Texas Register August 16, 2024 Volume: 49 Number: 33


Texas Register Table of Contents

The Governor Re:

Appointments Re:

Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Joel B. “Brandon” Brock, D.N.P.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Kara S. Chasteen.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Sarah Rosen Garrett.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Suzanne K. Gazda, M.D.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Qazi U. Javed, M.D.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Paula J. Kruppstadt, M.D.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Elizabeth R. Miller, Ph.D.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Amy L. Offutt, M.D.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Nathan A. Pullen.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Martha J. Shoultz.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Barry Smeltzer.
Appointed to the Pediatric Acute-Onset Neuropsychiatric Syndrome Advisory Council for a term to expire August 31, 2025, Melissa A. Smith.
Appointed to the Texas State Board of Examiners of Professional Counselors for a term to expire February 1, 2029, Sean Shahkarami.

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §355.8058, to require HHSC to use the most recent final audited cost report to calculate the base year average per resident amount for state-owned or state-operated teaching hospitals.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
DIVISION 4. MEDICAID HOSPITAL SERVICES
1 TAC §355.8058

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.8058, concerning Inpatient Direct Graduate Medical Education (GME) Reimbursement.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to make clarifying and corrective updates to this rule. In accordance with the existing rule regarding state-owned or state-operated teaching hospitals, HHSC uses the Centers for Medicare & Medicaid Services (CMS) final audited cost report (ACR) from state fiscal year (SFY) 2007 to calculate the base year average per resident amount for state-owned or state-operated teaching hospitals. The proposed rule will instruct HHSC to use the most recent final audited cost report to make this calculation. In addition, Medicare cost report line references will be updated to align with the calculation methodology for the GME programs.

SECTION-BY-SECTION SUMMARY

Formatting, punctuation, and grammar edits are made throughout the rule for clarity and consistency.

The proposed amendment to §355.8058(a)(2)(B)(i) updates the definition of “Base year average per resident amount” to be based on the most recent CMS final ACR instead of the final ACR ending in state fiscal year 2007. The proposed amendment also corrects the cost report line references for Medicaid allowable inpatient direct GME cost and unweighted full time equivalent (FTE) residents. This section of the rule applies to state-owned or state-operated teaching hospitals.

The proposed amendment to §355.8058(a)(2)(B)(ii) updates the definition of “Current FTE residents” by correcting the cost report form and line references for unweighted FTE residents. This section of the rule applies to state-owned or state-operated teaching hospitals.

The proposed amendment to §355.8058(a)(2)(B)(iii) updates the definition of “GME Medicaid inpatient utilization percentage” by correcting the cost report form and line references for inpatient days and clarifying the numerator and denominator used in the calculation. This section of the rule applies to state-owned or state-operated teaching hospitals.

The proposed amendment to §355.8058(a)(2)(E) clarifies the description of “quarterly FTE data” used to calculate the quarterly interim GME payments made to state-owned or state-operated teaching hospitals.

The proposed amendment to §355.8058(b)(2)(B) corrects the cost report line references for FTE residents. This section of the rule applies to non-state government-owned and operated teaching hospitals.

The proposed amendment to §355.8058(b)(2)(C) clarifies which value is used for Medicare per resident amount (PRA). This section of the rule applies to non-state government-owned and operated teaching hospitals.

The proposed amendment to §355.8058(b)(2)(D) more specifically cites the cost report line references for Medicaid and total inpatient days used to calculate the GME Medicaid inpatient utilization percentage. This section of the rule applies to non-state government-owned and operated teaching hospitals.

The proposed amendment to §355.8058(c)(2)(B)(i) corrects the cost report line references for FTE residents. This section of the rule applies to privately-owned hospitals.

The proposed amendment to §355.8058(c)(2)(C) clarifies the cost report line references for Medicare per resident amount (PRA). This section of the rule applies to privately-owned hospitals.


