26 Mar 2021

Texas Register March 26, 2021 Volume: 46 Number: 13

by | posted in: State Board of Dental Examiners, Texas Board of Chiropractic Examiners, Texas Department of Assistive and Rehabilitative Services, Texas Department of Insurance, Texas Department of Licensing and Regulation, Texas Department of State Health Services, Texas Health and Human Services Commission |

Texas Register Table of Contents

Texas Department of Licensing and Regulation

 

Withdrawn Rule

Withdrawing 16 TAC §117.35, which would have established requirements for licensed massage therapists’ human trafficking prevention training

CHAPTER 117. MASSAGE THERAPYSUBCHAPTER D. CONTINUING EDUCATION16 TAC §117.35OVERVIEWThe Texas Department of Licensing and Regulation withdraws the proposed new §117.35 which appeared in the November 20, 2020, issue of the Texas Register (45 TexReg 8231).SUMMARY OF WITHDRAWN RULE  The proposed rules purported to add new §117.35, which would allow an HHSC-approved human trafficking prevention training course to count for up to three hours of continuing education credit each license term. Providers of an HHSC-approved human trafficking prevention training course would not be required to obtain department approval as a continuing education provider and would not be required to comply with the requirements of §117.34.

Texas Department of Licensing and Regulation

Withdrawn Rule

Withdrawing 16 TAC §117.64, which would have updated transcript requirements for massage therapy licensure

CHAPTER 117. MASSAGE THERAPYSUBCHAPTER F. LICENSED MASSAGE SCHOOLS16 TAC §117.64OVERVIEWThe Texas Department of Licensing and Regulation withdraws the proposed amended §117.64 which appeared in the November 20, 2020, issue of the Texas Register (45 TexReg 8231).SUMMARY OF WITHDRAWN RULE The proposed rule purported to amend §117.64 to require massage schools to provide certified, rather than certified or original, copies of student transcripts on request, for a reasonable charge, if the student has fulfilled the financial obligation to the school. 

Texas Department of Insurance

Withdrawn Rule

Withdrawing the proposed repeal of 28 TAC §3.9208, which would have removed duplicative network accessibility and availability requirements for exclusive provider benefit plans

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER KK. EXCLUSIVE PROVIDER BENEFIT PLAN28 TAC §3.9208OVERVIEWThe Texas Department of Insurance withdraws the proposed repeal of §3.9208 which appeared in the September 25, 2020, issue of the Texas Register (28 TexReg 6684). SUMMARY OF WITHDRAWN RULE  The repeal of this section would have removed the requirement that EPBPs subject to Subchapter KK must comply with the network accessibility and availability requirements as outlined in 28 TAC §11.1607. Section 3.9208 is not necessary, because the requirements of §11.1607 are duplicative of HHSC’s review of its contractors’ networks.

State Board of Dental Examiners

Adopted Rules

Amending 22 TAC §108.7 to revise the minimum standard of care for administering Halcion (triazolam)

CHAPTER 108. PROFESSIONAL CONDUCTSUBCHAPTER A. PROFESSIONAL RESPONSIBILITY22 TAC §108.7The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §108.7, concerning the minimum standard of care. This amendment requires dentists to hold a Level 1 Minimal Sedation permit to administer Halcion (triazolam), and provides that dentists should administer Halcion (triazolam) in an in-office setting. This amendment is adopted with no changes to the proposed text as published in the January 8, 2021, issue of the Texas Register (46 TexReg 268). The rule will not be republished.

State Board of Dental Examiners

Adopted Rules

Amending 22 TAC §108.54 to update requirements for the advertisement of recognized dental specialties

CHAPTER 108. PROFESSIONAL CONDUCTSUBCHAPTER E. BUSINESS PROMOTION22 TAC §108.54The State Board of Dental Examiners (Board) adopts this amendment to 22 TAC §108.54, concerning the advertisement of recognized dental specialties. This amendment will update the language to include recently recognized dental specialties as approved and adopted by the American Dental Association’s National Commission on Recognition of Dental Specialties and Certifying Boards. The specialties include Oral Medicine, Dental Anesthesiology, and Orofacial Pain. The amendment also updates the language to show that the specialties are approved by ADA’s National Commission on Recognition of Dental Specialties and Certifying Boards. This amendment is adopted without changes to the proposed text as published in the January 8, 2021, issue of the Texas Register (46 TexReg 271), and will not be republished.

State Board of Dental Examiners

Adopted Rules

New 22 TAC §119.10, recognizing Oral Medicine as a dental specialty

CHAPTER 119. SPECIAL AREAS OF DENTAL PRACTICE22 TAC §119.10The State Board of Dental Examiners (Board) adopts new 22 TAC §119.10, concerning the recognition of Oral Medicine as a dental specialty. The new rule recognizes the specialty of Oral Medicine as approved and adopted by the American Dental Association’s National Commission on Recognition of Dental Specialties and Certifying Boards. Oral Medicine is the specialty of dentistry responsible for the oral health care of medically complex patients and for the diagnosis and management of medically-related diseases, disorders and conditions affecting the oral and maxillofacial region. This new rule is adopted without changes to the proposed text as published in the January 8, 2021, issue of the Texas Register (46 TexReg 273), and will not be republished.

State Board of Dental Examiners

Adopted Rules

New 22 TAC §119.11, recognizing Dental Anesthesiology as a dental specialty

CHAPTER 119. SPECIAL AREAS OF DENTAL PRACTICE22 TAC §119.11The State Board of Dental Examiners (Board) adopts new rule 22 TAC §119.11 concerning the recognition of Dental Anesthesiology as a dental specialty. The adopted new rule recognizes the specialty of Dental Anesthesiology as approved and adopted by the American Dental Association’s National Commission on Recognition of Dental Specialties and Certifying Boards. Dental Anesthesiology is the specialty of dentistry and discipline of anesthesiology encompassing the art and science of managing pain, anxiety, and overall patient health during dental, oral, maxillofacial and adjunctive surgical or diagnostic procedures throughout the entire perioperative period. The specialty is dedicated to promoting patient safety as well as access to care for all dental patients, including the very young and patients with special health care needs. This new rule is adopted with no changes to the proposed text as published in the January 8, 2021, issue of the Texas Register (46 TexReg 273), and will not be republished.

State Board of Dental Examiners

Adopted Rules

New 22 TAC §119.12, recognizing Orofacial Pain as a dental specialty

CHAPTER 119. SPECIAL AREAS OF DENTAL PRACTICE22 TAC §119.12The State Board of Dental Examiners (Board) adopts new rule 22 TAC §119.12 concerning the recognition of Orofacial Pain as a dental specialty. The adopted new rule recognizes the specialty of Orofacial Pain as approved and adopted by the American Dental Association’s National Commission on Recognition of Dental Specialties and Certifying Boards. Orofacial Pain is the specialty of dentistry that encompasses the diagnosis, management and treatment of pain disorders of the jaw, mouth, face, head and neck. The specialty of Orofacial Pain is dedicated to the evidenced-based understanding of the underlying pathophysiology, etiology, prevention and treatment of these disorders and improving access to interdisciplinary patient care. This new rule is adopted with no changes to the proposed text as published in the January 8, 2021, issue of the Texas Register (46 TexReg 274). The rule will not be republished.

