23 Oct 2020

Texas Register October 23, 2020 Volume: 45 Number: 43

by | posted in: Employees Retirement System of Texas, Governor, Texas Board of Physical Therapy Examiners, Texas Department of State Health Services, Texas Department on Aging and Disability Services, Texas Health and Human Services Commission, Texas Optometry Board, Texas State Board of Examiners of Marriage and Family Therapists |

Texas Register Table of Contents

Governor

 

Notices

Proclamation 41-3776: Clarifying which hospitals must suspend elective surgeries pursuant to Executive Order GA-31

OVERVIEWGovernor, by virtue of the power and authority vested by the Constitution and laws of the State of Texas,  amends the paragraph of Executive Order GA-31 that defines “areas with high hospitalizations” to read as follows, effective at 12:01 a.m. on October 14, 2020:”Areas with high hospitalizations” means any Trauma Service Area that has had seven consecutive days in which the number of COVID-19 hospitalized patients as a percentage of total hospital capacity exceeds 15 percent, until such time as the Trauma Service Area has seven consecutive days in which the number of COVID-19 hospitalized patients as a percentage of total hospital capacity is 15 percent or less. A current list of areas with high hospitalizations will be maintained at www.dshs.texas.gov/ga3031.DURATION This proclamation shall remain in effect and in full force for as long as Executive Order GA-31 is in effect and in full force, unless otherwise modified, amended, rescinded, or superseded by the governor.BACKGROUND AND JUSTIFICATION This proclamation amends and clarifies Executive Order GA-31, which requires that that certain hospitals suspend elective surgeries and that every hospital reserve 10% capacity during the COVID-19 crisis. 

Texas Health and Human Services Commission

Emergency Rule

Renewing emergency rule 1 TAC §355.205, which temporarily issued rate increases for certain Medicaid providers

CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER B. ESTABLISHMENT AND ADJUSTMENT OF REIMBURSEMENT RATES FOR MEDICAID1 TAC §355.205OVERVIEWThe Texas Health and Human Services Commission is renewing the effectiveness of emergency new §355.205 for a 60-day period. The text of the emergency rule was originally published in the July 3, 2020, issue of the Texas Register (45 TexReg 4429).New 1 TAC §355.205 is an emergency rule for emergency temporary reimbursement rate increases and limitations on use of emergency temporary funds for Medicaid in response to novel coronavirus (COVID-19). BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.To protect Medicaid clients, providers, and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting an emergency rule to give HHSC the ability to establish emergency temporary reimbursement rate increases and limitations for certain Medicaid providers that serve vulnerable populations.HHSC may currently implement reimbursement rate modifications in accordance with §355.201(c)(3), which allows HHSC to establish fees, rates, and charges for medical assistance in accordance with various criteria, including “…economic conditions that, in HHSC’s determination, substantially and materially affect provider participation.” In addition to potential reimbursement rate modifications that HHSC may implement pursuant to §355.201(c)(3), HHSC is adopting this emergency rule to establish an emergency temporary reimbursement methodology to issue rate increases to providers in response to the COVID-19 pandemic. HHSC sought and received approval for this increase as required by House Bill 1 (Article II, Special Provisions for Health and Human Services Agencies, Special Provision 14), 86th Texas Legislature, Regular Session, 2019, and was directed to restrict use of funds by providers. HHSC is adopting this emergency rule to describe the process by which HHSC will restrict providers from using the increased reimbursement rates to increase hourly wages paid to direct care staff on an ongoing basis; use of the funds for staff compensation is limited to overtime payments, lump sum bonuses, bonuses for hazard pay, or other types of compensation that will not result in future reductions to hourly wages when the emergency temporary reimbursement rate increase is discontinued, in accordance with the contingencies placed upon use of the funds.

Texas Health and Human Services Commission

Emergency Rule

New 26 TAC §500.21, updating certain requirements for End Stage Renal Disease facilities in response to the COVID-19 pandemic

CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSINGSUBCHAPTER B. END STAGE RENAL DISEASE FACILITIES26 TAC §500.21OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 500 COVID-19 Emergency Health Care Facility Licensing, new §500.21, concerning an emergency rule in response to COVID-19 in order to update and continue the regulatory requirements for end stage renal disease (ESRD) facilities to reduce barriers to treatment during the COVID-19 pandemic. HHSC is adopting this emergency rule to reduce barriers to treatment for dialysis patients by updating ESRD facility regulatory guidelines regarding staffing ratios, in-home visits, telemedicine, incident reporting, and education and training requirements for staff.BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.The purpose of the emergency rulemaking is to support the Governor’s March 13, 2020, proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas. In this proclamation, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this rule for ESRD Facility Requirements During the COVID-19 Pandemic.

