Texas Register Table of Contents
- 1 Governor
- 2 Texas Department of Licensing and Regulation
- 2.0.1 Proposed Rules Re:
- 2.0.1.1 Amending 16 TAC §111.2, to repeal the definition of “Provisional Licensee.”
- 2.0.1.2 Amending 16 TAC §111.12 and §111.13, to remove language requiring advisory board member terms to expire on specific odd-numbered years and to change the presiding officer’s term from one year to two years.
- 2.0.1.3 Amending 16 TAC §111.50 and §111.55, to modify clinical observation and experience requirements for speech-language pathology assistant applicants and streamline the application process.
- 2.0.1.4 Amending 16 TAC §111.70, to allow audiology license applicants to qualify with a master’s degree in audiology conferred on or before December 31, 2007, including foreign graduates.
- 2.0.1.5 Amending 16 TAC §111.220, to repeal the requirement that rules governing the sale of hearing instruments be adopted with the assistance of both advisory boards.
- 2.0.1.6 Amending 16 TAC §112.12 and §112.13, to remove language requiring advisory board member terms to expire on specific odd-numbered years and to change the presiding officer’s term from one year to two years.
- 2.0.1.7 Amending 16 TAC §112.32, to require applicants seeking their initial renewal of a hearing instrument fitter and dispenser license to complete 20 hours of continuing education.
- 2.0.1.8 Amending 16 TAC §112.70, to remove the exception allowing license renewal without completing continuing education for licensees within the first 24 months of licensure.
- 2.0.1.9 Amending 16 TAC §112.140, to remove the requirement that rules governing the sale of hearing instruments be adopted with the assistance of both advisory boards, and to allow hearing instruments to be sold to a minor with a written statement from any licensed physician.
- 2.0.1 Proposed Rules Re:
- 3 Texas Education Agency
- 4 Texas Department of Insurance
- 4.0.1 Proposed Rules Re:
- 4.0.1.1 Amending 28 TAC §3.205, to replace a reference to a repealed statute with a reference to new Insurance Code §1702.102(c) concerning prohibited rebates and inducements.
- 4.0.1.2 Amending 28 TAC §3.3403, to implement SB 896 by extending the initial coverage period for newborn children from 31 days to 60 days and extending the deadline for policyholders to notify the insurer from 31 days to 60 days.
- 4.0.1.3 Amending 28 TAC §3.3703, to implement HB 388 by adding a reference to the uniform coordination of benefits questionnaire, SB 1236 by requiring pharmacy and pharmacist contracts to comply with Insurance Code Chapter 1369, and SB 493 by prohibiting certain pharmacy benefit manager contract provisions.
- 4.0.1.4 Amending 28 TAC §§3.9208 and 3.9210, to replace references to Government Code Chapter 533 with Government Code Chapter 540 concerning the Medicaid Managed Care Program.
- 4.0.1.5 Amending 28 TAC §11.202, to delete the requirement that each item in a certificate of authority application be identified by a unique form number.
- 4.0.1.6 Amending 28 TAC §11.301 and §11.302, to update HMO filing requirements to align with 28 TAC Chapter 3, Subchapter A.
- 4.0.1.7 Amending 28 TAC §§11.501-11.504 and §11.506, and repealing 28 TAC §11.505, to update evidence of coverage filing requirements and implement SB 896 by extending newborn coverage from 31 days to 60 days.
- 4.0.1.8 Amending 28 TAC §11.701, to add a reference to filing requirements in 28 TAC Chapter 3, Subchapter A, and to reference major medical rate filing requirements implementing Insurance Code Chapter 1698.
- 4.0.1.9 Amending 28 TAC §11.901 and §11.902, to implement HB 388, HB 3211, SB 493, SB 926, and SB 1236 regarding physician and provider contracts and prohibited HMO conduct.
- 4.0.1.10 Amending 28 TAC §11.1402, to implement HB 3211 by requiring vision care plans to comply with Insurance Code §1451.1545.
- 4.0.1.11 Amending 28 TAC §11.1604, to update a cross-reference to §11.301 to conform to proposed amendments to that section.
- 4.0.1.12 Amending 28 TAC §11.2503, to implement HB 2221 by adding a citation to Insurance Code Chapter 1702.
- 4.0.1.13 Amending 28 TAC §26.9, to implement SB 896 by extending the initial coverage period for newborn children under small employer health benefit plans from the 32nd day to the 61st day after birth and extending the premium payment deadline from 31 days to 60 days.
- 4.0.1.14 Amending 28 TAC §26.305, to implement SB 896 by extending the initial coverage period for newborn children under large employer health benefit plans from the 32nd day to the 61st day after birth and extending the premium payment deadline from 31 days to 60 days.
- 4.0.1 Proposed Rules Re:
- 5 Texas Health and Human Services Commission
- 6 Texas Higher Education Coordinating Board
- 6.0.1 Adopted Rules Re:
- 6.0.2 Adopted Rule Reviews Re:
- 6.0.2.1 Adopting Title 19, Part 1, Chapter 23, Subchapter C, concerning the Physician Education Loan Repayment Assistance Program.
- 6.0.2.2 Adopting Title 19, Part 1, Chapter 23, Subchapter D, concerning the Mental Health Professionals Loan Repayment Assistance Program.
- 6.0.2.3 Adopting Title 19, Part 1, Chapter 23, Subchapter K, concerning the Nurse Loan Repayment Assistance Program.
- 7 Texas Board of Physical Therapy Examiners
Governor
Appointments Re:
Appointed to the Correctional Managed Health Care Committee for a term to expire February 1, 2029, Gonzalo J. Perez-Garcia, M.D. of Dallas, Texas (replacing John W. Burruss, M.D. of Dallas whose term expired).
Texas Department of Licensing and Regulation
Proposed Rules Re:
Amending 16 TAC §111.2, to repeal the definition of “Provisional Licensee.”
CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER A. GENERAL PROVISIONS
16 TAC §111.2
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, at Subchapter A, §111.2; Subchapter B, §111.12 and §111.13; Subchapter F, §111.50 and §111.55; Subchapter H, §111.70; and Subchapter W, §111.220, regarding the Speech-Language Pathologist and Audiologist program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologist and Audiologist.
The proposed rules are necessary to implement the statutory changes made by the 89th Legislature, Regular Session. Specifically, the proposed rules implement Senate Bill (SB) 904, Section 1, SB 905, Sections 1, 2, 3, and 4, and SB 2075, Sections 9 and 10, by the 89th Legislature, Regular Session (2025). The proposed rules also include changes suggested by Departmental divisions during the four-year rule review of Chapter 111, including the Licensing division and Compliance division.
The proposed rules remove language that would require the six-year terms of three members of the advisory board to expire on February 1 of each odd-numbered year and change the advisory board’s presiding officer’s term from one year to two years, allowing the advisory board member to serve their full six-term, regardless of when appointed.
The proposed rules eliminate the definition of “Provisional Licensee,” as provisional licenses are no longer needed now that the jurisprudence exam is always available. They also remove requirements for speech-language pathology (SLP) assistant applicants to submit verification of 25 clinical observation hours and 25 clinical assisting hours to the Department, as well as the requirement to complete any missing hours under direct supervision after licensure. Additionally, the rules renumber §111.55(b)(1) – (8).
The proposed rules amend the existing clinical observation and experience requirements for SLP assistants to require that verification of their 25 hours of clinical observation and 25 hours of clinical assisting experience are submitted to the assistant’s supervisor after the license is issued. The proposed rules also reorganize the requirements of §111.50(d) and §111.50(e) in a more logical manner.
The proposed rules allow audiology license applicants to qualify with a master’s degree in audiology awarded on or before December 31, 2007. Applicants awarded the equivalent of a master’s degree in audiology from a foreign university on or before December 31, 2007, must also obtain an evaluation showing their degree is equivalent to a degree from an accredited U.S. program. The rules also repeal the requirement that the Texas Commission of Licensing and Regulation adopt rules for selling hearing instruments with input from both the Speech-Language Pathologist and Audiologist Advisory Board and the Hearing Instrument Fitters and Dispensers Advisory Board.