Texas Department of State Health Services

Adopted Rules

Repealing 25 TAC §133.48 to remove outdated references to the Patient Safety Program for licensed hospitals

CHAPTER 133. HOSPITAL LICENSINGSUBCHAPTER C. OPERATIONAL REQUIREMENTS25 TAC §133.48OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts the repeal of §133.48, concerning Patient Safety Program.The repeal is adopted without changes to the proposed text as published in the November 20, 2020, issue of the Texas Register (45 TexReg 8237). This rule will not be republished.BACKGROUND AND JUSTIFICATION The repeal is necessary to remain consistent with Texas Health and Safety Code Chapter 241. The repeal removes outdated references to the Patient Safety Program. House Bill (H.B.) 1614, 78th Legislature, Regular Session, 2003, amended Texas Health and Safety Code Chapter 241, by adding Subchapter H, Patient Safety Program, requiring hospitals to report certain medical errors to HHSC. This subchapter expired under its own terms on September 1, 2007; therefore, the reporting requirements associated with H.B. 1614 are defunct.

Texas Department of State Health Services

Adopted Rules

Amending 25 TAC §135.26 to update reporting requirements for Ambulatory Surgical Centers

CHAPTER 135. AMBULATORY SURGICAL CENTERSSUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS25 TAC §135.26OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts amendments to §135.26, concerning Reporting Requirements. The amendment to §135.26 is adopted without changes to the proposed text as published in the November 20, 2020, issue of the Texas Register (45 TexReg 8238). The rule will not be republished. BACKGROUND AND JUSTIFICATION The amendment is necessary to remain consistent with Texas Health and Safety Code Chapter 243. The amendment and repeal remove outdated references to the Patient Safety Program and update reporting requirements for Ambulatory Surgical Centers (ASCs). House Bill (H.B.) 1614, 78th Legislature, Regular Session, 2003, amended Texas Health and Safety Code Chapter 243, by adding Subchapter B, Patient Safety Program, requiring ASCs to report certain medical errors to HHSC. This subchapter expired under its own terms on September 1, 2007; therefore, the reporting requirements associated with H.B. 1614 are defunct.

Texas Department of State Health Services

Adopted Rules

Repealing 25 TAC §135.27 to remove outdated references to the Patient Safety Program for Ambulatory Surgical Centers

CHAPTER 135. AMBULATORY SURGICAL CENTERSSUBCHAPTER A. OPERATING REQUIREMENTS FOR AMBULATORY SURGICAL CENTERS25 TAC §135.27The Texas Health and Human Services Commission (HHSC) adopts the repeal of §135.27, concerning Patient Safety Program.The repeal of §135.27 is adopted without changes to the proposed text as published in the November 20, 2020, issue of the Texas Register (45 TexReg 8238). The rule will not be republished. BACKGROUND AND JUSTIFICATION The repeal is necessary to remain consistent with Texas Health and Safety Code Chapter 243. The amendment and repeal remove outdated references to the Patient Safety Program and update reporting requirements for Ambulatory Surgical Centers (ASCs). House Bill (H.B.) 1614, 78th Legislature, Regular Session, 2003, amended Texas Health and Safety Code Chapter 243, by adding Subchapter B, Patient Safety Program, requiring ASCs to report certain medical errors to HHSC. This subchapter expired under its own terms on September 1, 2007; therefore, the reporting requirements associated with H.B. 1614 are defunct.

Texas Health and Human Services Commission

Adopted Rules

New 26 TAC, Chapter 360, Subchapter C, establishing the Specialized Telecommunications Assistance Program for deaf and hard-of-hearing individuals

CHAPTER 360. OFFICE OF DEAF AND HARD OF HEARING SERVICESSUBCHAPTER C. SPECIALIZED TELECOMMUNICATIONS ASSISTANCE PROGRAM26 TAC §§360.501, 360.503, 360.505, 360.507, 360.509, 360.511, 360.513, 360.515, 360.517, 360.519, 360.521, 360.523, 360.525, 360.527, 360.529, 360.531, 360.533, 360.535OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new Chapter 360, Subchapter C, concerning the Specialized Telecommunications Assistance Program, consisting of §§360.501, 360.503, 360.505, 360.507, 360.509, 360.511, 360.513, 360.515, 360.517, 360.519, 360.521, 360.523, 360.525, 360.527, 360.529, 360.531, 360.533, and 360.535.The rules are adopted without changes to the proposed text as published in the December 18, 2020, issue of the Texas Register (45 TexReg 9020), and therefore will not be republished.BACKGROUND AND JUSTIFICATION The new rules update and relocate the Specialized Telecommunications Assistance Program (STAP) rules from 40 TAC Chapter 109, Subchapter C to 26 TAC Chapter 360, Subchapter C. The relocation of the rules is necessary to implement Senate Bill 200, 84th Legislature, Regular Session, 2015, which transferred the functions of the legacy Department of Assistive and Rehabilitative Services (DARS) to HHSC. These adopted rules replace repealed rules in 40 TAC Chapter 109, Subchapter C. The rule repeals are adopted simultaneously elsewhere in this issue of the Texas Register.The text of the rules is largely carried over from 40 TAC Chapter 109, Subchapter C with some changes. One such change is to reflect the modernization of STAP. More specifically, HHSC developed a new online STAP database allowing registered vendors to claim vouchers issued through the system. Therefore, the proposed rules require registered vendors to claim vouchers online to be eligible for reimbursement.Another change is made to the eligibility requirements which establishes an age requirement of 5 years old to be eligible for vouchers toward equipment for telephone network access. This mitigates the likelihood of applicants and their families applying for STAP for communication access purposes rather than telephone access.Other changes include expanding the categories of professionals authorized to certify program applicants for vouchers, clarifying certifier and vendor responsibilities, and changing references from the legacy DARS to HHSC.