Texas Health and Human Services Commission

Proposed Rules

New 1 TAC §355.205, implementing temporary rate increases and limitations on use of emergency funds for Medicaid providers in response to the COVID-19 pandemic

CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER B. ESTABLISHMENT AND ADJUSTMENT OF REIMBURSEMENT RATES FOR MEDICAID1 TAC §355.205OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Texas Administrative Code (TAC) Title 1, Part 15, Chapter 355, Subchapter B, new §355.205, concerning Rule for Emergency Temporary Reimbursement Rate Increases and Limitations on Use of Emergency Temporary Funds for Medicaid in Response to Novel Coronavirus (COVID-19).Proposed new §355.205(a) and (b) introduce the emergency reimbursement and outline eligibility criteria for the increases. Subsection (c) provides a deadline by which a provider must submit an electronic attestation or be subject to recoupment. Subsection (d) and (e) specify the reconciliation process and how overpayments will be recouped if a provider fails to submit the attestation required in subsection (c). Subsections (f) and (g) provide guidance on procedures in the event of a disallowance of federal funds and the termination of the emergency temporary rate increases.BACKGROUND AND JUSTIFICATION The proposed new rule outlines the process by which HHSC will restrict eligible Medicaid providers from using temporarily increased reimbursement rates to increase hourly wages paid to direct care staff on an ongoing basis. In accordance with the contingencies placed upon use of the funds, use of the funds for staff compensation is limited to overtime payments, lump sum bonuses, bonuses for hazard pay, or other types of compensation that will not result in future reductions to hourly wages when the emergency temporary reimbursement rate increase is discontinued. Reimbursement rates were increased effective April 1, 2020, to ensure that these providers are able to purchase personal protective equipment, ensure adequate staff-to-client ratios, and take other necessary steps to serve clients individually rather than in congregate settings to protect the health and safety of the clients in their care.This new rule is based on an existing emergency rule adopted in response to the COVID-19 pandemic: §355.205, Emergency Rule for Emergency Temporary Reimbursement Rate Increases and Limitations on Use of Emergency Temporary Funds for Medicaid in Response to Novel Coronavirus (COVID-19). The provisions of this new rule are the same as the emergency rule. Except for a minor edit in the title of the rule and a clarifying edit in the text, there are no changes.

Texas State Board of Examiners of Marriage and Family Therapists

Proposed Rules

Amending 22 TAC §801.305 to update the schedule of sanctions

CHAPTER 801. LICENSURE AND REGULATION OF MARRIAGE AND FAMILY THERAPISTSSUBCHAPTER D. SCHEDULE OF SANCTIONS22 TAC §801.305OVERVIEWThe Texas Behavioral Health Executive Council proposes amended §801.305, relating to Schedule of Sanctions.The proposed amendment is being made so the schedule of sanctions better aligns with §801.302, regarding severity level and sanction guide.BACKGROUND AND JUSTIFICATIONIf a rule will pertain to a schedule of sanctions then the rule must first be proposed to the Executive Council by the applicable board for the profession before the Executive Council may propose or adopt such a rule, see §507.153 of the Tex. Occ. Code. The proposed amendment pertains to a schedule of sanctions for marriage and family therapists; therefore, the rule is covered by §507.153 of the Tex. Occ. Code.The Texas State Board of Examiners of Marriage and Family Therapists, in accordance with §502.1515 of the Tex. Occ. Code, previously voted and, by a majority, approved to propose this amended rule to the Executive Council. Therefore, the Executive Council has complied with Chapters 502 and 507 of the Tex. Occ. Code and may propose the rule amendment.

Texas Department of State Health Services

Proposed Rules

Repealing 25 TAC, Chapter 415, Subchapter C in order to transition governance of the mental health drug formulary to HHSC

CHAPTER 415. PROVIDER CLINICAL RESPONSIBILITIES–MENTAL HEALTH SERVICESSUBCHAPTER C. USE AND MAINTENANCE OF DEPARTMENT OF STATE HEALTH SERVICES/DEPARTMENT OF AGING AND DISABILITY SERVICES DRUG FORMULARY25 TAC §§415.101 – 415.111OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §415.101, concerning Purpose; §415.102, concerning Application; §415.103, concerning Definitions; §415.104, concerning General Requirements; §415.105, concerning Organization of DSHS/DADS Drug Formulary; §415.106, concerning Executive Formulary Committee; §415.107, concerning Responsibilities of the Executive Formulary Committee; §415.108, concerning Applying to Have a Drug Added to the Formulary; §415.109, concerning Changing the DSHS/DADS Drug Formulary; §415.110, concerning Prescribing Non-formulary Drugs; and §415.111, concerning Adverse Drug Reactions.The proposed rule repeals delete the rules in 25 TAC Chapter 415, Subchapter C, to reorganize and update the rules to be relocated to 26 TAC Chapter 306, Subchapter G.BACKGROUND AND JUSTIFICATION The proposed repeals are necessary to reflect the transition of programs from the Department of State Health Services (DSHS) to HHSC. Rules in Texas Administrative Code (TAC) Title 25, Part 1, Chapter 415, Subchapter C are repealed, updated, reorganized, and proposed in 26 TAC Chapter 306, Subchapter G. The new rules are proposed simultaneously elsewhere in this issue of the Texas Register.

