25 TAC §135.22, to reflect the transition of regulatory authority from DHS to HHSC, as well as specify the time frame for an ASC to return the license to HHSC when the ASC cannot provide sufficient evidence that it submitted a renewal application and fee.
- 2.0.2.3 Amending 25 TAC §§135.61 – 135.67, to place limits on an ASC’s authority to record HHSC interviews and internal discussions; update ASC inspection requirements; update ASC complaint investigation requirements; inform an ASC of the required timeframes for responding to a written Statement of Deficiencies; inform providers that HHSC reports conduct issues or complaints to the appropriate licensing authorities; inform an ASC about complaint registration against an HHSC inspector or investigator; and creates greater consistency between the ASC ruleset and other HHSC facility types.
- 2.0.3 In Addition Re:
- 3 Texas Medical Disclosure Panel
- 3.0.1 Proposed Rules:
- 3.0.1.1 Amending 25 TAC §§602.3, 602.5, 602.9, 602.16, to update the list of procedures and risks and hazards with plain language when possible, specifically the Digestive System, Endocrine System, Breast Surgery, and Urinary System Treatments and Procedures.
- 3.0.1.2 Amending 25 TAC §603.3, §603.16, to update the list of procedures and risks and hazards with plain language, when possible, specifically the Digestive System and Urinary System Treatments and Procedures.
- 3.0.1 Proposed Rules:
- 4 Cancer Prevention and Research Institute of Texas
- 5 Texas Health and Human Services Commission
- 5.0.1 Proposed Rules Re:
- 5.0.1.1 Amending 26 TAC §52.1, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.2 Amending 26 TAC §259.5, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.3 Amending 26 TAC §275.29, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.4 Amending 26 TAC §§280.1, 280.3, 280.5, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.5 Amending 26 TAC §306.45, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.6 Amending 26 TAC §306.45, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.7 Amending 26 TAC §306.273, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.8 Amending 26 TAC §351.2, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.9 Amending 26 TAC §358.103, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.10 Amending 26 TAC §554.2302, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.11 Amending 26 TAC §560.3, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.12 Amending 26 TAC §566.3, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.13 Amending 26 TAC §711.1, §711.3, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.14 Amending 26 TAC §711.1402, §711.1406, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.15 Amending 26 TAC §745.907, §745.911, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.16 Amending 26 TAC §745.8605, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.17 Amending 26 TAC §926.51, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.1.18 Amending 26 TAC §967.1, to update citations in the rule to the Texas Government Code Chapter 546.
- 5.0.2 In Addition Re:
- 5.0.1 Proposed Rules Re:
- 6 Texas Department of Insurance, Division of Workers’ Compensation
- 7 Texas Animal Health Commission
- 7.0.1 Withdrawn Rules:
- 7.0.1.1 Withdrawing 4 TAC §51.12, to set forth the requirements for sheep entering Texas.
- 7.0.1.2 Withdrawing 4 TAC §60.1, to eliminate the definition for “Blackfaced Sheep,” reorganize the definition of “Breed Associations and Registries” in alphabetical order, and add a definition for “Breeding Sheep.”
- 7.0.2 Adopted Rules Re:
- 7.0.1 Withdrawn Rules:
State Board of Dental Examiners
Proposed Rules Re:
CHAPTER 104. CONTINUING EDUCATION
22 TAC §104.1
OVERVIEW
The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §104.1, concerning continuing education requirements. The proposed amendment allows dentists and dental hygienists to reduce their 24-hour continuing education requirement by 2 hours if they attest they read all newsletters issued by the Texas State Board of Dental Examiners during their renewal period. The proposed amendment does not apply to the 16-hour technical and scientific requirement.
Amending 22 TAC §108.42, to remove the requirement that a mobile dental facility or portable dental unit have a lead apron with thyroid shields when x-rays are made.
CHAPTER 108. PROFESSIONAL CONDUCT
SUBCHAPTER D. MOBILE DENTAL FACILITIES
22 TAC §108.42
OVERVIEW
The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §108.42, concerning obtaining a permit. The proposed amendment removes the requirement that a mobile dental facility or portable dental unit must have a lead apron with thyroid shield when x-rays are made. The American Academy of Oral and Maxillofacial Radiology (AAOMR) recently issued guidelines titled “Patient shielding during dentomaxillofacial radiography” where the AAOMR recommended discontinuing the use of lead aprons and thyroid shields when making x-rays. The Board held a stakeholder meeting on September 27, 2024, where a majority of stakeholders stated that Board rules should be amended to remove requiring the use of lead aprons and thyroid shields based on the AAOMR guidelines.