Texas Health and Human Services Commission

Adopted Rules

New 26 TAC, Chapter 360, Subchapter C, updating and relocating rules governing the Specialized Telecommunications Assistance Program for deaf and hard-of-hearing individuals

CHAPTER 360. OFFICE OF DEAF AND HARD OF HEARING SERVICESSUBCHAPTER C. SPECIALIZED TELECOMMUNICATIONS ASSISTANCE PROGRAM26 TAC §§360.501, 360.503, 360.505, 360.507, 360.509, 360.511, 360.513, 360.515, 360.517, 360.519, 360.521, 360.523, 360.525, 360.527, 360.529, 360.531, 360.533, 360.535OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new Chapter 360, Subchapter C, concerning the Specialized Telecommunications Assistance Program, consisting of §§360.501, 360.503, 360.505, 360.507, 360.509, 360.511, 360.513, 360.515, 360.517, 360.519, 360.521, 360.523, 360.525, 360.527, 360.529, 360.531, 360.533, and 360.535.The rules are adopted without changes to the proposed text as published in the December 18, 2020, issue of the Texas Register (45 TexReg 9020), and therefore will not be republished.BACKGROUND AND JUSTIFICATION The new rules update and relocate the Specialized Telecommunications Assistance Program (STAP) rules from 40 TAC Chapter 109, Subchapter C to 26 TAC Chapter 360, Subchapter C. The relocation of the rules is necessary to implement Senate Bill 200, 84th Legislature, Regular Session, 2015, which transferred the functions of the legacy Department of Assistive and Rehabilitative Services (DARS) to HHSC. These adopted rules replace repealed rules in 40 TAC Chapter 109, Subchapter C. The rule repeals are adopted simultaneously elsewhere in this issue of the Texas Register.The text of the rules is largely carried over from 40 TAC Chapter 109, Subchapter C with some changes. One such change is to reflect the modernization of STAP. More specifically, HHSC developed a new online STAP database allowing registered vendors to claim vouchers issued through the system. Therefore, the proposed rules require registered vendors to claim vouchers online to be eligible for reimbursement.Another change is made to the eligibility requirements which establishes an age requirement of 5 years old to be eligible for vouchers toward equipment for telephone network access. This mitigates the likelihood of applicants and their families applying for STAP for communication access purposes rather than telephone access.Other changes include expanding the categories of professionals authorized to certify program applicants for vouchers, clarifying certifier and vendor responsibilities, and changing references from the legacy DARS to HHSC.

Texas Health and Human Services Commission

Adopted Rules

Repealing 26 TAC §510.47 to remove outdated references to the Patient Safety Program for private psychiatric hospitals and crisis stabilization units

CHAPTER 510. PRIVATE PSYCHIATRIC HOSPITALS AND CRISIS STABILIZATION UNITSSUBCHAPTER C. OPERATIONAL REQUIREMENTS26 TAC §510.47OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts the repeal of §510.47, concerning Patient Safety Program.The repeal is adopted without changes to the proposed text as published in the November 20, 2020, issue of the Texas Register (45 TexReg 8240). This rule will not be republished.BACKGROUND AND JUSTIFICATION The repeal is necessary to remain consistent with Texas Health and Safety Code Chapter 577. The repeal removes outdated references to the Patient Safety Program. House Bill (H.B.) 1614, 78th Legislature, Regular Session, 2003, amended Texas Health and Safety Code Chapter 577, by adding Subchapter B, Patient Safety Program, requiring private psychiatric hospitals and crisis stabilization units (PPHCSUs) to report certain medical errors to HHSC. This subchapter expired under its own terms on September 1, 2007; therefore, the reporting requirements associated with H.B. 1614 are defunct.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §3.3701 to clarify the applicability of rules governing preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs)

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANSDIVISION 1. GENERAL REQUIREMENTS28 TAC §3.3701OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §3.3701, concerning the applicability and scope of rules governing preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs). SUMMARY OF CHANGES An amendment to Subsection (c) modifies the reference to provisions to which 28 TAC Chapter 3, Subchapter X, is subject, changing the reference to the specific sections of Insurance Code Chapter 1451, Subchapter C, to cite the subchapter as a whole, in order to simplify the citation and incorporate the section added to the subchapter by HB 1757. The amendment also reorganizes the referenced provisions into numerical order.BACKGROUND AND JUSTIFICATION The amendments are necessary to implement House Bill 1757, House Bill 3911, and Article 1 of Senate Bill 1742, all adopted by the 86th Legislature, 2019. HB 1757 amended Insurance Code Chapter 1451, Subchapter C, to add pharmacists among other health care providers in Subchapter C, giving an insured the authority to select a pharmacist as a health care provider under the insured’s health insurance policy.HB 3911 amended Insurance Code §1301.0056 to provide that the Commissioner examine both PPBPs and EPBPs at least once every three years. The examinations should include qualifying examinations. Previously, the statute only required that EPBPs be examined at least once every five years.Article 1 of SB 1742 amended Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §3.3702 to clarify definitions related to rules governing preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs)

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANSDIVISION 1. GENERAL REQUIREMENTS28 TAC §3.3702OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §3.3702, concerning definitions related to rules governing preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs). SUMMARY OF CHANGES A detailed summary of changes made by the amendments to §3.3702 is included in this week’s edition of the Texas Register (46 Tex Reg 2029). BACKGROUND AND JUSTIFICATION The amendments are necessary to implement House Bill 1757, House Bill 3911, and Article 1 of Senate Bill 1742, all adopted by the 86th Legislature, 2019. HB 1757 amended Insurance Code Chapter 1451, Subchapter C, to add pharmacists among other health care providers in Subchapter C, giving an insured the authority to select a pharmacist as a health care provider under the insured’s health insurance policy.HB 3911 amended Insurance Code §1301.0056 to provide that the Commissioner examine both PPBPs and EPBPs at least once every three years. The examinations should include qualifying examinations. Previously, the statute only required that EPBPs be examined at least once every five years.Article 1 of SB 1742 amended Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §3.3705 to update disclosure requirements for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs)

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANSDIVISION 1. GENERAL REQUIREMENTS28 TAC §3.3705OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §3.3705, concerning communication with insured individuals by preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs). SUMMARY OF CHANGES A detailed summary of changes made by the amendments to §3.3705 is included in this week’s edition of the Texas Register (46 Tex Reg 2029). BACKGROUND AND JUSTIFICATION The amendments are necessary to implement House Bill 1757, House Bill 3911, and Article 1 of Senate Bill 1742, all adopted by the 86th Legislature, 2019. HB 1757 amended Insurance Code Chapter 1451, Subchapter C, to add pharmacists among other health care providers in Subchapter C, giving an insured the authority to select a pharmacist as a health care provider under the insured’s health insurance policy.HB 3911 amended Insurance Code §1301.0056 to provide that the Commissioner examine both PPBPs and EPBPs at least once every three years. The examinations should include qualifying examinations. Previously, the statute only required that EPBPs be examined at least once every five years.Article 1 of SB 1742 amended Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §3.3709 to update reporting requirements for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs)

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANSDIVISION 1. GENERAL REQUIREMENTS28 TAC §3.3709OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §3.3709, concerning the Annual Network Adequacy Report for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs). SUMMARY OF CHANGES A detailed summary of changes made by the amendments to §3.3709 is included in this week’s edition of the Texas Register (46 Tex Reg 2029). BACKGROUND AND JUSTIFICATION The amendments are necessary to implement House Bill 1757, House Bill 3911, and Article 1 of Senate Bill 1742, all adopted by the 86th Legislature, 2019. HB 1757 amended Insurance Code Chapter 1451, Subchapter C, to add pharmacists among other health care providers in Subchapter C, giving an insured the authority to select a pharmacist as a health care provider under the insured’s health insurance policy.HB 3911 amended Insurance Code §1301.0056 to provide that the Commissioner examine both PPBPs and EPBPs at least once every three years. The examinations should include qualifying examinations. Previously, the statute only required that EPBPs be examined at least once every five years.Article 1 of SB 1742 amended Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §3.3720 to clarify the applicability of general requirements to preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs)