Adopted Rules Re:

Adopting 26 TAC §506.37, to require special care facilities to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 506. SPECIAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §506.37

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §506.37, concerning Billing Requirements.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 26 TAC §507.50, to require end-stage renal disease facilities to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 507. END STAGE RENAL DISEASE FACILITIES
SUBCHAPTER D. OPERATIONAL REQUIREMENTS FOR PATIENT CARE AND TREATMENT
26 TAC §507.50

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §507.50, concerning Billing Requirements.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 26 TAC §509.67, to require freestanding emergency medical care facilities to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 509. FREESTANDING EMERGENCY MEDICAL CARE FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §509.67

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §509.67, concerning Billing Requirements.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 26 TAC §510.45, to require private psychiatric hospitals or crisis stabilization units to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITS
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §510.45

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §510.45, concerning Billing Requirements.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 26 TAC §511.75, to require limited service rural hospitals to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 511. LIMITED SERVICES RURAL HOSPITALS
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §511.75

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §511.75, concerning Billing Requirements.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 26 TAC §564.28, to require licensed chemical dependency treatment facilities to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 564. CHEMICAL DEPENDENCY TREATMENT FACILITIES
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
26 TAC §564.28

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §564.28, concerning Billing Requirements.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 26 TAC §§571.1 – 571.5, to clarify that accreditation is voluntary for recovery houses and which accreditation organizations may be used.

CHAPTER 571. VOLUNTARY RECOVERY HOUSING ACCREDITATION
SUBCHAPTER A. GENERAL PROVISIONS
26 TAC §§571.1 – 571.5

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new Chapter 571, concerning Voluntary Recovery Housing Accreditation. The new chapter consists of §571.1, concerning Purpose; §571.2, concerning Definitions; §571.3, concerning Approved Accrediting Organizations; §571.4, concerning Accreditation Not Required; §571.5, concerning Places Ineligible for Accreditation as a Recovery House; §571.11, concerning Standards for Accreditation; §571.21, concerning Accrediting Organization Requirements; §571.31, concerning Soliciting; §571.32, concerning Advertising Restrictions; and §571.41, concerning Accrediting Organization Enforcement Actions.

BACKGROUND AND JUSTIFICATION

The new rules are necessary to implement House Bill (H.B.) 299, 88th Legislature, Regular Session, 2023.

H.B. 299 added new Texas Health and Safety Code (THSC) Chapter 469 to establish a voluntary accreditation program for recovery housing programs. THSC Chapter 469, in part, requires HHSC to adopt minimum standards for a voluntary recovery housing accreditation process. THSC §469.002(b) requires HHSC to approve only the National Alliance for Recovery Residences (NARR) or the Oxford House Incorporated to serve as an accrediting organization that provides accreditation to qualifying recovery houses.

THSC Chapter 469 also defines several key terms, outlines the responsibilities of the accreditation organizations, clarifies certain places are ineligible for accreditation as a recovery house, requires certain recovery houses to designate a responsible party, requires HHSC to prepare an annual report, prohibits soliciting and certain advertising, outlines enforcement procedures for accreditation organizations, and clarifies effective September 1, 2025, a recovery house must be accredited by an accrediting organization under this chapter to receive state money.

The new rules are necessary to establish and adopt the minimum standards for recovery housing accreditation required by THSC §469.002.


Adopting 26 TAC §571.11, to describe accreditation standards for recovery housing.

CHAPTER 571. VOLUNTARY RECOVERY HOUSING ACCREDITATION
SUBCHAPTER B. MINIMUM STANDARDS FOR ACCREDITATION
26 TAC §571.11

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new Chapter 571, concerning Voluntary Recovery Housing Accreditation. The new chapter consists of §571.1, concerning Purpose; §571.2, concerning Definitions; §571.3, concerning Approved Accrediting Organizations; §571.4, concerning Accreditation Not Required; §571.5, concerning Places Ineligible for Accreditation as a Recovery House; §571.11, concerning Standards for Accreditation; §571.21, concerning Accrediting Organization Requirements; §571.31, concerning Soliciting; §571.32, concerning Advertising Restrictions; and §571.41, concerning Accrediting Organization Enforcement Actions.

