Texas Register Table of Contents
- 1 Governor
- 2 Texas Health and Human Services Commission
- 3 Texas Medical Board
- 4 Texas Health and Human Services Commission
- 5 Texas State Board of Pharmacy
- 6 Texas State Board of Pharmacy
- 7 Texas State Board of Pharmacy
- 8 Texas State Board of Pharmacy
- 9 Texas Medical Board
- 10 Texas Medical Board
- 11 Texas Health and Human Services Commission
- 12 Employees Retirement System of Texas
- 13 Employees Retirement System of Texas
- 14 Texas State Board of Pharmacy
- 15 Texas State Board of Pharmacy
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
Governor
Notices
Executive Order GA-27: Requiring certain hospitals in Bexar, Dallas, Harris, and Travis counties to suspend elective surgeries
OVERVIEWGovernor orders the following effective at 11:59 p.m. on Friday, June 26, 2020:Every hospital that is licensed under Chapter 241 of the Texas Health and Safety Code, and is also located in Bexar, Dallas, Harris, or Travis counties, shall postpone all surgeries and procedures that are not medically necessary to diagnose or correct a serious medical condition of, or to preserve the life of, a patient who without timely performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician.Exception: This prohibition shall not apply to any surgery or procedure that, if performed in accordance with the commonly accepted standard of clinical practice, would not deplete any hospital capacity needed to cope with the COVID-19 disaster.Scope: The governor may, by proclamation, add to or subtract from the list of counties covered by this prohibition.This executive order does not supersede Executive Orders GA-10, GA-13, GA-17, GA-19, GA-24, GA-25, or GA-26. Effective Duration:This executive order shall remain in effect and in full force until modified, amended, rescinded, or superseded by the governor.BACKGROUND AND JUSTIFICATION The Governor’s rationale for issuing Executive Order GA-27 is listed in this week’s edition of the Texas Register (45 Tex Reg 4421).
Texas Health and Human Services Commission
Emergency Rule
New 1 TAC §355.205, temporarily issuing rate increases for certain Medicaid providers
CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER B. ESTABLISHMENT AND ADJUSTMENT OF REIMBURSEMENT RATES FOR MEDICAID1 TAC §355.205OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 1 Texas Administrative Code, Chapter 355, Reimbursement Rates, new §355.205, concerning an emergency rule for emergency temporary reimbursement rate increases and limitations on use of emergency temporary funds for Medicaid in response to novel coronavirus (COVID-19). BACKGROUND AND JUSTIFICATION As authorized by Texas Government Code §2001.034, HHSC may adopt an emergency rule without prior notice or hearing upon finding that an imminent peril to the public health, safety, or welfare requires adoption on fewer than 30 days’ notice. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed for not longer than 60 days.To protect Medicaid clients, providers, and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting an emergency rule to give HHSC the ability to establish emergency temporary reimbursement rate increases and limitations for certain Medicaid providers that serve vulnerable populations.HHSC may currently implement reimbursement rate modifications in accordance with §355.201(c)(3), which allows HHSC to establish fees, rates, and charges for medical assistance in accordance with various criteria, including “…economic conditions that, in HHSC’s determination, substantially and materially affect provider participation.” In addition to potential reimbursement rate modifications that HHSC may implement pursuant to §355.201(c)(3), HHSC is adopting this emergency rule to establish an emergency temporary reimbursement methodology to issue rate increases to providers in response to the COVID-19 pandemic. HHSC sought and received approval for this increase as required by House Bill 1 (Article II, Special Provisions for Health and Human Services Agencies, Special Provision 14), 86th Texas Legislature, Regular Session, 2019, and was directed to restrict use of funds by providers. HHSC is adopting this emergency rule to describe the process by which HHSC will restrict providers from using the increased reimbursement rates to increase hourly wages paid to direct care staff on an ongoing basis; use of the funds for staff compensation is limited to overtime payments, lump sum bonuses, bonuses for hazard pay, or other types of compensation that will not result in future reductions to hourly wages when the emergency temporary reimbursement rate increase is discontinued, in accordance with the contingencies placed upon use of the funds.