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANSDIVISION 2. PREFERRED AND EXCLUSIVE PROVIDER PLANS REQUIREMENTS28 TAC §3.3720 OVERVIEWThe Commissioner of Insurance adopts amendments to 28 TAC §3.3720, concerning requirements for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs). SUMMARY OF CHANGES The heading of §3.3720 is amended to add the words “Preferred and,” and the text is revised to specify which sections are applicable to both PPBPs and EPBPs, and which sections are applicable only to EPBPs. The amendments to this section implement HB 3911 by making §§3.3721 – 3.3723 applicable to both PPBPs and EPBPs rather than only EPBPs, while specifying that §3.3724 and §3.3725 remain applicable only to EPBPs.BACKGROUND AND JUSTIFICATION The amendments are necessary to implement House Bill 1757, House Bill 3911, and Article 1 of Senate Bill 1742, all adopted by the 86th Legislature, 2019. HB 1757 amended Insurance Code Chapter 1451, Subchapter C, to add pharmacists among other health care providers in Subchapter C, giving an insured the authority to select a pharmacist as a health care provider under the insured’s health insurance policy.HB 3911 amended Insurance Code §1301.0056 to provide that the Commissioner examine both PPBPs and EPBPs at least once every three years. The examinations should include qualifying examinations. Previously, the statute only required that EPBPs be examined at least once every five years.Article 1 of SB 1742 amended Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §3.3721 to require network approval for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs)

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANSDIVISION 2. PREFERRED AND EXCLUSIVE PROVIDER PLANS REQUIREMENTS28 TAC §3.3721OVERVIEWThe Commissioner of Insurance adopts amendments to 28 TAC §3.3721, concerning network approval for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs). SUMMARY OF CHANGES Preferred and Exclusive Provider Benefit Plan Network Approval Required. The heading of §3.3721 is amended to add the words “Preferred and,” and the text of the section is revised to address both PPBPs and EPBPs. The amendments to this section implement HB 3911 by making provider benefit plan network approval required for both PPBPs and EPBPs instead of only EPBPs. Both PPBPs and EPBPs are now required to undergo qualifying examinations under Insurance Code §1301.0056, as amended by HB 3911.BACKGROUND AND JUSTIFICATION The amendments are necessary to implement House Bill 1757, House Bill 3911, and Article 1 of Senate Bill 1742, all adopted by the 86th Legislature, 2019. HB 1757 amended Insurance Code Chapter 1451, Subchapter C, to add pharmacists among other health care providers in Subchapter C, giving an insured the authority to select a pharmacist as a health care provider under the insured’s health insurance policy.HB 3911 amended Insurance Code §1301.0056 to provide that the Commissioner examine both PPBPs and EPBPs at least once every three years. The examinations should include qualifying examinations. Previously, the statute only required that EPBPs be examined at least once every five years.Article 1 of SB 1742 amended Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §3.3722 to clarify application and modification requirements for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs)

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANSDIVISION 2. PREFERRED AND EXCLUSIVE PROVIDER PLANS REQUIREMENTS28 TAC §3.3722OVERVIEWThe Commissioner of Insurance adopts amendments to 28 TAC §3.3722, concerning methods for achieving approval and modification for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs). SUMMARY OF CHANGES A detailed summary of changes made by the amendments to §3.3722 is included in this week’s edition of the Texas Register (46 Tex Reg 2034). BACKGROUND AND JUSTIFICATION The amendments are necessary to implement House Bill 1757, House Bill 3911, and Article 1 of Senate Bill 1742, all adopted by the 86th Legislature, 2019. HB 1757 amended Insurance Code Chapter 1451, Subchapter C, to add pharmacists among other health care providers in Subchapter C, giving an insured the authority to select a pharmacist as a health care provider under the insured’s health insurance policy.HB 3911 amended Insurance Code §1301.0056 to provide that the Commissioner examine both PPBPs and EPBPs at least once every three years. The examinations should include qualifying examinations. Previously, the statute only required that EPBPs be examined at least once every five years.Article 1 of SB 1742 amended Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §3.3723 to update examination requirements for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs)

CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIESSUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANSDIVISION 2. PREFERRED AND EXCLUSIVE PROVIDER PLANS REQUIREMENTS28 TAC §3.3723OVERVIEWThe Commissioner of Insurance adopts amendments to 28 TAC §3.3723, concerning examinations for preferred provider benefit plans (PPBPs) and exclusive provider benefit plans (EPBPs). SUMMARY OF CHANGES Examinations. Amendments to this section implement HB 3911 and clarify applicable law. Section 3.3723(a) is amended to address both PPBPs and EPBPs and to require an examination at least once every three years rather than five years. Both PPBPs and EPBPs must now be examined at least once every three years under Insurance Code §1301.0056, as amended by HB 3911. Section 3.3723(b) is amended to clarify that examinations are conducted pursuant to Insurance Code Chapter 1301 in addition to the other listed authorities.In response to comment, §3.3723(f) as proposed has been changed to reflect the correct heading of §3.3722, as amended; §3.3723(f)(1) as proposed is changed to clarify that the provision is only applicable to EPBPs; and §3.3723(f)(5) as proposed is changed to clarify that the provision is applicable to both EPBPs and PPBPs. Additionally, for consistency with agency rule drafting style, §3.3723(a), (d), and (e) as proposed is changed by capitalizing the word “commissioner.”BACKGROUND AND JUSTIFICATION The amendments are necessary to implement House Bill 1757, House Bill 3911, and Article 1 of Senate Bill 1742, all adopted by the 86th Legislature, 2019. HB 1757 amended Insurance Code Chapter 1451, Subchapter C, to add pharmacists among other health care providers in Subchapter C, giving an insured the authority to select a pharmacist as a health care provider under the insured’s health insurance policy.HB 3911 amended Insurance Code §1301.0056 to provide that the Commissioner examine both PPBPs and EPBPs at least once every three years. The examinations should include qualifying examinations. Previously, the statute only required that EPBPs be examined at least once every five years.Article 1 of SB 1742 amended Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §11.204 to update application procedures for an HMO’s certificate of authority

CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONSSUBCHAPTER C. APPLICATION FOR CERTIFICATE OF AUTHORITY28 TAC §11.204OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §11.204, concerning health maintenance organizations’ (HMOs’) application for certificate of authority. SUMMARY OF CHANGES Amendments to §11.204(19)(B)(iv) and §11.204(19)(C)(iii) replace “city” with “the municipality in which the facility is located or county in which the facility is located if the facility is in the unincorporated area of the county” to align to the requirements of Insurance Code §1451.504, as amended by SB 1742. In response to comment, §11.204(19)(B)(vii) and §11.204(19)(C)(vi) have been changed from the text as proposed to require telephone numbers to conform to §1451.504(b). As a result of those changes, existing §11.204(19)(B)(vii) – (xi) and §11.204(19)(C)(vi) – (viii) are renumbered.Amendments replace existing §11.204(19)(D) to require the additional information regarding health care facilities and facility-based physicians described in Insurance Code §1451.504, as amended by SB 1742. The existing language of §11.204(19)(D) is no longer needed because the information required by the provision is duplicative of the new requirements replacing it.Additionally, for consistency with agency rule drafting style, the text of §11.204(10)(A) as proposed has been changed by replacing the period with a semi-colon and the text of §11.204(16)(A) and (17) as proposed has been changed by capitalizing the word “commissioner.”Last, the word “paragraph” was capitalized in §11.204(15) as proposed. However, this change has not been adopted, to maintain consistency with the SOS’s drafting style.BACKGROUND AND JUSTIFICATION The amendments to §§11.204, 11.303, 11.1600, 11.1607, 11.1610, and 11.1612 implement Senate Bill 1742, 86th Legislature, 2019. SB 1742 amends Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians. SB 1742 also amends Insurance Code §843.3481 to require HMOs to provide certain information regarding any preauthorization requirements for health care services.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §11.303 to clarify applicability of certain rules to the appeal of an HMO’s examination report

CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONSSUBCHAPTER D. REGULATORY REQUIREMENTS FOR AN HMO AFTER ISSUANCE OF CERTIFICATE OF AUTHORITY28 TAC §11.303OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §11.303, concerning health maintenance organizations (HMOs) examination reports.SUMMARY OF CHANGES An amendment to §11.303(a) adds a reference to 28 TAC §7.83 to clarify that the section applies to an appeal of an HMO examination report.BACKGROUND AND JUSTIFICATION The amendments to §§11.204, 11.303, 11.1600, 11.1607, 11.1610, and 11.1612 implement Senate Bill 1742, 86th Legislature, 2019. SB 1742 amends Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians. SB 1742 also amends Insurance Code §843.3481 to require HMOs to provide certain information regarding any preauthorization requirements for health care services.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §11.1600 to require that HMOs provide certain information to prospective and current contract holders, as well as enrollees

CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONSSUBCHAPTER Q. OTHER REQUIREMENTS28 TAC §11.1600OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC § 11.1600, concerning health maintenance organizations’ (HMOs’) communication requirements for prospective and current contract holders, as well as enrollees.SUMMARY OF CHANGES Amendments to §11.1600(b)(9) implement SB 1742 by requiring HMOs to provide information required by Insurance Code §843.3481 and to also reference additional requirements relating to preauthorization in 28 TAC Chapter 19, Subchapter R. The current information required in §11.1600(b)(9) is deleted and replaced because Insurance Code §843.3481 requires that HMOs provide greater detail on their preauthorization requirements. In response to comment, §11.1600(b)(9) as proposed has been modified to make clear that providing additional information beyond that described in Insurance Code §843.3481 and 28 TAC Chapter 19, Subchapter R, is not required.Additionally, for consistency with agency rule drafting style, the text of §11.1600(b)(14)(D)(i) as proposed has been changed by hyphenating “third party” and the text of §11.1600(c) as proposed is changed by capitalizing the word “commissioner.”Last, the words “subsection” and “subsections” were capitalized in §11.1600(d) and §11.1600(j) as proposed. However, this change has not been adopted, to maintain consistency with SOS drafting style.BACKGROUND AND JUSTIFICATION The amendments to §§11.204, 11.303, 11.1600, 11.1607, 11.1610, and 11.1612 implement Senate Bill 1742, 86th Legislature, 2019. SB 1742 amends Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians. SB 1742 also amends Insurance Code §843.3481 to require HMOs to provide certain information regarding any preauthorization requirements for health care services.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §11.1607 to clarify the applicability of network adequacy requirements to certain HMO contracts

CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONSSUBCHAPTER Q. OTHER REQUIREMENTS28 TAC §11.1607OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §11.1607, concerning accessibility and availability requirements for health maintenance organizations (HMOs).SUMMARY OF CHANGES New §11.1607(p) provides that §11.1607(j) and (k) do not apply to a health benefit plan written by an HMO for a contract with the Health and Human Services Commission (HHSC) to provide services under the Texas Children’s Health Insurance Program (CHIP), Medicaid, or with the State Rural Health Care System. TDI’s review of the network adequacy requirements under this section is unnecessary because it is duplicative of HHSC’s review of its contractors’ networks.As proposed, §11.1607(l) exempted HHSC’s contractors’ networks from all of §11.1607, but in response to comment, the exemption has been limited to the network filing requirements in §11.1607(j) and (k). The language of the exemption has also been modified to encompass both HMOs and exclusive provider benefit plans that are subject to §11.1607 under 28 TAC §3.9208. Existing §11.1607(l) will remain unchanged. Additionally, the words “subsections” and “subsection” were capitalized in this section as proposed. However, these changes have not been adopted, to maintain consistency with SOS drafting style.BACKGROUND AND JUSTIFICATION The amendments to §§11.204, 11.303, 11.1600, 11.1607, 11.1610, and 11.1612 implement Senate Bill 1742, 86th Legislature, 2019. SB 1742 amends Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians. SB 1742 also amends Insurance Code §843.3481 to require HMOs to provide certain information regarding any preauthorization requirements for health care services.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §11.1610 to clarify the applicability of the Annual Network Adequacy Report requirements to certain HMO contracts

CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONSSUBCHAPTER Q. OTHER REQUIREMENTS28 TAC §11.1610OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §11.1610, concerning the Annual Network Adequacy Report for health maintenance organizations (HMOs).SUMMARY OF CHANGES The amendment to §11.1610 adds new §11.1610(g). This subsection provides that §11.1610 does not apply to a health benefit plan written by an HMO for a contract with HHSC to provide services under CHIP, Medicaid, or with the State Rural Health Care System. TDI’s review of the annual network adequacy report under this section is not necessary because it is duplicative of HHSC’s review of its contractors’ networks. Additionally, for consistency with agency rule drafting style, the text of §11.1610(e) and (f) as proposed has been changed by capitalizing the word “commissioner.”BACKGROUND AND JUSTIFICATION The amendments to §§11.204, 11.303, 11.1600, 11.1607, 11.1610, and 11.1612 implement Senate Bill 1742, 86th Legislature, 2019. SB 1742 amends Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians. SB 1742 also amends Insurance Code §843.3481 to require HMOs to provide certain information regarding any preauthorization requirements for health care services.

Texas Department of Insurance

Adopted Rules

Amending 28 TAC §11.1612 to update mandatory disclosure requirements for HMOs

CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONSSUBCHAPTER Q. OTHER REQUIREMENTS28 TAC §11.1612OVERVIEWThe Commissioner of Insurance adopts amended 28 TAC §11.1612, concerning mandatory disclosure requirements for health maintenance organizations (HMOs).SUMMARY OF CHANGES An amendment to §11.1612(a)(1) revises the provision to include a requirement that the provider listing describe a provider’s specialty, if any, to align with the requirements of Insurance Code §1451.504 and §1451.505, as amended by SB 1742. New §11.1612(h)(10) and (11) include the new detailed facility and facility-based physician provider directory information requirements in Insurance Code §1451.504, as amended by SB 1742.Additionally, for consistency with agency rule drafting style, the text of §11.1612(j)(1) as proposed has been changed by replacing the word “percent” with the percent symbol.Last, the words “subsection” and “paragraph” were capitalized in §11.1612(i) and §11.1612(j) as proposed. However, these changes have not been adopted, to maintain consistency with SOS drafting style.BACKGROUND AND JUSTIFICATION The amendments to §§11.204, 11.303, 11.1600, 11.1607, 11.1610, and 11.1612 implement Senate Bill 1742, 86th Legislature, 2019. SB 1742 amends Insurance Code Chapter 1451, Subchapter K, to add more detailed requirements for health care provider directories, including a requirement for more information regarding facilities and facility-based physicians. SB 1742 also amends Insurance Code §843.3481 to require HMOs to provide certain information regarding any preauthorization requirements for health care services.