BACKGROUND AND JUSTIFICATION

The new rules are necessary to implement House Bill (H.B.) 299, 88th Legislature, Regular Session, 2023.

H.B. 299 added new Texas Health and Safety Code (THSC) Chapter 469 to establish a voluntary accreditation program for recovery housing programs. THSC Chapter 469, in part, requires HHSC to adopt minimum standards for a voluntary recovery housing accreditation process. THSC §469.002(b) requires HHSC to approve only the National Alliance for Recovery Residences (NARR) or the Oxford House Incorporated to serve as an accrediting organization that provides accreditation to qualifying recovery houses.

THSC Chapter 469 also defines several key terms, outlines the responsibilities of the accreditation organizations, clarifies certain places are ineligible for accreditation as a recovery house, requires certain recovery houses to designate a responsible party, requires HHSC to prepare an annual report, prohibits soliciting and certain advertising, outlines enforcement procedures for accreditation organizations, and clarifies effective September 1, 2025, a recovery house must be accredited by an accrediting organization under this chapter to receive state money.

The new rules are necessary to establish and adopt the minimum standards for recovery housing accreditation required by THSC §469.002.


Adopting 26 TAC §571.21, to explain the accreditation organization requirements and the designated responsible party requirements.

CHAPTER 571. VOLUNTARY RECOVERY HOUSING ACCREDITATION
SUBCHAPTER C. ACCREDITING ORGANIZATION REQUIREMENTS
26 TAC §571.21

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new Chapter 571, concerning Voluntary Recovery Housing Accreditation. The new chapter consists of §571.1, concerning Purpose; §571.2, concerning Definitions; §571.3, concerning Approved Accrediting Organizations; §571.4, concerning Accreditation Not Required; §571.5, concerning Places Ineligible for Accreditation as a Recovery House; §571.11, concerning Standards for Accreditation; §571.21, concerning Accrediting Organization Requirements; §571.31, concerning Soliciting; §571.32, concerning Advertising Restrictions; and §571.41, concerning Accrediting Organization Enforcement Actions.

BACKGROUND AND JUSTIFICATION

The new rules are necessary to implement House Bill (H.B.) 299, 88th Legislature, Regular Session, 2023.

H.B. 299 added new Texas Health and Safety Code (THSC) Chapter 469 to establish a voluntary accreditation program for recovery housing programs. THSC Chapter 469, in part, requires HHSC to adopt minimum standards for a voluntary recovery housing accreditation process. THSC §469.002(b) requires HHSC to approve only the National Alliance for Recovery Residences (NARR) or the Oxford House Incorporated to serve as an accrediting organization that provides accreditation to qualifying recovery houses.

THSC Chapter 469 also defines several key terms, outlines the responsibilities of the accreditation organizations, clarifies certain places are ineligible for accreditation as a recovery house, requires certain recovery houses to designate a responsible party, requires HHSC to prepare an annual report, prohibits soliciting and certain advertising, outlines enforcement procedures for accreditation organizations, and clarifies effective September 1, 2025, a recovery house must be accredited by an accrediting organization under this chapter to receive state money.

The new rules are necessary to establish and adopt the minimum standards for recovery housing accreditation required by THSC §469.002.


Adopting 26 TAC §571.31, §571.32, to describe soliciting and advertising restrictions.

CHAPTER 571. VOLUNTARY RECOVERY HOUSING ACCREDITATION
SUBCHAPTER D. PROHIBITED ACTIONS
26 TAC §571.31, §571.32

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new Chapter 571, concerning Voluntary Recovery Housing Accreditation. The new chapter consists of §571.1, concerning Purpose; §571.2, concerning Definitions; §571.3, concerning Approved Accrediting Organizations; §571.4, concerning Accreditation Not Required; §571.5, concerning Places Ineligible for Accreditation as a Recovery House; §571.11, concerning Standards for Accreditation; §571.21, concerning Accrediting Organization Requirements; §571.31, concerning Soliciting; §571.32, concerning Advertising Restrictions; and §571.41, concerning Accrediting Organization Enforcement Actions.