Texas Health and Human Services Commission

Proposed Rules

New 26 TAC, Chapter 306, Subchapter G, establishing HHSC’s governance of the drug formulary

CHAPTER 306. BEHAVIORAL HEALTH DELIVERY SYSTEMSUBCHAPTER G. USE AND MAINTENANCE OF THE HEALTH AND HUMAN SERVICES COMMISSION PSYCHIATRIC DRUG FORMULARY26 TAC §§306.351 – 306.360OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §306.351, concerning Purpose; §306.352, concerning Application; §303.353, concerning Definitions; §306.354, concerning General Requirements; §306.355, concerning Organization of HHSC Psychiatric Drug Formulary; §306.356, concerning Responsibilities of the Psychiatric Executive Formulary Committee; §306.357, concerning Adding a Drug to the HHSC Psychiatric Drug Formulary; §306.358, concerning Changing the HHSC Psychiatric Drug Formulary; §306.359, concerning Prescribing Non-formulary Drugs; and §306.360, concerning Adverse Drug Reactions.SECTION-BY-SECTION SUMMARYA summary of each new rule is included in this week’s edition of the Texas Register (45 Tex Reg 7520). BACKGROUND AND JUSTIFICATION The purpose of the proposed new rules is to move HHSC rules in Texas Administrative Code (TAC) Title 25, Chapter 415, Subchapter C and 40 TAC Chapter 5, Subchapter C to 26 TAC Chapter 306, Subchapter G as part of consolidating HHSC rules. The rules are repealed, updated, and reorganized, as they have not been reviewed since 2002, and are placed in 26 TAC Chapter 306. The rule project workgroup has updated the rules for clarity using plain language where possible and to provide a simpler description of the composition and operation of the agency’s formulary committee. The repeal of those rules is proposed simultaneously elsewhere in this issue of the Texas Register.

Employees Retirement System of Texas

Proposed Rules

Amending 34 TAC §63.3 and §63.4 to update election procedures for the Board of Trustees

CHAPTER 63. BOARD OF TRUSTEES34 TAC §63.3, §63.4OVERVIEWThe Employees Retirement System of Texas (ERS) proposes amendments to 34 Texas Administrative Code (TAC) Chapter 63, concerning Board of Trustees, by amending §63.3 (Election of Trustees (Nomination Process)) and §63.4 (Election of Trustees (Ballot)).BACKGROUND AND JUSTIFICATION ERS is a constitutional trust fund established as set forth in Article XVI, §67, Texas Constitution, and further organized pursuant to Title 8, Tex. Gov’t Code, as well as 34 Texas Administrative Code, §§61.1 et seq.Section 63.3, concerning Election of Trustees (Nomination Process), is proposed to be amended to allow ERS to collect required signatures for potential candidates for election to the ERS Board of Trustees through a secure and efficient electronic verification process in addition to the current paper-based process and to allow for the use of personal identifiers that are not based on social security numbers. Section 63.4, concerning Election of Trustees (Ballot), is proposed to be amended to make its language consistent with the language of §63.3.

Texas Department on Aging and Disability Services

Proposed Rules

Repealing 40 TAC, Chapter 5, Subchapter C in order to transition governance of the intellectual disability drug formulary to HHSC

CHAPTER 5. PROVIDER CLINICAL RESPONSIBILITIES–INTELLECTUAL DISABILITY SERVICESSUBCHAPTER C. USE AND MAINTENANCE OF DRUG FORMULARY40 TAC §§5.101 – 5.114OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes the repeal of §5.101, concerning Purpose; §5.102, concerning Application; §5.103, concerning Definitions; §5.104, concerning General Requirements; §5.105, concerning Organization of TDMHMR Drug Formulary; §5.106, concerning Executive Formulary Committee; §5.107, concerning Responsibilities of the Executive Formulary Committee; §5.108, concerning Applying to Have a Drug Added to the Formulary; §5.109, concerning Changing the TDMHMR Drug Formulary; §5.110, concerning Prescribing Non-formulary Drugs; §5.111, concerning Adverse Drug Reactions; §5.112, concerning Exhibit; §5.113, concerning References; and §5.114, concerning Distribution.The proposed rule repeals delete the rules in 40 TAC Chapter 5, Subchapter C, to reorganize and update the rules to be relocated to 26 TAC Chapter 306, Subchapter G.BACKGROUND AND JUSTIFICATION The proposed repeals are necessary to reflect the transition of programs from the Department of Aging and Disability Services to HHSC. Rules in Texas Administrative Code (TAC) Title 40, Part 1, Chapter 5, Subchapter C are repealed, updated, reorganized, and proposed in 26 TAC Chapter 306, Subchapter G. The new rules are proposed simultaneously elsewhere in this issue of the Texas Register.

Texas Optometry Board

Adopted Rules

Amending 22 TAC §273.10 to prohibit disciplinary action for a licensee’s failure to pay student loans

CHAPTER 273. GENERAL RULES22 TAC §273.10OVERVIEWThe Texas Optometry Board adopts amendments to §273.10 of Chapter 273, Title 22, without changes to the proposed text as published in the June 26, 2020, issue of the Texas Register (45 TexReg 4292). The rule will not be republished.The amendments prohibit disciplinary action by a licensing agency because of a default on a student loan or a breach of a student loan repayment contract or scholarship contract.BACKGROUND AND JUSTIFICATION The Texas Optometry Board adopts amendments to 22 TAC §273.10 (Licensee Compliance with Payment Obligations) to implement Senate Bill 37, 86th Legislature, Regular Session, prohibiting disciplinary action by a licensing agency because of a default on a student loan or a breach of a student loan repayment contract or scholarship contract.