Texas Department of Assistive and Rehabilitative Services

Adopted Rules

Repealing 40 TAC, Chapter 109, Subchapter C to allow for the relocation of rules governing the Specialized Telecommunications Assistance Program for deaf and hard-of-hearing individuals

CHAPTER 109. OFFICE FOR DEAF AND HARD OF HEARING SERVICESSUBCHAPTER C. SPECIALIZED TELECOMMUNICATIONS ASSISTANCE PROGRAM40 TAC §§109.501, 109.503, 109.505, 109.507, 109.509, 109.511, 109.513, 109.515, 109.517, 109.519, 109.521, 109.523, 109.525, 109.527, 109.529, 109.531, 109.533OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts the repeal of Chapter 109, Subchapter C, concerning the Specialized Telecommunications Assistance Program, in its entirety. BACKGROUND AND JUSTIFICATION The repeal updates and relocates the Specialized Telecommunications Assistance Program (STAP) rules from 40 TAC Chapter 109, Subchapter C to 26 TAC Chapter 360, Subchapter C. The relocation of the rules is necessary to implement Senate Bill 200, 84th Legislature, Regular Session, 2015, which transferred the functions of the legacy Department of Assistive and Rehabilitative Services (DARS) to HHSC. The new rules are adopted simultaneously elsewhere in this issue of the Texas Register.

Texas Department of Licensing and Regulation

Adopted Rules

Following official rule review, TDI re-adopts six chapters governing licensing for health-related programs

Title 16, Part 4Following official rule review, the Texas Department of Licensing and Regulation (Department) has readopted the chapters listed below, in their entirety, under Title 16, Part 4, of the Texas Administrative Code (TAC):Chapter 100, General Provisions for Health-Related Programs;Chapter 110, Athletic Trainers;Chapter 111, Speech-Language Pathologists and Audiologists;Chapter 112, Hearing Instrument Fitters and Dispensers;Chapter 114, Orthotists and Prosthetists;Chapter 115, Midwives;Chapter 116, Dietitians.

Texas Health and Human Services Commission

In Addition

HHSC will submit an amendment to the Texas State Plan for Medical Assistance regarding Medicaid coverage of certain treatments for opioid use disorder

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 October 1, 2020.The proposed amendment is in response to the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment [SUPPORT] for Patients and Communities Act, section 1006(b), which requires states to provide Medicaid coverage of medication assisted treatment (MAT) for opioid use disorder and related counseling services.ADDITIONAL INFORMATIONTo obtain copies of the proposed amendment, interested parties may contact Jennifer Blundell, State Plan Coordinator, through addresses listed in this week’s edition of the Texas Register (46 Tex Reg 2095). BACKGROUND AND JUSTIFICATION Texas Medicaid currently covers all U.S. Food and Drug Administration-approved medications for opioid use disorder, including methadone, buprenorphine, and naltrexone. In addition, Texas Medicaid covers related substance use disorder (SUD) assessments and counseling. MAT and related SUD treatment services are covered as optional services in the Texas Medicaid State Plan. This proposed amendment will clarify existing MAT-related benefits and shift these services and payment from optional to mandatory benefits in the Medicaid State Plan, as directed in the Centers for Medicare and Medicaid Services (CMS) State Health Official letter #20-005, issued December 30, 2020.PUBLIC COMMENT Written comments and/or requests to review comments may be sent by U.S. mail, overnight mail, special delivery mail, hand delivery, or email, using addresses listed in this week’s edition of the Texas Register (46 Tex Reg 2095). 

Texas Health and Human Services Commission

Adopted Rules

Amending 1 TAC §353.1305 to clarify timing limitations for the Medicaid Uniform Hospital Rate Increase Program

CHAPTER 353. MEDICAID MANAGED CARESUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES1 TAC §353.1305 OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts an amendment to §353.1305, concerning Uniform Hospital Rate Increase Program for program periods before September 1, 2021.The Uniform Hospital Rate Increase Program was initially implemented on December 1, 2017, and operated under Texas Administrative Code Title 1 §353.1301 and §353.1305 for the initial program year and subsequent years. Section 353.1301 is not being amended at this time. The amendment to §353.1305 will make the rule applicable to the program before September 1, 2021.BACKGROUND AND JUSTIFICATIONTo continue incentivizing hospitals to improve access, quality, and innovation in the provision of hospital services in Year 5 of the program (i.e., September 1, 2021, through August 31, 2022) and beyond, HHSC is adopting new quality metrics, eligibility requirements and financing components for the program. HHSC is also adopting these amendments to comply with federal regulations that require directed-payment programs (DPPs) to advance goals included in the state’s managed care quality strategy and to align with the ongoing efforts to transition from the Delivery System Reform Incentive Payment (DSRIP) program.

Texas Health and Human Services Commission

Adopted Rules

New 1 TAC §353.1306, establishing the framework for the Medicaid Comprehensive Hospital Increase Reimbursement Program for program periods on or after September 1, 2021

CHAPTER 353. MEDICAID MANAGED CARESUBCHAPTER O. DELIVERY SYSTEM AND PROVIDER PAYMENT INITIATIVES1 TAC §353.1306OVERVIEWThe Texas Health and Human Services Commission (HHSC) adopts new §353.1306, concerning Comprehensive Hospital Increase Reimbursement Program for program periods on or after September 1, 2021.New §353.1306 will apply to the program beginning on September 1, 2021, and will re-name the program the Comprehensive Hospital Increase Reimbursement Program (CHIRP), which will be comprised of the Uniform Hospital Rate Increase Payment (UHRIP) and the Average Commercial Incentive Award (ACIA). A description of the conceptual framework of the program is included in this week’s edition of the Texas Register (46 TexReg 1977).BACKGROUND AND JUSTIFICATIONTo continue incentivizing hospitals to improve access, quality, and innovation in the provision of hospital services in Year 5 of the program (i.e., September 1, 2021, through August 31, 2022) and beyond, HHSC is adopting new quality metrics, eligibility requirements and financing components for the program. HHSC is also adopting these amendments to comply with federal regulations that require directed-payment programs (DPPs) to advance goals included in the state’s managed care quality strategy and to align with the ongoing efforts to transition from the Delivery System Reform Incentive Payment (DSRIP) program.

