Texas Register Table of Contents
- 1 Texas Department of Insurance, Division of Workers’ Compensation
- 1.0.1 Proposed Rules Re:
- 1.0.1.1 Amending 28 TAC §133.10, §133.20, to require an assignment number for certain enumerated services and to clarify that the ninety-five day period for the timely submission of a bill for additional testing begins on the date of service of the additional testing.
- 1.0.1.2 Amending 28 TAC §133.200, to correct a reference in the rules relating to medical bill processing.
- 1.0.1.3 Amending 28 TAC §133.502, to require an assignment number in the prior authorization field for professional, institutional or hospital, dental, and pharmacy electronic medical bills.
- 1.0.1.4 Amending 28 TAC §§134.209, 134.210, 134.235, 134.239, 134.240, 134.250, 134.260, to update references and to clarify reimbursements and modifiers for billing.
- 1.0.1.5 New 28 TAC §§134.235, 134.239, 134.240, to consolidate and update rules relating to billing and reimbursement requirements.
- 1.0.1 Proposed Rules Re:
- 2 Texas Department of Licensing and Regulation
- 2.0.1 Adopted Rules Re:
- 2.0.1.1 Amending 16 TAC §111.2 and new §111.3, to update existing definitions related to hearing aids and to add information about over-the-counter hearing aids.
- 2.0.1.2 Amending 16 TAC §111.201, to clarify rules related to the fitting and dispensing of hearing instruments, including a requirement that a written statement of a medical evaluation is provided in instances where the client is under the age of 18.
- 2.0.1.3 Amending 16 TAC §111.220, to clarify that the thirty-day trial period referenced in the section relates to a hearing instrument.
- 2.0.1.4 Amending 16 TAC §112.2 and new §112.3, to update definitions and to clarify that except as provided in the rule, Chapter 112 does not apply to activities related to over-the-counter hearing aids.
- 2.0.1.5 Amending 16 TAC §112.70, to provide that a licensee who serves as a proctor for the practical test may receive up to one continuing education credit hour for each test date, for up to four hours per license term.
- 2.0.1.6 Amending 16 TAC §112.92, §112.96, to require licensees to inform clients of the website address of the Department in each written contract for services and on a sign in their primary place of business.
- 2.0.1.7 Amending 16 TAC §112.140, to clarify that the 30-day trial period referenced in this rule relates to a hearing instrument and to require medical evaluations or waivers of evaluation to be maintained only if they are provided.
- 2.0.1 Adopted Rules Re:
- 3 Texas Department of Insurance
- 4 Department of Aging and Disability Services
- 4.0.1 Adopted Rules Re:
- 4.0.1.1 Repealing 40 TAC §94.1, to delete the rule under the DADS which has been replaced with the proposed new rules in Title 26, Part 1, Chapter 556, concerning nurse aides.
- 4.0.1.2 Repealing 40 TAC §95.1, to delete the rule under the DADS which has been replaced with the proposed new rules in Title 26, Part 1, Chapter 557.
- 4.0.1.3 Repealing 40 TAC §99.1, to delete the rule under the DADS which has been replaced with the proposed new rules in Title 26, Part 1, Chapter 560, addressing denial or refusal of license.
- 4.0.1 Adopted Rules Re:
- 5 Texas Department of State Health Services
- 5.0.1 Proposed Rule Reviews Re:
- 5.0.1.1 Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter concerning Minimum Guidelines for Human Donor Milk Banks.
- 5.0.1.2 Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter concerning Specific Additional Requirements for Drugs.
- 5.0.1.3 Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter concerning Occupational Health.
- 5.0.1 Proposed Rule Reviews Re:
Texas Department of Insurance, Division of Workers’ Compensation
Proposed Rules Re:
Amending 28 TAC §133.10, §133.20, to require an assignment number for certain enumerated services and to clarify that the ninety-five day period for the timely submission of a bill for additional testing begins on the date of service of the additional testing.
