Texas Register June 26, 2020 Volume: 45 Number: 26

Texas Register Table of Contents

Governor

 

Notices

Proclamation 41-3741: Renewing the state of disaster for all Texas counties as a result of COVID-19

OVERVIEWIn accordance with the authority vested by Section 418.014 of the Texas Government Code, Governor hereby renews the disaster proclamation for all counties in Texas.Pursuant to Section 418.017, Governor authorizes the use of all available resources of state government and of political subdivisions that are reasonably necessary to cope with this disaster.Pursuant to Section 418.016, any regulatory statute prescribing the procedures for conduct of state business or any order or rule of a state agency that would in any way prevent, hinder, or delay necessary action in coping with this disaster shall be suspended upon written approval of the Office of the Governor. However, to the extent that the enforcement of any state statute or administrative rule regarding contracting or procurement would impede any state agency’s emergency response that is necessary to cope with this declared disaster, Governor hereby suspends such statutes and rules for the duration of this declared disaster for that limited purpose.BACKGROUND AND JUSTIFICATION The Governor’s rationale for issuing Proclamation 41-3741 is listed in this week’s edition of the Texas Register (45 Tex Reg 4243). 


Texas Optometry Board

Proposed Rules

Amending 22 TAC §273.10 to prohibit disciplinary action against a licensee for defaulting on a student loan

CHAPTER 273. GENERAL RULES22 TAC §273.10The Texas Optometry Board proposes amendments to 22 TAC §273.10 (Licensee Compliance with Payment Obligations) to implement Senate Bill 37, 86th Legislature, Regular Session, prohibiting disciplinary action by a licensing agency because of a default on a student loan or a breach of a student loan repayment contract or scholarship contract.


Texas Health and Human Services Commission

Withdrawn Rule

Withdrawing emergency rule 26 TAC §745.10001, which outlined rules for daycare operations in response to COVID-19

CHAPTER 745. LICENSINGSUBCHAPTER X. EMERGENCY RULESDIVISION 1. RULES FOR CERTAIN DAY CARE OPERATIONS IN RESPONSE TO COVID-1926 TAC §745.10001The Health and Human Services Commission withdraws the emergency adoption of new 26 TAC §745.10001 which appeared in the April 24, 2020, issue of the Texas Register (45 TexReg 2608). Emergency rule §745.10001 outlined rules for certain daycare operations in response to COVID-19. 


Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §§130.42, 130.44, 130.45 to require human trafficking and controlled substances training as a condition for podiatrist licensure

CHAPTER 130. PODIATRIC MEDICINE PROGRAMSUBCHAPTER D. DOCTOR OF PODIATRIC MEDICINE16 TAC §§130.42, 130.44, 130.45OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 130, Subchapter D, §130.42, and §130.45  without changes to the proposed text as published in the January 3, 2020, issue of the Texas Register (45 TexReg 50). These rules will not be republished.The Commission also adopts amendments to Subchapter D, §130.44 regarding the Podiatry Program with changes to the proposed text as published in the January 3, 2020, issue of the Texas Register (45 TexReg 50). This rule will be republished.SECTION-BY-SECTION SUMMARYThe adopted rules amend §130.42 to require the completion of human trafficking prevention training for each renewal on or after September 1, 2020. This training is required by Texas Occupations Code §116.003.The adopted rules amend §130.44 to require two hours of continuing medical education (CME) related to prescribing and monitoring controlled substances prior to the first anniversary of podiatric medical licensure. The amendment requires one hour of CME covering best practices, alternative treatment options, and multimodal approaches to pain management for podiatrists whose practice involves the prescription and dispensation of opioids. Additionally, the amendment revises the CME due date requirements and provides a guide to transition for CME requirements as the Department moves podiatric license renewal to biennial periods. After publication of the proposed rule text, the Department made changes to subsection (o) to consistently use the word “licensee.”The adopted rules amend §130.45, by deleting subsection (f), which was duplicative of a similar subsection in §130.44.