Texas Medical Board
Emergency Rule
Amending 22 TAC §187.2, §187.6, §187.16 to allow participants to appear before a Board proceedings via videoconference or teleconference
CHAPTER 187. PROCEDURAL RULESSUBCHAPTER A. GENERAL PROVISIONS AND DEFINITIONS22 TAC §187.2, §187.6SUBCHAPTER B. INFORMAL BOARD PROCEEDINGS22 TAC §187.16OVERVIEWThe Texas Medical Board (Board) adopts on an emergency basis amendments to 22 TAC §§187.2 (Definitions), 187.6 (Appearances Personally or by Representative) and 187.16 (Informal Show Compliance (ISC) Information and Notices), effective immediately upon filing.The emergency amendment to §187.2(6) adds a definition of “appear/appearance” to include the opportunity to appear before a Board proceeding via videoconference or teleconference. The amendments to §187.6 and §187.16 are conforming amendments to incorporate consistent usage of the term “appear” and “appearance.”BACKGROUND AND JUSTIFICATION There is currently a sharp increase in COVID-19 cases in certain areas of Texas. Further, Governor Abbott stated on June 23, 2020, “[u]nless you do need to go out, the safest place for you is at your home.” Thus, the emergency amendments are necessary to facilitate safe continuity of operations of the Texas Medical Board with respect to resolution of complaint investigations. These complaint investigations and disciplinary process comprise essential functions of the Board. The Board currently has approximately 175 cases postponed. The emergency amendments will provide the Board with the ability to implement maximum safety measures mitigating against the spread of COVID-19.
Texas Health and Human Services Commission
Emergency Rule
New 26 TAC §745.10003, imposing heightened safety measures as a condition of licensing for certain day care operations
CHAPTER 745. LICENSINGSUBCHAPTER X. EMERGENCY RULESDIVISION 1. RULES FOR CERTAIN DAY CARE OPERATIONS IN RESPONSE TO COVID-1926 TAC §745.10003OVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts on an emergency basis in Title 26 Texas Administrative Code, Chapter 745 Licensing, new §745.10003, concerning an emergency rule with ongoing requirements for certain day care operations in response to COVID-19.To protect children in day care and the public health, safety, and welfare of the state during the COVID-19 pandemic, HHSC is adopting an emergency rule to: (1) require compliance with CDC requirements for child care programs; (2) require caregiver training related to COVID-19; (3) require screening of persons and children entering an operation and explicitly deny entry to persons or children that meet a screening criteria;(4) require a pick-up and drop-off plan for children; (5) require stricter standards when changing diapers and when clothes get contaminated; (6) adjust the HVAC system; (7) limit the use of cloth toys; (8) require the posting of handwashing posters; (9) limit the use of food preparation sinks; (10) not allow the serving of family style meals; and (11) clarify that a more restrictive rule or executive order controls.BACKGROUND AND JUSTIFICATION As authorized by 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. Emergency rules adopted under Texas Government Code §2001.034 may be effective for not longer than 120 days and may be renewed once for not longer than 60 days.The purpose of the emergency rulemaking is to support: (1) the Governor’s continuing March 13, 2020 proclamation certifying that the COVID-19 virus poses an imminent threat of disaster in the state and declaring a state of disaster for all counties in Texas; and (2) the minimum standard health protocols that the Governor’s Strike Force to Open Texas created to help protect the health and safety of employees and children in child care centers during COVID-19. In the Governor’s proclamation, he 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. The Commission accordingly finds that an imminent peril to the public health, safety, and welfare of the state requires immediate adoption of this Emergency Rule with Ongoing Requirements for Certain Day Care Operations in Response to COVID-19.
Texas State Board of Pharmacy
Proposed Rules
Amending 22 TAC §281.65 to impose an administrative penalty for failure to access a patient’s Prescription Monitoring Program before dispensing certain controlled substances
CHAPTER 281. ADMINISTRATIVE PRACTICE AND PROCEDURESSUBCHAPTER C. DISCIPLINARY GUIDELINES22 TAC §281.65The Texas State Board of Pharmacy proposes amendments to §281.65 concerning Schedule of Administrative Penalties. The amendments, if adopted, add an administrative penalty for the violation of failing to access the Prescription Monitoring Program for a patient’s information before dispensing opioids, benzodiazepines, barbiturates, or carisoprodol, and update a citation reference.
Texas State Board of Pharmacy
Proposed Rules
Amending 22 TAC §291.9 to remove references to a class of pharmacies which no longer exists
CHAPTER 291. PHARMACIESSUBCHAPTER A. ALL CLASSES OF PHARMACIES22 TAC §291.9The Texas State Board of Pharmacy proposes amendments to §291.9, concerning Prescription Pick Up Locations. The amendments, if adopted, remove an outdated reference to Class H pharmacies, which no longer exist.
Texas State Board of Pharmacy
Proposed Rules
Amending 22 TAC §291.121 to expand the ability of certain healthcare facilities to provide remote pharmacy services
CHAPTER 291. PHARMACIESSUBCHAPTER G. SERVICES PROVIDED BY PHARMACIES22 TAC §291.121The Texas State Board of Pharmacy proposes amendments to §291.121, concerning Remote Pharmacy Services. The amendments, if adopted, allow remote pharmacies services to be provided using an automated pharmacy system to be provided at healthcare facilities regulated under Chapter 241 and removes the limitation that the services may only be provided to inpatients of the remote site.