Amending 22 TAC §111.1, to remove unnecessary subsections no longer in effect.
CHAPTER 111. STANDARDS FOR PRESCRIBING CONTROLLED SUBSTANCES AND DANGEROUS DRUGS
22 TAC §111.1
OVERVIEW
The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §111.1, concerning additional continuing education requirements. The proposed amendment removes subsection (a) and paragraph (b)(1) because they are no longer in effect. The current continuing education requirement regarding controlled substances is found in paragraph (1) of this amended rule and in 22 TAC §104.1(2)(B). The proposed amendment also updates the name of the title for 22 TAC §104.1.
Amending 22 TAC §113.2, to remove the requirement that dental patients must be protected by a lead apron with thyroid collar.
CHAPTER 113. REQUIREMENTS FOR DENTAL OFFICES
22 TAC §113.2
OVERVIEW
The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §113.2, concerning X-Ray Laboratories. The proposed amendment removes the requirement that dental patients must be protected by a lead apron with thyroid collar. The American Academy of Oral and Maxillofacial Radiology (AAOMR) recently issued guidelines titled “Patient shielding during dentomaxillofacial radiography” where the AAOMR recommended discontinuing the use of lead aprons and thyroid shields when making x-rays. The Board held a stakeholder meeting on September 27, 2024, where a majority of stakeholders stated that Board rules should be amended to remove requiring the use of lead aprons and thyroid shields based on the AAOMR guidelines.
Amending 22 TAC §114.12, to require a biennial renewal cycle for dental assistant registrations.
CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL–DENTAL ASSISTANTS
22 TAC §114.12
OVERVIEW
The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §114.12, concerning continuing education for certificate holders. The proposed amendment updates the rule to reflect that dental assistant registrations have a biennial renewal cycle. In addition, the proposed amendment requires registered dental assistants to complete two hours of continuing education in the laws and regulations of the Board.
Proposed Rule Reviews Re:
Reviewing Title 22, Part 5, to consider for readoption, revision, or repeal of the chapter concerning professional conduct and visual dental health inspections.
The Texas State Board of Dental Examiners (Board) files this Notice of Intent to Review to consider for re-adoption, revision, or repeal the chapters listed below, in their entirety, contained in Title 22, Part 5, of the Texas Administrative Code. This review is being conducted in accordance with Texas Government Code §2001.039.
Texas Department of State Health Services
Proposed Rules Re:
CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER Y. ADVERSE LICENSING, LISTING, OR REGISTRATION DECISIONS
25 TAC §1.601
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §1.601, concerning Decisions Based on Interagency Records.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rule to Texas Government Code Chapter 526 that becomes effective on April 1, 2025. The proposed amendment updates the affected citations to Texas Government Code.
Withdrawn Rules Re:
Withdrawing 25 TAC §§135.21, 135.24, 135.25, to repeal the Inspections, Enforcement, and Complaints sections because the content of the rule has been added to proposed new §135.62, §135.67, and §135.63.
CHAPTER 135. AMBULATORY SURGICAL CENTERS
SUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS
25 TAC §§135.21, 135.24, 135.25
OVERVIEW
The Department of State Health Services withdraws the adopted repeal of §§135.21, 135.24, and 135.25 which appeared in the November 15, 2024, issue of the Texas Register (49 TexReg 9238).
CHAPTER 135. AMBULATORY SURGICAL CENTERS
SUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS
25 TAC §135.22
OVERVIEW
The Department of State Health Services withdraws adopted amendments to §135.22 which appeared in the November 15, 2024, issue of the Texas Register (49 TexReg 9238).
CHAPTER 135. AMBULATORY SURGICAL CENTERS
SUBCHAPTER D. INSPECTION, INVESTIGATION, AND ENFORCEMENT PROCEDURES
25 TAC §§135.61 – 135.67
The Department of State Health Services withdraws adopted new §§135.61 – 135.67 which appeared in the November 15, 2024, issue of the Texas Register (49 TexReg 9238).