Texas Department of Licensing and Regulation

Adopted Rules

New 16 TAC §130.59, clarifying the limits on opioid prescription by a podiatrist as a treatment for acute pain

CHAPTER 130. PODIATRIC MEDICINE PROGRAMSUBCHAPTER E. PRACTITIONER RESPONSIBILITIES AND CODE OF ETHICS16 TAC §130.59OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts new rule Subchapter E, §130.59 regarding the Podiatry Program, with changes to the proposed text as published in the January 3, 2020, issue of the Texas Register (45 TexReg 50). This rule will be republished.SECTION-BY-SECTION SUMMARYThe adopted rules create new §130.59 that outlines the limits on the prescription of opioids to treat acute pain. The new section also requires the electronic prescription of all controlled substance prescriptions after September 1, 2021, and provides a list of exceptions for this requirement. Additionally, in response to a public comment submitted by the Texas Medical Association, the Department removed published subsection (c) from Subchapter E, §130.59 and the rest of the subsections were re-lettered.


Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §130.60 to include applicable fees for Active Duty Military Members and Podiatric Medical Radiological Technicians

CHAPTER 130. PODIATRIC MEDICINE PROGRAMSUBCHAPTER F. FEES16 TAC §130.60The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 130, Subchapter F, §130.60 regarding the Podiatry Program, without changes to the proposed text as published in the January 3, 2020, issue of the Texas Register (45 TexReg 50). These rules will not be republished.The adopted rules amend §130.60 to provide the fees applicable for Active Duty Military Members ($0), and Podiatric Medical Radiological Technicians ($25).


Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §130.72 to establish permissible disciplinary action for a podiatrist’s improper dissemination of protected information

CHAPTER 130. PODIATRIC MEDICINE PROGRAMSUBCHAPTER G. ENFORCEMENT16 TAC §130.72OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 130, Subchapter G, §130.72, regarding the Podiatry Program, without changes to the proposed text as published in the January 3, 2020, issue of the Texas Register (45 TexReg 50). These rules will not be republished.The adopted rules amend §130.72 to establish grounds for disciplinary actions and sanctions based upon improper access and dissemination of information obtained from the PMP. Additionally, the amendment incorporates denial of licensure, and suspension or revocation of licenses, for offenses identified in Chapter 108, Subchapter B, of the Occupations Code.


Texas Medical Board

Adopted Rules

Amending 22 TAC §175.1 and §175.2 to include administrative fees for Radiology Assistants

CHAPTER 175. FEES AND PENALTIES22 TAC §175.1, §175.2OVERVIEWThe Texas Medical Board (Board) adopts amendments to 22 TAC 175, §175.1, concerning Application and Administrative Fees and §175.2, concerning Registration and Renewal Fees, without changes to the proposed text as published in the March 20, 2020, issue of the Texas Register (45 TexReg 1935). The adopted rules will not be republished.SECTION-BY-SECTION SUMMARYSections 175.1 and 175.2 were amended to add application, registration and renewal fees for Radiology Assistance, a new certificate type mandated by and in accordance with House Bill 1504 (86th Regular Session).Section 175.1, relating to Application and Administrative Fees, regarding fees for processing an application for a certificate, added an application and certificate fee for a Radiologist Assistant Certificate in the amount of $140.00, and also to add a fee for an application for a temporary certificate in the amount of $140.00 amendments to add a new definition for “personnel”, distinguishing personnel from physicians.Section 175.2, relating to Registration and Renewal Fees, was amended to provide the fee amount for biennial renewal of a Radiologist Assistant Certificate, in the amount of $100.00.


Texas Medical Board

Adopted Rules

Amending 22 TAC §178.8 to update time limitations for filing an appeal following the Board’s dismissal of a complaint

CHAPTER 178. COMPLAINTS22 TAC §178.8The Texas Medical Board (Board) adopts amendments to Title 22, Part 9, §178.8, concerning Appeals, without changes to the proposed text as published in the March 27, 2020, issue of the Texas Register (45 TexReg 2126). The adopted rule will not be republished.Section 178.8, relating to Appeals, was amended to add language requiring that the board receive a complainant’s appeal no later than 90 days after the complainant’s receipt of notice of the board’s dismissal of the complaint.


