Texas Register August 23, 2024 Volume: 49 Number: 34


Texas Register Table of Contents

Office of the Attorney General

Requests for Opinion Re:

Whether the Health and Human Services Commission has the authority to regulate and license providers of Individualized Skills and Socialization services under chapter 103 of the Human Resources Code or other law (RQ-0555-KP).

Briefs requested by September 5, 2024


Texas Animal Health Commission

Proposed Rules Re:

Amending 4 TAC §40.6, to eliminate definitions and references related to surveillance zones, eliminate certain requirements for surveillance zones, add a new containment zone in Coleman County to respond to CWD detection and management, and reformatting.

CHAPTER 40. CHRONIC WASTING DISEASE
4 TAC §40.6

OVERVIEW

The Texas Animal Health Commission (Commission) proposes amendments to Title 4, Texas Administrative Code, Chapter 40 titled “Chronic Wasting Disease.” Specifically, amendments are proposed to §40.6 CWD Movement Restriction Zones.

BACKGROUND AND JUSTIFICATION

The purpose of this chapter is to prevent and control the incidence of chronic wasting disease (CWD) in Texas by seeking to reduce the risk of interstate and intrastate transmission of CWD in susceptible cervid species. The Commission proposes amendments to §40.6 to eliminate surveillance zones and add two new containment zones based on high-risk CWD exposure. These amendments will provide more targeted surveillance and reduce the risk of CWD being spread from areas where it may exist while eliminating unnecessary restrictions from other areas.

CWD is a degenerative and fatal neurological communicable disease recognized by the veterinary profession that affects susceptible cervid species. CWD poses a serious threat to livestock and exotic livestock that the Commission is charged with protecting. CWD can spread through natural movements of infected animals and transportation of live infected animals or carcass parts. Specifically, prions are shed from infected animals in saliva, urine, blood, soft‑antler material, feces, or from animal decomposition, which ultimately contaminates the environment in which CWD susceptible species live. CWD has a long incubation period, so animals infected with CWD may not exhibit clinical signs of the disease for months or years after infection. The disease can be passed through contaminated environmental conditions and may persist for a long period of time. Currently, no vaccine or treatment for CWD exists.

The purpose of the movement restriction zones is to both increase surveillance and reduce the risk of CWD being spread from areas of high risk where it may exist. As required by §40.6(g), the Commission reviewed the movement restriction zones and recommends the modifications as stated herein.

SECTION‑BY‑SECTION SUMMARY

The proposed changes to §40.6(a) eliminate the definition of “CWD Surveillance Zone (SZ)” and other references to surveillance zone throughout the definitions.

The proposed amendment to §40.6(b)(9) would add a new containment zone in Coleman County in response to the detection of CWD in a free‑range white‑tailed deer in that county.

The proposed amendment to §40.6(b)(10) would add a new containment zone in Collingsworth County in response to high-risk elk from an adjacent farm.

The proposed changes to §40.6(b)(2) would eliminate all surveillance zones.

The proposed changes to §40.6(d) would eliminate requirements associated with surveillance zones.

The proposed changes to §40.6(e) would eliminate carcass movement requirements for surveillance zones.

The proposed changes to §40.6(f)-(g) renumber the sections to match formatting.


Texas Department of Insurance, Division of Workers’ Compensation

Proposed Rules Re:

Amending 28 TAC §§134.500 – 134.504, 134.520, 134.530, 134.540, 134.550, to correct obsolete references, implement editorial changes, and remove unnecessary references.

CHAPTER 134. BENEFITS–GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
SUBCHAPTER F. PHARMACEUTICAL BENEFITS
28 TAC §§134.500 – 134.504, 134.520, 134.530, 134.540, 134.550

OVERVIEW

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes the following changes to 28 TAC Chapter 134, Subchapter F, concerning pharmaceutical benefits: repeal 28 TAC §134.506 and §134.510, and amend 28 TAC §§134.500 – 134.504, 134.520, 134.530, 134.540, and 134.550. Subchapter F implements Texas Labor Code §§408.028 and 413.011, and Texas Insurance Code Chapter 1305. The DWC medical advisor recommends the amendments to the commissioner of workers’ compensation under Labor Code §413.0511(b).