In Addition Re:
Licensing Actions for Radioactive Materials (.pdf)
For more information, please visit this week’s edition of the Texas Register at 49 Tex. Reg. 10028.
Licensing Actions for Radioactive Materials (.pdf)
For more information, please visit this week’s edition of the Texas Register at 49 Tex. Reg. 10035.
Licensing Actions for Radioactive Materials (.pdf)
For more information, please visit this week’s edition of the Texas Register at 49 Tex. Reg. 10041.
Texas Medical Disclosure Panel
Proposed Rules:
Amending 25 TAC §§602.3, 602.5, 602.9, 602.16, to update the list of procedures and risks and hazards with plain language when possible, specifically the Digestive System, Endocrine System, Breast Surgery, and Urinary System Treatments and Procedures.
CHAPTER 602. PROCEDURE REQUIRING FULL DISCLOSURE OF SPECIFIC RISKS AND HAZARDS–LIST A
25 TAC §§602.3, 602.5, 602.9, 602.16
OVERVIEW
The Texas Medical Disclosure Panel (Panel) proposes amendments to §602.3, concerning Digestive System Treatments and Procedures; §602.5, concerning Endocrine System Treatments and Procedures; §602.9, concerning Breast Surgery (non-cosmetic) Treatments and Procedures; and §602.16, concerning Urinary System Treatments and Procedures.
BACKGROUND AND PURPOSE
These amendments are proposed in accordance with Texas Civil Practice and Remedies Code §74.102, which created the Panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure.
The purpose of these amendments is to modify the list of procedures and risks and hazards in §§602.3, 602.5, 602.9, and 602.16 and update these sections using plain language when possible.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §602.3, Digestive System Treatments and Procedures, revises and lists additional types of digestive system treatments and procedures that the Panel has determined require full disclosure of the risks and hazards associated with them, and includes plain language explanations, where necessary.
The proposed amendment to §602.5, Endocrine System Treatments and Procedures, revises and lists additional types of endocrine system treatments and procedures that the Panel has determined require full disclosure of the risks and hazards associated with them, and includes plain language explanations, where necessary.
The proposed amendment to §602.9, Breast Surgery (Non-cosmetic) Treatments and Procedures, revises and lists additional types of breast surgery (non-cosmetic) treatments and procedures that the Panel has determined require full disclosure of the risks and hazards associated with them, and includes plain language explanations, where necessary.
The proposed amendment to §602.16, Urinary System Treatments and Procedures, revises and lists additional types of urinary system treatments and procedures that the Panel has determined require full disclosure of the risks and hazards associated with them, and includes plain language explanations, where necessary.
Amending 25 TAC §603.3, §603.16, to update the list of procedures and risks and hazards with plain language, when possible, specifically the Digestive System and Urinary System Treatments and Procedures.
CHAPTER 603. PROCEDURES REQUIRING NO DISCLOSURE OF SPECIFIC RISKS AND HAZARDS–LIST B
25 TAC §603.3, §603.16
The Texas Medical Disclosure Panel (Panel) proposes amendments to §603.3, concerning Digestive System Treatments and Procedures; and §603.16, concerning Urinary System Treatments and Procedures.
BACKGROUND AND PURPOSE
These amendments are proposed in accordance with Texas Civil Practice and Remedies Code §74.102, which created the Panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure.
The purpose of these amendments is to modify the list of procedures and risks and hazards in §603.3 and §603.16 and update these sections using plain language when possible.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §603.3, Digestive System Treatments and Procedures, revises and lists additional types of digestive system treatments and procedures that the Panel has determined require no disclosure of specific risks and hazards associated with them, and includes plain language explanations, where necessary.
The proposed amendment to §603.16, Urinary System Treatments and Procedures, revises and lists additional types of urinary system treatments and procedures that the Panel has determined require no disclosure of specific risks and hazards associated with them, and includes plain language explanations, where necessary.
Cancer Prevention and Research Institute of Texas
Proposed Rules Re:
Amending 25 TAC §703.13, §703.26, to increase the grant recipient audit threshold, which is consistent with CPRIT’s administrative rules; add certain unallowable expenses for grant recipients; and make other non-substantive, technical amendments.
