Texas Register Table of Contents
- 1 Texas Health and Human Services Commission
- 1.0.1 Emergency Rules Re:
- 1.0.2 Adopted Rules Re:
- 1.0.2.1 Repealing 1 TAC §§371.212, 371.214, 371.216, which concerned utilization review requirements and procedures.
- 1.0.2.2 New 1 TAC §§371.212, 371.214, 371.216, 371.218, 371.220, 371.222, 371.224, 371.226, 371.228, 371.230, describing nursing facility provider utilization review requirements, which now offers the option for desk reviews.
- 1.0.2.3 New 1 TAC §392.703, requiring the Texas Department of Family and Protective Services (DFPS) to accept and evaluate unsolicited proposals from entities to provide community-based care services.
- 1.0.2.4 Amending 26 TAC §§307.155, 307.163, 307.165, 307.167, 307.169, 307.175, and new §§307.157 and 307.159, concerning outpatient competency restoration services for behavioral health programs.
- 1.0.2.5 Repealing 26 TAC §307.157, §307.159, which concerned the timeline for outpatient competency restoration services for behavioral health programs.
- 1.0.3 In Addition Re:
- 2 Texas Higher Education Coordinating Board
Texas Health and Human Services Commission
Emergency Rules Re:
New 26 TAC §500.4, permitting a licensed hospital to participate in CMS Acute Hospital Care at Home Program to allow for expanded hospital capacity.
CHAPTER 500. COVID-19 EMERGENCY HEALTH CARE FACILITY LICENSING
SUBCHAPTER A. HOSPITALS
26 TAC §500.4
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 500, COVID-19 Emergency Health Care Facility Licensing, new §500.4, concerning an emergency rule in response to COVID-19 in order to permit a licensed hospital to participate in the Centers for Medicare & Medicaid Services (CMS) Acute Hospital Care at Home Program to expand hospital capacity in response to the COVID-19 pandemic.
Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.
BACKGROUND AND JUSTIFICATION
As authorized by Texas Government Code §2001.034, the Commission may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice.
The purpose of the emergency rulemaking is to support the Governor’s proclamations relating to the continued response to the COVID-19 disaster. In these proclamations, the Governor authorized the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster and directed that government entities and businesses would continue providing essential services. HHSC accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this emergency rule for Participating in the Centers for Medicare and Medicaid Services Acute Hospital Care at Home Program During the COVID-19 Pandemic.
To protect hospital patients and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting an emergency rule to temporarily permit a currently licensed hospital to participate in the CMS hospitals at home program to expand hospital capacity in response to the COVID-19 pandemic.
Adopted Rules Re:
Repealing 1 TAC §§371.212, 371.214, 371.216, which concerned utilization review requirements and procedures.
CHAPTER 371. MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY
SUBCHAPTER C. UTILIZATION REVIEW
1 TAC §§371.212, 371.214, 371.216
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts the repeal of §371.212, concerning Minimum Data Set Assessments; §371.214, concerning Resource Utilization Group Classification System; and §371.216, concerning Waiver of Extrapolation; and adopts new §371.212, concerning Utilization Review of Nursing Facilities; §371.214, concerning HHSC-Approved Online RUG or Other HHSC-Required Training Course; §371.216, concerning Nursing Facility Clinical Records; §371.218, concerning Onsite and Desk Utilization Reviews of Nursing Facilities; §371.220, concerning Exit Conferences; §371.222, concerning Reconsideration of Utilization Review Results; §371.224, concerning Appeals of Reconsideration Results; §371.226, concerning Calculation of Overpayments and Underpayments; §371.228, concerning Recoveries; and §371.230, concerning Waiver of Extrapolation.
The repeal of §§371.212, 371.214, and 371.216 are adopted without changes as published in the October 21, 2022, issue of the Texas Register (47 TexReg 6944). The repeals will not be republished.
New §§371.212, 371.214, 371.216, 371.218, 371.220, 371.222, 371.224, 371.226, 371.228, and 371.230 are adopted without changes to the proposed text as published in the October 21, 2022, issue of the Texas Register (47 TexReg 6944). The rules will not be republished.
BACKGROUND AND JUSTIFICATION
The purpose of the repeals and new rules is to update procedures, modernize language, remove unnecessary or duplicative language, and add the option for desk reviews.
The Office of Inspector General (OIG) Nursing Facility Utilization Review (NFUR) unit performs reviews to evaluate the quality of care, medical necessity, appropriateness, and efficiency of healthcare or services to nursing facility residents. Utilization review may include the assessment of the accuracy of coded items by review of clinical records, business records, observation of the recipient, interviews, and other relevant sources of information.