BACKGROUND AND JUSTIFICATION

The changes update and reorganize Subchapter F. Repealing §134.506 and §134.510, and amending §§134.500 – 134.504, 134.520, 134.530, 134.540, and 134.550 is necessary to remove obsolete provisions and to update references and language to be consistent with other rules. Labor Code §408.028 requires the commissioner by rule to adopt a closed formulary under §413.011, as well as a fee schedule, and provides requirements for prescribing prescription drugs, generic pharmaceutical medications, and over-the-counter alternatives. Insurance Code Chapter 1305 authorizes the establishment of workers’ compensation health care networks for providing workers’ compensation medical benefits and provides standards for the certification, administration, evaluation, and enforcement of their delivery of health care services to injured employees. The proposed changes also include nonsubstantive editorial and formatting changes that make updates for plain language and agency style to improve the rule’s clarity.

SECTION-BY-SECTION SUMMARY

Section 134.500. The proposed changes delete the definition of “open formulary.” The Texas workers’ compensation system now uses a closed formulary, so the reference to an open formulary is unnecessary. The proposed changes correct a reference to the injured employee’s Social Security number to specify only the last four digits of the number. The proposed changes also renumber the paragraphs where needed and make editorial and formatting updates for plain language and agency style. Amending §134.500 is necessary to enhance the rule’s clarity and accuracy.

Section 134.501. The proposed changes correct obsolete references and make editorial and formatting updates for plain language and agency style. Amending §134.501 is necessary to enhance the rule’s clarity and accuracy.

Section 134.502. The proposed changes make editorial and formatting updates for plain language and agency style. Amending §134.502 is necessary to enhance the rule’s clarity.

Section 134.503. The proposed changes make editorial and formatting updates for plain language and agency style. Amending §134.503 is necessary to enhance the rule’s clarity.

Section 134.504. The proposed changes correct a reference to the claimant’s Social Security number to specify only the last four digits of the number. The proposed changes also correct obsolete references and make editorial and formatting updates for plain language and agency style. Amending §134.504 is necessary to enhance the rule’s clarity and accuracy.

Section 134.520. The proposed changes update the section title to remove an unnecessary reference to the 2011 transition to a closed formulary, add the sentence, “The closed formulary applies to all drugs that are prescribed and dispensed for outpatient use,” to be consistent with §134.530 and §134.540, and make editorial and formatting updates for plain language and agency style. Amending §134.520 is necessary to enhance the rule’s clarity and accuracy.

Section 134.530. The proposed changes remove unnecessary references, correct obsolete references, and make editorial and formatting updates for plain language and agency style. Amending §134.530 is necessary to enhance the rule’s clarity and accuracy.

Section 134.540. The proposed changes remove unnecessary references, correct obsolete references, and make editorial and formatting updates for plain language and agency style. Amending §134.540 is necessary to enhance the rule’s clarity and accuracy.

Section 134.550. The proposed changes correct obsolete references, update DWC’s website address, clarify text, and make editorial and formatting updates for plain language and agency style. Amending §134.550 is necessary to enhance the rule’s clarity and accuracy.


Amending 28 TAC §134.506, §134.510, to repeal obsolete transitional provisions to ensure that the published rules are current.

CHAPTER 134. BENEFITS–GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
SUBCHAPTER F. PHARMACEUTICAL BENEFITS
28 TAC §134.506, §134.510

OVERVIEW

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes the following changes to 28 TAC Chapter 134, Subchapter F, concerning pharmaceutical benefits: repeal 28 TAC §134.506 and §134.510, and amend 28 TAC §§134.500 – 134.504, 134.520, 134.530, 134.540, and 134.550. Subchapter F implements Texas Labor Code §§408.028 and 413.011, and Texas Insurance Code Chapter 1305. The DWC medical advisor recommends the amendments to the commissioner of workers’ compensation under Labor Code §413.0511(b).