CHAPTER 133. GENERAL MEDICAL PROVISIONS
SUBCHAPTER B. HEALTH CARE PROVIDER BILLING PROCEDURES
28 TAC §133.10, §133.20
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes to amend 28 TAC §§133.10, 133.20, 133.200, and 133.502, concerning billing and reimbursement for certain workers’ compensation-specific services, including designated doctor examinations, required medical examinations, work status reports, and maximum medical improvement (MMI) evaluations and impairment rating (IR) examinations by treating and referred doctors. The amendments implement Texas Labor Code Chapters 408 and 413, which govern workers’ compensation benefits, including medical examinations required to establish benefit entitlements, and medical review to ensure compliance with DWC rules for health care, including medical policies and fee guidelines. The DWC medical advisor recommends the amendments to the commissioner of workers’ compensation under Labor Code §413.0511(b).
BACKGROUND AND JUSTIFICATION
Amending §§133.10, 133.20, 133.200, and 133.502 is necessary to attract and retain designated doctors, required medical examination doctors, and doctors that perform MMI evaluations and IR examinations, by addressing billing and reimbursement issues, reducing disputes, and decreasing the administrative burden of participating in the program. Labor Code Chapter 408 entitles an employee that sustains a compensable injury to all health care reasonably required by the nature of the injury as and when needed. Specifically, the employee is entitled to health care that cures or relieves the effects naturally resulting from the compensable injury, promotes recovery, or enhances the ability of the employee to return to or retain employment. To help determine the health care that meets those standards, the designated doctor program established under Chapter 408 provides for commissioner-ordered medical examinations to resolve any question about the impairment caused by the compensable injury, the attainment of MMI, the extent of the employee’s compensable injury, whether the injured employee’s disability is a direct result of the work-related injury, the ability of the employee to return to work, or other similar issues. Maintaining a viable program that ensures that injured employees can access examinations in a timely way is essential to meeting the statutory mandate of providing health care for injured employees.
Amending 28 TAC §133.200, to correct a reference in the rules relating to medical bill processing.
CHAPTER 133. GENERAL MEDICAL PROVISIONS
SUBCHAPTER C. MEDICAL BILL PROCESSING/AUDIT BY INSURANCE CARRIER
28 TAC §133.200
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes to amend 28 TAC §§133.10, 133.20, 133.200, and 133.502, concerning billing and reimbursement for certain workers’ compensation-specific services, including designated doctor examinations, required medical examinations, work status reports, and maximum medical improvement (MMI) evaluations and impairment rating (IR) examinations by treating and referred doctors. The amendments implement Texas Labor Code Chapters 408 and 413, which govern workers’ compensation benefits, including medical examinations required to establish benefit entitlements, and medical review to ensure compliance with DWC rules for health care, including medical policies and fee guidelines. The DWC medical advisor recommends the amendments to the commissioner of workers’ compensation under Labor Code §413.0511(b).
BACKGROUND AND JUSTIFICATION
Amending §§133.10, 133.20, 133.200, and 133.502 is necessary to attract and retain designated doctors, required medical examination doctors, and doctors that perform MMI evaluations and IR examinations, by addressing billing and reimbursement issues, reducing disputes, and decreasing the administrative burden of participating in the program. Labor Code Chapter 408 entitles an employee that sustains a compensable injury to all health care reasonably required by the nature of the injury as and when needed. Specifically, the employee is entitled to health care that cures or relieves the effects naturally resulting from the compensable injury, promotes recovery, or enhances the ability of the employee to return to or retain employment. To help determine the health care that meets those standards, the designated doctor program established under Chapter 408 provides for commissioner-ordered medical examinations to resolve any question about the impairment caused by the compensable injury, the attainment of MMI, the extent of the employee’s compensable injury, whether the injured employee’s disability is a direct result of the work-related injury, the ability of the employee to return to work, or other similar issues. Maintaining a viable program that ensures that injured employees can access examinations in a timely way is essential to meeting the statutory mandate of providing health care for injured employees.
