Texas Register Table of Contents
- 1 Texas Medical Board
- 2 Texas Board of Nursing
- 3 Texas Board of Chiropractic Examiners
- 4 Texas Board of Physical Therapy Examiners
- 5 Texas Board of Occupational Therapy Examiners
- 6 Texas Board of Occupational Therapy Examiners
- 7 Texas Board of Occupational Therapy Examiners
- 8 Texas Department of Insurance
- 9 Texas Health and Human Services Commission
- 10 State Board of Dental Examiners
- 11 State Board of Dental Examiners
- 12 State Board of Dental Examiners
- 13 State Board of Dental Examiners
- 14 State Board of Dental Examiners
- 15 State Board of Dental Examiners
- 16 State Board of Dental Examiners
- 17 State Board of Dental Examiners
- 18 State Board of Dental Examiners
- 19 Texas Department of State Health Services
- 20 Texas Department of Insurance
- 21 Texas Department of Insurance
- 22 Texas Department of State Health Services
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
Texas Medical Board
Emergency Rule
Amending 22 TAC §174.5 to allow physicians to issue prescriptions for established chronic pain patients via telemedicine
CHAPTER 174. TELEMEDICINESUBCHAPTER A. TELEMEDICINE22 TAC §174.5OVERVIEW The Texas Medical Board (Board) adopts, on an emergency ba- sis, amendments to 22 TAC §174.5, effective June 5, 2020.The emergency amendment would allow physicians to utilize telemedicine to issue refill prescriptions for scheduled medications to established chronic pain patients if the physician determines that such telemedicine treatment is needed due to the COVID-19 pandemic.BACKGROUND AND JUSTIFICATIONOn March 13, the Governor of Texas certified COVID-19 as pos- ing an imminent threat of disaster to the public health and safety and declared a state of disaster in all counties of Texas. On March 19, 2020, the Texas Governor issued a waiver suspend- ing the strict enforcement of §174.5(e)(2)(A) which generally pro- hibits the utilization of telemedicine to prescribe scheduled drugs for the treatment of chronic pain. The waiver was issued in order to protect public health and curb the spread of COVID-19 by providing patients access to schedule drugs needed to ensure on-going treatment of chronic pain and avoid potential adverse consequences associated with the abrupt cessation of pain medication. The waiver was extended on April 9, 2020, and again on May 8, 2020. The waiver expires at 11:59 pm on June 5, 2020.Therefore, the emergency amendment to §174.5(e) is immediately necessary to help the state’s physicians, physician assistants and other health care professionals continue to mitigate the risk of exposure to COVID-19 and provide necessary medical services to related to chronic pain management with controlled substances for patients. Pursuant to the Governor’s declaration of disaster issued on March 13, 2020, related to COVID-19, physicians determining whether to utilize telemedicine medical services for the treatment of chronic pain with scheduled medications, must give due consideration to additional important parameters to ensure the safety of the patient.
Texas Board of Nursing
Emergency Rule
Amending 22 TAC §217.24 to allow Advanced Practice Registered Nurses to issue certain controlled substances via telemedicine
CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE22 TAC §217.24OVERVIEW The Texas Board of Nursing adopts emergency amendments to Texas Administrative Code §217.24 pursuant to a finding of imminent peril to the public health, safety, and welfare which requires adoption in fewer than thirty (30) days’ notice as authorized by Tex. Gov’t. Code §2001.034.BACKGROUND AND JUSTIFICATIONOn March 23, 2020, the Office of the Governor granted a waiver of the Texas Board of Nursing Rule 217.24(e)(1) that limits the Advanced Practice Registered Nurses’ ability to issue prescriptions for controlled substances for chronic pain via telemedicine. A waiver from this prohibition for refilling controlled substances for chronic pain patients evaluated via telemedicine was in effect until June 6, 2020, when the waiver expired.Accordingly, emergency amendments to §217.24 are necessary to help the Advanced Practice Registered Nurses to continue to mitigate the risk of exposure to COVID-19 and provide necessary medical services related to chronic pain management with controlled substances for patients. This action will avoid a gap in care for chronic pain patients. The emergency amendment is only be applicable to those Advanced Practice Registered Nurses whose delegating physicians agree to permit them to is- sue refills for these patients via telemedicine. The Advanced Practice Registered Nurse must continue to exercise appropriate professional judgment and all documentation requirements must be met. The services provided are limited to refills of con- trolled substances in schedules III through V.