BACKGROUND AND JUSTIFICATION

The changes update and reorganize Subchapter F. Repealing §134.506 and §134.510, and amending §§134.500 – 134.504, 134.520, 134.530, 134.540, and 134.550 is necessary to remove obsolete provisions and to update references and language to be consistent with other rules. Labor Code §408.028 requires the commissioner by rule to adopt a closed formulary under §413.011, as well as a fee schedule, and provides requirements for prescribing prescription drugs, generic pharmaceutical medications, and over-the-counter alternatives. Insurance Code Chapter 1305 authorizes the establishment of workers’ compensation health care networks for providing workers’ compensation medical benefits and provides standards for the certification, administration, evaluation, and enforcement of their delivery of health care services to injured employees. The proposed changes also include nonsubstantive editorial and formatting changes that make updates for plain language and agency style to improve the rule’s clarity.

SECTION-BY-SECTION SUMMARY

Section 134.506. Section 134.506 is repealed because it is an obsolete transitional provision. Repealing §134.506 is necessary to ensure that the published rules are current.

Section 134.510. Section 134.510 is repealed because it is an obsolete transitional provision. Repealing §134.510 is necessary to ensure that the published rules are current.


Amending 28 TAC §147.10, to correct duplicated information concerning the computation of impairment income benefits in the title of §147.10.

CHAPTER 147. DISPUTE RESOLUTION–AGREEMENTS, SETTLEMENTS, COMMUTATIONS
28 TAC §147.10

OVERVIEW

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes to amend the title of 28 TAC §147.10, concerning commutation of impairment income benefits. Section 147.10 implements Labor Code §408.128.

BACKGROUND AND JUSTIFICATION

The amendment corrects an inadvertent duplication in the title of §147.10. The recent proposal amending Chapter 147, which was published in the April 5, 2024, issue of the Texas Register (49 TexReg 2165) reorganized the chapter to make it easier to understand and use. In that proposal, the title of §147.10 was inadvertently renamed to duplicate the title of §147.11. Amending §147.10 is necessary to correct the title of §147.10 to Commutation of Impairment Income Benefits to better describe its purpose.


State Board of Dental Examiners

Adopted Rules Re:

Adopting 22 TAC §104.1, to give course instructors who offer continuing education through a provider listed in §104.2 two hours of continuing education credit for every one hour of instruction.

CHAPTER 104. CONTINUING EDUCATION
22 TAC §104.1

OVERVIEW

The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §104.1, concerning Continuing Education Requirements, without changes to the proposed text as published in the June 7, 2024, issue of the Texas Register (49 TexReg 4001). The rule will not be republished. The adopted amendment allows course instructors who offer continuing education through a provider listed in §104.2 of this title to receive 2 hours of continuing education credit for every 1 hour of instruction provided. This credit applies per course, per renewal period.

The Texas Academy of General Dentistry (TAGD) provided a written comment in support of adoption of the rule as proposed. As an approved CE course provider, TAGD believes it is reasonable to allow course instructors to receive 2 hours of CE credit for every hour of course instruction in recognition of the work that is put into developing and presenting continuing education classes. TAGD hopes that it will serve as an incentive for more dentists to share their expertise and serve as instructors. No changes to the proposed rule were made as a result of the comment.


Adopting 22 TAC §107.3, to prohibit a licensing agency from disciplining or denying a license to an individual who has defaulted on a student loan.

CHAPTER 107. DENTAL BOARD PROCEDURES
SUBCHAPTER A. PROCEDURES GOVERNING GRIEVANCES, HEARINGS, AND APPEALS
22 TAC §107.3

OVERVIEW

The State Board of Dental Examiners (Board) adopts this repeal of 22 TAC §107.3, concerning the effects of student loan payment default on licensure. The repeal is adopted without changes to the proposed version in the June 7, 2024, issue of the Texas Register (49 TexReg 4003) and the rule will not be republished. The adopted repeal implements Senate Bill 37 of the 86th Texas Legislature, Regular Session (2019). The bill prohibits a licensing agency from taking disciplinary action against a person who has defaulted on a student loan, or denying a license to that person based on a default of a student loan.


Adopting 22 TAC §107.17, to update the cited SOAH rule from 1 TAC §155.103 to 1 TAC §155.105.