CHAPTER 703. GRANTS FOR CANCER PREVENTION AND RESEARCH
25 TAC §703.13, §703.26
OVERVIEW
The Cancer Prevention and Research Institute of Texas (“CPRIT” or “the Institute”) proposes amending 25 Texas Administrative Code §703.13 and §703.26 relating the grant recipient audit threshold, unallowable grant recipient expenses, and a reference to Texas Grant Management Standards.
BACKGROUND AND PURPOSE
The proposed amendment to §703.13(b) increases the grant recipient audit threshold from $750,000 to $1 million. The amendment harmonizes CPRIT’s administrative rules with recent changes to the Texas Grant Management Standards (TxGMS) published by the Comptroller of Public Accounts. Currently, CPRIT grantees who expend $750,000 or more in state funds must obtain either an annual single independent audit, a program specific independent audit, or an agreed upon procedures engagement. CPRIT follows the guidance in TxGMS to determine the audit threshold. On October 1, 2024, the Comptroller’s of Public Accounts released a new version of TxGMS that increased the threshold to $1 million.
CPRIT proposes amending §703.26(e) to add the following as an unallowable expense for grant recipients, “Reimbursements to employees for their out-of-pocket health insurance premium or other health care expenses which are not made through an employer-sponsored plan established under Section 105 of the Internal Revenue Code.” For these expenses to be considered fringe benefits that are reimbursable from CPRIT grant funds, the employer must have an established health reimbursement arrangement program under Section 105 of the Internal Revenue Code. Thus, this amendment clarifies that CPRIT program standards for reimbursements conform to other relevant laws.
Lastly, the Institute proposes a non-substantive, technical amendment to § 703.26(b). This amendment proposes replacing an outdated reference to the Uniform Grant Management Standards (UGMS) with a reference to TxGMS. CPRIT relied on UGMS, the predecessor to TxGMS, as guidance for grant recipients and referred to it in the Institute’s administrative rules. When TxGMS went into effect, CPRIT updated its administrative rules to replace references to UGMS with references to TxGMS. The proposed amendment to § 703.26(b) corrects a reference that was inadvertently excluded from the previous update.
Texas Health and Human Services Commission
Proposed Rules Re:
Amending 26 TAC §52.1, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 52. CONTRACTING FOR COMMUNITY SERVICES
SUBCHAPTER A. APPLICATION AND DEFINITIONS
26 TAC §52.1
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §52.1, concerning Application.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to Texas Government Code Chapter 546 that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
Amending 26 TAC §259.5, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 259. COMMUNITY LIVING ASSISTANCE AND SUPPORT SERVICES (CLASS) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) SERVICES
SUBCHAPTER A. DEFINITIONS, DESCRIPTION OF SERVICES, AND EXCLUDED SERVICES
26 TAC §259.5
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §259.5, concerning Definitions.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rule to Texas Government Code sections that become effective on April 1, 2025. The proposed amendment updates the affected citations to Texas Government Code.
Amending 26 TAC §275.29, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 275. CONSUMER MANAGED PERSONAL ATTENDANT SERVICES (CMPAS) PROGRAM
SUBCHAPTER B. ELIGIBILITY AND SERVICE PLANS
26 TAC §275.29
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §275.29, concerning Assessment and Eligibility Determination.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to a Texas Government Code section that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
Amending 26 TAC §§280.1, 280.3, 280.5, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 280. PEDIATRIC TELECONNECTIVITY RESOURCE PROGRAM FOR RURAL TEXAS
26 TAC §§280.1, 280.3, 280.5
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §280.1, concerning Purpose; §280.3, concerning Definitions; and §280.5, concerning Grant Program Administration.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rules to Texas Government Code sections that become effective on April 1, 2025. The proposed amendments update the affected citations to Texas Government Code.
Amending 26 TAC §306.45, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER B. STANDARDS OF CARE IN CRISIS STABILIZATION UNITS
DIVISION 1. GENERAL REQUIREMENTS
26 TAC §306.45
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §306.45, concerning Definitions; and §306.273, concerning MH Case Management Employee Competencies.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rules to Texas Government Code sections that become effective on April 1, 2025. The proposed amendments update the affected citations to Texas Government Code.