Texas Board of Chiropractic Examiners
Proposed Rules
Amending 22 TAC §78.14 to clarify requirements for obtaining a Board-issued acupuncture permit
CHAPTER 78. SCOPE OF PRACTICE22 TAC §78.14OVERVIEW The Texas Board of Chiropractic Examiners (Board) proposes amendments to 22 TAC §78.14 (Acupuncture). The purpose of the amendments is to clarify the qualifications a licensee must demonstrate to obtain a Board-issued acupuncture permit.BACKGROUND AND JUSTIFICATIONUnder the proposed amendments of subsection (e), a licensee seeking an acupuncture permit may qualify under three methods. For recent licensees (and all future licensees), the requirement remains the completion of a 100 hour acupuncture course and passing the National Board of Chiropractic Examiners’ acupuncture exam. For those licensees who have been safely practicing acupuncture for several years, they have the option (depending on the length of time they have been practicing acupuncture) of demonstrating they held a chiropractic license and passed an exam in a 100 hour acupuncture course before January 1, 2010, or that they completed substantial acupuncture training before January 1, 2000, and can attest to having practiced acupuncture for at least ten years before January 1, 2010.The amendments also remove redundant language in subsections (c) and (k) stating that a licensee may not practice or advertise acupuncture without first obtaining a Board permit; violations of those requirements are already subject to disciplinary action under subsection (b) of this rule and in the Board’s advertising rules in 22 TAC §77.1 (Advertising and Public Communications).The amendments also add clarifying language to subsection (g) to make clear that a licensee may apply for an acupuncture permit by simply making a written request to the Board. The Board is also amending the language in subsection (d), which prohibits the delegation of acupuncture, from “cannot” to “may not” to conform to rule drafting conventions.
Texas Board of Physical Therapy Examiners
Proposed Rules
Amending 22 TAC §§341.1, 341.6, 341.8, 341.9 to require human trafficking prevention training as a condition for licensure
CHAPTER 341. LICENSE RENEWAL22 TAC §§341.1, 341.6, 341.8, 341.9OVERVIEW The Texas Board of Physical Therapy Examiners proposes amending 22 Texas Administrative Code (TAC) Chapter 341, License Renewal, specifically the following sections: §341.1. Requirements for Renewal§341.6. License Restoration§341.8. Inactive Status§341.9. Retired Status; Performing Voluntary Charity CareBACKGROUND AND JUSTIFICATIONThe amendments are proposed pursuant to the provisions in HB 2059 during the 86th Legislative Session that mandates the addition of human trafficking prevention training for health care practitioners as a condition of license renewal.
Texas Board of Occupational Therapy Examiners
Proposed Rules
Amending 40 TAC §367.1 to require human trafficking prevention training as a condition for licensure
CHAPTER 367. CONTINUING EDUCATION40 TAC §367.1OVERVIEW The Texas Board of Occupational Therapy Examiners proposes amendments to 40 Texas Administrative Code §367.1, Continuing Education. The amendments are proposed to add requirements concerning training on the prevention of human trafficking pursuant to House Bill 2059 of the 86th Regular Legislative Session in 2019.BACKGROUND AND JUSTIFICATIONHouse Bill 2059 requires that a health care practitioner successfully complete a training course on human trafficking prevention approved by the executive commissioner of the Health and Human Services Commission as a condition for license renewal. The Bill defines “health care practitioner” as an individual who provides direct patient care. The proposed amendments to §367.1 and proposed amendments to other chapters of the Board rules will require the completion of human trafficking prevention training as condition for license renewal for all occupational therapy licensees. The proposed amendments also pre-approve up to two contact hours for a human trafficking prevention training course and would allow a specific training course to be repeated for credit during a subsequent renewal period.
Texas Board of Occupational Therapy Examiners
Proposed Rules
Amending 40 TAC §370.2 and §370.3 to increase efficiency in late renewal or restoration of a license
CHAPTER 370. LICENSE RENEWAL40 TAC §370.2, §370.3OVERVIEW The Texas Board of Occupational Therapy Examiners proposes amendments to the following sections in 40 Texas Administrative Code: §370.2, Late Renewal§370.3, Restoration of a Texas LicenseBACKGROUND AND JUSTIFICATIONThe amendments are proposed to support the Board in streamlining and increasing the efficiency of its licensing processes, including through the use of digital technology, and reduce potential burdens for applicants. The amendments also cleanup and modify requirements for the renewal of an expired license and add human trafficking prevention training requirements pursuant to House Bill 2059 of the 86th Regular Legislative Session in 2019.