Texas Health and Human Services Commission

Adopted Rules

New 1 TAC §353.1307, establishing quality metrics for the evaluation of the Comprehensive Hospital Increase Reimbursement Program

Adopted Rules

Amending 16 TAC §117.20 and §117.24 to update application and training requirements for massage therapists and student-permit holders

CHAPTER 117. MASSAGE THERAPYSUBCHAPTER C. LICENSED MASSAGE THERAPIST AND STUDENT PERMIT16 TAC §117.20, §117.24OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 117, Subchapter C, §117.20 and §117.24, regarding licensed massage therapist and students permits. SECTION-BY-SECTION SUMMARYThe adopted rules amend §117.20 by requiring massage therapist applicants to ensure that a certified transcript or other record of all relevant coursework is submitted to the Department. This change clarifies that massage schools in Texas may send a record of coursework electronically to the Department, through the new PALMS (Program Automation for the Licensing of Massage Students) system for reporting hours and enrolled students. The adopted change also allows applicants from out-of-state schools to send the Department a certified transcript. Changes were made to subsection (a)(4) by adding the word “acceptable” to the proposed amended language.The adopted rules amend §117.24 by requiring massage therapists to complete an HHSC-approved human trafficking prevention training and provide proof of completion to renew their massage therapist license. This training must be completed before each license renewal.BACKGROUND AND JUSTIFICATION The adopted rules are necessary to implement House Bill (HB) 2059, 86th Legislature, Regular Session (2019). HB 2059 requires massage therapists and other health care practitioners to complete a human trafficking prevention training course in order to renew their license. The Executive Commissioner of the Health and Human Services Commission (HHSC) approves human trafficking prevention courses, including at least one course that is available without charge, and posts a list of approved courses on the HHSC website. The statutory provisions created by HB 2059 are located in Texas Occupations Code, Chapter 116. The adopted rules implement this training requirement. The adopted rules also clearly require that a new written consent be obtained before each session involving breast massage of a female client. Additionally, the adopted rules make clean-up and clarification changes designed to update the rules and make them easier to understand.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §117.30 and §117.31 to make non-substantive, clarifying changes to language implementing the continuing education requirement for massage therapists

CHAPTER 117. MASSAGE THERAPYSUBCHAPTER D. CONTINUING EDUCATION16 TAC §117.30, §117.31OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 117, Subchapter D, §117.30 and §117.31, regarding continuing education requirements for massage therapists. SECTION-BY-SECTION SUMMARYThe adopted rules amend §117.30 by correcting a typographical error.The adopted rules amend §117.31 by re-wording subsection (a) for clarity.BACKGROUND AND JUSTIFICATION The adopted rules are necessary to implement House Bill (HB) 2059, 86th Legislature, Regular Session (2019). HB 2059 requires massage therapists and other health care practitioners to complete a human trafficking prevention training course in order to renew their license. The Executive Commissioner of the Health and Human Services Commission (HHSC) approves human trafficking prevention courses, including at least one course that is available without charge, and posts a list of approved courses on the HHSC website. The statutory provisions created by HB 2059 are located in Texas Occupations Code, Chapter 116. The adopted rules implement this training requirement. The adopted rules also clearly require that a new written consent be obtained before each session involving breast massage of a female client. Additionally, the adopted rules make clean-up and clarification changes designed to update the rules and make them easier to understand.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §117.82 to require that licensed massage establishments enforce the new informed consent requirement for breast massage of a female client

CHAPTER 117. MASSAGE THERAPYSUBCHAPTER G. LICENSED MASSAGE ESTABLISHMENTS16 TAC §117.82OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 117, Subchapter G, §117.82, regarding licensed massage establishments. SECTION-BY-SECTION SUMMARYThe adopted rules amend §117.82 to refer to the new written consent that must be obtained before each massage therapy session involving breast massage of a female client.BACKGROUND AND JUSTIFICATION The adopted rules are necessary to implement House Bill (HB) 2059, 86th Legislature, Regular Session (2019). HB 2059 requires massage therapists and other health care practitioners to complete a human trafficking prevention training course in order to renew their license. The Executive Commissioner of the Health and Human Services Commission (HHSC) approves human trafficking prevention courses, including at least one course that is available without charge, and posts a list of approved courses on the HHSC website. The statutory provisions created by HB 2059 are located in Texas Occupations Code, Chapter 116. The adopted rules implement this training requirement. The adopted rules also clearly require that a new written consent be obtained before each session involving breast massage of a female client. Additionally, the adopted rules make clean-up and clarification changes designed to update the rules and make them easier to understand.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §§117.90 – 117.92 to incorporate the new informed consent requirement for breast massage of a female client into the massage therapist code of ethics

CHAPTER 117. MASSAGE THERAPYSUBCHAPTER H. RESPONSIBILITIES OF THE LICENSEE AND CODE OF ETHICS16 TAC §§117.90 – 117.92OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 117, Subchapter H, §§117.90, 117.91, and 117.92, regarding the code of ethics for massage therapists. SECTION-BY-SECTION SUMMARYThe adopted rules amend §117.90 and §117.90 to refer to the new written consent that must be obtained before each massage therapy session involving breast massage of a female client.The adopted rules amend §117.91 to clearly require a new written consent be obtained before each session involving breast massage of a female client. The adopted rules also re-title §117.91 to refer to written consent.BACKGROUND AND JUSTIFICATION The adopted rules are necessary to implement House Bill (HB) 2059, 86th Legislature, Regular Session (2019). HB 2059 requires massage therapists and other health care practitioners to complete a human trafficking prevention training course in order to renew their license. The Executive Commissioner of the Health and Human Services Commission (HHSC) approves human trafficking prevention courses, including at least one course that is available without charge, and posts a list of approved courses on the HHSC website. The statutory provisions created by HB 2059 are located in Texas Occupations Code, Chapter 116. The adopted rules implement this training requirement. The adopted rules also clearly require that a new written consent be obtained before each session involving breast massage of a female client. Additionally, the adopted rules make clean-up and clarification changes designed to update the rules and make them easier to understand.

Texas Department of Licensing and Regulation

Adopted Rules

Amending 16 TAC §130.59 to establish procedures for waiving the electronic prescribing requirements for podiatrists issuing controlled substances

CHAPTER 130. PODIATRIC MEDICINE PROGRAMSUBCHAPTER E. PRACTITIONER RESPONSIBILITIES AND CODE OF ETHICS16 TAC §130.59OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 130, Subchapter E, §130.59, regarding the code of ethics for the Podiatry Program. SUMMARY OF CHANGES The adopted rules amend 16 TAC §130.59, Opioid Prescription Limits and Required Electronic Prescribing. The adopted rules establish a procedure and specify criteria for the Department to apply when granting a waiver from the electronic prescribing requirements for controlled substances. New subsection (d) establishes the Department’s authority to require a form, the one-year time period for a waiver, and the renewal application timeline. New subsection (e) establishes the criteria that a waiver request must satisfy for the Department to grant a waiver. New subsection (f) establishes the Department’s authority to revoke or refuse to grant a waiver.BACKGROUND AND JUSTIFICATIONThe adopted rules provide for a waiver of the requirements in Texas Health and Safety Code §481.074 and §481.075 for controlled substance prescriptions to be issued electronically (electronic prescribing requirements) and repeal the rule adopting a penalty matrix. House Bill (HB) 2174, 86th Legislature, Regular Session (2019), and Texas Health and Safety Code §481.0756 authorize the Department to grant licensed podiatrists a waiver from electronic prescribing requirements. The adopted rules also repeal the rule adopting a penalty matrix for the Podiatry program. The statutory requirement for adopting a penalty matrix rule in Texas Occupations Code §202.6011 was repealed by HB 2847, 86th Legislature, Regular Session (2019).