SECTION-BY-SECTION SUMMARY
The proposed rules amend §111.2. Definitions. The proposed rules repeal the definition of “Provisional Licensee.” Provisional licenses for Speech-Language Pathologists and Audiologists originated when the jurisprudence exam was offered only a few times a year, allowing individuals to work while waiting to take it. Now, the jurisprudence exam is accessible year-round, making such provisional licenses unnecessary.
Amending 16 TAC §111.12 and §111.13, to remove language requiring advisory board member terms to expire on specific odd-numbered years and to change the presiding officer’s term from one year to two years.
CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER B. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS ADVISORY BOARD
16 TAC §111.12, §111.13
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, at Subchapter A, §111.2; Subchapter B, §111.12 and §111.13; Subchapter F, §111.50 and §111.55; Subchapter H, §111.70; and Subchapter W, §111.220, regarding the Speech-Language Pathologist and Audiologist program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologist and Audiologist.
The proposed rules are necessary to implement the statutory changes made by the 89th Legislature, Regular Session. Specifically, the proposed rules implement Senate Bill (SB) 904, Section 1, SB 905, Sections 1, 2, 3, and 4, and SB 2075, Sections 9 and 10, by the 89th Legislature, Regular Session (2025). The proposed rules also include changes suggested by Departmental divisions during the four-year rule review of Chapter 111, including the Licensing division and Compliance division.
The proposed rules remove language that would require the six-year terms of three members of the advisory board to expire on February 1 of each odd-numbered year and change the advisory board’s presiding officer’s term from one year to two years, allowing the advisory board member to serve their full six-term, regardless of when appointed.
SECTION-BY-SECTION SUMMARY
The proposed rules amend §111.12, Terms; Vacancies. The proposed rules under subsection (a) remove language that would require the six-year terms of three members of the advisory board to expire on February 1 of each odd-numbered year.
The proposed rules amend §111.13, Officers. The proposed rules under subsection (a) change the advisory board’s presiding officer’s term from one year to two years.
Amending 16 TAC §111.50 and §111.55, to modify clinical observation and experience requirements for speech-language pathology assistant applicants and streamline the application process.
CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER F. REQUIREMENTS FOR ASSISTANT IN SPEECH-LANGUAGE PATHOLOGY LICENSE
16 TAC §111.50, §111.55
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, at Subchapter A, §111.2; Subchapter B, §111.12 and §111.13; Subchapter F, §111.50 and §111.55; Subchapter H, §111.70; and Subchapter W, §111.220, regarding the Speech-Language Pathologist and Audiologist program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologist and Audiologist.
The proposed rules are necessary to implement the statutory changes made by the 89th Legislature, Regular Session. Specifically, the proposed rules implement Senate Bill (SB) 904, Section 1, SB 905, Sections 1, 2, 3, and 4, and SB 2075, Sections 9 and 10, by the 89th Legislature, Regular Session (2025). The proposed rules also include changes suggested by Departmental divisions during the four-year rule review of Chapter 111, including the Licensing division and Compliance division.
SECTION-BY-SECTION SUMMARY
The proposed rules add new rules to §111.50, Assistant in Speech-Language Pathology License–Licensing Requirements–Education and Clinical Observation and Experience. Specifically, the new rules modify §111.50(d), Clinical Observation and Experience.
The proposed rules add new §111.50(d)(2), which requires that if any of the 25 hours of clinical observation and 25 hours of clinical assisting experience required for licensure as a SLP assistant were earned during training, then this verification must be submitted to the assistant’s supervisor after the license is issued.
The proposed rules also amend §111.50, Assistant in Speech-Language Pathology License–Licensing Requirements–Education and Clinical Observation and Experience. Specifically, the proposed rules amend §111.50(d)(1) to clarify that the requirements of §111.50(d)(1) are prescribed by §111.50(d), not §111.50(e).
Also, the proposed rules reorganize the requirements of §111.50(d) and §111.50(e) in a more logical manner. Specifically, the proposed rules move former §111.50(e) to §111.50(d)(3), move former §111.50(e)(1) to §111.50(d)(3)(A), move former §111.50(e)(2) to §111.50(d)(3)(B), and move former §111.50(d)(2) to §111.50(e).
The proposed rules amend §111.55, Assistant in Speech-Language Pathology License–Application and Eligibility Requirements.
The proposed rules repeal subsection (b)(5) and remove the requirement that applicants for licensure as an assistant in speech-language pathology must provide the Department verification from their university program that the applicant completed 25 hours of clinical observation and 25 hours of clinical assisting experience.
The proposed rules repeal subsection (b)(6) and remove the requirement that applicants who did not obtain all 25 hours of clinical observation and 25 hours of clinical assisting experience complete those hours under direct supervision by an approved supervisor after the license is issued.
Finally, the proposed rules renumber §111.55(b)(1) – (8).
Amending 16 TAC §111.70, to allow audiology license applicants to qualify with a master’s degree in audiology conferred on or before December 31, 2007, including foreign graduates.
CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER H. REQUIREMENTS FOR AUDIOLOGY LICENSE
16 TAC §111.70
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, at Subchapter A, §111.2; Subchapter B, §111.12 and §111.13; Subchapter F, §111.50 and §111.55; Subchapter H, §111.70; and Subchapter W, §111.220, regarding the Speech-Language Pathologist and Audiologist program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologist and Audiologist.
The proposed rules are necessary to implement the statutory changes made by the 89th Legislature, Regular Session. Specifically, the proposed rules implement Senate Bill (SB) 904, Section 1, SB 905, Sections 1, 2, 3, and 4, and SB 2075, Sections 9 and 10, by the 89th Legislature, Regular Session (2025). The proposed rules also include changes suggested by Departmental divisions during the four-year rule review of Chapter 111, including the Licensing division and Compliance division.
SECTION-BY-SECTION SUMMARY
The proposed rules amend §111.70, Audiology License–Licensing Requirements. The proposed rules under subsection (b) now authorize an applicant seeking licensure as an audiologist to qualify if the applicant possesses a master’s degree in audiology conferred on or before December 31, 2007.
The proposed rule of subsection (d) now require an applicant who earned a master’s degree in audiology at a foreign university on or before December 31, 2007 to hire a transcript evaluation service to determine the applicant’s degree is the equivalent of a degree obtained from a program accredited by a national accrediting organization approved by the commission or department and recognized by the United States secretary of education under the Higher Education Act of 1965 (20 U.S.C. Section 1001 et seq.).
Finally, the proposed rules renumber §111.70(e) and (f).
Amending 16 TAC §111.220, to repeal the requirement that rules governing the sale of hearing instruments be adopted with the assistance of both advisory boards.
CHAPTER 111. SPEECH-LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS
SUBCHAPTER W. JOINT RULE REGARDING THE SALE OF HEARING INSTRUMENTS
16 TAC §111.220
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 111, at Subchapter A, §111.2; Subchapter B, §111.12 and §111.13; Subchapter F, §111.50 and §111.55; Subchapter H, §111.70; and Subchapter W, §111.220, regarding the Speech-Language Pathologist and Audiologist program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 111, implement Texas Occupations Code, Chapter 401, Speech-Language Pathologist and Audiologist.
The proposed rules are necessary to implement the statutory changes made by the 89th Legislature, Regular Session. Specifically, the proposed rules implement Senate Bill (SB) 904, Section 1, SB 905, Sections 1, 2, 3, and 4, and SB 2075, Sections 9 and 10, by the 89th Legislature, Regular Session (2025). The proposed rules also include changes suggested by Departmental divisions during the four-year rule review of Chapter 111, including the Licensing division and Compliance division.
SECTION-BY-SECTION SUMMARY
The proposed rules amend §111.220, Requirements Regarding the Sale of Hearing Instruments. The proposed rules under subsection (a) repeal the requirement that the TDLR Commission adopt rules governing the sale of hearing instruments with the assistance of both the Speech-Language Pathologist and Audiologist Advisory Board and the Hearing Instrument Fitters and Dispensers Advisory Board.
Amending 16 TAC §112.12 and §112.13, to remove language requiring advisory board member terms to expire on specific odd-numbered years and to change the presiding officer’s term from one year to two years.
CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER B. HEARING INSTRUMENT FITTERS AND DISPENSERS ADVISORY BOARD
16 TAC §112.12, §112.13
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter B, §112.12 and §112.13; Subchapter D, §112.32; Subchapter H, §112.70; and Subchapter O, §112.140; regarding the Hearing Instrument Fitters and Dispensers program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers.