Texas State Board of Pharmacy
Proposed Rules
Amending 22 TAC §291.153 to update facility requirements for Class G pharmacies
CHAPTER 291. PHARMACIESSUBCHAPTER H. OTHER CLASSES OF PHARMACY22 TAC §291.153The Texas State Board of Pharmacy proposes amendments to §291.153 concerning Central Prescription Drug or Medication Order Processing Pharmacy (Class G). The amendments, if adopted, remove the requirement for a Class G pharmacy to have a sink exclusive of restroom facilities, and correct grammatical errors.
Texas Medical Board
Adopted Rules
Amending 22 TAC §166.2 to require physicians to complete pain management and human trafficking training
CHAPTER 166. PHYSICIAN REGISTRATION22 TAC §166.2OVERVIEWThe Texas Medical Board (Board) adopts amendments to Title 22, Part 9, §166.2, concerning Continuing Medical Education, with non-substantive changes to the proposed text as published in the March 27, 2020, issue of the Texas Register (45 TexReg 2120). The adopted rule will be republished.The new language requires that physicians complete at least two hours of continuing medical education (CME) training in topics related to pain management, and the prescription of opioids and other controlled substances. Additionally, the amendments add language requiring a course in the topic of human trafficking prevention. The new courses are to be completed as part of the formal course hours required each biennial registration period. Other changes adopted to 166.2 are made to reorganize and format the rule.BACKGROUND AND JUSTIFICATION The amendments are adopted in order to implement new continuing education requirements set forth by H.B. 2059, H.B. 2174, H.B. 2454, and H.B. 3285, passed by the 86th Legislature, Regular Session (2019).
Texas Medical Board
Adopted Rules
Amending 22 TAC §172.13 to clarify requirements for and process to obtain conceded eminence
CHAPTER 172. TEMPORARY AND LIMITED LICENSESSUBCHAPTER C. LIMITED LICENSES22 TAC §172.13OVERVIEWThe Texas Medical Board (Board) adopts amendments to Title 22, Part 9, §172.13, concerning Conceded Eminence with non-substantive changes, as described below, to the proposed text as published in the March 27, 2020, issue of the Texas Register (45 TexReg 2123). The adopted rule will be republished.Section 172.13, relating to Conceded Eminence, was amended to add language to clarify the requirements for and process to obtain conceded eminence. Superfluous language is deleted. The rule was also reorganized and renumbered for clarity.SECTION-BY-SECTION SUMMARYSubsection (c) lists qualifications the Board shall consider in determining whether an applicant has recognized conceded eminence and authority in the applicant’s specialty. Examination requirements have been deleted from subsection (c) and expanded upon in subsection (e).Subsection (d) lists requirements to be shown in an application for conceded eminence. Consideration for foreign applicants who may not be able to maintain a foreign license or certificate has been made in paragraph (1)(B).Subsection (e) lists examination requirements. Previously, subsection (c)(3) required that an applicant not have failed a licensing examination within a three-attempt limit. Subsection (e)(2) is now expanded, based on stakeholder input, to accept examinations not only accepted by the board for licensure, but also accepted for licensure in another state, territory, Canadian province, or country, or accepted for specialty board certification.Subsection (f) lists additional requirements and documentation necessary for a conceded eminence application. Based on stakeholder input, paragraph (3) adds a substantial equivalence analysis for subspecialty training programs that have received ACGME accreditation after the applicant’s participation.Subsections (g) through (l) contains information and requirements listed in the Texas Occupations Code Annotated, §155.006, previously contained in the rule.
Texas Health and Human Services Commission
Adopted Rules
New 26 TAC, Chapter 711, Subchapter L, transferring management of the Employee Misconduct Registry from DFPS to HHSC
CHAPTER 711. INVESTIGATIONS OF INDIVIDUALS RECEIVING SERVICES FROM CERTAIN PROVIDERSSUBCHAPTER L. EMPLOYEE MISCONDUCT REGISTRY26 TAC §§711.1401 – 711.1404, 711.1406 – 711.1408, 711.1413 – 711.1415, 711.1417, 711.1419, 711.1421, 711.1423, 711.1425 – 711.1427, 711.1429, 711.1431, 711.1432, 711.1434OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §§711.1401 – 711.1404, 711.1406 – 711.1408, 711.1413 – 711.1415, 711.1417, 711.1419, 711.1421, 711.1423, 711.1425 – 711.1427, 711.1429, 711.1431, 711.1432, and 711.1434 in Chapter 711, Subchapter L, concerning Employee Misconduct Registry.These new rules are adopted without changes to the proposed text as published in the March 13, 2020, issue of the Texas Register (45 TexReg 1833). These rules will not be republished.BACKGROUND AND JUSTIFICATIONSenate Bill (S.B.) 200, 84th Legislature Regular Session, 2016, transferred certain functions previously performed by the Department of Family and Protective Services (DFPS) to HHSC and reorganized health and human services delivery in Texas. Certain functions previously performed by DFPS transferred to HHSC in accordance with Texas Government Code, §531.0201, §531.02011, and §531.02013. As a result, both agencies need the rules currently located in Title 40, Chapter 711, Subchapter O, Employee Misconduct Registry; therefore, HHSC is adopting new rules in Title 26 for use by HHSC. These rules create a new subchapter in Title 26, Chapter 711, Subchapter L, Employee Misconduct Registry, which copy necessary rules from Title 40, Chapter 711, Subchapter O, Employee Misconduct Registry, update references to other rules and reflect agency language changes where appropriate.