Texas Board of Physical Therapy Examiners

Adopted Rules

Amending 22 TAC §329.5 to update licensing requirements for foreign-trained applicants

CHAPTER 329. LICENSING PROCEDURE22 TAC §329.5The Texas Board of Physical Therapy Examiners adopts the amendments to 22 Texas Administrative Code (TAC) §329.5 (Licensing Procedures for Foreign-Trained Applicants). The amendments are adopted without changes to the proposed text as published in the August 21, 2020, issue of the Texas Register (45 TexReg 5824). The rule will not be republished.The amendment is adopted to update the Test of English as a Foreign Language (TOEFL) minimum standards accepted by the board as proof of English language proficiency for a foreign-trained licensure applicant. The amendment eliminates outdated scores and adds the most recent TOEFL scores adopted by the Federation of State Boards of Physical Therapy (FSBPT).

Texas Board of Physical Therapy Examiners

Adopted Rules

Amending 22 TAC §344.1 to update the schedule of sanctions

CHAPTER 344. ADMINISTRATIVE FINES AND PENALTIES22 TAC §344.1The Texas Board of Physical Therapy Examiners adopts the amendments to 22 Texas Administrative Code (TAC) §344.1, regarding changes to the Schedule of Sanctions graphic. The amendments are adopted without changes to the proposed text as published in the August 21, 2020, issue of the Texas Register (45 TexReg 5825). The rule will not be republished.The amendment is adopted to update the Schedule of Sanctions graphic by removing the sanctions for not registering a physical therapy facility and practicing in an unregistered physical therapy facility pursuant to the repeal of physical therapy facility registration and annual renewal pursuant to SB 317 during the 85th Legislative Session; and to add a range of fines that can be imposed per violation to each category of disciplinary action.

Texas Health and Human Services Commission

Adopted Rules

New 26 TAC §§567.1 – 567.6, establishing general provisions for the Certificate of Public Advantage

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER A. GENERAL PROVISIONS26 TAC §§567.1 – 567.6OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts new §§567.1 – 567.6 in Texas Administrative Code (TAC) Title 26, Part 1, Chapter 567. The new rules are adopted without changes to the proposed text as published in the July 10, 2020, issue of the Texas Register (45 TexReg 4704). These rules will not be republished.The anew rules outline general provisions for the Certificate of Public Advantage. SECTION-BY-SECTION SUMMARY Proposed new §567.1, relating to Purpose, describes the purpose of the rules in 26 TAC, Chapter 567.Proposed new §567.2, relating to Definitions, defines the key terms and phrases used in the rules.Proposed new §567.3, relating to Applicability, describes the criteria for hospitals to be eligible to apply for a COPA.Proposed new §567.4, relating to Certificate of Public Advantage Required, notes that a merger agreement will not receive immunity under HSC Chapter 314A without a COPA.Proposed new §567.5, relating to Compliance, describes the requirements for applying and operating under a COPA.Proposed new §567.6, relating to Scope, describes the parameters and limitations of a COPA.BACKGROUND AND JUSTIFICATIONThe new sections are necessary to implement House Bill (H.B.) 3301, 86th Legislature, Regular Session, 2019, which added Chapter 314A to Texas Health and Safety Code (HSC). This chapter requires HHSC, as the agency designated by the governor under HSC §314A.004, to adopt rules for the administration and implementation of Chapter 314A. This chapter permits qualifying hospitals in certain counties to apply for a Certificate of Public Advantage (COPA). A COPA grants merging hospitals immunity from federal and state antitrust laws.The new sections require hospitals eligible to apply for a COPA to pay a fee if applying for a COPA and, if granted a COPA, pay an annual supervision fee, report changes that could affect the COPA, submit an annual report, request approval from HHSC to change rates, and submit a corrective action plan if found to be out of compliance with 26 TAC Chapter 567.

Texas Health and Human Services Commission

Adopted Rules

New 26 TAC §§567.21 – 567.26, establishing requirements for application and issuance of the Certificate of Public Advantage

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER B. APPLICATION AND ISSUANCE26 TAC §§567.21 – 567.26OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts new §§567.21 – 567.26 in Texas Administrative Code (TAC) Title 26, Part 1, Chapter 567. The new rules are adopted without changes to the proposed text as published in the July 10, 2020, issue of the Texas Register (45 TexReg 4704). These rules will not be republished.The new rules outline requirements for application and issuance of the Certificate of Public Advantage. SECTION-BY-SECTION SUMMARY Proposed new §567.21, relating to Changes That Could Affect the Certificate of Public Advantage, requires applicants to notify HHSC of certain events concerning hospitals that are party to the agreement.Proposed new §567.22, relating to Application, describes the COPA application process and requirements.Proposed new §567.23, relating to Texas Health and Human Services Commission Review, notes HHSC’s standard of review of the application.Proposed new §567.24, relating to Attorney General Review, describes HHSC’s duty to consult with the Attorney General on each COPA application.Proposed new §567.25, relating to Fees, describes the COPA application fee and the annual supervision fee for each hospital operating under a COPA.Proposed new §567.26, relating to Conditions for Issuing a Certificate of Public Advantage, describes the conditions under which HHSC will issue a COPA.BACKGROUND AND JUSTIFICATIONThe new sections are necessary to implement House Bill (H.B.) 3301, 86th Legislature, Regular Session, 2019, which added Chapter 314A to Texas Health and Safety Code (HSC). This chapter requires HHSC, as the agency designated by the governor under HSC §314A.004, to adopt rules for the administration and implementation of Chapter 314A. This chapter permits qualifying hospitals in certain counties to apply for a Certificate of Public Advantage (COPA). A COPA grants merging hospitals immunity from federal and state antitrust laws.The new sections require hospitals eligible to apply for a COPA to pay a fee if applying for a COPA and, if granted a COPA, pay an annual supervision fee, report changes that could affect the COPA, submit an annual report, request approval from HHSC to change rates, and submit a corrective action plan if found to be out of compliance with 26 TAC Chapter 567.