CHAPTER 133. GENERAL MEDICAL PROVISIONS
SUBCHAPTER G. ELECTRONIC MEDICAL BILLING, REIMBURSEMENT, AND DOCUMENTATION
28 TAC §133.502
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes to amend 28 TAC §§133.10, 133.20, 133.200, and 133.502, concerning billing and reimbursement for certain workers’ compensation-specific services, including designated doctor examinations, required medical examinations, work status reports, and maximum medical improvement (MMI) evaluations and impairment rating (IR) examinations by treating and referred doctors. The amendments implement Texas Labor Code Chapters 408 and 413, which govern workers’ compensation benefits, including medical examinations required to establish benefit entitlements, and medical review to ensure compliance with DWC rules for health care, including medical policies and fee guidelines. The DWC medical advisor recommends the amendments to the commissioner of workers’ compensation under Labor Code §413.0511(b).
BACKGROUND AND JUSTIFICATION
Amending §§133.10, 133.20, 133.200, and 133.502 is necessary to attract and retain designated doctors, required medical examination doctors, and doctors that perform MMI evaluations and IR examinations, by addressing billing and reimbursement issues, reducing disputes, and decreasing the administrative burden of participating in the program. Labor Code Chapter 408 entitles an employee that sustains a compensable injury to all health care reasonably required by the nature of the injury as and when needed. Specifically, the employee is entitled to health care that cures or relieves the effects naturally resulting from the compensable injury, promotes recovery, or enhances the ability of the employee to return to or retain employment. To help determine the health care that meets those standards, the designated doctor program established under Chapter 408 provides for commissioner-ordered medical examinations to resolve any question about the impairment caused by the compensable injury, the attainment of MMI, the extent of the employee’s compensable injury, whether the injured employee’s disability is a direct result of the work-related injury, the ability of the employee to return to work, or other similar issues. Maintaining a viable program that ensures that injured employees can access examinations in a timely way is essential to meeting the statutory mandate of providing health care for injured employees.
Amending 28 TAC §§134.209, 134.210, 134.235, 134.239, 134.240, 134.250, 134.260, to update references and to clarify reimbursements and modifiers for billing.
CHAPTER 134. BENEFITS–GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
SUBCHAPTER C. MEDICAL FEE GUIDELINES
28 TAC §§134.209, 134.210, 134.235, 134.239, 134.240, 134.250, 134.260
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes: to repeal 28 TAC §§134.235, 134.239, and 134.240; amend 28 TAC §§134.209, 134.210, and 134.250; and proposes new 28 TAC §§134.235, 134.239, 134.240, and 134.260, concerning medical fee guidelines for certain workers’ compensation-specific services, including designated doctor examinations, required medical examinations, work status reports, and maximum medical improvement (MMI) evaluations and impairment rating (IR) examinations by treating and referred doctors. The repeals, amendments, and new sections (collectively, “changes”) implement Texas Labor Code Chapters 408 and 413, which govern workers’ compensation benefits, including medical examinations required to establish benefit entitlements, and medical review to ensure compliance with DWC rules for health care, including medical policies and fee guidelines. The DWC medical advisor recommends the changes to the commissioner of workers’ compensation under Labor Code §413.0511(b).
BACKGROUND AND JUSTIFICATION
The changes adjust the billing methodology and reimbursement rates for certain workers’ compensation-specific services, including designated doctor examinations, required medical examinations, work status reports, and MMI evaluations and IR examinations by treating and referred doctors. They adjust the fees once by applying the Medicare Economic Index (MEI) percentage adjustment factor for the period 2009 – 2024, and then after the initial adjustment, adjust the fees annually on January 1 by applying the MEI percentage adjustment factor in §134.203(c)(2) which is how most other fees are adjusted annually in the system. They round the fees to whole dollars to simplify calculations and reduce errors. They eliminate unnecessary billing modifiers, eliminate a required sequence for modifiers, and replace the diagnosis-related estimate and range of motion billing methods with a single method of billing. They also create a $100 missed appointment fee and a $300 specialist fee. In addition, they eliminate tiering. For designated doctors and required medical examination doctors, all issues addressed within one examination will be paid at the established fee and not reduced.
New 28 TAC §§134.235, 134.239, 134.240, to consolidate and update rules relating to billing and reimbursement requirements.