The replacement of §§371.212, 371.214, and 371.216 with the new sections updates and re-organizes the OIG nursing facility utilization review procedures and provider requirements by: re-organizing the structure of the NFUR rules; providing procedures for desk reviews; deleting redundant language excerpted from the Resident Assessment Instrument (RAI) User’s Manual; adding language that links OIG’s use of extrapolation with existing Texas Administrative Code rule §371.35; and providing for the use of a case mix classification system that succeeds resource utilization groups (RUGs).
New 1 TAC §§371.212, 371.214, 371.216, 371.218, 371.220, 371.222, 371.224, 371.226, 371.228, 371.230, describing nursing facility provider utilization review requirements, which now offers the option for desk reviews.
CHAPTER 371. MEDICAID AND OTHER HEALTH AND HUMAN SERVICES FRAUD AND ABUSE PROGRAM INTEGRITY
SUBCHAPTER C. UTILIZATION REVIEW
1 TAC §§371.212, 371.214, 371.216, 371.218, 371.220, 371.222, 371.224, 371.226, 371.228, 371.230
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts the repeal of §371.212, concerning Minimum Data Set Assessments; §371.214, concerning Resource Utilization Group Classification System; and §371.216, concerning Waiver of Extrapolation; and adopts new §371.212, concerning Utilization Review of Nursing Facilities; §371.214, concerning HHSC-Approved Online RUG or Other HHSC-Required Training Course; §371.216, concerning Nursing Facility Clinical Records; §371.218, concerning Onsite and Desk Utilization Reviews of Nursing Facilities; §371.220, concerning Exit Conferences; §371.222, concerning Reconsideration of Utilization Review Results; §371.224, concerning Appeals of Reconsideration Results; §371.226, concerning Calculation of Overpayments and Underpayments; §371.228, concerning Recoveries; and §371.230, concerning Waiver of Extrapolation.
The repeal of §§371.212, 371.214, and 371.216 are adopted without changes as published in the October 21, 2022, issue of the Texas Register (47 TexReg 6944). The repeals will not be republished.
New §§371.212, 371.214, 371.216, 371.218, 371.220, 371.222, 371.224, 371.226, 371.228, and 371.230 are adopted without changes to the proposed text as published in the October 21, 2022, issue of the Texas Register (47 TexReg 6944). The rules will not be republished.
BACKGROUND AND JUSTIFICATION
The purpose of the repeals and new rules is to update procedures, modernize language, remove unnecessary or duplicative language, and add the option for desk reviews.
The Office of Inspector General (OIG) Nursing Facility Utilization Review (NFUR) unit performs reviews to evaluate the quality of care, medical necessity, appropriateness, and efficiency of healthcare or services to nursing facility residents. Utilization review may include the assessment of the accuracy of coded items by review of clinical records, business records, observation of the recipient, interviews, and other relevant sources of information.
The replacement of §§371.212, 371.214, and 371.216 with the new sections updates and re-organizes the OIG nursing facility utilization review procedures and provider requirements by: re-organizing the structure of the NFUR rules; providing procedures for desk reviews; deleting redundant language excerpted from the Resident Assessment Instrument (RAI) User’s Manual; adding language that links OIG’s use of extrapolation with existing Texas Administrative Code rule §371.35; and providing for the use of a case mix classification system that succeeds resource utilization groups (RUGs).
New 1 TAC §392.703, requiring the Texas Department of Family and Protective Services (DFPS) to accept and evaluate unsolicited proposals from entities to provide community-based care services.
CHAPTER 392. PURCHASE OF GOODS AND SERVICES FOR SPECIFIC HEALTH AND HUMAN SERVICES COMMISSION PROGRAMS
SUBCHAPTER H. DFPS CONTRACTED SERVICES
1 TAC §392.703
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts new §392.703, concerning Unsolicited Proposals for Community-Based Care Services.
The new §392.703 is adopted without changes to the proposed text as published in the November 4, 2022, issue of the Texas Register (47 TexReg 7385). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption of new §392.703 is necessary to comply with Senate Bill (S.B.) 1896, 87th Legislature, Regular Session, 2021. S.B. 1896 amended Texas Family Code §264.157 to require DFPS to accept and evaluate unsolicited proposals from entities based in this state to provide community-based care services in geographic areas where DFPS has not implemented community-based care. The statute also requires HHSC, in conjunction with DFPS, to adopt rules to ensure the proposals comply with state procurement laws and rules.
Amending 26 TAC §§307.155, 307.163, 307.165, 307.167, 307.169, 307.175, and new §§307.157 and 307.159, concerning outpatient competency restoration services for behavioral health programs.