BACKGROUND AND JUSTIFICATION

The new rules are necessary to implement House Bill (H.B.) 299, 88th Legislature, Regular Session, 2023.

H.B. 299 added new Texas Health and Safety Code (THSC) Chapter 469 to establish a voluntary accreditation program for recovery housing programs. THSC Chapter 469, in part, requires HHSC to adopt minimum standards for a voluntary recovery housing accreditation process. THSC §469.002(b) requires HHSC to approve only the National Alliance for Recovery Residences (NARR) or the Oxford House Incorporated to serve as an accrediting organization that provides accreditation to qualifying recovery houses.

THSC Chapter 469 also defines several key terms, outlines the responsibilities of the accreditation organizations, clarifies certain places are ineligible for accreditation as a recovery house, requires certain recovery houses to designate a responsible party, requires HHSC to prepare an annual report, prohibits soliciting and certain advertising, outlines enforcement procedures for accreditation organizations, and clarifies effective September 1, 2025, a recovery house must be accredited by an accrediting organization under this chapter to receive state money.

The new rules are necessary to establish and adopt the minimum standards for recovery housing accreditation required by THSC §469.002.


Adopting 26 TAC §571.41, to explain the accrediting organization enforcement actions.

CHAPTER 571. VOLUNTARY RECOVERY HOUSING ACCREDITATION
SUBCHAPTER E. ENFORCEMENT
26 TAC §571.41

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts new Chapter 571, concerning Voluntary Recovery Housing Accreditation. The new chapter consists of §571.1, concerning Purpose; §571.2, concerning Definitions; §571.3, concerning Approved Accrediting Organizations; §571.4, concerning Accreditation Not Required; §571.5, concerning Places Ineligible for Accreditation as a Recovery House; §571.11, concerning Standards for Accreditation; §571.21, concerning Accrediting Organization Requirements; §571.31, concerning Soliciting; §571.32, concerning Advertising Restrictions; and §571.41, concerning Accrediting Organization Enforcement Actions.

BACKGROUND AND JUSTIFICATION

The new rules are necessary to implement House Bill (H.B.) 299, 88th Legislature, Regular Session, 2023.

H.B. 299 added new Texas Health and Safety Code (THSC) Chapter 469 to establish a voluntary accreditation program for recovery housing programs. THSC Chapter 469, in part, requires HHSC to adopt minimum standards for a voluntary recovery housing accreditation process. THSC §469.002(b) requires HHSC to approve only the National Alliance for Recovery Residences (NARR) or the Oxford House Incorporated to serve as an accrediting organization that provides accreditation to qualifying recovery houses.

THSC Chapter 469 also defines several key terms, outlines the responsibilities of the accreditation organizations, clarifies certain places are ineligible for accreditation as a recovery house, requires certain recovery houses to designate a responsible party, requires HHSC to prepare an annual report, prohibits soliciting and certain advertising, outlines enforcement procedures for accreditation organizations, and clarifies effective September 1, 2025, a recovery house must be accredited by an accrediting organization under this chapter to receive state money.

The new rules are necessary to establish and adopt the minimum standards for recovery housing accreditation required by THSC §469.002.


Adopted Rule Reviews Re:

Adopting Title 1, Part 15, concerning Reimbursement Rates.

The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 1, Part 15, of the Texas Administrative Code (1 TAC):

Chapter 355, Reimbursement Rates


Adopting Title 1, Part 15, concerning Medicaid Eligibility for the Elderly and People with Disabilities.

The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 1, Part 15, of the Texas Administrative Code (TAC):

Chapter 358, Medicaid Eligibility for the Elderly and People with Disabilities


In Addition Re:

Public Notice – Texas State Plan for Medical Assistance Amendment

The Texas Health and Human Services Commission (HHSC) announces its intent to submit amendments to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendments will be effective September 1, 2024.