CHAPTER 134. BENEFITS–GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
SUBCHAPTER C. MEDICAL FEE GUIDELINES
28 TAC §§134.235, 134.239, 134.240
OVERVIEW
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) proposes: to repeal 28 TAC §§134.235, 134.239, and 134.240; amend 28 TAC §§134.209, 134.210, and 134.250; and proposes new 28 TAC §§134.235, 134.239, 134.240, and 134.260, concerning medical fee guidelines for certain workers’ compensation-specific services, including designated doctor examinations, required medical examinations, work status reports, and maximum medical improvement (MMI) evaluations and impairment rating (IR) examinations by treating and referred doctors. The repeals, amendments, and new sections (collectively, “changes”) implement Texas Labor Code Chapters 408 and 413, which govern workers’ compensation benefits, including medical examinations required to establish benefit entitlements, and medical review to ensure compliance with DWC rules for health care, including medical policies and fee guidelines. The DWC medical advisor recommends the changes to the commissioner of workers’ compensation under Labor Code §413.0511(b).
BACKGROUND AND JUSTIFICATION
The changes adjust the billing methodology and reimbursement rates for certain workers’ compensation-specific services, including designated doctor examinations, required medical examinations, work status reports, and MMI evaluations and IR examinations by treating and referred doctors. They adjust the fees once by applying the Medicare Economic Index (MEI) percentage adjustment factor for the period 2009 – 2024, and then after the initial adjustment, adjust the fees annually on January 1 by applying the MEI percentage adjustment factor in §134.203(c)(2) which is how most other fees are adjusted annually in the system. They round the fees to whole dollars to simplify calculations and reduce errors. They eliminate unnecessary billing modifiers, eliminate a required sequence for modifiers, and replace the diagnosis-related estimate and range of motion billing methods with a single method of billing. They also create a $100 missed appointment fee and a $300 specialist fee. In addition, they eliminate tiering. For designated doctors and required medical examination doctors, all issues addressed within one examination will be paid at the established fee and not reduced.
Texas Department of Licensing and Regulation
Adopted Rules Re:
CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER A. GENERAL PROVISIONS
16 TAC §111.2, §111.3
OVERVIEW
The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter U, §111.201; and Subchapter W, §111.220; and adopts a new rule at Subchapter A, §111.3, regarding the Speech-Language Pathologists and Audiologists program, without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5369). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists, and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department).
The adopted rules implement changes made to Texas Occupations Code, Chapter 401 by Senate Bill (SB) 2017, 88th Legislature, Regular Session (2023); implement changes made by the U.S. Food and Drug Administration (FDA) in its final rule regarding over-the-counter hearing aids and prescription hearing aids; and clarify the requirements regarding medical statements for sales of hearing instruments to individuals under 18 years of age.
CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER U. FITTING AND DISPENSING OF HEARING INSTRUMENTS
16 TAC §111.201
OVERVIEW
The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter U, §111.201; and Subchapter W, §111.220; and adopts a new rule at Subchapter A, §111.3, regarding the Speech-Language Pathologists and Audiologists program, without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5369). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists, and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department).
The adopted rules implement changes made to Texas Occupations Code, Chapter 401 by Senate Bill (SB) 2017, 88th Legislature, Regular Session (2023); implement changes made by the U.S. Food and Drug Administration (FDA) in its final rule regarding over-the-counter hearing aids and prescription hearing aids; and clarify the requirements regarding medical statements for sales of hearing instruments to individuals under 18 years of age.
Amending 16 TAC §111.220, to clarify that the thirty-day trial period referenced in the section relates to a hearing instrument.
CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER W. JOINT RULE REGARDING THE SALE OF HEARING INSTRUMENTS
16 TAC §111.220
OVERVIEW
The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, Subchapter A, §111.2; Subchapter U, §111.201; and Subchapter W, §111.220; and adopts a new rule at Subchapter A, §111.3, regarding the Speech-Language Pathologists and Audiologists program, without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5369). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 111 implement Texas Occupations Code, Chapter 401, Speech-Language Pathologists and Audiologists, and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department).