CHAPTER 107. DENTAL BOARD PROCEDURES
SUBCHAPTER A. PROCEDURES GOVERNING GRIEVANCES, HEARINGS, AND APPEALS
22 TAC §107.17

OVERVIEW

The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §107.17, concerning service in non-rulemaking proceedings. The amendment is adopted without changes to the proposed text as published in the June 7, 2024, issue of the Texas Register (49 TexReg 4003) and will not be republished. The adopted amendment updates the cited SOAH rule from 1 TAC §155.103 to 1 TAC §155.105.


Adopting 22 TAC §107.105, to remove citation language from the rule and allow the Board to issue administrative penalties pursuant to §264.001 of the Dental Practice Act, and board rule 22 TAC §107.201.

CHAPTER 107. DENTAL BOARD PROCEDURES
SUBCHAPTER B. COMPLAINTS AND INVESTIGATIONS
22 TAC §107.105

OVERVIEW

The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §107.105, concerning collection of information and records. The amendment is adopted without changes to the proposed text as published in the June 7, 2024, issue of the Texas Register (49 TexReg 4004) and will not be republished. Because the Board no longer issues citations, the adopted amendment removes the citation language from the rule. Instead, the Board issues administrative penalties pursuant to §264.001 of the Dental Practice Act, and board rule 22 TAC §107.201.


Adopting 22 TAC §107.106, to remove citation language from the rule and allow the Board to issue administrative penalties pursuant to §264.001 of the Dental Practice Act, and board rule 22 TAC §107.201.

CHAPTER 107. DENTAL BOARD PROCEDURES
SUBCHAPTER B. COMPLAINTS AND INVESTIGATIONS
22 TAC §107.106

OVERVIEW

The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §107.106, concerning confidentiality of investigations. The amendment is adopted without changes to the proposed text as published in the June 7, 2024, issue of the Texas Register (49 TexReg 4005) and will not be republished. Because the Board no longer issues citations, the adopted amendment removes the citation language from the rule. Instead, the Board issues administrative penalties pursuant to §264.001 of the Dental Practice Act, and board rule 22 TAC §107.201.


Adopting 22 TAC §107.300, to remove citation language from the rule and allow the Board to issue administrative penalties pursuant to §264.001 of the Dental Practice Act, and board rule 22 TAC §107.201.

CHAPTER 107. DENTAL BOARD PROCEDURES
SUBCHAPTER D. COMPLIANCE PROGRAM
22 TAC §107.300

OVERVIEW

The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §107.300, concerning responsibilities of compliance division. The amendment is adopted without changes to the proposed text as published in the June 7, 2024, issue of the Texas Register (49 TexReg 4006) and will not be republished. Because the Board no longer issues citations, the adopted amendment removes the citation language from the rule. Instead, the Board issues administrative penalties pursuant to §264.001 of the Dental Practice Act, and board rule 22 TAC §107.201.


Adopting 22 TAC §577.15, to increase the license application fees for all licenses issued under the statute.

CHAPTER 577. GENERAL ADMINISTRATIVE DUTIES
SUBCHAPTER B. STAFF
22 TAC §577.15

OVERVIEW

The Texas Commission of Licensing and Regulation (Commission), on behalf of the Texas Board of Veterinary Medical Examiners (TBVME), adopts amendments to an existing rule at 22 Texas Administrative Code (TAC), Chapter 577, Subchapter B, §577.15, regarding the General Administrative Duties, without changes to the proposed text as published in the June 21, 2024, issue of the Texas Register (49 TexReg 4572). This rule will not be republished.


Texas Board of Veterinary Medical Examiners

Adopted Rules Re:

Adopting 22 TAC §577.15, to increase the license application fees for all licenses issued under the statute.

CHAPTER 577. GENERAL ADMINISTRATIVE DUTIES
SUBCHAPTER B. STAFF
22 TAC §577.15

OVERVIEW

The Texas Commission of Licensing and Regulation (Commission), on behalf of the Texas Board of Veterinary Medical Examiners (TBVME), adopts amendments to an existing rule at 22 Texas Administrative Code (TAC), Chapter 577, Subchapter B, §577.15, regarding the General Administrative Duties, without changes to the proposed text as published in the June 21, 2024, issue of the Texas Register (49 TexReg 4572). This rule will not be republished.


Texas State Board of Pharmacy

Adopted Rule Reviews Re:

Adopting the review of Title 22, Part 15, concerning Pharmacies and the Destruction of Drugs.