Texas Education Agency

Proposed Rules Re:

Amending 19 TAC §103.1401, §103.1403, to reorganize and update sections.

CHAPTER 103. HEALTH AND SAFETY
SUBCHAPTER EE. COMMISSIONER’S RULES ON PREVENTION, AWARENESS, AND REPORTING OF CHILD ABUSE OR NEGLECT, INCLUDING TRAFFICKING OF A CHILD
19 TAC §103.1401, §103.1403

OVERVIEW

The Texas Education Agency (TEA) proposes new §103.1401 and §103.1403, concerning prevention, awareness, and reporting of child abuse or neglect, including trafficking of a child. The proposed new sections would relocate existing requirements from 19 TAC Chapter 61, Subchapter EE, relating to school district policies on reporting child abuse and neglect and required signage pertaining to criminal offenses of human trafficking. Proposed new §103.1401 would include updates to school district policy requirements to align with Texas Family Code, §261.104, as amended by House Bill (HB) 63, 88th Texas Legislature, Regular Session, 2023. Proposed new §103.1403 would include updates to signage requirements to align with Senate Bill (SB) 2069, HB 3553, and HB 3554, 88th Texas Legislature, Regular Session, 2023.

BACKGROUND AND JUSTIFICATION

Proposed new §103.1401 would include existing requirements from 19 TAC §61.1051, which relates to the reporting of child abuse and neglect and related training requirements for school districts and open-enrollment charter schools. The following updates would align the new section with HB 63, 88th Texas Legislature, Regular Session, 2023. Proposed new §103.1401(b)(2)(D) would require local policies for reporting to include notice that oral reports made to the Texas Department of Family and Protective Services are recorded. Proposed new §103.1401(b)(2)(E) would require local policies to include notice that an individual making a report must provide his or her name, telephone number, and address and include an explanation of the limited circumstances under which the identity of an individual making a report may be disclosed.

Proposed new §103.1403 would include existing requirements from 19 TAC §61.1053, which relates to signage requirements for posting the offenses of human trafficking on public school premises. To align with SB 2069, 88th Texas Legislature, Regular Session, 2023, proposed new §103.1403(a) would be updated to remove the definition of “premises” and modify the definition of “school.” Proposed new §103.1403(b) would also align with SB 2069 by updating the required location of signage. Proposed new §103.1403(c)(1)(A) would update the information related to penalties for trafficking of persons to align with changes to Texas Penal Code, §20A.02, made by HB 3553 and HB 3554, 88th Texas Legislature, Regular Session, 2023.


Texas Department of State Health Services

Adopted Rules Re:

Adopting 25 TAC §§1.1 – 1.4, to create eligibility requirements for a patient with a severe chronic disease to access and use an investigational drug, biological product, or device and describe the requirement for an informed consent form.

CHAPTER 1. MISCELLANEOUS PROVISIONS
SUBCHAPTER A. INVESTIGATIONAL TREATMENTS FOR PATIENTS WITH SEVERE CHRONIC DISEASES
25 TAC §§1.1 – 1.4

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts new Subchapter A, §§1.1 – 1.4, concerning Investigational Treatments for Patients with Severe Chronic Diseases. The new rules are adopted without changes to the proposed text as published in the May 3, 2024, issue of the Texas Register (49 TexReg 2923). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The adoption implements Senate Bill 773, 88th Legislature, Regular Session, 2023, which added Chapter 490 to the Texas Health and Safety Code allowing access to investigational treatments for patients with severe chronic disease. Texas Health and Safety Code §490.002 requires DSHS to designate medical conditions considered to be severe chronic diseases. Texas Health and Safety Code §490.052 states that DSHS may prescribe a form for the informed consent required by the new subchapter.


Adopting 25 TAC §133.46, to require hospitals to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 133. HOSPITAL LICENSING
SUBCHAPTER C. OPERATIONAL REQUIREMENTS
25 TAC §133.46

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §133.46, concerning Billing Requirements.