The adopted rules implement changes made to Texas Occupations Code, Chapter 401 by Senate Bill (SB) 2017, 88th Legislature, Regular Session (2023); implement changes made by the U.S. Food and Drug Administration (FDA) in its final rule regarding over-the-counter hearing aids and prescription hearing aids; and clarify the requirements regarding medical statements for sales of hearing instruments to individuals under 18 years of age.
CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER A. GENERAL PROVISIONS
16 TAC §112.2, §112.3
OVERVIEW
The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter A, §112.2; Subchapter H, §112.70; Subchapter J, §112.92 and §112.96; and Subchapter O, §112.140; and adopts a new rule at Subchapter A, §112.3, regarding the Hearing Instrument Fitters and Dispensers program, without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5375). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC Chapter 112 implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers, and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department).
The adopted rules implement changes made to Texas Occupations Code, Chapter 402 by Senate Bill (SB) 2017, 88th Legislature, Regular Session (2023); implement changes made by the U.S. Food and Drug Administration (FDA) in its final rule regarding over-the-counter hearing aids and prescription hearing aids; make changes to provide continuing education credit for proctors of the practical test; and update language to reference the Department’s website in contracts and signs.
Amending 16 TAC §112.70, to provide that a licensee who serves as a proctor for the practical test may receive up to one continuing education credit hour for each test date, for up to four hours per license term.
CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER H. CONTINUING EDUCATION REQUIREMENTS
16 TAC §112.70
OVERVIEW
The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter A, §112.2; Subchapter H, §112.70; Subchapter J, §112.92 and §112.96; and Subchapter O, §112.140; and adopts a new rule at Subchapter A, §112.3, regarding the Hearing Instrument Fitters and Dispensers program, without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5375). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC Chapter 112 implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers, and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department).
The adopted rules implement changes made to Texas Occupations Code, Chapter 402 by Senate Bill (SB) 2017, 88th Legislature, Regular Session (2023); implement changes made by the U.S. Food and Drug Administration (FDA) in its final rule regarding over-the-counter hearing aids and prescription hearing aids; make changes to provide continuing education credit for proctors of the practical test; and update language to reference the Department’s website in contracts and signs.
Amending 16 TAC §112.92, §112.96, to require licensees to inform clients of the website address of the Department in each written contract for services and on a sign in their primary place of business.
CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER J. RESPONSIBILITIES OF THE LICENSEE
16 TAC §112.92, §112.96
OVERVIEW
The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter A, §112.2; Subchapter H, §112.70; Subchapter J, §112.92 and §112.96; and Subchapter O, §112.140; and adopts a new rule at Subchapter A, §112.3, regarding the Hearing Instrument Fitters and Dispensers program, without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5375). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC Chapter 112 implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers, and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department).
The adopted rules implement changes made to Texas Occupations Code, Chapter 402 by Senate Bill (SB) 2017, 88th Legislature, Regular Session (2023); implement changes made by the U.S. Food and Drug Administration (FDA) in its final rule regarding over-the-counter hearing aids and prescription hearing aids; make changes to provide continuing education credit for proctors of the practical test; and update language to reference the Department’s website in contracts and signs.
Amending 16 TAC §112.140, to clarify that the 30-day trial period referenced in this rule relates to a hearing instrument and to require medical evaluations or waivers of evaluation to be maintained only if they are provided.
CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER O. JOINT RULE REGARDING THE SALE OF HEARING INSTRUMENTS
16 TAC §112.140
OVERVIEW
The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter A, §112.2; Subchapter H, §112.70; Subchapter J, §112.92 and §112.96; and Subchapter O, §112.140; and adopts a new rule at Subchapter A, §112.3, regarding the Hearing Instrument Fitters and Dispensers program, without changes to the proposed text as published in the September 22, 2023, issue of the Texas Register (48 TexReg 5375). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC Chapter 112 implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers, and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department).