Texas Health and Human Services Commission

Adopted Rules

New 26 TAC §§567.31 – 567.33, establishing operational requirements for the Certificate of Public Advantage

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER C. OPERATIONAL REQUIREMENTS26 TAC §§567.31 – 567.33OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts new §§567.31 – 567.33 in Texas Administrative Code (TAC) Title 26, Part 1, Chapter 567. The new rules are adopted without changes to the proposed text as published in the July 10, 2020, issue of the Texas Register (45 TexReg 4704). These rules will not be republished.The new rules outline operational requirements for the Certificate fo Public Advantage.  SECTION-BY-SECTION SUMMARY Proposed new §567.31, relating to Terms, notes HHSC’s ability to require hospitals operating under a COPA to comply with additional terms or conditions, if necessary.Proposed new §567.32, relating to Annual Report, describes the annual reporting requirements for each hospital operating under a COPA.Proposed new §567.33, relating to Voluntary Termination, allows a hospital operating under a COPA to voluntarily terminate a COPA on 30 days’ notice.BACKGROUND AND JUSTIFICATIONThe new sections are necessary to implement House Bill (H.B.) 3301, 86th Legislature, Regular Session, 2019, which added Chapter 314A to Texas Health and Safety Code (HSC). This chapter requires HHSC, as the agency designated by the governor under HSC §314A.004, to adopt rules for the administration and implementation of Chapter 314A. This chapter permits qualifying hospitals in certain counties to apply for a Certificate of Public Advantage (COPA). A COPA grants merging hospitals immunity from federal and state antitrust laws.The new sections require hospitals eligible to apply for a COPA to pay a fee if applying for a COPA and, if granted a COPA, pay an annual supervision fee, report changes that could affect the COPA, submit an annual report, request approval from HHSC to change rates, and submit a corrective action plan if found to be out of compliance with 26 TAC Chapter 567.

Texas Health and Human Services Commission

Adopted Rules

New 26 TAC §567.41, establishing parameters on rate review for the Certificate of Public Advantage

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER D. RATE REVIEW26 TAC §567.41OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts new §567.41 in Texas Administrative Code (TAC) Title 26, Part 1, Chapter 567. The new rules are adopted without changes to the proposed text as published in the July 10, 2020, issue of the Texas Register (45 TexReg 4704). These rules will not be republished.Proposed new §567.41, relating to Rate Reviews for Hospitals Operating Under a Certificate of Public Advantage, describes the review process for proposed rate changes for hospital services and requirements for HHSC’s approval or denial of a proposed rate change.BACKGROUND AND JUSTIFICATIONThe new sections are necessary to implement House Bill (H.B.) 3301, 86th Legislature, Regular Session, 2019, which added Chapter 314A to Texas Health and Safety Code (HSC). This chapter requires HHSC, as the agency designated by the governor under HSC §314A.004, to adopt rules for the administration and implementation of Chapter 314A. This chapter permits qualifying hospitals in certain counties to apply for a Certificate of Public Advantage (COPA). A COPA grants merging hospitals immunity from federal and state antitrust laws.The new sections require hospitals eligible to apply for a COPA to pay a fee if applying for a COPA and, if granted a COPA, pay an annual supervision fee, report changes that could affect the COPA, submit an annual report, request approval from HHSC to change rates, and submit a corrective action plan if found to be out of compliance with 26 TAC Chapter 567.

Texas Health and Human Services Commission

Adopted Rules

New 26 TAC §§567.51 – 567.54, establishing parameters for enforcement of the Certificate of Public Advantage

CHAPTER 567. CERTIFICATE OF PUBLIC ADVANTAGESUBCHAPTER E. ENFORCEMENT26 TAC §§567.51 – 567.54OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts new §§567.51 – 567.54 in Texas Administrative Code (TAC) Title 26, Part 1, Chapter 567. The new rules are adopted without changes to the proposed text as published in the July 10, 2020, issue of the Texas Register (45 TexReg 4704). These rules will not be republished.The new rules relate to enforcement for the Certificate of Public Advantage. SECTION-BY-SECTION SUMMARY Proposed new §567.51, relating to Supervision, describes the duty of HHSC to supervise each hospital operating under a COPA.Proposed new §567.52, relating to Annual Review, describes HHSC’s annual review process.Proposed new §567.53, relating to Investigation; Consequences, describes HHSC’s authority to investigate a hospital and the potential consequences of an investigation.Proposed new §567.54, relating to Corrective Action Plan; describes HHSC’s authority to require a corrective action plan and the timeframes associated with corrective action plans.BACKGROUND AND JUSTIFICATIONThe new sections are necessary to implement House Bill (H.B.) 3301, 86th Legislature, Regular Session, 2019, which added Chapter 314A to Texas Health and Safety Code (HSC). This chapter requires HHSC, as the agency designated by the governor under HSC §314A.004, to adopt rules for the administration and implementation of Chapter 314A. This chapter permits qualifying hospitals in certain counties to apply for a Certificate of Public Advantage (COPA). A COPA grants merging hospitals immunity from federal and state antitrust laws.The new sections require hospitals eligible to apply for a COPA to pay a fee if applying for a COPA and, if granted a COPA, pay an annual supervision fee, report changes that could affect the COPA, submit an annual report, request approval from HHSC to change rates, and submit a corrective action plan if found to be out of compliance with 26 TAC Chapter 567.