The amendment to §133.46 is adopted without changes to the proposed text as published in the April 26, 2024, issue of the Texas Register (49 TexReg 2612). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 25 TAC §135.4, to require Ambulatory Surgical Centers to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 135. AMBULATORY SURGICAL CENTERS
SUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS
25 TAC §135.4

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §135.4, concerning Ambulatory Surgical Center (ASC) Operation.

The amendment to §135.4 is adopted without changes to the proposed text as published in the April 26, 2024, issue of the Texas Register (49 TexReg 2614). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 25 TAC §137.39, to require birthing centers to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 137. BIRTHING CENTERS
SUBCHAPTER D. OPERATIONAL AND CLINICAL STANDARDS FOR THE PROVISION AND COORDINATION OF TREATMENT AND SERVICES
25 TAC §137.39

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §137.39, concerning General Requirements for the Provision and Coordination of Treatment and Services.

The amendment to §137.39 is adopted without changes to the proposed text as published in the April 26, 2024, issue of the Texas Register (49 TexReg 2616). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 25 TAC §139.60, to require abortion facilities to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 139. ABORTION FACILITY REPORTING AND LICENSING
SUBCHAPTER D. MINIMUM STANDARDS FOR LICENSED ABORTION FACILITIES
25 TAC §139.60

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §139.60, concerning Other State and Federal Compliance Requirements.

The amendment to §139.60 is adopted without changes to the proposed text as published in the April 26, 2024, issue of the Texas Register (49 TexReg 2618). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopting 25 TAC §229.144, to require narcotic treatment programs to comply with HSC Chapter 185 itemized billing requirements.

CHAPTER 229. FOOD AND DRUG
SUBCHAPTER J. MINIMUM STANDARDS FOR NARCOTIC TREATMENT PROGRAMS
25 TAC §229.144

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §229.144, concerning State and Federal Statutes and Regulations.

The amendment to §229.144 is adopted without changes to the proposed text as published in the April 26, 2024, issue of the Texas Register (49 TexReg 2620). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement Senate Bill (S.B.) 490, 88th Legislature, Regular Session, 2023.

S.B. 490 added new Texas Health and Safety Code (HSC) Chapter 185, which requires a health care provider to send a written, itemized bill of the alleged cost of each health care service and supply when the provider requests payment from a patient after providing the patient with a health care service or related supply.

HSC §185.003, as added by S.B. 490, requires HHSC to take disciplinary action against a provider that violates HSC Chapter 185 on or after September 1, 2023, as if the provider violated an applicable licensing law.

The amendment is necessary to add information regarding these itemized-bill requirements.


Adopted Rule Reviews Re:

Adopting Title 25, Part 1, concerning Preventive Health and Health Services Block Grant.

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the review of the chapter below in Title 25, Part 1, of the Texas Administrative Code (TAC):

Chapter 84, Preventive Health and Health Services Block Grant


In Addition Re:

Licensing Actions for Radioactive Materials

For more information, please visit this week’s edition of the Texas Register at 49 Tex Reg 6305.


Licensing Actions for Radioactive Materials

For more information, please visit this week’s edition of the Texas Register at 49 Tex Reg 6311.


Texas Department of Insurance, Division of Workers’ Compensation

Proposed Rule Reviews Re:

Reviewing Title 28, Part 2, to consider for readoption, revision, or repeal the chapter concerning General Provisions Applicable to All Benefits; Designated Doctor Procedures and Requirements; and Benefits–Calculation of Average Weekly Wage.

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) will review all sections in 28 Texas Administrative Code:

-Chapter 126 (General Provisions Applicable to All Benefits);

-Chapter 127 (Designated Doctor Procedures and Requirements); and

-Chapter 128 (Benefits–Calculation of Average Weekly Wage).


Council on Cardiovascular Disease and Stroke

Adopted Rule Reviews Re:

Adopting Title 25, Part 15, concerning Rules.

The Texas Council on Cardiovascular Disease and Stroke adopts the review of the chapter listed below, in its entirety, contained in Title 25, Part 15, of the Texas Administrative Code:

Chapter 1051, Rules