Amending 26 TAC §306.45, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEM
SUBCHAPTER E. MENTAL HEALTH CASE MANAGEMENT
26 TAC §306.273
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §306.45, concerning Definitions; and §306.273, concerning MH Case Management Employee Competencies.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rules to Texas Government Code sections that become effective on April 1, 2025. The proposed amendments update the affected citations to Texas Government Code.
Amending 26 TAC §306.273, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 330. LIDDA ROLE AND RESPONSIBILITIES
26 TAC §330.17
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §330.17, concerning LIDDA Administrative Functions.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to a Texas Government Code section that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
Amending 26 TAC §351.2, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 351. CHILDREN WITH SPECIAL HEALTH CARE NEEDS SERVICES PROGRAM
26 TAC §351.2
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §351.2, concerning Definitions.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to a Texas Government Code section that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
Amending 26 TAC §358.103, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 358. CHILDREN’S AUTISM PROGRAM
SUBCHAPTER A. GENERAL RULES
26 TAC §358.103
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §358.103, concerning Legal Authority.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to a Texas Government Code section that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
Amending 26 TAC §554.2302, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 554. NURSING FACILITY REQUIREMENTS FOR LICENSURE AND MEDICAID CERTIFICATION
SUBCHAPTER X. REQUIREMENTS FOR MEDICAID-CERTIFIED FACILITIES
26 TAC §554.2302
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §554.2302, concerning Requirements for a Contracted Medicaid Facility.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to a Texas Government Code section that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
Amending 26 TAC §560.3, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 560. DENIAL OR REFUSAL OF LICENSE
26 TAC §560.3
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §560.3, concerning Adverse Licensing Record.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rule to a Texas Government Code section that becomes effective on April 1, 2025. The proposed amendment updates the affected citations to Texas Government Code.
Amending 26 TAC §566.3, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 566. TEXAS HOME LIVING (TXHML) PROGRAM AND COMMUNITY FIRST CHOICE (CFC) CERTIFICATION STANDARDS
26 TAC §566.3
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §566.3, concerning Definitions.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to a Texas Government Code section that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
Amending 26 TAC §711.1, §711.3, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 711. INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS
SUBCHAPTER A. INTRODUCTION
26 TAC §711.1, §711.3
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §711.1, concerning What is the purpose of this chapter; §711.3, concerning How are the terms in this chapter defined; §711.1402, concerning How are the terms in this subchapter defined; and §711.1406, concerning How is the term agency defined for the purpose of this subchapter.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rules to Texas Government Code sections that become effective on April 1, 2025. The proposed amendments update the affected citations to Texas Government Code.
Amending 26 TAC §711.1402, §711.1406, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 711. INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERS
SUBCHAPTER L. EMPLOYEE MISCONDUCT REGISTRY
26 TAC §711.1402, §711.1406
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §711.1, concerning What is the purpose of this chapter; §711.3, concerning How are the terms in this chapter defined; §711.1402, concerning How are the terms in this subchapter defined; and §711.1406, concerning How is the term agency defined for the purpose of this subchapter.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rules to Texas Government Code sections that become effective on April 1, 2025. The proposed amendments update the affected citations to Texas Government Code.
Amending 26 TAC §745.907, §745.911, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 745. LICENSING
SUBCHAPTER G. CONTROLLING PERSONS
26 TAC §745.907, §745.911
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §745.907, concerning What are the consequences of Licensing designating me as a controlling person; §745.911, concerning In what other circumstances may a person not serve as a controlling person at my operation; and §745.8605, concerning When can Licensing recommend or impose an enforcement action against my operation.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rules to Texas Government Code Chapter 526 that becomes effective on April 1, 2025. The proposed amendments update the affected citations to Texas Government Code.
Amending 26 TAC §745.8605, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 745. LICENSING
SUBCHAPTER L. ENFORCEMENT ACTIONS
DIVISION 1. OVERVIEW OF ENFORCEMENT ACTIONS
26 TAC §745.8605
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §745.907, concerning What are the consequences of Licensing designating me as a controlling person; §745.911, concerning In what other circumstances may a person not serve as a controlling person at my operation; and §745.8605, concerning When can Licensing recommend or impose an enforcement action against my operation.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update citations in the rules to Texas Government Code Chapter 526 that becomes effective on April 1, 2025. The proposed amendments update the affected citations to Texas Government Code.