Texas Board of Occupational Therapy Examiners
Proposed Rules
Amending 40 TAC §371.1 and §371.2 to increase efficiency and to require human trafficking prevention training for inactive or retired status licensure
CHAPTER 371. INACTIVE AND RETIRED STATUS40 TAC §371.1, §371.2OVERVIEW The Texas Board of Occupational Therapy Examiners proposes amendments to the following sections in 40 Texas Administrative Code: §371.1, Inactive Status§371.2, Retired StatusBACKGROUND AND JUSTIFICATIONThe amendments to the sections are proposed to cleanup and clarify the sections and to reduce the requirements to initiate retired status. In addition, amendments to §371.2 are proposed to add requirements concerning training on the prevention of human trafficking pursuant to House Bill 2059 of the 86th Regular Legislative Session in 2019. Cleanups and clarifications to the sections include amendments to provisions concerning fees to add greater uniformity and clarity to the manner in which such are referenced.
Texas Department of Insurance
Withdrawn Rule
Withdrawing the emergency adoption of 28 TAC §§21.4901 – 21.4904, concerning disclosures by out-of-network providers
CHAPTER 21. TRADE PRACTICES SUBCHAPTER OO. DISCLOSURES BY OUT-OF-NETWORK PROVIDERS28 TAC §§21.4901 – 21.4904The Texas Department of Insurance withdraws the emergency adoption of new 28 TAC §§21.4901 – 21.4904 which appeared in the January 3, 2020, issue of the Texas Register (45 TexReg 13), and concerned disclosures by out-of-network providers. Following withdrawal of the emergency rule, new 28 TAC §§21.4901 – 21.4904 have been formally adopted and are detailed on 45 Tex Reg 4204.
Texas Health and Human Services Commission
Adopted Rules
Amending 1 TAC §355.112 to create separate rate-enhancement categories for attendants providing certain HCS and TxHmL services
CHAPTER 355. REIMBURSEMENT RATES SUBCHAPTER A. COST DETERMINATION PROCESS1 TAC §355.112OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.112, concerning Attendant Compensation Rate Enhancement. The amendment to §355.112 is adopted without changes to the proposed text as published in the March 20, 2020, issue of the Texas Register (45 TexReg 1915). The rule will not be republished.The amendment to §355.112 creates separate rate enhancement categories for day habilitation (DH) services and non-DH services for Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) programs and for services in a residential setting for the HCS program. The change allows flexibility in the rate enhancement program for HCS and TxHmL providers of services that do not utilize an hourly unit of service.BACKGROUND AND JUSTIFICATIONThe purpose of the amendment to §355.112 is to implement Rider 44 of the 2020-21 General Appropriations Act, Article II, House Bill 1, 86th Legislature, Regular Session, 2019 (Rider 44). Rider 44(a)(4) appropriated funds for the creation of separate categories in the Attendant Compensation Rate Enhancement (rate enhancement) programs which serve individuals with intellectual and developmental disabilities in order to increase participation in those rate enhancement programs. The rider directed that the categories be based on the number of attendant hours included in the billing unit.
State Board of Dental Examiners
Adopted Rules
Amending 22 TAC §101.3 to condition dental licensure on Level II background verification by Board staff, rather than a third-party vendor
CHAPTER 101. DENTAL LICENSURE22 TAC §101.3OVERVIEWThe State Board of Dental Examiners (Board) adopts the amendment to 22 TAC §101.3, concerning the requirements for licensure by credentials. This amendment is adopted without changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2812), and will not be republished.This amendment will remove the requirement that an applicant must submit an application to the Professional Background Information Services (PBIS), a third party vendor, for determination of a successful background verification. BACKGROUND AND JUSTIFICATIONThis rulemaking resulted from Board staff’s effort to reduce licensure costs and streamline the application process for applicants. Board staff is equipped to complete Level II background verification.