CHAPTER 307. BEHAVIORAL HEALTH PROGRAMS
SUBCHAPTER D. OUTPATIENT COMPETENCY RESTORATION
26 TAC §§307.155, 307.157, 307.159, 307.163, 307.165, 307.167, 307.169, 307.175
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts amendments to §307.155, concerning Definitions; §307.163, concerning Assessment, Reassessment, Court Reporting, and Extension; §307.165, concerning Discharge Requirements; §307.167, concerning Data; §307.169, concerning Written Policies and Procedures; §307.175, concerning Compliance with Statutes and Rules; the repeal of §307.157, concerning Criteria for Admission to an Outpatient Competency Restoration Program; §307.159, concerning Recommendation Regarding Outpatient Competency Restoration Program Admission; and new §307.157, concerning Recommendation Regarding Outpatient Competency Restoration Program Admission; and §307.159, concerning Admission to an Outpatient Competency Restoration Program.
Section 307.157 is adopted with changes to the proposed text as published in the October 14, 2022, issue of the Texas Register (47 TexReg 6809). This rule will be republished.
Sections 307.155, 307.159, 307.163, 307.165, 307.167, 307.169, and 307.175, and the repeals of §307.157 and §307.159 are adopted without changes to the proposed text as published in the October 14, 2022, issue of the Texas Register (47 TexReg 6809). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The adopted rules implement Senate Bill 49, 87th Legislature, Regular Session, 2021 which amended Texas Code of Criminal Procedure Article 46B relating to when competency restoration services begin and when an extension of the initial restoration period begins. In addition, HHSC adopts amendments to clarify statutory requirements and language for consistency and understanding, reorder requirements in the order in which processes occur, and update and add cross references.
Repealing 26 TAC §307.157, §307.159, which concerned the timeline for outpatient competency restoration services for behavioral health programs.
CHAPTER 307. BEHAVIORAL HEALTH PROGRAMS
SUBCHAPTER D. OUTPATIENT COMPETENCY RESTORATION
26 TAC §307.157, §307.159
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts amendments to §307.155, concerning Definitions; §307.163, concerning Assessment, Reassessment, Court Reporting, and Extension; §307.165, concerning Discharge Requirements; §307.167, concerning Data; §307.169, concerning Written Policies and Procedures; §307.175, concerning Compliance with Statutes and Rules; the repeal of §307.157, concerning Criteria for Admission to an Outpatient Competency Restoration Program; §307.159, concerning Recommendation Regarding Outpatient Competency Restoration Program Admission; and new §307.157, concerning Recommendation Regarding Outpatient Competency Restoration Program Admission; and §307.159, concerning Admission to an Outpatient Competency Restoration Program.
Section 307.157 is adopted with changes to the proposed text as published in the October 14, 2022, issue of the Texas Register (47 TexReg 6809). This rule will be republished.
Sections 307.155, 307.159, 307.163, 307.165, 307.167, 307.169, and 307.175, and the repeals of §307.157 and §307.159 are adopted without changes to the proposed text as published in the October 14, 2022, issue of the Texas Register (47 TexReg 6809). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The adopted rules implement Senate Bill 49, 87th Legislature, Regular Session, 2021 which amended Texas Code of Criminal Procedure Article 46B relating to when competency restoration services begin and when an extension of the initial restoration period begins. In addition, HHSC adopts amendments to clarify statutory requirements and language for consistency and understanding, reorder requirements in the order in which processes occur, and update and add cross references.
In Addition Re:
Revised Public Notice – Texas State Plan Amendment
The Texas Health and Human Services Commission (HHSC) announces its intent to submit an amendment to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act. This public notice is to correct the effective date, listed as March 1, 2021, on the notice posted to the Texas Register January 20, 2023, which serves the same purpose. The proposed amendment has an updated effective date of March 11, 2021.
The proposed amendment documents coverage of COVID-19 prevention and treatment as benefits in Texas Medicaid, including coverage for conditions that may seriously complicate COVID-19 treatment.
Texas Higher Education Coordinating Board
In Addition Re:
Notice of Opportunity to Comment on Proposed Field of Study Curriculum for Nursing
OVERVIEW
The Texas Higher Education Coordinating Board (THECB or Coordinating Board) staff is providing an opportunity for written public comment on a revision of the Field of Study Curriculum (FOSC) for Nursing.
The recommended courses are as follows:
Designated Core Courses in the Field of Study: PSYC 2301: General Psychology; ENGL 1301: Composition 1; ENGL 1302: Composition II; MATH 1342: Elementary Statistical Methods; BIOL 2401/2301 + 2101 (Anatomy and Physiology I); and BIOL 2402/2302 + 2102 (Anatomy and Physiology II).