The proposed rules are necessary to implement Senate Bill (SB) 904 89th Legislature, Regular Session (2025), specifically, Sections 2, 3, and 4, and SB 2075 (2025), specifically, Sections 11 and 12. The proposed rules remove language that would require the six-year terms of three members of the advisory board to expire on February 1 of each odd-numbered year, allowing each advisory board member to serve their full six-year term, regardless of when appointed. The proposed rules also change the advisory board’s presiding officer’s term from one year to two years.
The proposed rules require applicants seeking their initial renewal of their hearing instrument fitter and dispenser license to complete 20 hours of continuing education; remove the requirement that the Commission adopt rules governing the sale of hearing instruments with the assistance of both the Hearing Instrument Fitters and Dispensers Advisory Board and the Speech-Language Pathologist and Audiologist Advisory Board; remove the exception that allowed the Department to renew a license of a licensee who does not comply with the applicable continuing education requirements if the applicant is within the first 24 months of licensure; and allow hearing instruments to be sold to a minor with a written statement signed by a licensed physician, rather than requiring the statement to be signed by a licensed physician specializing in diseases of the ear.
SECTION-BY-SECTION SUMMARY
The proposed rules amend §112.12, Terms; Vacancies. The proposed rules under subsection (a) remove language that would require the six-year terms of three members of the advisory board to expire on February 1 of each odd-numbered year, allowing each advisory board member to serve their full six-year term, regardless of when appointed.
The proposed rules amend §112.13, Officers. The proposed rules under subsection (a) change the advisory board’s presiding officer’s term from one year to two years.
Amending 16 TAC §112.32, to require applicants seeking their initial renewal of a hearing instrument fitter and dispenser license to complete 20 hours of continuing education.
CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER D. HEARING INSTRUMENT FITTER AND DISPENSER LICENSE
16 TAC §112.32
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter B, §112.12 and §112.13; Subchapter D, §112.32; Subchapter H, §112.70; and Subchapter O, §112.140; regarding the Hearing Instrument Fitters and Dispensers program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers.
The proposed rules are necessary to implement Senate Bill (SB) 904 89th Legislature, Regular Session (2025), specifically, Sections 2, 3, and 4, and SB 2075 (2025), specifically, Sections 11 and 12. The proposed rules remove language that would require the six-year terms of three members of the advisory board to expire on February 1 of each odd-numbered year, allowing each advisory board member to serve their full six-year term, regardless of when appointed. The proposed rules also change the advisory board’s presiding officer’s term from one year to two years.
The proposed rules require applicants seeking their initial renewal of their hearing instrument fitter and dispenser license to complete 20 hours of continuing education; remove the requirement that the Commission adopt rules governing the sale of hearing instruments with the assistance of both the Hearing Instrument Fitters and Dispensers Advisory Board and the Speech-Language Pathologist and Audiologist Advisory Board; remove the exception that allowed the Department to renew a license of a licensee who does not comply with the applicable continuing education requirements if the applicant is within the first 24 months of licensure; and allow hearing instruments to be sold to a minor with a written statement signed by a licensed physician, rather than requiring the statement to be signed by a licensed physician specializing in diseases of the ear.
SECTION-BY-SECTION SUMMARY
The proposed rules amend §112.32, Hearing Instrument Fitter and Dispenser License–License Term; Renewals. The proposed rules under subsection (c) now require applicants seeking their initial renewal of their hearing instrument fitter and dispenser license to complete 20 hours of continuing education.
Amending 16 TAC §112.70, to remove the exception allowing license renewal without completing continuing education for licensees within the first 24 months of licensure.
CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER H. CONTINUING EDUCATION REQUIREMENTS
16 TAC §112.70
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter B, §112.12 and §112.13; Subchapter D, §112.32; Subchapter H, §112.70; and Subchapter O, §112.140; regarding the Hearing Instrument Fitters and Dispensers program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers.
The proposed rules are necessary to implement Senate Bill (SB) 904 89th Legislature, Regular Session (2025), specifically, Sections 2, 3, and 4, and SB 2075 (2025), specifically, Sections 11 and 12. The proposed rules remove language that would require the six-year terms of three members of the advisory board to expire on February 1 of each odd-numbered year, allowing each advisory board member to serve their full six-year term, regardless of when appointed. The proposed rules also change the advisory board’s presiding officer’s term from one year to two years.
The proposed rules require applicants seeking their initial renewal of their hearing instrument fitter and dispenser license to complete 20 hours of continuing education; remove the requirement that the Commission adopt rules governing the sale of hearing instruments with the assistance of both the Hearing Instrument Fitters and Dispensers Advisory Board and the Speech-Language Pathologist and Audiologist Advisory Board; remove the exception that allowed the Department to renew a license of a licensee who does not comply with the applicable continuing education requirements if the applicant is within the first 24 months of licensure; and allow hearing instruments to be sold to a minor with a written statement signed by a licensed physician, rather than requiring the statement to be signed by a licensed physician specializing in diseases of the ear.
SECTION-BY-SECTION SUMMARY
The proposed rules amend §112.70. Continuing Education–Hours, Courses, and Methods of Delivery. The proposed rules under subsection (i) remove the exception that allowed the Department to renew a license of a licensee who does not comply with the applicable continuing education requirements if the applicant is within the first 24 months of licensure.
Amending 16 TAC §112.140, to remove the requirement that rules governing the sale of hearing instruments be adopted with the assistance of both advisory boards, and to allow hearing instruments to be sold to a minor with a written statement from any licensed physician.
CHAPTER 112. HEARING INSTRUMENT FITTERS AND DISPENSERS
SUBCHAPTER O. JOINT RULE REGARDING THE SALE OF HEARING INSTRUMENTS
16 TAC §112.140
OVERVIEW
The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 112, Subchapter B, §112.12 and §112.13; Subchapter D, §112.32; Subchapter H, §112.70; and Subchapter O, §112.140; regarding the Hearing Instrument Fitters and Dispensers program. These proposed changes are referred to as the “proposed rules.”
BACKGROUND AND JUSTIFICATION
The rules under 16 TAC, Chapter 112, implement Texas Occupations Code, Chapter 402, Hearing Instrument Fitters and Dispensers.
The proposed rules are necessary to implement Senate Bill (SB) 904 89th Legislature, Regular Session (2025), specifically, Sections 2, 3, and 4, and SB 2075 (2025), specifically, Sections 11 and 12. The proposed rules remove language that would require the six-year terms of three members of the advisory board to expire on February 1 of each odd-numbered year, allowing each advisory board member to serve their full six-year term, regardless of when appointed. The proposed rules also change the advisory board’s presiding officer’s term from one year to two years.
The proposed rules require applicants seeking their initial renewal of their hearing instrument fitter and dispenser license to complete 20 hours of continuing education; remove the requirement that the Commission adopt rules governing the sale of hearing instruments with the assistance of both the Hearing Instrument Fitters and Dispensers Advisory Board and the Speech-Language Pathologist and Audiologist Advisory Board; remove the exception that allowed the Department to renew a license of a licensee who does not comply with the applicable continuing education requirements if the applicant is within the first 24 months of licensure; and allow hearing instruments to be sold to a minor with a written statement signed by a licensed physician, rather than requiring the statement to be signed by a licensed physician specializing in diseases of the ear.
SECTION-BY-SECTION SUMMARY
The proposed rules amend §112.140, Requirements Regarding the Sale of Hearing Instruments. The proposed rules under subsection (a) remove the requirement that the TDLR Commission adopt rules governing hearing instruments with the assistance of both the Hearing Instrument Fitters and Dispensers Advisory Board and the Speech-Language Pathologist and Audiologist Advisory Board.
The proposed rules add new subsection (f). The proposed rule allows hearing instruments to be sold to a minor with a written statement signed by a licensed physician, rather than requiring the statement to be signed by a licensed physician specializing in diseases of the ear.
Texas Education Agency
Proposed Rules Re:
Amending 19 TAC §89.1053, to revise and expand definitions, clarify procedural requirements for use of restraint, seclusion, and time-out, and establish a crisis prevention and intervention training requirement for school systems serving students with disabilities.