Amending 26 TAC §926.51, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 926. STATE FACILITY REQUIREMENTS TO ENHANCE THE SAFETY OF INDIVIDUALS RECEIVING SERVICES
SUBCHAPTER B. CRIMINAL HISTORY CHECKS AND REGISTRY CLEARANCES AT STATE FACILITIES
26 TAC §926.51
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §926.51, concerning Definitions.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to Texas Government Code Chapter 546 that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
Amending 26 TAC §967.1, to update citations in the rule to the Texas Government Code Chapter 546.
CHAPTER 967. CLIENT CARE OF INDIVIDUALS RECEIVING SERVICES AT STATE SUPPORTED LIVING CENTERS
SUBCHAPTER A. STATE SUPPORTED LIVING CENTER INDEPENDENT MORTALITY REVIEW
26 TAC §967.1
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §967.1, concerning Independent Mortality Review.
BACKGROUND AND PURPOSE
House Bill 4611, 88th Legislature, Regular Session, 2023, made certain non-substantive revisions to Subtitle I, Title 4, Texas Government Code, which governs HHSC, Medicaid, and other social services as part of the legislature’s ongoing statutory revision program. This proposal is necessary to update a citation in the rule to Texas Government Code Chapter 546 that becomes effective on April 1, 2025. The proposed amendment updates the affected citation to Texas Government Code.
In Addition Re:
Public Notice – Community First Choice (CFC) Renewal Effective June 1, 2025
OVERVIEW
The Texas Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to renew the Community First Choice (CFC) Selective Contracting program authorized under §1915(b)(4) of the Social Security Act (the Act). HHSC provides home and community-based attendant services under the state plan pursuant to §1915(k) of the Act but has a waiver under the CFC Selective Contracting program to limit choice of CFC providers. CMS has approved the current CFC Selective Contracting program through May 31, 2025. The proposed effective date for this renewal is June 1, 2025.
Texas Department of Insurance, Division of Workers’ Compensation
Proposed Rules Re:
Amending 28 TAC §133.30, to allow a treating doctor to use telemedicine or telehealth for injured employees that meet certain conditions, such as undergoing an examination by the treating doctor for the condition in question at least once before the examination to certify MMI; provide consent; and the injury must qualify as a minor injury.
CHAPTER 133. GENERAL MEDICAL PROVISIONS
SUBCHAPTER B. HEALTH CARE PROVIDER BILLING PROCEDURES
28 TAC §133.30
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes to amend 28 TAC §133.30, concerning telemedicine, telehealth, and teledentistry services. Section 133.30 implements Texas Labor Code §413.011. The DWC medical advisor recommends the amendments to the commissioner of workers’ compensation under Labor Code §413.0511(b).
BACKGROUND AND PURPOSE
The amendments to §133.30 allow a treating doctor to use telemedicine or telehealth to certify maximum medical improvement (MMI) under §§130.1 and 130.2 of this title, concerning certification of maximum medical improvement and evaluation of permanent impairment, under the following conditions. The injured employee must have been examined by the treating doctor for the condition in question at least once before the examination to certify MMI. The injured employee must consent to the examination to certify MMI by telemedicine or telehealth. The condition in question must qualify as a minor injury, such as §130.2(a)(2) of this title contemplates, that requires no additional treatment, and has resulted in no impairment. A minor injury does not require application of the AMA Guides, so under §130.1 of this title, the treating doctor is allowed to certify MMI with no impairment.
The amendments specify that such an evaluation must be billed in compliance with the MMI billing requirements in §134.250 of this title, concerning maximum medical improvement evaluations and impairment rating examinations by treating doctors. The treating doctor’s billing and reimbursement are the same for an in-person MMI evaluation and a telemedicine MMI evaluation. They do not expand the scope of practice or authorize new treatments. Health care providers should refer to their licensing boards’ rules for practicing telemedicine and telehealth. The amendments do not allow a doctor to assign an impairment rating by a telemedicine or telehealth examination. The amendments are proposed to be effective for examinations conducted by treating doctors to certify MMI by telemedicine or telehealth conducted on or after January 1, 2025.