Discipline Foundation Courses (10 semester credit hours): PSYC 2314: Lifespan Growth & Development; BIOL 2420/2320 + 2120 (Microbiology for Non-Science Majors); and BIOL 1322/HECO 1322 (Nutrition and Diet Therapy).
In addition to these courses, each general academic institution will have the opportunity to submit to the Coordinating Board six (6) semester credit hours of Directed Electives selected by the institution from the Academic Course Guide Manual. The complete FOSC will consist of the Designated Core Courses and Discipline Foundation Courses listed above, as well as Directed Electives selected by the relevant general academic institutions in compliance with the transfer rules in TAC Chapter 4, Subchapter B, including §§4.23(4), 4.32(b)(3), and 4.33.
General academic institutions will be required to transfer these courses and apply them for academic credit towards degree programs with majors in the following CIP Code:
51.3801: Registered Nursing/Registered Nurse
BACKGROUND AND JUSTIFICATION
Texas Education Code (TEC) Chapter 61, Subchapter S, establishes policies to facilitate statewide transfer, including the FOSC. Institutions must accept partially or fully completed Field of Study Curricula for academic credit toward the degree program in which the transfer student enrolls (TEC §61.823). The Coordinating Board has promulgated rules related to transfer policy in 19 Texas Administrative Code (TAC) Chapter 1, Subchapter V, and Chapter 4, Subchapter B. Posting requirements may be found in 19 TAC §§4.33(f) and 1.239(b).
The Nursing Discipline-Specific Subcommittee met on October 12-13, 2022, to consider and make recommendations to the Texas Transfer Advisory Committee regarding the FOSC for this discipline. On December 7, 2022, the Texas Transfer Advisory Committee adopted the subcommittee recommendations for the designated Texas Core Curriculum courses and the Discipline Foundation Courses and recommended their submission to the Commissioner of Higher Education for final approval.
WRITTEN COMMENTS
Written comments about the proposed changes must be sent to Elizabeth Mayer, Assistant Commissioner for Academic and Health Affairs, Texas Higher Education Coordinating Board, P.O. Box 12788, Austin, Texas 78711, or via email to Elizabeth.Mayer@highered.texas.gov. Comments must be received by 5:00 p.m., March 4, 2023, to be considered.
Notice of Opportunity to Comment on Proposed Field of Study Curriculum for Psychology
OVERVIEW
The Texas Higher Education Coordinating Board (THECB or Coordinating Board) staff is providing an opportunity for written public comment on a revision of the Field of Study Curriculum (FOSC) for Psychology.
The recommended courses are as follows:
Designated Core Courses in the Field of Study: PSYC 2301: General Psychology.
Discipline Foundation Courses (9 semester credit hours): PSYC 2314: Lifespan Growth & Development; PSYC 2317: Statistical Methods in Psychology; and PSYC 2319: Social Psychology.
In addition to these courses, each general academic institution will have the opportunity to submit to the Coordinating Board nine (9) semester credit hours of Directed Electives selected by the institution from the Academic Course Guide Manual. The complete FOSC will consist of the Designated Core Courses and Discipline Foundation Courses listed above, as well as Directed Electives selected by the relevant general academic institutions in compliance with the transfer rules in TAC Chapter 4, Subchapter B, including §§4.23(4), 4.32(b)(3), and 4.33.
General academic institutions will be required to transfer these courses and apply them for academic credit towards degree programs with majors in the following CIP Code:
42.0101: Psychology, General
BACKGROUND AND JUSTIFICATION
Texas Education Code (TEC) Chapter 61, Subchapter S, establishes policies to facilitate statewide transfer, including the FOSC. Institutions must accept partially or fully completed Field of Study Curricula for academic credit toward the degree program in which the transfer student enrolls (TEC §61.823). The Coordinating Board has promulgated rules related to transfer policy in 19 Texas Administrative Code (TAC) Chapter 1, Subchapter V, and Chapter 4, Subchapter B. Posting requirements may be found in 19 TAC §§4.33(f) and 1.239(b).
The Psychology Discipline-Specific Subcommittee met on May 10-11, 2022, to consider and make recommendations to the Texas Transfer Advisory Committee regarding the FOSC for this discipline. On December 7, 2022, the Texas Transfer Advisory Committee adopted the subcommittee recommendations for the designated Texas Core Curriculum courses and the Discipline Foundation Courses and recommended their submission to the Commissioner of Higher Education for final approval.
WRITTEN COMMENTS
Written comments about the proposed changes must be sent to Elizabeth Mayer, Assistant Commissioner for Academic and Health Affairs, Texas Higher Education Coordinating Board, P.O. Box 12788, Austin, Texas 78711, or via email to Elizabeth.Mayer@highered.texas.gov. Comments must be received by 5:00 p.m., March 4, 2023, to be considered.