CHAPTER 89. ADAPTATIONS FOR SPECIAL POPULATIONS
SUBCHAPTER AA. COMMISSIONER’S RULES CONCERNING SPECIAL EDUCATION SERVICES
DIVISION 2. CLARIFICATION OF PROVISIONS IN FEDERAL REGULATIONS
19 TAC §89.1053
OVERVIEW
The Texas Education Agency (TEA) proposes an amendment to §89.1053, concerning procedures for use of restraint and time-out. The proposed amendment would revise, expand, and align existing definitions; clarify procedural requirements; and establish a crisis prevention and intervention training requirement for school systems consistent with Senate Bill (SB) 133, 88th Texas Legislature, Regular Session, 2023, and House Bill (HB) 2 and SB 568, 89th Texas Legislature, Regular Session, 2025.
BACKGROUND AND JUSTIFICATION
Section 89.1053 establishes the procedures governing the use of restraint and time-out for students receiving special education and related services. The proposed amendment to the section title would align the rule with state statute.
The proposed amendment to subsection (a) would add a requirement for crisis prevention and intervention training to align with HB 2 and SB 568 and would further clarify practices that constitute prohibited forms of confinement.
The proposed amendment to subsection (b) would add definitions for the terms crisis, crisis prevention and intervention training, imminent, law enforcement duties, seclusion, and taser and expand the existing definitions for emergency and restraint to promote clarity and consistency in implementation in alignment with SB 133, HB 2, and SB 568.
Proposed new subsection (d)(5) would clarify training requirements to emphasize instruction on disability-related behaviors and evidence-based, individualized positive behavioral interventions in alignment with SB 133, HB 2, and SB 568.
The proposed amendment to subsection (e) would clarify documentation and notification requirements for each use of restraint, including establishing a uniform timeline for placement of written documentation in a student’s special education eligibility folder to support admission, review, and dismissal (ARD) committee review.
The proposed amendment to subsection (f) would align with HB 2 and SB 568 by reaffirming that restraint may not be used as a disciplinary or behavior management technique or as a method to gain student compliance.
The proposed amendment to subsection (g) would clarify that the ARD committee is responsible for reviewing, at least annually, the use, amount, and effectiveness of time-out as a behavioral intervention and for considering any necessary revisions to the student’s individualized education plan, behavioral intervention plan, or positive behavior supports to align with HB 2 and SB 568.
The proposed amendment to subsection (i) would clarify documentation requirements for time-out to ensure consistent data collection that enables ARD committees and TEA to monitor use, evaluate effectiveness, and verify compliance with individualized planning requirements.
New subsection (j) would add requirements and criteria for crisis prevention and intervention training to align with HB 2 and SB 568.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §89.1053 renames the section to “Procedures for the Use of Confinement, Restraint, Seclusion, and Time-Out” to align the rule with state statute.
Subsection (a) is amended to add crisis prevention and intervention training as a required program element and to reaffirm the prohibition on confining students in locked spaces as a discipline or behavior management practice.
Subsection (b) is amended to add new definitions for “crisis,” “crisis prevention and intervention training,” “imminent,” “law enforcement duties,” “seclusion,” and “taser,” and to expand the existing definitions for “emergency” and “restraint.” The definition of “emergency” is clarified to require that harm be imminent. “Restraint” is divided into “physical restraint” and “mechanical restraint.” “Seclusion” is defined as confinement in a locked space of less than 50 square feet designed solely to seclude a person.
Subsection (d)(5) is added to require that training on the use of restraint include instruction on disability-related behaviors, including those associated with neurological, developmental, or emotional disabilities, and evidence-based strategies to prevent, reduce, or respond to such behaviors.
Subsection (e) is amended to clarify documentation and notification requirements for each use of restraint. Written documentation must be placed in the student’s special education eligibility folder no later than the third school day after the restraint. The subsection also clarifies that each separate use of restraint requires its own notification and documentation and may not be combined into a single notification.
Subsection (f) is amended to reaffirm that restraint may not be used as a disciplinary or behavior management technique or as a method to gain student compliance.
Subsection (g) is amended to require that the ARD committee review, at least annually, the use, amount, and effectiveness of time-out as a behavioral intervention and consider whether revisions to the student’s IEP, behavioral intervention plan, or positive behavior supports are necessary.
Subsection (i) is amended to require that if a student has a behavior improvement plan or behavioral intervention plan, the school district must document each use of time-out prompted by a behavior specified in the plan, including a description of that behavior.
New subsection (j) establishes crisis prevention and intervention training requirements. School districts must create, document, and use risk criteria based on job role, campus assignments, or incident history to determine which personnel, including support staff and law enforcement, require training and the extent of training needed. Personnel who are designated as high risk must receive training that includes non-violent crisis intervention techniques, verbal de-escalation strategies, and safe physical intervention procedures. School districts shall require training using standards from the State Board for Educator Certification’s continuing education clearinghouse in accordance with TEC, §21.4514.
Texas Department of Insurance
Proposed Rules Re:
Amending 28 TAC §3.205, to replace a reference to a repealed statute with a reference to new Insurance Code §1702.102(c) concerning prohibited rebates and inducements.
CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER C. APPROVAL, DISAPPROVAL, AND WITHDRAWAL OF APPROVAL OF CERTAIN PARTICIPATING POLICY FORMS
28 TAC §3.205
OVERVIEW
The Texas Department of Insurance (TDI) proposes to amend 28 TAC §§3.205, 3.3403, 3.3703, 3.9208, and 3.9210, concerning certain participating policy forms, health coverage of newborn children, and preferred and exclusive provider benefit plans. The amendments implement House Bill 4611, 88th Legislature, 2023; House Bills 388, 1620, and 2221, 89th Legislature, 2025; and Senate Bills 493, 896, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§3.205, 3.3403, 3.3703, 3.9208, and 3.9210 are necessary to implement the following legislation.
HB 388 requires health benefit plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 1620 revises Government Code references throughout the Insurance Code to reflect statutory amendments relating to Medicaid enacted in HB 4611, which made nonsubstantive revisions to various health and human services laws.
HB 2221 moves requirements concerning unlawful rebates and inducements to new Insurance Code Chapter 1702.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the enrollment period for newborn children from 31 days to 60 days.
SB 1236 expands requirements for pharmacy benefit network contracts.
SECTION-BY-SECTION SUMMARY
Section 3.205. A proposed amendment to §3.205 replaces the reference to Insurance Code §541.056(c), which was repealed by HB 2221, with new Insurance Code §1702.102(c), which was added by HB 2221.
Amending 28 TAC §3.3403, to implement SB 896 by extending the initial coverage period for newborn children from 31 days to 60 days and extending the deadline for policyholders to notify the insurer from 31 days to 60 days.
CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER U. NEWBORN CHILDREN COVERAGE
28 TAC §3.3403
OVERVIEW
The Texas Department of Insurance (TDI) proposes to amend 28 TAC §§3.205, 3.3403, 3.3703, 3.9208, and 3.9210, concerning certain participating policy forms, health coverage of newborn children, and preferred and exclusive provider benefit plans. The amendments implement House Bill 4611, 88th Legislature, 2023; House Bills 388, 1620, and 2221, 89th Legislature, 2025; and Senate Bills 493, 896, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§3.205, 3.3403, 3.3703, 3.9208, and 3.9210 are necessary to implement the following legislation.
HB 388 requires health benefit plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 1620 revises Government Code references throughout the Insurance Code to reflect statutory amendments relating to Medicaid enacted in HB 4611, which made nonsubstantive revisions to various health and human services laws.
HB 2221 moves requirements concerning unlawful rebates and inducements to new Insurance Code Chapter 1702.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the enrollment period for newborn children from 31 days to 60 days.
SB 1236 expands requirements for pharmacy benefit network contracts.
SECTION-BY-SECTION SUMMARY
Section 3.3403. The proposed amendments to §3.3403 implement SB 896. Subsections (a), (b), and (d) are amended by striking general references to “a period of time” for newborn coverage and replacing them with the concrete time period of “before the 61st day after the child’s birth.” Subsection (e) is amended by replacing references to a 31-day initial coverage period with a 60-day initial coverage period.
Subsections (f) – (h), addressing the original implementation period of Insurance Code §1367.003, are deleted because they are no longer relevant. Subsection (i) is redesignated as subsection (f), and a title is added to the statutory reference in the subsection to conform to agency style.