The Texas State Board of Pharmacy adopts the review of Chapter 291, Subchapter D (§§291.71 – 291.77), concerning Pharmacies (Institutional Pharmacy (Class C)).


Texas Department of State Health Services

Adopted Rule Reviews Re:

Adopting the review of Title 25, Part 1, concerning Shellfish Sanitation.

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 241, Shellfish Sanitation


Texas Council for Developmental Disabilities

In Addition Re:

Request for Applications: Enhancing Statewide Community Engagement

The Texas Council for Developmental Disabilities (TCDD) announces the availability of funds to enhance capacity to conduct outreach activities across the state. This project will raise awareness about the capabilities and competencies of individuals with developmental disabilities (DD), educate and support communities to become accessible and responsive to the needs of individuals with DD and their families, and inform policymakers through dissemination of information, best practices, and strategies. Deliverables will include but are not limited to the development and management of digital products including online training modules and videos, gathering public input and needs assessment data, and collecting personal impact stories. Engaging an external communications entity aligns with TCDD strategic objectives to engage with state and community partners and broaden the impact of our local grant initiatives.

TCDD has approved funding for one organization for up to three years. Funding is approved for up to $200,000 each year. Funds available for this project are provided to TCDD by the Administration for Community Living (ACL), U.S. Department of Health and Human Services, with 100% federal funding pursuant to the Developmental Disabilities Assistance and Bill of Rights Act. Funding for the project is dependent on the results of a review process established by TCDD and on the availability of funds. Non-federal matching funds of at least 25% of total project costs are required for projects. Non-federal matching funds at a reduced rate of 10% of the total project costs are required for project activities conducted in federally designated poverty areas.


Request for Applications: Next Generation Engagement: How Experience Influences Advocacy

The Texas Council for Developmental Disabilities (TCDD) announces the availability of funds to conduct a generational analysis among parents and family members of individuals with developmental disabilities (DD) in order to better understand 1) disability experience and self-perceptions, 2) preferred learning styles for education and training, and 3) preferred methods of advocacy of individuals with DD and family members across generational ages and life experiences. The analysis will include a review of existing literature on generational behaviors as well as collection of new data from individuals with DD and family members of all ages. This information will inform advocacy strategies, training curriculum formats, and outreach and dissemination efforts in order to improve overall engagement across the diverse disability community in Texas.

TCDD has approved funding for one organization for up to two years. Funding is approved for up to $250,000 each year. Funds available for this project are provided to TCDD by the Administration for Community Living (ACL), U.S. Department of Health and Human Services, with 100% federal funding pursuant to the Developmental Disabilities Assistance and Bill of Rights Act. Funding for the project is dependent on the results of a review process established by TCDD and on the availability of funds. Non-federal matching funds of at least 25% of total project costs are required for projects. Non-federal matching funds at a reduced rate of 10% of the total project costs are required for project activities conducted in federally designated poverty areas.


Texas Health and Human Services Commission

In Addition Re:

Notice of Update to the APR-DRG Grouper 41 Proposals

Hearing. The Texas Health and Human Services Commission (HHSC) conducted a public hearing on August 19, 2024, at 9:00 a.m., to receive public comments on proposed updates for the All Patient Refined-Diagnosis Related Group (APR-DRG) version update for Hospital Inpatient services, specifically DRG Grouper 41. These updates included Statistical Data Relative Weight (RW), Mean Length of Stay (MLOS), Day Threshold, and universal mean used to reimburse Medicaid Inpatient Hospital Services.

During the hearing it was announced that the proposed implementation date would be changed from October 1, 2024, to September 1, 2024. Updates to the proposed implementation date were posted on the HHSC website at https://www.hhs.texas.gov/about/meetings-events.


Texas Department of Insurance:

In Addition Re:

Company Licensing — Applications to do Business

Application to do business in the state of Texas for Opportunity Life Insurance Company, a foreign life, accident and/or health company. The home office is in Cincinnati, Ohio.

Application for Genworth Insurance Company, a foreign life, accident and/or health company, to change its name to CareScout Insurance Company. The home office is in Raleigh, North Carolina.