Employees Retirement System of Texas
Adopted Rules
Amending 34 TAC §302.2 to clarify Texas Emergency Services Retirement System procedure for benefit distribution
TITLE 34. PUBLIC FINANCEPART 11. TEXAS EMERGENCY SERVICES RETIREMENT SYSTEMCHAPTER 302. GENERAL PROVISIONS RELATING TO THE TEXAS EMERGENCY SERVICES RETIREMENT SYSTEM34 TAC §302.2The Texas Emergency Services Retirement System (TESRS) adopts amendments to §302.2 concerning general provisions relating to TESRS, without changes to the proposed text as published in the April 24, 2020, edition of the Texas Register (45 TexReg 2692). The rules will not be republished.The adopted amendments clarify the Board rule regarding benefit distributions to satisfy the plan qualification requirements under the Internal Revenue Code of 1986, as amended.
Employees Retirement System of Texas
Adopted Rules
Amending 34 TAC §310.5 and adding new §§ 310.13 and 310.14 to clarify administrative processes for the Texas Emergency Services Retirement System
TITLE 34. PUBLIC FINANCEPART 11. TEXAS EMERGENCY SERVICES RETIREMENT SYSTEMCHAPTER 310. ADMINISTRATION OF THE TEXAS EMERGENCY SERVICES RETIREMENT SYSTEM34 TAC §§310.5, 310.13, 310.14OVERVIEWThe Texas Emergency Services Retirement System (TESRS) adopts amendments to 34 TAC §310.5 and new rules §§310.13, and 310.14, concerning the administration of TESRS, without changes to the proposed text as published in the April 24, 2020 edition of the Texas Register (44 TexReg 2696). These rules will not be republished.These sections address clarifications and changes related to administrative processes and to allow the administration of TESRS to comply with House Bill (H.B.) 3247, 86th Legislature, Regular Session, 2019, which amended §§861 – 865, Texas Government Code.SECTION-BY-SECTION SUMMARYThe amendments to §310.5 establish the staggered two-year terms served by trustees of the local board to begin March 1st and end the last day of February of the second year and would further describe the composition of the six-member local board.New rule §310.13 describes the delegation of local board duties to the executive director as provided under §865.0121, Texas Government Code, when the trustees of a local board have not been appointed or when the local board fails to perform its duties.New rule §310.14 describes the delegation of duties to the executive director upon the discontinuance of department participation in the pension system as provided under §864.010 when a department ceases to exist or withdraws from the pension system.
Texas State Board of Pharmacy
Notices
Rule Review: Board intends to review 22 TAC §§291.71 – 291.77, concerning institutional pharmacies
Title 22, Part 15The Texas State Board of Pharmacy files this notice of intent to review Chapter 291, (§§291.71 – 291.77), concerning Pharmacies (Institutional Pharmacy (Class C)), pursuant to the Texas Government Code §2001.039, regarding Agency Review of Existing Rules.Comments regarding whether the reason for adopting the rule continues to exist, may be submitted to Megan G. Holloway, Assistant General Counsel, Texas State Board of Pharmacy, 333 Guadalupe Street, Suite 3-500, Austin, Texas, 78701, FAX (512) 305-8061. Comments must be received by 5:00 p.m., August 1, 2020.
Texas State Board of Pharmacy
Notices
Rule Review: Board intends to review 22 TAC §§303.1 – 303.3, concerning the destruction of drugs
Title 22, Part 15The Texas State Board of Pharmacy files this notice of intent to review Chapter 303, (§§303.1 – 303.3), concerning Destruction of Drugs, pursuant to the Texas Government Code §2001.039, regarding Agency Review of Existing Rules.Comments regarding whether the reason for adopting the rule continues to exist, may be submitted to Megan G. Holloway, Assistant General Counsel, Texas State Board of Pharmacy, 333 Guadalupe Street, Suite 3-500, Austin, Texas, 78701, FAX (512) 305-8061. Comments must be received by 5:00 p.m., August 1, 2020.