Amending 28 TAC §3.3703, to implement HB 388 by adding a reference to the uniform coordination of benefits questionnaire, SB 1236 by requiring pharmacy and pharmacist contracts to comply with Insurance Code Chapter 1369, and SB 493 by prohibiting certain pharmacy benefit manager contract provisions.
CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER X. PREFERRED AND EXCLUSIVE PROVIDER PLANS
DIVISION 1. GENERAL REQUIREMENTS
28 TAC §3.3703
OVERVIEW
The Texas Department of Insurance (TDI) proposes to amend 28 TAC §§3.205, 3.3403, 3.3703, 3.9208, and 3.9210, concerning certain participating policy forms, health coverage of newborn children, and preferred and exclusive provider benefit plans. The amendments implement House Bill 4611, 88th Legislature, 2023; House Bills 388, 1620, and 2221, 89th Legislature, 2025; and Senate Bills 493, 896, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§3.205, 3.3403, 3.3703, 3.9208, and 3.9210 are necessary to implement the following legislation.
HB 388 requires health benefit plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 1620 revises Government Code references throughout the Insurance Code to reflect statutory amendments relating to Medicaid enacted in HB 4611, which made nonsubstantive revisions to various health and human services laws.
HB 2221 moves requirements concerning unlawful rebates and inducements to new Insurance Code Chapter 1702.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the enrollment period for newborn children from 31 days to 60 days.
SB 1236 expands requirements for pharmacy benefit network contracts.
SECTION-BY-SECTION SUMMARY
Section 3.3703. The proposed amendments to §3.3703 implement HB 388, HB 493, and SB 1236. Subsection (a)(21) is amended by adding a reference to Insurance Code §1203.153. Consistent with SB 1236, new subsection (a)(31) requires a contract between an insurer and a pharmacy or pharmacist to comply with Insurance Code Chapter 1369. New subsection (a)(32) prohibits certain contract provisions in a contract between an insurer and a pharmacy or pharmacist, consistent with Insurance Code §4151.155 as added by SB 493. Although §4151.155 affects contracts involving a pharmacy benefit manager, subsection (a)(32) applies to contracts involving an insurer to ensure requirements for insurers and their pharmacy benefit managers are consistent. New subsection (a)(33) is added to cross-reference 28 TAC §7.1613, which addresses requirements for a contract between an issuer and a third-party administrator (TPA), including a requirement for a TPA to be contractually obligated to comply with all statutory and regulatory requirements related to a function carried out by the TPA. This makes clear that the requirements of §3.3703 apply to health plan contracts with physicians or providers, whether the plan contracts directly or relies on a TPA such as a pharmacy benefit manager to contract.
Amending 28 TAC §§3.9208 and 3.9210, to replace references to Government Code Chapter 533 with Government Code Chapter 540 concerning the Medicaid Managed Care Program.
CHAPTER 3. LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
SUBCHAPTER KK. EXCLUSIVE PROVIDER BENEFIT PLAN
28 TAC §3.9208, §3.9210
OVERVIEW
The Texas Department of Insurance (TDI) proposes to amend 28 TAC §§3.205, 3.3403, 3.3703, 3.9208, and 3.9210, concerning certain participating policy forms, health coverage of newborn children, and preferred and exclusive provider benefit plans. The amendments implement House Bill 4611, 88th Legislature, 2023; House Bills 388, 1620, and 2221, 89th Legislature, 2025; and Senate Bills 493, 896, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§3.205, 3.3403, 3.3703, 3.9208, and 3.9210 are necessary to implement the following legislation.
HB 388 requires health benefit plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 1620 revises Government Code references throughout the Insurance Code to reflect statutory amendments relating to Medicaid enacted in HB 4611, which made nonsubstantive revisions to various health and human services laws.
HB 2221 moves requirements concerning unlawful rebates and inducements to new Insurance Code Chapter 1702.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the enrollment period for newborn children from 31 days to 60 days.
SB 1236 expands requirements for pharmacy benefit network contracts.
SECTION-BY-SECTION SUMMARY
Section 3.9208. The proposed amendment to §3.9208 replaces the reference to Government Code Chapter 533 with Government Code Chapter 540, as repealed and replaced by HB 4611, and consistent with HB 1620.
Section 3.9210. The proposed amendment to §3.9210(a) replaces the reference to Government Code Chapter 533 with Government Code Chapter 540, as repealed and replaced by HB 4611 and consistent with HB 1620.
CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONS
SUBCHAPTER C. APPLICATION FOR CERTIFICATE OF AUTHORITY
28 TAC §11.202
OVERVIEW
The Texas Department of Insurance (TDI) proposes to repeal 28 TAC §11.505 and amend §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.506, 11.701, 11.901, 11.902, 11.1402, 11.1604, and 11.2503, concerning health maintenance organizations (HMOs). The repeal and amendments update HMO filing rules to align with filing requirements in 28 TAC Chapter 3, Subchapter A, and implement House Bills 388, 2221, and 3211, 89th Legislature, 2025; and Senate Bills 493, 896, 926, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§11.504, 11.506, 11.901, 11.902, 11.1402, and 11.2503 are necessary to implement the following legislation:
HB 388 requires health plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 2221 repeals certain provisions in Insurance Code Chapter 541, concerning unlawful rebates and inducements, and replaces them with similar provisions in new Chapter 1702.
HB 3211 establishes new contracting requirements for vision care plans.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the period during which a newborn child is automatically covered and the deadline to enroll a newborn child into coverage.
SB 926 expands provisions related to health plans that use steering or tiering to encourage enrollees to use certain network physicians and providers.
SB 1236 expands requirements for pharmacy benefit network contracts.
Additional amendments to §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.701, and 11.1604, and the repeal of §11.505 are necessary to update HMO filing rules to align with filing requirements for life, health, and HMO products in 28 TAC Chapter 3, Subchapter A. Historically, HMO filing requirements were addressed exclusively in Chapter 11. However, in 2025, TDI modernized the rules in 28 TAC Chapter 3, Subchapter A, and expanded the scope to include all HMO filings that are filed with TDI’s Life and Health Division through the NAIC’s System for Electronic Rates and Forms Filing (SERFF) after an HMO receives a certificate of authority. The proposed amendments and repeal remove provisions that duplicate or conflict with the provisions in 28 TAC Chapter 3, Subchapter A. Because of the proposed reorganization of §11.301, cross-references in other sections of Chapter 11 are amended to conform to the reorganized subsections and paragraphs.
SECTION-BY-SECTION SUMMARY
Section 11.202. An amendment is proposed to §11.202 to delete subsection (i), which requires each item in the application to be identified by a unique form number. This requirement is no longer necessary. Form numbers are needed only for filings made in SERFF, and applicable requirements are contained in 28 TAC Chapter 3, Subchapter A. The deletion of subsection (i) conforms to the proposed amendments to §11.301.
Amending 28 TAC §11.301 and §11.302, to update HMO filing requirements to align with 28 TAC Chapter 3, Subchapter A.
CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONS
SUBCHAPTER D. REGULATORY REQUIREMENTS FOR AN HMO AFTER ISSUANCE OF CERTIFICATE OF AUTHORITY
28 TAC §11.301, §11.302
OVERVIEW
The Texas Department of Insurance (TDI) proposes to repeal 28 TAC §11.505 and amend §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.506, 11.701, 11.901, 11.902, 11.1402, 11.1604, and 11.2503, concerning health maintenance organizations (HMOs). The repeal and amendments update HMO filing rules to align with filing requirements in 28 TAC Chapter 3, Subchapter A, and implement House Bills 388, 2221, and 3211, 89th Legislature, 2025; and Senate Bills 493, 896, 926, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§11.504, 11.506, 11.901, 11.902, 11.1402, and 11.2503 are necessary to implement the following legislation:
HB 388 requires health plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 2221 repeals certain provisions in Insurance Code Chapter 541, concerning unlawful rebates and inducements, and replaces them with similar provisions in new Chapter 1702.
HB 3211 establishes new contracting requirements for vision care plans.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the period during which a newborn child is automatically covered and the deadline to enroll a newborn child into coverage.
SB 926 expands provisions related to health plans that use steering or tiering to encourage enrollees to use certain network physicians and providers.
