Texas Register Table of Contents
- 1 Texas Health and Human Services Commission
- 2 Texas Health and Human Services Commission
- 3 Texas Board of Veterinary Medical Examiners
- 4 Texas Board of Veterinary Medical Examiners
- 5 Texas Health and Human Services Commission
- 6 Governor
- 7 Governor
- 8 Governor
- 9 Governor
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Texas Health and Human Services Commission
Emergency Rule
New 26 TAC §558.950, allowing limited indoor and outdoor visitation at hospice inpatient units during the COVID-19 crisis
CHAPTER 558. LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIESSUBCHAPTER I. RESPONSE TO COVID-19 AND PANDEMIC-LEVEL COMMUNICABLE DISEASE26 TAC §558.950OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26, Texas Administrative Code, Chapter 558, Licensing Standards for Home and Community Support Services Agencies, Subchapter I, Response to COVID-19 and Pandemic-Level Communicable Disease, new §558.950, concerning an emergency rule in response to COVID-19 describing requirements for limited indoor and outdoor visitation in a hospice inpatient unit. HHSC is adopting this emergency rule to require limited indoor and outdoor visitation in a hospice inpatient unit. The purpose of the new rule is to describe the requirements related to such visits.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.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 emergency rule for Hospice Inpatient Units COVID-19 Response–Reopening Visitation.
Texas Health and Human Services Commission
Proposed Rules
CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER J. PURCHASED HEALTH SERVICESDIVISION 4. MEDICAID HOSPITAL SERVICES1 TAC §355.8065OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.8065, concerning Disproportionate Share Hospital Reimbursement Methodology.SUMMARY OF CHANGES A detailed summary of specific changes made to each subsection of §355.8065 is included in this week’s edition of the Texas Register (46 Tex Reg 2533). BACKGROUND AND JUSTIFICATION The Disproportionate Share Hospital (DSH) program payments are made by HHSC to qualifying hospitals that serve a large number of Medicaid and uninsured individuals. Federal law establishes an annual DSH allotment for each state that limits Federal Financial Participation (FFP) for total statewide DSH payments made to hospitals. Federal law also limits FFP for DSH payments through the hospital-specific DSH limit. In Texas, the state has established a State Payment Cap that limits the amount of payments that a provider receives through the interim payment process. This proposal amends the definitions of certain provider classes, describes a methodology for redistribution of certain recouped funds, modifies the calculation of the low-income utilization rate to reflect federal law, and makes other clarifying amendments.
Texas Board of Veterinary Medical Examiners
Proposed Rules
Amending 22 TAC §571.15 to update requirements for temporary licensure of out-of-state veterinarians
CHAPTER 571. LICENSINGSUBCHAPTER A. GENERAL22 TAC §571.15The Texas Board of Veterinary Medical Examiners (Board) proposes this amendment to §571.15, concerning temporary veterinary license. The purpose of the proposed amendment is to help make temporary licensure less restrictive for out of state veterinarians who wish to volunteer their services in high need areas in Texas.
Texas Board of Veterinary Medical Examiners
Proposed Rules
Amending 22 TAC §573.27 to broaden the scope of rules on honesty, integrity and fair dealing in veterinary practice
CHAPTER 573. RULES OF PROFESSIONAL CONDUCTSUBCHAPTER C. RESPONSIBILITIES TO CLIENTS22 TAC §573.27The Texas Board of Veterinary Medical Examiners (Board) proposes this amendment to §573.27, concerning honesty, integrity and fair dealing. The purpose of the proposed amendment is to ensure that the rule for honesty, integrity and fair dealing is more inclusive and reflective of the types of complaints received and adjudicated by the Board. This rule modifies existing regulations.
Texas Health and Human Services Commission
Adopted Rules
Amending 1 TAC §353.1320 and §353.1322 to clarify the circumstances under which a Medicaid MCO must provide rate increases to certain Community Mental Health Centers (CMHCs)
CHAPTER 353. MEDICAID MANAGED CARESUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES1 TAC §353.1320, §353.1322OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §353.1320, concerning Directed Payment Program for Behavioral Health Services; and new §353.1322, concerning Quality Metrics for the Directed Payment Program for Behavioral Health Services.BACKGROUND AND JUSTIFICATION The purpose of the new rules is to describe the circumstances under which HHSC will direct a Medicaid managed care organization (MCO) to provide a uniform percentage rate increase and a uniform dollar increase in the form of prospective monthly payments to community mental health centers (CMHCs) in the MCO’s network in a participating service delivery area (SDA) for the provision of services by CMHCs. The new rules also describe the methodology used by HHSC to determine the amounts of the rate and dollar increases.HHSC is encouraging CMHCs to earn certification as Certified Community Behavioral Health Clinics (CCBHC) to implement processes and delivery of care that are consistent with the CCBHC model. Currently, Medicaid payments to CMHCs that are either CCBHC entities or in the process of getting certified, made through either the fee-for-service (FFS) or managed care models, may not cover all costs of Medicaid allowable services provided by CMHCs. HHSC is adopting these rules to establish a new program developed under the Delivery System Reform Incentive Payment program (DSRIP) Transition Plan.HHSC anticipates that the increased payments to participating CMHCs will sustain access to services, promote better health outcomes, and increase focus on improving quality goals that are established as part of the Texas Medicaid program.In May 2016, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that allows a state to direct expenditures under its contract with MCOs under certain limited circumstances. Under the federal rule, a state may direct an MCO to raise rates for a class of providers of a particular service by a uniform dollar amount or percentage, or as a performance incentive, subject to approval of the contract arrangements by CMS. To obtain approval, the arrangements must be based on the utilization and delivery of services; direct expenditures equally, and using the same terms of performance, for a class of providers of a particular service; advance at least one of the goals and objectives of the state’s Medicaid quality strategy and have an evaluation plan to measure the effectiveness of the arrangements at doing so; not condition provider participation on an intergovernmental transfer (IGT); and not be automatically renewed.These rules authorize HHSC to use IGTs from sponsoring governmental entities to support MCO capitation payment increases in one or more SDAs. Each MCO within the SDA will be contractually required by the state to increase payments by a uniform percentage and dollar amount for the applicable component, respectively, for one or more classes of CMHCs that provide services within the SDA.