Texas Optometry Board

Notices

Following official rule review, the Board has readopted selected rules from 22 TAC, Chapters 271, 272, 273, and 275

OVERVIEWThe Texas Optometry Board readopts without change Texas Administrative Code, Title 22, Chapters 271, 272, 273, and 275, pursuant to the Texas Government Code, §2001.039. The agency proposed the review of the chapters in the March 6, 2020, issue of the Texas Register (45 TexReg 1722). After reviewing the rules in Chapters 271, 272, 273, and 275, the agency finds that the reasons for initially adopting the rules continue to exist and readopts the rules. DETAILED SUMMARY The agency has proposed an amendment to 22 TAC §273.10 to remove an outdated section. The agency has adopted changes to 22 TAC §275.2 during the review process.The following rules in Chapter 271 are being readopted: §271.1, Definitions; §271.2, Applications; §271.3, Jurisprudence Examination Administration; §271.5, Licensure without Examination; §271.6, National Board Examination; and §271.7, Criminal History Evaluation Letters.The following rules in Chapter 272 are being readopted: §272.1, Open Records; §272.2, Historically Underutilized Businesses; and §272.3, Contract and Purchasing Procedures.The following rules in Chapter 273 are being readopted: §273.1, Surrender of License; §273.2, Use of Name of Retired or Deceased Optometrist; §273.3, Contact Lenses as Prize or Premium; §273.4, Fees (Not Refundable); §273.5, Clinical Instruction and Practice Limited License for Clinical Faculty; §273.6, Licenses for a Limited Period; §273.7, Inactive Licenses and Retired License for Volunteer Charity Care; §273.8, Renewal of License; §273.9, Public Interest Information; §273.10, Licensee Compliance with Payment Obligations; §273.11, Public Participation in Meetings; §273.12, Profile Information; §273.13, Contract or Employment with Community Health Centers; and §273.14, License Applications for Military Service Member, Military Veteran, and Military Spouse.The following rules in Chapter 275 are being readopted: §275.1, General Requirements; and §275.2, Required Education.

Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for Indian Health Services

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for Indian Health Services.The proposed payment rates were calculated in accordance with Title 1 of the Texas Administrative Code, §355.8620, which addresses the reimbursement methodology for Services Provided in Indian Health Service and Tribal Facilities.The payment rates for the Indian Health Services are proposed to be effective January 1, 2020.A briefing packet describing the proposed payment rates will be made available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only.Please register for the HHSC Public Rate Hearing for Medicaid Calendar Fee Review, HCPCS Updates, and Medical Policy Updates to be held on November 13, 2020 9:00 a.m. CST at:https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.HHSC will broadcast the public hearing; the broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings. The broadcast will be archived and can be accessed on demand at the same website. The hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medicaid Biennial Calendar Fee Review

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Medicaid Biennial Calendar Fee Review.The payment rates for the Medicaid Biennial Calendar Fee Review are proposed to be effective March 1, 2021, for the following services:AnesthesiaAmbulatory Surgical Center (ASC)/Hospital Based ASCBirthing CentersClinical LabsClinical Labs GapfillG Codes HospitalsGeneral and Integumentary System SurgeryNervous System SurgeryOrthotic Procedures and DevicesPhysician Administered Drugs (PAD) Non-OncologyPAD OncologyPAD VaccinesPAD NDCX ListA briefing packet describing the proposed payment rates will be made available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILSDue to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only.Please register for the HHSC Public Rate Hearing for Medicaid Calendar Fee Review, HCPCS Updates, and Medical Policy Updates to be held on November 13, 2020 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.HHSC will broadcast the public hearing; the broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings. The broadcast will be archived and can be accessed on demand at the same website. The hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medical Policy Review of Colorectal Cancer Screening Policy

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Medical Policy Review of Colorectal Cancer Screening Policy.The payment rates for the Medical Policy Review of Colorectal Cancer Screening Policy are proposed to be effective March 1, 2021.A briefing packet describing the proposed payments rates will be made available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only.Please register for the HHSC Public Rate Hearing for Medicaid Calendar Fee Review, HCPCS Updates, and Medical Policy Updates to be held on November 13, 2020, at 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.HHSC will broadcast the public hearing; the broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings. The broadcast will be archived and can be accessed on demand at the same website. The hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medical Policy Review of Digital Breast Tomosynthesis