Texas Medical Board

Adopted Rules

Amending 22 TAC §§180.1 – 180.4 to update current Texas Physician Health Program processes

CHAPTER 180. TEXAS PHYSICIAN HEALTH PROGRAM22 TAC §§180.1 – 180.4OVERVIEWThe Texas Medical Board (Board) adopts amendments to the Title of Chapter 180 to change the name to Texas Physician Health Program, §180.1, concerning Purpose, §180.2, concerning Definitions, §180.3, concerning Texas Physician Health Program, §180.4, concerning Operation of Program without changes to the proposed text as published in the March 27, 2020, issue of the Texas Register (45 TexReg 2127). The adopted rules will not be republished.SECTION-BY-SECTION SUMMARYSection 180.1, relating to Purpose, was amended to describe the authority for rulemaking and the purpose of the Texas Physician Health Program under Chapter 167 of the Texas Occupations Code.Section 180.2, relating to Definitions, was amended to update existing definitions and add new definitions in order to maintain consistency within this chapter.Section 180.3, relating to Texas Physician Health Program, was amended to clarify and update existing language to ensure consistency with current program processes and TXPHP Governing Board directives.Section 180.4, relating to Operation of Program, was amended to clarify and update existing language to ensure consistency with current program processes and TXPHP Governing Board directives.


Texas Medical Board

Adopted Rules

Repealing 22 TAC §180.7, which governed rehabilitation orders within the Texas Physician Health Program

CHAPTER 180. TEXAS PHYSICIAN HEALTH PROGRAM22 TAC §180.7The Texas Medical Board (Board) adopts the repeal of §180.7, relating to Rehabilitation Orders, without changes to the proposed text as published in the March 27, 2020, issue of the Texas Register (45 TexReg 2127). The adopted rule will not be republished.

Texas Medical Board

Adopted Rules

Amending 22 TAC §195.1 and §195.4 to distinguish “personnel” from “physicians” for rules governing pain management clinics

CHAPTER 195. PAIN MANAGEMENT CLINICS22 TAC §195.1, §195.4OVERVIEWThe Texas Medical Board (Board) adopts amendments to 22 TAC 195, §195.1, concerning Definitions and §195.4, concerning Operation of Pain Management Clinics, without changes to the proposed text as published in the March 27, 2020, issue of the Texas Register (45 TexReg 2131). The adopted rules will not be republished.The amendments were necessitated by House Bill 2454 (86th Legislature, R.S.), which set forth new continuing education requirements in the topic of opioid prescribing and provided that the new hours may not be credited toward hours required under board rule for pain clinic personnel.SECTION-BY-SECTION SUMMARYSection 195.1, relating to Definitions, was amended to add a new definition for “personnel”, distinguishing personnel from physicians.Section 195.4, relating to Operation of Pain Management Clinics, was amended to add language distinguishing personnel from physicians who may be employed or contracted to provide medical services at a pain clinic.


Texas Department of State Health Services

Adopted Rules

Repealing 45 TAC, Chapter 49, Subchapters A-D, and adopting new Subchapter A to reflect changes in authority for the Oral Health Improvement Program