Texas Department of Licensing and Regulation

Adopted Rules

Repealing 16 TAC §130.74, which currently contains the penalty matrix for the podiatry program

CHAPTER 130. PODIATRIC MEDICINE PROGRAMSUBCHAPTER G. ENFORCEMENT16 TAC §130.74OVERVIEWThe Texas Commission of Licensing and Regulation (Commission) adopts the repeal of an existing rule at Subchapter G, §130.74, regarding enforcement of the Podiatry Program.SUMMARY OF CHANGES The adopted rules repeal 16 TAC §130.74, Penalty Matrix. The repeal of this rule reduces redundancy and increases efficiency by harmonizing the program with other Department programs which do not maintain a penalty matrix in rule. Texas Occupations Code §51.302(c) requires the Commission to establish a written enforcement plan that provides specific ranges of penalties for specific violations and the criteria by which the Department determines the amount of the penalty. The Department’s enforcement plan contains a schedule of penalties for each program known as a “penalty matrix.” The podiatry penalty matrix was incorporated into the Department’s enforcement plan when it was created and it will continue to serve its purpose there after 16 TAC §130.74 is repealed. A public notice of revisions to the enforcement plan is published in the Texas Register as required by Texas Occupations Code §51.302(c) each time a program’s penalty matrix is revised.BACKGROUND AND JUSTIFICATIONThe adopted rules provide for a waiver of the requirements in Texas Health and Safety Code §481.074 and §481.075 for controlled substance prescriptions to be issued electronically (electronic prescribing requirements) and repeal the rule adopting a penalty matrix. House Bill (HB) 2174, 86th Legislature, Regular Session (2019), and Texas Health and Safety Code §481.0756 authorize the Department to grant licensed podiatrists a waiver from electronic prescribing requirements. The adopted rules also repeal the rule adopting a penalty matrix for the Podiatry program. The statutory requirement for adopting a penalty matrix rule in Texas Occupations Code §202.6011 was repealed by HB 2847, 86th Legislature, Regular Session (2019).

Texas Board of Chiropractic Examiners

Adopted Rules

New 22 TAC §74.1, establishing procedures for substance abuse testing of certain applicants

CHAPTER 74. SUBSTANCE ABUSE TESTING AND MONITORING22 TAC §74.1The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §74.1 (Substance Abuse Testing and Monitoring of Applicants) with non-substantive changes to the text as published in the December 25, 2020, issue of the Texas Register (45 TexReg 9385). The rule will be republished.This rule formally states the Board’s procedures when certain applicants for a chiropractic license may be subject to substance abuse testing and monitoring in order to obtain a probationary license.

Texas Board of Chiropractic Examiners

Adopted Rules

New 22 TAC §74.2, establishing procedures for substance abuse testing of certain licensees

CHAPTER 74. SUBSTANCE ABUSE TESTING AND MONITORING22 TAC §74.2The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §74.2 (Substance Abuse Testing and Monitoring of Licensees) without changes to the proposed text as published in the December 25, 2020, issue of the Texas Register (45 TexReg 9386). The rule will not be republished.The Board adopts this rule to comply with Texas Occupations Code §201.602, which requires the Board to adopt by rule a system for monitoring a licensee’s compliance with conditions imposed by the Board in disciplinary actions. The purpose of the rule is to permit licensees with substance abuse problems an opportunity to retain their license while still being subject to oversight by the Board.Under the rule, which formalizes the Board’s current practice, a licensee who agrees to undergo substance abuse testing and monitoring as part of an agreed order in a disciplinary action shall bear the cost; the Board shall make reasonable efforts to minimize that cost.

Texas Board of Chiropractic Examiners

Adopted Rules

New 22 TAC §75.9, establishing best practices for closing down a chiropractic practice

CHAPTER 75. BUSINESS PRACTICES22 TAC §75.9The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §75.9, concerning Closing a Practice, with changes to the text as published in the December 4, 2020, issue of the Texas Register (45 TexReg 8698). The rule will be republished.The purpose of the rule is to provide a licensee with the recommended minimum steps the licensee should take to avoid patient abandonment and to protect patient records when closing down a chiropractic practice.

Texas Board of Chiropractic Examiners

Adopted Rules

New 22 TAC §78.10, clarifying that the practice of chiropractic medicine on animals falls outside the scope of the Board’s jurisdiction

CHAPTER 78. SCOPE OF PRACTICE22 TAC §78.10The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §78.10 (Prohibitions on Animal Chiropractic) without changes to the text as published in the December 4, 2020, issue of the Texas Register (45 TexReg 8699). The rule will not be republished.Through this rule, the Board states that while animal chiropractic is outside the scope of chiropractic, the Board will not sanction a licensee for performing animal chiropractic under the supervision of a licensed veterinarian as long as the licensee does so in accordance with any rules on the practice adopted by TBVME. This makes it clear to all that the regulation of animal chiropractic falls under the jurisdiction of TBVME, not the Board. The rule further states the Board will not sanction a licensee for advertising animal chiropractic services as long as the advertising is again in accordance with any applicable TBVME rules.

Texas Board of Chiropractic Examiners

Adopted Rules

Repealing current 22 TAC §80.4 to allow for the introduction of an updated schedule of penalties

CHAPTER 80. COMPLAINTS22 TAC §80.4The Texas Board of Chiropractic Examiners (Board) adopts the repeal of 22 TAC §80.4 (Schedule of Penalties) as published in the December 4, 2020, issue of the Texas Register (45 TexReg 8700). The repeal will not be republished.The Board will adopt a new §80.4 in a separate rulemaking. Because of the Board’s comprehensive rule revisions over the last two years, the cites to other rules contained in §80.4 are now out of date.

Texas Board of Chiropractic Examiners

Adopted Rules

New 22 TAC §80.4, establishing an updated schedule of penalties

CHAPTER 80. COMPLAINTS22 TAC §80.4The Texas Board of Chiropractic Examiners (Board) adopts new 22 TAC §80.4 (Schedule of Penalties) without changes to the text as published in the December 4, 2020, issue of the Texas Register (45 TexReg 8701). The rule will not be republished.The new rule incorporates the Board’s recent major revision of its overall rules into the legal cites in the penalty schedule. The new penalty schedule also organizes rule violations into functional areas for better readability. The text of the rule further clarifies the circumstances when the Board will not report certain administrative violations to national practitioner databases.

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