Amending §133.30 is necessary to ensure better and more convenient access to evaluations necessary to certify MMI, to ensure that more required MMI evaluations are conducted on time, and to clarify how doctors must bill and be reimbursed for MMI evaluations conducted by telemedicine or telehealth. For example, when a treating doctor treats and releases an injured employee for a minor injury, such as a scrape or a bruise, and does not anticipate that the injured employee will need additional treatment, the amendments allow the treating doctor to use telemedicine or telehealth to determine that the injured employee has reached MMI but has no permanent impairment. Treating doctors can certify MMI under current rules, and the amendments just allow them to do so by telemedicine or telehealth under specific conditions. In addition, the number of disputes from treating doctor certifications of MMI under current rules is very low. Based on medical billing data reported to DWC, treating doctors submitted over 36,000 bills in calendar year 2023 for these MMI examinations. Over 34,000 claims were associated with those bills containing CPT code 99455, and of those claims, only 259 were associated with an MMI or impairment rating dispute.
Labor Code §413.011 requires the commissioner to adopt health care reimbursement policies and guidelines that reflect the standardized reimbursement structures found in other health care delivery systems with minimal modifications to those reimbursement methodologies as necessary to meet occupational injury requirements. It also requires that the commissioner’s adopted medical policies or guidelines be designed to ensure the quality of medical care and achieve medical cost control, and to enhance a timely and appropriate return to work. Amending §133.30 to allow a treating doctor to use telemedicine or telehealth to certify MMI and to ensure that billing and reimbursement for that evaluation are consistent with the billing requirements in §134.250 meets the requirements in Labor Code §413.011.
Texas Animal Health Commission
Withdrawn Rules:
Withdrawing 4 TAC §51.12, to set forth the requirements for sheep entering Texas.
OVERVIEW
The Texas Animal Health Commission withdraws proposed amendments to 4 TAC §51.12 which appeared in the June 14, 2024, issue of the Texas Register (49 TexReg 4122).
Withdrawing 4 TAC §60.1, to eliminate the definition for “Blackfaced Sheep,” reorganize the definition of “Breed Associations and Registries” in alphabetical order, and add a definition for “Breeding Sheep.”
CHAPTER 60. SCRAPIE
4 TAC §60.1
OVERVIEW
The Texas Animal Health Commission withdraws proposed amendments to 4 TAC §60.1 which appeared in the June 14, 2024, issue of the Texas Register (49 TexReg 4123).
Adopted Rules Re:
CHAPTER 40. CHRONIC WASTING DISEASE
4 TAC §40.6
OVERVIEW
The Texas Animal Health Commission (Commission) in a duly noticed meeting on November 12, 2024, adopted amendments to §40.6, concerning CWD Movement Restriction Zones. Section 40.6 is adopted without changes to the proposed text published in the August 23, 2024, issue of the Texas Register (49 TexReg 6345) and will not be republished.
BACKGROUND AND PURPOSE
The purpose of this chapter is to prevent and control the incidence of chronic wasting disease (CWD) in Texas by seeking to reduce the risk of interstate and intrastate transmission of CWD in susceptible cervid species. The Commission adopts amendments to §40.6 to eliminate surveillance zones and add two new containment zones based on high-risk CWD exposure. These amendments will provide more targeted surveillance and reduce the risk of CWD being spread from areas where it may exist while eliminating unnecessary restrictions from other areas.
CWD is a degenerative and fatal neurological communicable disease recognized by the veterinary profession that affects susceptible cervid species. CWD poses a serious threat to livestock and exotic livestock that the Commission is charged with protecting. CWD can spread through natural movements of infected animals and transportation of live infected animals or carcass parts. Specifically, prions are shed from infected animals in saliva, urine, blood, soft‑antler material, feces, or from animal decomposition, which ultimately contaminates the environment in which CWD susceptible species live. CWD has a long incubation period, so animals infected with CWD may not exhibit clinical signs of the disease for months or years after infection. The disease can be passed through contaminated environmental conditions and may persist for a long period of time. Currently, no vaccine or treatment for CWD exists.
The purpose of the movement restriction zones is to both increase surveillance and reduce the risk of CWD being spread from areas of high risk where it may exist. As required by §40.6(g), the Commission reviewed the movement restriction zones and recommends the modifications as stated herein.