Governor
Appointments
Governor reappoints three members to the Texas Optometry Board
Appointments for April 1, 2021Appointed to the Texas Optometry Board, for terms to expire January 31, 2027:Ronald L. “Ron” Hopping, O.D. of Friendswood, Texas (Dr. Hopping is being reappointed);Carey A. Patrick, O.D. of Allen, Texas (Dr. Patrick is being reappointed);Rene D. Pena of El Paso, Texas (Mr. Pena is being reappointed).
Governor
Appointments
Governor reappoints one member and appoints one new member to the Texas State Board of Acupuncture Examiners
Appointments for April 6, 2021Appointed to the Texas State Board of Acupuncture Examiners, for terms to expire January 31, 2027: Maria M. Garcia of Plano, Texas (Ms. Garcia is being reappointed);Samantha A. Gonzalez of San Antonio, Texas (replacing Dawn Lin of Sugar Land, whose term expired).
Governor
Notices
Executive Order GA-35: Ensuring that no governmental entity compels any individual to receive a COVID-19 vaccine
OVERVIEWBy virtue of the power and authority vested by the Constitution and laws of the State of Texas, the Governor does hereby order the following on a statewide basis effective immediately:1. Suspension of Section 81.082(f)(1) of the Texas Health and Safety Code to the extent necessary to ensure that no governmental entity can compel any individual to receive a COVID-19 vaccine administered under an emergency use authorization.2. State agencies and political subdivisions shall not adopt or enforce any order, ordinance, policy, regulation, rule, or similar measure that requires an individual to provide, as a condition of receiving any service or entering any place, documentation regarding the individual’s vaccination status for any COVID-19 vaccine administered under an emergency use authorization. The Governor hereby suspends Section 81.085(i) of the Texas Health and Safety Code to the extent necessary to enforce this prohibition. This paragraph does not apply to any documentation requirements necessary for the administration of a COVID-19 vaccine.3. Any public or private entity that is receiving or will receive public funds through any means, including grants, contracts, loans, or other disbursements of taxpayer money, shall not require a consumer to provide, as a condition of receiving any service or entering any place, documentation regarding the consumer’s vaccination status for any COVID-19 vaccine administered under an emergency use authorization. No consumer may be denied entry to a facility financed in whole or in part by public funds for failure to provide documentation regarding the consumer’s vaccination status for any COVID-19 vaccine administered under an emergency use authorization.LEGAL EFFECTNothing in this executive order shall be construed to limit the ability of a nursing home, state supported living center, assisted living facility, or long-term care facility to require documentation of a resident’s vaccination status for any COVID-19 vaccine.This executive order shall supersede any conflicting order issued by local officials in response to the COVID-19 disaster. The Governor hereby suspends Sections 418.1015(b) and 418.108 of the Texas Government Code, Chapter 81, Subchapter E of the Texas Health and Safety Code, and any other relevant statutes, to the extent necessary to ensure that local officials do not impose restrictions in response to the COVID-19 disaster that are inconsistent with this executive order.This executive order does not supersede Executive Orders GA-10, GA-13, or GA-34. This executive order shall remain in effect and in full force unless it is modified, amended, rescinded, or superseded by the governor.BACKGROUND AND JUSTIFICATION The Governor’s rationale for issuing Executive Order GA-35 is included in this week’s edition of the Texas Register (46 Tex Reg 2515).
Governor
Notices
Proclamation 41-3811: Renewing the disaster proclamation for all counties in Texas in response to COVID-19
OVERVIEWIn accordance with the authority vested by Section 418.014 of the Texas Government Code, the Governor does hereby renew the disaster proclamation for all counties in Texas:Pursuant to Section 418.017, the Governor authorizes the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster.Pursuant to Section 418.016, any regulatory statute prescribing the procedures for conduct of state business or any order or rule of a state agency that would in any way prevent, hinder, or delay necessary action in coping with this disaster shall be suspended upon written approval of the Office of the Governor. However, to the extent that the enforcement of any state statute or administrative rule regarding contracting or procurement would impede any state agency’s emergency response that is necessary to cope with this declared disaster, the Governor hereby suspends such statutes and rules for the duration of this declared disaster for that limited purpose.BACKGROUND AND JUSTIFICATIONGovernor’s rationale for issuing Proclamation 41-3811 is included in this week’s edition of the Texas Register (46 Tex Reg 2516).
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