State Board of Dental Examiners
Adopted Rules
Amending 22 TAC §101.4 to condition temporary dental licensure on Level II background verification by Board staff, rather than a third-party vendor and to require biennual renewal
CHAPTER 101. DENTAL LICENSURE22 TAC §101.4OVERVIEWThe State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §101.4, concerning the requirements for temporary licensure by credentials. This amendment is adopted with changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2814), and will be republished.This amendment removes the requirement that an applicant must submit an application to the Professional Background Information Services (PBIS), a third party vendor, for determination of a successful background verification. The amendment also clarifies that biennual, not annual, renewals are required.BACKGROUND AND JUSTIFICATIONThis rulemaking resulted from Board staff’s effort to reduce licensure costs and streamline the application process for applicants. Board staff is equipped to complete Level II background verification.
State Board of Dental Examiners
Adopted Rules
New 22 TAC §101.14, suspending dental licensure requirements for qualified military spouses
CHAPTER 101. DENTAL LICENSURE22 TAC §101.14OVERVIEWThe State Board of Dental Examiners (Board) adopts new 22 TAC §101.14, concerning Exemption from Licensure for Certain Military Spouses. This new rule is adopted without changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2815), and will not be republished.This rule allows qualified military spouses to practice dentistry without obtaining a license to practice dentistry during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas.BACKGROUND AND JUSTIFICATIONThe adopted new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses.
State Board of Dental Examiners
Adopted Rules
New 22 TAC §101.15, clarifying the process for reinstating a cancelled or expired dental license
CHAPTER 101. DENTAL LICENSURE22 TAC §101.15The State Board of Dental Examiners (Board) adopts new 22 TAC §101.15 concerning Reinstatement of a Cancelled License. This new rule is adopted with changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2816), and will be republished.This rule will clarify the Board’s considerations when reviewing an application for licensure for an applicant who previously held a Texas license that expired and was subsequently cancelled.
State Board of Dental Examiners
Adopted Rules
Amending 22 TAC §103.3 to condition dental hygiene licensure on Level II background verification by Board staff, rather than a third-party vendor
CHAPTER 103. DENTAL HYGIENE LICENSURE22 TAC §103.3OVERVIEWThe State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §103.3, concerning the requirements for licensure by credentials. This amendment is adopted without changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2817). The rule will not be republished.This amendment removes the requirement that an applicant must submit an application to the Professional Background Information Services (PBIS), a third party vendor, for determination of a successful background verification.BACKGROUND AND JUSTIFICATIONThis rulemaking resulted from Board staff’s effort to reduce licensure costs and streamline the application process for applicants. Board staff is equipped to complete Level II background verification.
State Board of Dental Examiners
Adopted Rules
Amending 22 TAC §103.4 to condition temporary dental hygiene licensure on Level II background verification by Board staff, rather than a third-party vendor and to require biennual renewal
CHAPTER 103. DENTAL HYGIENE LICENSURE22 TAC §103.4OVERVIEWThe State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §103.4, concerning the requirements for temporary licensure by credentials. This amendment is adopted without changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2818). The rule will not be republished.This amendment removes the requirement that an applicant must submit an application to the Professional Background Information Services (PBIS), a third party vendor, for determination of a successful background verification. The amendment also clarifies that biannual, not annual, renewals are required.BACKGROUND AND JUSTIFICATIONThis rulemaking resulted from Board staff’s effort to reduce licensure costs and streamline the application process for applicants. Board staff is equipped to complete Level II background verification.
State Board of Dental Examiners
Adopted Rules
New 22 TAC §103.10, suspending dental hygiene licensure requirements for qualified military spouses
CHAPTER 103. DENTAL HYGIENE LICENSURE22 TAC §103.10OVERVIEWThe State Board of Dental Examiners (Board) adopts new 22 TAC §103.10 concerning Exemption from Licensure for Certain Military Spouses. This new rule is adopted without changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2819), and will not be republished.BACKGROUND AND JUSTIFICATIONThe adopted new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses.
State Board of Dental Examiners
Adopted Rules
New 22 TAC §103.11, clarifying the process for reinstating a cancelled or expired dental hygiene license
CHAPTER 103. DENTAL HYGIENE LICENSURE22 TAC §103.11The State Board of Dental Examiners (Board) adopts new rule 22 TAC §103.11, concerning Reinstatement of a Cancelled License. This new rule is adopted with changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2820). The rule will be republished.This rule clarifies the Board’s considerations when reviewing an application for licensure for an applicant who previously held a Texas license that expired and was subsequently cancelled.