CHAPTER 49. ORAL HEALTH IMPROVEMENT PROGRAMOVERVIEWThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of the following rules in 25 TAC, Chapter 49, concerning the Oral Health Program:Subchapter A (General Provisions): §§49.1 – 49.4Subchapter B (Recipient Participation in FFS Oral Health Treatment Benefits): §§49.5 – 49.9Subchapter C (Provider Participation in FF Oral Health Treatment Benefits): §§49.10, 49.13 – 49.15Subchapter D (Appeals Process for FFS Oral health Treatment Benefits and Services):  §§49.16 – 49.18Following the repeal of the above rules, Commissioner also adopts new Subchapter A (General Provisions) §§49.1 – 49.6, concerning the Oral Health Improvement Program. The repeal of §§49.1 – 49.10, 49.13 – 49.18 and new §§49.1 – 49.6 are adopted without changes to the proposed text as published in the March 6, 2020, issue of the Texas Register (45 TexReg 1598), and therefore will not be republished.BACKGROUND AND JUSTIFICATIONThe new rules repeal and replace rules in Chapter 49, in accordance with Texas Government Code, §2001.039, regarding Agency Review of Existing Rules. The repeal and new rules are necessary to accurately reflect program activities and functions of the Oral Health Improvement Program, due to changes implemented by Senate Bill 200 and Senate Bill 219, 84th Legislature, Regular Session, 2015.The repealed rules included direct client services, which were transferred to HHSC post transformation. The Oral Health Improvement Program remains at DSHS as a public health program that promotes oral health and reduces the burden of dental disease through evidence-based public health initiatives including oral health education and preventive interventions. The program also conducts oral health surveillance activities, analyzes data from multiple sources, and disseminates findings to stakeholders.


Texas Board of Chiropractic Examiners

Transferred Rule

Transferring 22 TAC §72.19 (Fees) and §77.3 (Patient’s Rights to Disclosure of Charges) to improve accessibility

Under Texas Occupations Code §§201.152 and 201.1525, the Texas Board of Chiropractic Examiners (Board) is authorized to promulgate necessary rules to regulate the practice of chiropractic. As part of its ongoing rule review process, the Board has determined that two of its current rules are ill-placed within 22 Texas Administrative Code Part 3, Chapters 71 to 82, and that a transfer is needed to improve their accessibility.Current 22 TAC §72.19 (Fees) should remain within Chapter 72 (Fees, License Applications and Renewals) but should be renumbered to §72.1.Current 22 TAC 22 TAC §77.3 (Patient’s Rights to Disclosure of Charges  should be transferred from Chapter 77 (Advertising and Public Communications) to Chapter 75 (Business Practices). 


Texas Health and Human Services Commission

In Addition

HHSC intends to submit an amendment to the Texas State Plan for Medical Assistance to maintain up-to-date reimbursement methodology

OVERVIEWThe 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. The amendment is proposed to be effective July 1, 2020.The purpose of this amendment is to implement a reimbursement methodology for when a new national procedure code is assigned for HealthCare Common Procedure Coding System Updates and when federally-mandated reimbursement rates, physician-administered drugs (PADs), or biological products are released. This will allow HHSC to set preliminary rates for new codes prior to a rate hearing.PUBLIC COMMENTInterested parties may obtain additional information and/or a free copy of the proposed amendment by contacting Cynthia Henderson, State Plan Policy Advisor, by mail at the Health and Human Services Commission, P.O. Box 13247, Mail Code H-600, Austin, TX 78711; by telephone at (512) 487-3349; by facsimile at (512) 730-7472; or by e-mail at Medicaid_Chip_SPA_Inquiries@hhsc.state.tx.us. Copies of the proposed amendment will be available for review at the local county offices of HHSC, which were formerly the local offices of the Texas Department of Aging and Disability Services.Written comments about the proposed amendment and/or requests to review comments may be sent by U.S. mail, overnight mail, special delivery mail, hand delivery, fax, or email to addresses provided in this week’s edition of the Texas Register (45 Tex Reg 4412).


Texas Department of State Health Services

In Addition

Correcting an error in the previously-published Texas Asbestos Health Protection Rules Penalty Matrix

The Department of State Health services published a Texas Asbestos Health Protection Rules Penalty Matrix in the April 17, 2020, issue of the Texas Register (45 TexReg 2588). Due to a software error, the matrix was published incorrectly. Some of the “X’s” were missing from the violation columns and other “X’s” were misplaced.The correct Asbestos Penalty Matrix Graphic is published in this week’s edition of the Texas Register (45 Tex Reg 4413).