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive public comment on proposed Medicaid payment rates for the Medical Policy Review of Digital Breast Tomosynthesis.The payment rates for the Medical Policy Review of Digital Breast Tomosynthesis are proposed to be effective March 1, 2021.A briefing packet describing the proposed payments rates will be available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only.Please register for the HHSC Public Rate Hearing for Medicaid Calendar Fee Review, HCPCS Updates, and Medical Policy Updates to be held on November 13, 2020, at 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medical Policy Review of Nutritional (Enteral) Products, Supplies, and Equipment – Home Health & CCP: Immobilized Lipase Cartridge

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Medical Policy Review of Nutritional (Enteral) Products, Supplies, and Equipment – Home Health & CCP: Immobilized Lipase Cartridge.he payment rates for the Medical Policy Review of Nutritional (Enteral) Products, Supplies, and Equipment – Home Health & CCP: Immobilized Lipase Cartridge are proposed to be effective March 1, 2021.A briefing packet describing the proposed payment rates will be made available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will now be conducted online only. No physical entry to the hearing will be permitted.Please register for the HHSC Public Rate Hearing for Medicaid Calendar Fee Review, HCPCS Updates, and Medical Policy Updates to be held on November 13, 2020, at 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medical Policy Review of Stereotactic Radiosurgery

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Medical Policy Review of Stereotactic Radiosurgery.The payment rates for the Medical Policy Review of Stereotactic Radiosurgery are proposed to be effective March 1, 2021.A briefing packet describing the proposed payments rates will be made available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will now be conducted online only. No physical entry to the hearing will be permitted.Please register to HHSC Public Rate Hearing for Medicaid Calendar Fee Review, HCPCS Updates, and Medical Policy Updates to be held on November 13, 2020, at 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Medical Policy Review of Telemonitoring Update

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Medical Policy Review of Telemonitoring Update.The payment rates for the Medical Policy Review of Telemonitoring Update are proposed to be effective March 1, 2021.A briefing packet describing the proposed payment rates will be made available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only.Please register for the HHSC Public Rate Hearing for Medicaid Calendar Fee Review, HCPCS Updates, and Medical Policy Updates to be held on November 13, 2020, at 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Notice of Public Hearing on Proposed Medicaid Payment Rates for the Review of Healthcare Common Procedure Coding System (HCPCS) Updates

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Quarterly HCPCS Updates.The payment rates for the Quarterly HCPCS Updates are proposed to be effective March 1, 2021.A briefing packet describing the proposed payment rates will be made available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only.Please register for the HHSC Public Rate Hearing for Quarterly HCPCS Updates to be held on November 13, 2020, 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd, Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Public Notice – Amendment to the Deaf Blind with Multiple Disabilities (DBMD) Waiver effective February 28, 2021

OVERVIEWThe Texas Health and Human Services Commission (HHSC) is submitting to the Centers for Medicare & Medicaid Services (CMS) a request to amend the Deaf Blind with Multiple Disabilities (DBMD) waiver administered under section 1915(c) of the Social Security Act. CMS has approved this waiver through February 28, 2023. The proposed effective date for the amendment is February 28, 2021.The request proposes to make the following changes:Appendices B and J will be revised to reduce the unduplicated number of participants that the waiver will serve (Factor C) and increase the maximum number of participants to be served at any point in time (PIT) during waiver years three through five (March 1, 2020 through February 28, 2023) to more accurately reflect current utilization trends. Revising the Factor C and PIT will have an impact on the calculations for the overall projected cost of the waiver services (Factor D) and the overall projected cost of other Medicaid Services furnished to waiver participants (D Prime (D’)) for the same waiver years.BACKGROUND AND JUSTIFICATION The DBMD waiver program serves individuals with legal blindness, deafness, or a condition that leads to deaf-blindness, and at least one additional disability that limits functional abilities. The program serves individuals in the community who would otherwise require care in an intermediate care facility for individuals with intellectual disability or a related condition.ADDITIONAL INFORMATIONIf you want to obtain a free copy of the proposed request to amend the waiver, including the DBMD settings transition plan, or if you have questions, need additional information or want to submit comments regarding this amendment or the DBMD settings transition plan, you may contact Luis Solorio by U.S. mail, telephone, fax, or email. Those addresses are listed in this week’s edition of the Texas Register (45 Tex Reg 7641). 

Texas Health and Human Services Commission

In Addition

Public Notice – Proposed Medicaid Payment Rates for the Medical Policy Review of Wound Care

OVERVIEWThe Texas Health and Human Services Commission (HHSC) will conduct a public hearing on November 13, 2020, at 9:00 a.m., to receive comment on proposed Medicaid payment rates for the Medical Policy Review of Wound Care.The payment rates for the Medical Policy Review of Wound Care are proposed to be effective March 1, 2021.A briefing packet describing the proposed payments rates will be made available at https://rad.hhs.texas.gov/rate-packets on or after October 30, 2020. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by telephone at (512) 730-7401; by fax at (512) 730-7475; or by e-mail at RADAcuteCare@hhsc.state.tx.us.HEARING DETAILS Due to the declared state of disaster stemming from COVID-19, this hearing will be conducted online only.Please register for the HHSC Public Rate Hearing for Medicaid Calendar Fee Review, HCPCS Updates, and Medical Policy Updates to be held on November 13, 2020, at 9:00 a.m. CST at: https://attendee.gotowebinar.com/register/6544792796314405390. After registering, you will receive a confirmation email containing information about joining the webinar.PUBLIC COMMENT Written comments regarding the proposed payment rates may be submitted in lieu of, or in addition to, oral testimony until 5:00 p.m. the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by e-mail to RADAcuteCare@hhsc.state.tx.us. In addition, written comments may be sent by overnight mail to Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, Brown-Heatly Building, 4900 North Lamar Blvd., Austin, Texas 78751.