The adopted rules implement changes made to Texas Occupations Code, Chapter 402 by Senate Bill (SB) 2017, 88th Legislature, Regular Session (2023); implement changes made by the U.S. Food and Drug Administration (FDA) in its final rule regarding over-the-counter hearing aids and prescription hearing aids; make changes to provide continuing education credit for proctors of the practical test; and update language to reference the Department’s website in contracts and signs.
Texas Department of Insurance
Adopted Rules Re:
Repealing 28 TAC §§3.8001 – 3.8005, 3.8007 – 3.8030, to change the chemical dependency treatment standards for group health benefit plans.
CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER HH. STANDARDS FOR REASONABLE COST CONTROL AND UTILIZATION REVIEW FOR CHEMICAL DEPENDENCY TREATMENT CENTERS
28 TAC §§3.8001 – 3.8005, 3.8007 – 3.8030
OVERVIEW
The commissioner of the Texas Department of Insurance (TDI) adopts the repeal of 28 TAC §§3.8001 – 3.8005 and §§3.8007 – 3.8030, and adopts new 28 TAC §3.8001, concerning chemical dependency treatment standards. The new section is adopted with changes to the proposed text published in the July 14, 2023, issue of the Texas Register (48 TexReg 3829). The rule will be republished. Section 3.8001 was revised in response to public comment and to reference up-to-date criteria.
BACKGROUND AND JUSTIFICATION
The repeals of 28 TAC §§3.8001 – 3.8030 are necessary to remove existing dated and obsolete standards. New §3.8001 requires group health benefit plan issuers subject to Insurance Code Chapter 1368 to use the applicable treatment criteria published in the 27th edition of the MCG Care Guidelines (formerly Milliman Care Guidelines), the 3rd edition of the American Society of Addiction Medicine (ASAM) Criteria, or the 4th edition, Volume I, Adults, of the ASAM Criteria for any utilization review of treatment required under Insurance Code Chapter 1368. Both the 3rd edition ASAM Criteria and the 4th edition, Volume 1, are in effect and are collectively referred to as the ASAM Criteria. This provides group health benefit plans flexibility to select the treatment standards that work best for their utilization review systems. Following the MCG Care Guidelines and the ASAM Criteria will ensure that group health benefit plan issuers cover an appropriate continuum of care for treatment of substance use disorders and support the health, safety, and welfare of Texas insureds.
New 28 TAC §3.8001, to provide new standards for chemical dependency treatment standards for use by group health benefit plans.
CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER HH. STANDARDS FOR REASONABLE COST CONTROL AND UTILIZATION REVIEW FOR CHEMICAL DEPENDENCY TREATMENT CENTERS
28 TAC §3.8001
OVERVIEW
The commissioner of the Texas Department of Insurance (TDI) adopts the repeal of 28 TAC §§3.8001 – 3.8005 and §§3.8007 – 3.8030, and adopts new 28 TAC §3.8001, concerning chemical dependency treatment standards. The new section is adopted with changes to the proposed text published in the July 14, 2023, issue of the Texas Register (48 TexReg 3829). The rule will be republished. Section 3.8001 was revised in response to public comment and to reference up-to-date criteria.
BACKGROUND AND JUSTIFICATION
The repeals of 28 TAC §§3.8001 – 3.8030 are necessary to remove existing dated and obsolete standards. New §3.8001 requires group health benefit plan issuers subject to Insurance Code Chapter 1368 to use the applicable treatment criteria published in the 27th edition of the MCG Care Guidelines (formerly Milliman Care Guidelines), the 3rd edition of the American Society of Addiction Medicine (ASAM) Criteria, or the 4th edition, Volume I, Adults, of the ASAM Criteria for any utilization review of treatment required under Insurance Code Chapter 1368. Both the 3rd edition ASAM Criteria and the 4th edition, Volume 1, are in effect and are collectively referred to as the ASAM Criteria. This provides group health benefit plans flexibility to select the treatment standards that work best for their utilization review systems. Following the MCG Care Guidelines and the ASAM Criteria will ensure that group health benefit plan issuers cover an appropriate continuum of care for treatment of substance use disorders and support the health, safety, and welfare of Texas insureds.