SB 1236 expands requirements for pharmacy benefit network contracts.
Additional amendments to §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.701, and 11.1604, and the repeal of §11.505 are necessary to update HMO filing rules to align with filing requirements for life, health, and HMO products in 28 TAC Chapter 3, Subchapter A. Historically, HMO filing requirements were addressed exclusively in Chapter 11. However, in 2025, TDI modernized the rules in 28 TAC Chapter 3, Subchapter A, and expanded the scope to include all HMO filings that are filed with TDI’s Life and Health Division through the NAIC’s System for Electronic Rates and Forms Filing (SERFF) after an HMO receives a certificate of authority. The proposed amendments and repeal remove provisions that duplicate or conflict with the provisions in 28 TAC Chapter 3, Subchapter A. Because of the proposed reorganization of §11.301, cross-references in other sections of Chapter 11 are amended to conform to the reorganized subsections and paragraphs.
SECTION-BY-SECTION SUMMARY
Section 11.301. The proposed amendments to §11.301 modify the filing requirements to conform to changes adopted in 28 TAC Chapter 3, Subchapter A, which broadly address filing requirements for life, health, and HMO products and remove the need for most HMO-specific filing requirements. As part of these amendments, provisions throughout the section are reorganized into subsections, renumbered paragraphs, and redesignated subparagraphs.
Section 11.302. An amendment is proposed to §11.302(b)(4) to revise a reference to §11.301 to conform to proposed amendments to that section.
Amending 28 TAC §§11.501-11.504 and §11.506, and repealing 28 TAC §11.505, to update evidence of coverage filing requirements and implement SB 896 by extending newborn coverage from 31 days to 60 days.
CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONS
SUBCHAPTER F. EVIDENCE OF COVERAGE
28 TAC §§11.501-11.504, 11.505, 11.506
OVERVIEW
The Texas Department of Insurance (TDI) proposes to repeal 28 TAC §11.505 and amend §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.506, 11.701, 11.901, 11.902, 11.1402, 11.1604, and 11.2503, concerning health maintenance organizations (HMOs). The repeal and amendments update HMO filing rules to align with filing requirements in 28 TAC Chapter 3, Subchapter A, and implement House Bills 388, 2221, and 3211, 89th Legislature, 2025; and Senate Bills 493, 896, 926, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§11.504, 11.506, 11.901, 11.902, 11.1402, and 11.2503 are necessary to implement the following legislation:
HB 388 requires health plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 2221 repeals certain provisions in Insurance Code Chapter 541, concerning unlawful rebates and inducements, and replaces them with similar provisions in new Chapter 1702.
HB 3211 establishes new contracting requirements for vision care plans.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the period during which a newborn child is automatically covered and the deadline to enroll a newborn child into coverage.
SB 926 expands provisions related to health plans that use steering or tiering to encourage enrollees to use certain network physicians and providers.
SB 1236 expands requirements for pharmacy benefit network contracts.
Additional amendments to §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.701, and 11.1604, and the repeal of §11.505 are necessary to update HMO filing rules to align with filing requirements for life, health, and HMO products in 28 TAC Chapter 3, Subchapter A. Historically, HMO filing requirements were addressed exclusively in Chapter 11. However, in 2025, TDI modernized the rules in 28 TAC Chapter 3, Subchapter A, and expanded the scope to include all HMO filings that are filed with TDI’s Life and Health Division through the NAIC’s System for Electronic Rates and Forms Filing (SERFF) after an HMO receives a certificate of authority. The proposed amendments and repeal remove provisions that duplicate or conflict with the provisions in 28 TAC Chapter 3, Subchapter A. Because of the proposed reorganization of §11.301, cross-references in other sections of Chapter 11 are amended to conform to the reorganized subsections and paragraphs.
SECTION-BY-SECTION SUMMARY
Section 11.501. The proposed amendments to §11.501 remove outdated filing fee provisions in subsection (b) and replace them with references to the filing requirements in 28 TAC Chapter 3, Subchapter A. Subsection (c), regarding matrix filing fees, is deleted.
Section 11.502. The proposed amendments to §11.502 modify subsection (a) to revise the reference to §11.301 to conform to the proposed amendments reorganizing that section and add a reference to filing requirements in 28 TAC Chapter 3, Subchapter A.
Section 11.503. The proposed amendments to §11.503 revise subsection (a) to add a reference to filing requirements contained in 28 TAC Chapter 3, Subchapter A. Subsection (c) is amended to remove a reference to §11.505, which is proposed for repeal. To avoid duplication with provisions in §3.23 and 28 TAC §11.301, subsections (d) – (f) are deleted.
Section 11.504. The proposed amendments to §11.504 revise subsection (a)(1) to add a reference to filing requirements in 28 TAC Chapter 3, Subchapter A, and revise subsection (a)(3) to implement HB 2221 by adding a reference to new Insurance Code Chapter 1702.
Repeal of Section 11.505. The proposed repeal of §11.505 avoids duplication with filing requirements in 28 TAC Chapter 3, Subchapter A.
Section 11.506. The proposed amendments to §11.506(b)(8)(D)(iii) and (v) implement SB 896 by expanding required coverage for newborn children from 31 days to 60 days following birth and by extending the deadline to notify the HMO.
Amending 28 TAC §11.701, to add a reference to filing requirements in 28 TAC Chapter 3, Subchapter A, and to reference major medical rate filing requirements implementing Insurance Code Chapter 1698.
CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONS
SUBCHAPTER H. SCHEDULE OF CHARGES
28 TAC §11.701
OVERVIEW
The Texas Department of Insurance (TDI) proposes to repeal 28 TAC §11.505 and amend §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.506, 11.701, 11.901, 11.902, 11.1402, 11.1604, and 11.2503, concerning health maintenance organizations (HMOs). The repeal and amendments update HMO filing rules to align with filing requirements in 28 TAC Chapter 3, Subchapter A, and implement House Bills 388, 2221, and 3211, 89th Legislature, 2025; and Senate Bills 493, 896, 926, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§11.504, 11.506, 11.901, 11.902, 11.1402, and 11.2503 are necessary to implement the following legislation:
HB 388 requires health plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 2221 repeals certain provisions in Insurance Code Chapter 541, concerning unlawful rebates and inducements, and replaces them with similar provisions in new Chapter 1702.
HB 3211 establishes new contracting requirements for vision care plans.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the period during which a newborn child is automatically covered and the deadline to enroll a newborn child into coverage.
SB 926 expands provisions related to health plans that use steering or tiering to encourage enrollees to use certain network physicians and providers.
SB 1236 expands requirements for pharmacy benefit network contracts.
Additional amendments to §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.701, and 11.1604, and the repeal of §11.505 are necessary to update HMO filing rules to align with filing requirements for life, health, and HMO products in 28 TAC Chapter 3, Subchapter A. Historically, HMO filing requirements were addressed exclusively in Chapter 11. However, in 2025, TDI modernized the rules in 28 TAC Chapter 3, Subchapter A, and expanded the scope to include all HMO filings that are filed with TDI’s Life and Health Division through the NAIC’s System for Electronic Rates and Forms Filing (SERFF) after an HMO receives a certificate of authority. The proposed amendments and repeal remove provisions that duplicate or conflict with the provisions in 28 TAC Chapter 3, Subchapter A. Because of the proposed reorganization of §11.301, cross-references in other sections of Chapter 11 are amended to conform to the reorganized subsections and paragraphs.
SECTION-BY-SECTION SUMMARY
Section 11.701. The proposed amendments to §11.701 add a reference in subsection (a) to the filing requirements in 28 TAC Chapter 3, Subchapter A. New subsection (c) is added to reference requirements for major medical rate filings in 28 TAC Chapter 3, Subchapter F, which implements Insurance Code Chapter 1698.
Amending 28 TAC §11.901 and §11.902, to implement HB 388, HB 3211, SB 493, SB 926, and SB 1236 regarding physician and provider contracts and prohibited HMO conduct.
CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONS
SUBCHAPTER J. PHYSICIAN AND PROVIDER CONTRACTS AND ARRANGEMENTS
28 TAC §11.901, §11.902
OVERVIEW
The Texas Department of Insurance (TDI) proposes to repeal 28 TAC §11.505 and amend §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.506, 11.701, 11.901, 11.902, 11.1402, 11.1604, and 11.2503, concerning health maintenance organizations (HMOs). The repeal and amendments update HMO filing rules to align with filing requirements in 28 TAC Chapter 3, Subchapter A, and implement House Bills 388, 2221, and 3211, 89th Legislature, 2025; and Senate Bills 493, 896, 926, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§11.504, 11.506, 11.901, 11.902, 11.1402, and 11.2503 are necessary to implement the following legislation:
HB 388 requires health plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 2221 repeals certain provisions in Insurance Code Chapter 541, concerning unlawful rebates and inducements, and replaces them with similar provisions in new Chapter 1702.
HB 3211 establishes new contracting requirements for vision care plans.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the period during which a newborn child is automatically covered and the deadline to enroll a newborn child into coverage.
SB 926 expands provisions related to health plans that use steering or tiering to encourage enrollees to use certain network physicians and providers.
SB 1236 expands requirements for pharmacy benefit network contracts.
Additional amendments to §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.701, and 11.1604, and the repeal of §11.505 are necessary to update HMO filing rules to align with filing requirements for life, health, and HMO products in 28 TAC Chapter 3, Subchapter A. Historically, HMO filing requirements were addressed exclusively in Chapter 11. However, in 2025, TDI modernized the rules in 28 TAC Chapter 3, Subchapter A, and expanded the scope to include all HMO filings that are filed with TDI’s Life and Health Division through the NAIC’s System for Electronic Rates and Forms Filing (SERFF) after an HMO receives a certificate of authority. The proposed amendments and repeal remove provisions that duplicate or conflict with the provisions in 28 TAC Chapter 3, Subchapter A. Because of the proposed reorganization of §11.301, cross-references in other sections of Chapter 11 are amended to conform to the reorganized subsections and paragraphs.
SECTION-BY-SECTION SUMMARY
Section 11.901. The proposed amendments to §11.901 implement legislation related to health plan contracting. An amendment to subsection (b)(12) implements HB 388 by adding a citation to new Insurance Code §1203.153, in connection to a requirement for a contracted physician or provider to retain records on a patient’s other health plan coverage, including the coordination of benefits questionnaire. New subsection (h) is added to implement SB 1236 by requiring that a contract between an HMO and a pharmacy or pharmacist comply with pharmacy benefits contracting standards in Insurance Code Chapter 1369.
Section 11.902. Subsection (a)(7) is redesignated as (a)(8), and new subsection (a)(7) is added to implement HB 3211 by prohibiting HMO conduct that violates §1451.1545 or §1451.157. New subsection (a)(9) is added to implement SB 493 by prohibiting conduct that violates Insurance Code §4151.155.
Subsection (b) is amended to implement SB 926 by adding a reference to Insurance Code §843.322. To avoid duplicating the statute, subparagraphs (A) – (D) of paragraph (3) are deleted.
Amending 28 TAC §11.1402, to implement HB 3211 by requiring vision care plans to comply with Insurance Code §1451.1545.
CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONS
SUBCHAPTER O. ADMINISTRATIVE PROCEDURES
28 TAC §11.1402
OVERVIEW
The Texas Department of Insurance (TDI) proposes to repeal 28 TAC §11.505 and amend §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.506, 11.701, 11.901, 11.902, 11.1402, 11.1604, and 11.2503, concerning health maintenance organizations (HMOs). The repeal and amendments update HMO filing rules to align with filing requirements in 28 TAC Chapter 3, Subchapter A, and implement House Bills 388, 2221, and 3211, 89th Legislature, 2025; and Senate Bills 493, 896, 926, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§11.504, 11.506, 11.901, 11.902, 11.1402, and 11.2503 are necessary to implement the following legislation:
HB 388 requires health plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 2221 repeals certain provisions in Insurance Code Chapter 541, concerning unlawful rebates and inducements, and replaces them with similar provisions in new Chapter 1702.
HB 3211 establishes new contracting requirements for vision care plans.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the period during which a newborn child is automatically covered and the deadline to enroll a newborn child into coverage.
SB 926 expands provisions related to health plans that use steering or tiering to encourage enrollees to use certain network physicians and providers.
SB 1236 expands requirements for pharmacy benefit network contracts.
Additional amendments to §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.701, and 11.1604, and the repeal of §11.505 are necessary to update HMO filing rules to align with filing requirements for life, health, and HMO products in 28 TAC Chapter 3, Subchapter A. Historically, HMO filing requirements were addressed exclusively in Chapter 11. However, in 2025, TDI modernized the rules in 28 TAC Chapter 3, Subchapter A, and expanded the scope to include all HMO filings that are filed with TDI’s Life and Health Division through the NAIC’s System for Electronic Rates and Forms Filing (SERFF) after an HMO receives a certificate of authority. The proposed amendments and repeal remove provisions that duplicate or conflict with the provisions in 28 TAC Chapter 3, Subchapter A. Because of the proposed reorganization of §11.301, cross-references in other sections of Chapter 11 are amended to conform to the reorganized subsections and paragraphs.
SECTION-BY-SECTION SUMMARY
Section 11.1402. An amendment is proposed to §11.1402 to implement HB 3211 by adding new subsection (e) to require vision care plans specifically to comply with Insurance Code §1451.1545.
Amending 28 TAC §11.1604, to update a cross-reference to §11.301 to conform to proposed amendments to that section.
CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONS
SUBCHAPTER Q. OTHER REQUIREMENTS
28 TAC §11.1604
OVERVIEW
The Texas Department of Insurance (TDI) proposes to repeal 28 TAC §11.505 and amend §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.506, 11.701, 11.901, 11.902, 11.1402, 11.1604, and 11.2503, concerning health maintenance organizations (HMOs). The repeal and amendments update HMO filing rules to align with filing requirements in 28 TAC Chapter 3, Subchapter A, and implement House Bills 388, 2221, and 3211, 89th Legislature, 2025; and Senate Bills 493, 896, 926, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§11.504, 11.506, 11.901, 11.902, 11.1402, and 11.2503 are necessary to implement the following legislation:
HB 388 requires health plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 2221 repeals certain provisions in Insurance Code Chapter 541, concerning unlawful rebates and inducements, and replaces them with similar provisions in new Chapter 1702.
HB 3211 establishes new contracting requirements for vision care plans.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the period during which a newborn child is automatically covered and the deadline to enroll a newborn child into coverage.
SB 926 expands provisions related to health plans that use steering or tiering to encourage enrollees to use certain network physicians and providers.
SB 1236 expands requirements for pharmacy benefit network contracts.
Additional amendments to §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.701, and 11.1604, and the repeal of §11.505 are necessary to update HMO filing rules to align with filing requirements for life, health, and HMO products in 28 TAC Chapter 3, Subchapter A. Historically, HMO filing requirements were addressed exclusively in Chapter 11. However, in 2025, TDI modernized the rules in 28 TAC Chapter 3, Subchapter A, and expanded the scope to include all HMO filings that are filed with TDI’s Life and Health Division through the NAIC’s System for Electronic Rates and Forms Filing (SERFF) after an HMO receives a certificate of authority. The proposed amendments and repeal remove provisions that duplicate or conflict with the provisions in 28 TAC Chapter 3, Subchapter A. Because of the proposed reorganization of §11.301, cross-references in other sections of Chapter 11 are amended to conform to the reorganized subsections and paragraphs.
SECTION-BY-SECTION SUMMARY
Section 11.1604. A proposed amendment to §11.1604 revises a reference in paragraph (2) to §11.301 to conform to proposed amendments to that section.
Amending 28 TAC §11.2503, to implement HB 2221 by adding a citation to Insurance Code Chapter 1702.
CHAPTER 11. HEALTH MAINTENANCE ORGANIZATIONS
SUBCHAPTER Z. POINT-OF-SERVICE RIDERS
28 TAC §11.2503
OVERVIEW
The Texas Department of Insurance (TDI) proposes to repeal 28 TAC §11.505 and amend §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.506, 11.701, 11.901, 11.902, 11.1402, 11.1604, and 11.2503, concerning health maintenance organizations (HMOs). The repeal and amendments update HMO filing rules to align with filing requirements in 28 TAC Chapter 3, Subchapter A, and implement House Bills 388, 2221, and 3211, 89th Legislature, 2025; and Senate Bills 493, 896, 926, and 1236, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Amendments to §§11.504, 11.506, 11.901, 11.902, 11.1402, and 11.2503 are necessary to implement the following legislation:
HB 388 requires health plans to use a uniform coordination of benefits questionnaire that is adopted by TDI.