Texas Health and Human Services Commission

In Addition

Public Notice – Texas Home Living (TxHmL) Waiver Application

OVERVIEWThe Texas Health and Human Services Commission (HHSC) is submitting to the Centers for Medicare & Medicaid Services (CMS) a request to amend the waiver application for the Texas Home Living (TxHmL) waiver program authorized under section 1915(c) of the Social Security Act. CMS has approved the TxHmL waiver application through February 28, 2022. The proposed effective date for this amendment is February 28, 2021.This request proposes to update Appendix B and Appendix J of the waiver application to reduce the unduplicated number of participants that the waiver program will serve (Factor C) and the maximum number of participants to be served at any point in time (PIT) during waiver year four for the period of March 1, 2020 through February 28, 2021 and waiver year five for the period of March 1, 2021 through February 28 2022. The requested amendment more accurately reflects current utilization trends.BACKGROUND AND JUSTIFICATION The TxHmL waiver program provides services and supports to individuals with intellectual disabilities who live in their own homes or in the home of a family member. Services and supports are intended to enhance quality of life, functional independence, and health and well-being in continued community-based living and to enhance, rather than replace, existing informal or formal supports and resources. Services include day habilitation, respite, supported employment, financial management services, support consultation, adaptive aids, audiology services, behavioral support, community support, dental treatment, dietary service, employment assistance, minor home modifications, occupational therapy services, physical therapy services, nursing, and speech-language pathology.ADDITIONAL INFORMATIONThe complete waiver amendment request can be found online on the Health and Human Services website at: https://hhs.texas.gov/laws-regulations/policies-rules/waivers.An individual may obtain a free copy of the proposed waiver amendment, including the TxHmL settings transition plan, or ask questions, obtain additional information, or submit comments regarding this amendment or the TxHmL settings transition plan, by contacting Luis Solorio by U.S. mail, telephone, fax, or email. Those addresses are listed in this week’s edition of the Texas Register (45 Tex Reg 7642). 

Texas Department of State Health Services

In Addition

Controlled Substances: Order Removing Approved Cannabidiol Drugs from Schedule V, Adding Cenobamate to Schedule V, and Adding Isotonitazene to Schedule I Temporarily Scheduled Substances

FEDERAL ACTIONThe Drug Enforcement Administration (DEA) issued an interim final rule to codify statutory amendments to the Controlled Substances Act (CSA) made by the Agriculture Improvement Act of 2018 (AIA), regarding the scope of regulatory controls over marihuana-related constituents. This interim final rule was published in the Federal Register, Volume 85, Number 163, Pages 51639-51645, and takes effect August 21, 2020.The order removes from schedule V a “drug product in finished dosage formulation that has been approved by the U.S. Food and Drug Administration that contains cannabidiol (2-[1R-3-methyl-6R-(1-methylethenyl)-2-cyclohexen-1-yl]-5-pentyl-1,3-benzenediol) derived from cannabis and no more than 0.1% (w/w) residual tetrahydrocannabinols.”The Drug Enforcement Administration issued a final rule adopting, without change, an interim final rule with request for comments published in the Federal Register on March 10, 2020, placing cenobamate [(1R)-1-(2-chlorophenyl)-2-(tetrazol-2-yl)ethyl] carbamate, including its salts, in schedule V of the Controlled Substances Act. This final rule was published in the Federal Register, Volume 85, Number 162, pages 51340-51342, and takes effect August 20, 2020.The Acting Administrator of the Drug Enforcement Administration issued a temporary order to schedule N,N-diethyl-2-(2-(4 isopropoxybenzyl)-5-nitro-1H-benzimidazol-1-yl)ethan-1-amine (commonly known as isotonitazene), including its isomers, esters, ethers, salts, and salts of isomers, esters, and ethers whenever the existence of such isomers, esters, ethers,and salts is possible, in schedule I. This temporary scheduling action was published in the Federal Register, Volume 85, Number 162, pages 51342-51346, and takes effect August 20, 2020. The action was taken for the following reasons:1. Isotonitazene has high potential for abuse;2. There is currently no accepted medical use in treatment in the United States;3. There is a lack of accepted safety for use under medical supervision; and4. Control of isotonitazine is necessary to avoid an imminent hazard to public safety.STATE ACTION Pursuant to Section 481.034(g), as amended by the 75th legislature, of the Texas Controlled Substances Act, Health and Safety Code, Chapter 481, at least thirty-one days have expired since notice of the above referenced actions were published in the Federal Register. In the capacity as Commissioner of the Texas Department of State Health Services, John Hellerstedt, M.D., does hereby order the removal of approved cannabidiol drugs from Schedule V; adoption of a final rule placing cenobamate in schedule V; and the placement of isotonitazine into schedule I temporarily controlled substances.

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