State Board of Dental Examiners
Adopted Rules
New 22 TAC §114.7, allowing the extension of dental assistant duties to qualified military spouses
CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL–DENTAL ASSISTANTS22 TAC §114.7OVERVIEWThe State Board of Dental Examiners (Board) proposes new rule 22 TAC §114.7 concerning Exemption from Licensure for Certain Military Spouses. This new rule is adopted with changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2821), and will be republished.BACKGROUND AND JUSTIFICATIONThe proposed new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses.
Texas Department of State Health Services
Adopted Rules
New 22 TAC §114.7, allowing the extension of dental assistant duties to qualified military spouses
CHAPTER 114. EXTENSION OF DUTIES OF AUXILIARY PERSONNEL–DENTAL ASSISTANTS22 TAC §114.7OVERVIEWThe State Board of Dental Examiners (Board) proposes new rule 22 TAC §114.7 concerning Exemption from Licensure for Certain Military Spouses. This new rule is adopted with changes to the proposed text as published in the May 1, 2020, issue of the Texas Register (45 TexReg 2821), and will be republished.BACKGROUND AND JUSTIFICATIONThe proposed new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses.
Texas Department of Insurance
Adopted Rules
New 28 TAC §§21.4901 – 21.4904, limiting balance billing practices for out-of-network providers
CHAPTER 21. TRADE PRACTICESSUBCHAPTER OO. DISCLOSURES BY OUT-OF-NETWORK PROVIDERS28 TAC §§21.4901 – 21.4904OVERVIEWThe Commissioner of Insurance adopts new 28 Texas Administrative Code (TAC) §§21.4901 – 21.4904, concerning disclosures by out-of-network providers. The new sections are adopted with changes to the proposed text as published in the January 10, 2020, issue of the Texas Register (45 TexReg 268). The department adopts §21.4902 and §21.4904 without changes to the proposed text. The department revises §21.4901 and §21.4903 to correct punctuation for consistency with agency style, and the department also revises §21.4903 in response to public comments. Sections 21.4901 and 21.4903 will be republished.BACKGROUND AND JUSTIFICATIONThe new rules interpret and implement SB 1264, which does the following:Prohibits balance billing for certain health benefit claims under certain health benefit plans;Provides exceptions to balance billing prohibitions; and Authorizes an independent dispute resolution process for claim disputes between certain out-of-network providers and health benefit plan issuers and administrators.
Texas Department of Insurance
Adopted Rules
New 28 TAC §§21.4901 – 21.4904, limiting balance billing practices for out-of-network providers
CHAPTER 21. TRADE PRACTICESSUBCHAPTER OO. DISCLOSURES BY OUT-OF-NETWORK PROVIDERS28 TAC §§21.4901 – 21.4904OVERVIEWThe Commissioner of Insurance adopts new 28 Texas Administrative Code (TAC) §§21.4901 – 21.4904, concerning disclosures by out-of-network providers. The new sections are adopted with changes to the proposed text as published in the January 10, 2020, issue of the Texas Register (45 TexReg 268). The department adopts §21.4902 and §21.4904 without changes to the proposed text. The department revises §21.4901 and §21.4903 to correct punctuation for consistency with agency style, and the department also revises §21.4903 in response to public comments. Sections 21.4901 and 21.4903 will be republished.BACKGROUND AND JUSTIFICATIONThe new rules interpret and implement SB 1264, which does the following:Prohibits balance billing for certain health benefit claims under certain health benefit plans;Provides exceptions to balance billing prohibitions; and Authorizes an independent dispute resolution process for claim disputes between certain out-of-network providers and health benefit plan issuers and administrators.
Texas Department of State Health Services
In Addition
Correction of a publishing error concerning required data release for emergency hospitals visits under 25 TAC §421.78
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopted amendments to 25 TAC §421.78 in the June 12, 2020, issue of the Texas Register (45 TexReg 4044).Due to an error by the Texas Register, the text in 25 TAC §421.78(d)(10)(V) – (Z) was published incorrectly. The text should read as follows:(V) APG Code (Obtained from 3MTM APG Grouper) if applicable (Up to 10);(W) APG Category Code (Obtained from 3MTM APG Grouper) if ap-plicable (Up to 10);(X) APG Type Code (Obtained from 3MTM APG Grouper) if applicable (Up to 10);(Y) Final APG Assignment Code (Obtained from 3MTM APG Grouper) if applicable (Up to 10);(Z) Final APG Category Code (Obtained from 3MTM APG Grouper) if applicable (Up to 10).