Department of Aging and Disability Services
Adopted Rules Re:
Repealing 40 TAC §94.1, to delete the rule under the DADS which has been replaced with the proposed new rules in Title 26, Part 1, Chapter 556, concerning nurse aides.
CHAPTER 94. NURSE AIDES
40 TAC §94.1
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts the repeal of Title 40, Part 1, Chapter 94, Nurse Aides, consisting of §94.1.
The repeal of Chapter 94 is adopted without changes to the proposed text as published in the October 20, 2023, issue of the Texas Register (48 TexReg 6198). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption removes unnecessary rules from the Texas Administrative Code. As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to HHSC in accordance with Texas Government Code §531.0201 and §531.02011. In September 2018, the rules pertaining to Nurse Aides in Chapter 94 were repealed and proposed as new rules in Title 26, Part 1, Chapter 556, and a reference to those rules was adopted in Chapter 94. This reference is no longer needed and not the current practice for repealing and proposing new rules.
Repealing 40 TAC §95.1, to delete the rule under the DADS which has been replaced with the proposed new rules in Title 26, Part 1, Chapter 557.
CHAPTER 95. MEDICATION AIDES–PROGRAM REQUIREMENTS
40 TAC §95.1
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts the repeal of Title 40, Part 1, Chapter 95, Medication Aides–Program Requirements, consisting of §95.1.
The repeal is adopted without changes to the proposed text as published in the October 20, 2023, issue of the Texas Register (48 TexReg 6199). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption removes unnecessary rules from the Texas Administrative Code. As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to HHSC in accordance with Texas Government Code §531.0201 and §531.02011. In September 2018, the rules pertaining to Medication Aides–Program Requirements in Chapter 95 were repealed and proposed as new rules in Title 26, Part 1, Chapter 557, and a reference to those rules was adopted in Chapter 95. This reference is no longer needed and not the current practice for repealing and proposing new rules.
Repealing 40 TAC §99.1, to delete the rule under the DADS which has been replaced with the proposed new rules in Title 26, Part 1, Chapter 560, addressing denial or refusal of license.
CHAPTER 99. DENIAL OR REFUSAL OF LICENSE
40 TAC §99.1
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts the repeal of Title 40, Part 1, Chapter 99, Denial or Refusal of License, consisting of §99.1.
The repeal is adopted without changes to the proposed text as published in the October 20, 2023, issue of the Texas Register (48 TexReg 6200). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption removes unnecessary rules from the Texas Administrative Code. As required by Texas Government Code §531.0202(b), the Department of Aging and Disability Services (DADS) was abolished effective September 1, 2017, after all of its functions were transferred to HHSC in accordance with Texas Government Code §531.0201 and §531.02011. In September 2018, the rules pertaining to Denial or Refusal of License in Chapter 99 were repealed and proposed as new rules in Title 26, Part 1, Chapter 560, and a reference to those rules was adopted in Chapter 99. This reference is no longer needed and not the current practice for repealing and proposing new rules.
Texas Department of State Health Services
Proposed Rule Reviews Re:
Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter concerning Minimum Guidelines for Human Donor Milk Banks.
The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:
Chapter 227, Minimum Guidelines for Human Donor Milk Banks.
Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter concerning Specific Additional Requirements for Drugs.
The Texas Health and Human Services Commission (HHSC), on behalf of Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:
Chapter 230, Specific Additional Requirements for Drugs
Subchapter A Average Manufacture Price and Purchase Price Reporting for Pharmaceuticals
Subchapter B Limitations on Sales of Products Containing Ephedrine, Pseudoephedrine, And Norpseudoephedrine.
Reviewing Title 25, Part 1, to consider for readoption, revision, or repeal the chapter concerning Occupational Health.
The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:
Chapter 295, Occupational Health
Subchapter A Hazard Communication
Subchapter B Fees for Asbestos Services
Subchapter D Occupational Health Guidelines
Subchapter F Guidelines for Selection and Use of Face and Eye Protection in Public Schools
Subchapter G Sanitation at Temporary Places of Employment
Subchapter I Texas Environmental Lead Reduction