HB 2221 repeals certain provisions in Insurance Code Chapter 541, concerning unlawful rebates and inducements, and replaces them with similar provisions in new Chapter 1702.
HB 3211 establishes new contracting requirements for vision care plans.
SB 493 prohibits certain pharmacy benefit manager contract provisions.
SB 896 extends the period during which a newborn child is automatically covered and the deadline to enroll a newborn child into coverage.
SB 926 expands provisions related to health plans that use steering or tiering to encourage enrollees to use certain network physicians and providers.
SB 1236 expands requirements for pharmacy benefit network contracts.
Additional amendments to §§11.202, 11.301, 11.302, 11.501 – 11.504, 11.701, and 11.1604, and the repeal of §11.505 are necessary to update HMO filing rules to align with filing requirements for life, health, and HMO products in 28 TAC Chapter 3, Subchapter A. Historically, HMO filing requirements were addressed exclusively in Chapter 11. However, in 2025, TDI modernized the rules in 28 TAC Chapter 3, Subchapter A, and expanded the scope to include all HMO filings that are filed with TDI’s Life and Health Division through the NAIC’s System for Electronic Rates and Forms Filing (SERFF) after an HMO receives a certificate of authority. The proposed amendments and repeal remove provisions that duplicate or conflict with the provisions in 28 TAC Chapter 3, Subchapter A. Because of the proposed reorganization of §11.301, cross-references in other sections of Chapter 11 are amended to conform to the reorganized subsections and paragraphs.
SECTION-BY-SECTION SUMMARY
Section 11.2503. An amendment is proposed to §11.2503(d) to implement HB 2221 by adding a citation to Insurance Code Chapter 1702.
CHAPTER 26. EMPLOYER-RELATED HEALTH BENEFIT PLAN REGULATIONS
SUBCHAPTER A. DEFINITIONS, SEVERABILITY, AND SMALL EMPLOYER HEALTH REGULATIONS
28 TAC §26.9
OVERVIEW
The Texas Department of Insurance (TDI) proposes to amend 28 TAC §26.9 and §26.305, concerning small employer and large employer health benefit plans. The amendments implement Senate Bill 896, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Proposed amendments to §26.9 and §26.305 are necessary to implement SB 896, which expands the coverage period for newborn children under small and large employer health plans subject to Insurance Code Chapter 1501. SB 896 extends the end date of the mandatory coverage period from the 32nd day to the 61st day after a child’s birth, and extends the deadline for an enrollee to notify the health plan and pay any additional premium from the 31st day to the 60th day after the date of birth.
SECTION-BY-SECTION SUMMARY
Section 26.9. The proposed amendments to §26.9 implement SB 896. Subsection (a)(4) is amended by replacing the reference to newborn coverage termination on the 32nd day after birth with the 61st day after birth. And the subsection is also amended by replacing the references to a 31-day premium payment deadline with a 60-day payment deadline.
CHAPTER 26. EMPLOYER-RELATED HEALTH BENEFIT PLAN REGULATIONS
SUBCHAPTER C. LARGE EMPLOYER HEALTH INSURANCE REGULATIONS
28 TAC §26.305
OVERVIEW
The Texas Department of Insurance (TDI) proposes to amend 28 TAC §26.9 and §26.305, concerning small employer and large employer health benefit plans. The amendments implement Senate Bill 896, 89th Legislature, 2025.
BACKGROUND AND JUSTIFICATION
Proposed amendments to §26.9 and §26.305 are necessary to implement SB 896, which expands the coverage period for newborn children under small and large employer health plans subject to Insurance Code Chapter 1501. SB 896 extends the end date of the mandatory coverage period from the 32nd day to the 61st day after a child’s birth, and extends the deadline for an enrollee to notify the health plan and pay any additional premium from the 31st day to the 60th day after the date of birth.
SECTION-BY-SECTION SUMMARY
Section 26.305. The proposed amendments to §26.305 implement SB 896. Subsection (f) is amended by replacing the reference to newborn coverage termination on the 32nd day after birth with the 61st day after birth. Subsection (f)(2) is amended by replacing the references to a 31-day premium payment deadline with a 60-day payment deadline. An amendment to subsection (h)(1) deletes “an” to correct a grammatical error.
Texas Health and Human Services Commission
Adopted Rules Re:
Amending 1 TAC §355.8443 and §355.8600, to align the rules with current practices and modernize the informal cost report review process.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
DIVISION 23. EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT (EPSDT)
1 TAC §355.8443
DIVISION 31. AMBULANCE SERVICES
1 TAC §355.8600
OVERVIEW
The executive commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §355.8443, concerning Reimbursement Methodology for School Health and Related Services (SHARS), and §355.8600, concerning Reimbursement Methodology for Ambulance Services.
Section 355.8443 and §355.8600 are adopted without changes to the proposed text as published in the February 13, 2026, issue of the Texas Register (51 TexReg 787). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to align the rules with current updated practices and reduce administrative burdens by modernizing the informal review process for cost reports.
SECTION-BY-SECTION SUMMARY
The adopted rules amend §355.8443, concerning Reimbursement Methodology for School Health and Related Services (SHARS), and §355.8600, concerning Reimbursement Methodology for Ambulance Services. Section 355.8443 and §355.8600 are adopted without changes to the proposed text as published in the February 13, 2026, issue of the Texas Register (51 TexReg 787).
Proposed Rule Reviews Re:
Reviewing Title 26, Part 1, to consider for readoption, revision, or repeal the chapter concerning Anatomical Gift.
The Texas Health and Human Services Commission (HHSC) proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 26, Part 1, of the Texas Administrative Code (TAC):
CHAPTER 990, Anatomical Gift
This review is conducted in accordance with the requirements of Texas Government Code §2001.039, which requires state agencies, every four years, to assess whether the initial reasons for adopting a rule continue to exist. After reviewing its rules, the agency will readopt, readopt with amendments, or repeal its rules.
Comments on the review of Chapter 990, Anatomical Gift, may be submitted to HHSC Rules Coordination Office, Mail Code 4102, P.O. Box 13247, Austin, Texas 78711-3247, or by email to hhsrulescoordinationoffice@hhs.texas.gov. When emailing comments, please indicate “Comments on Proposed Rule Review Chapter 990” in the subject line. The deadline for comments is on or before 5:00 p.m. central time on the 31st day after the date this notice is published in the Texas Register.
Adopted Rule Reviews Re:
Adopting Title 1, Part 15, concerning Refugee Cash Assistance and Medical Assistance Programs.
The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 1, Part 15, of the Texas Administrative Code (TAC):
CHAPTER 375, Refugee Cash Assistance And Medical Assistance Programs
Notice of the review of this chapter was published in the February 27, 2026, issue of the Texas Register (51 TexReg 1311) for public comment.
The 31-day comment period ended March 30, 2026. During this period, HHSC did not receive any comments regarding the proposed rule review.
HHSC has reviewed Chapter 375 in accordance with Texas Government Code §2001.039, which requires state agencies to assess, every four years, whether the initial reasons for adopting a rule continue to exist.
The agency determined that the original reasons for adopting all rules in the chapter continue to exist and readopts Chapter 375. Any amendments, if applicable, to Chapter 375 identified by HHSC in the rule review will be proposed in a future issue of the Texas Register.
Adopting Title 1, Part 15, concerning Refugee Social Services.
The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 1, Part 15, of the Texas Administrative Code (TAC):
CHAPTER 376, Refugee Social Services
Notice of the review of this chapter was published in the February 27, 2026, issue of the Texas Register (51 TexReg 1311) for public comment.
The 31-day comment period ended March 30, 2026. During this period, HHSC did not receive any comments regarding the proposed rule review.
HHSC has reviewed Chapter 376 in accordance with Texas Government Code §2001.039, which requires state agencies to assess, every four years, whether the initial reasons for adopting a rule continue to exist.
The agency determined that the original reasons for adopting all rules in the chapter continue to exist and readopts Chapter 376. Any amendments, if applicable, to Chapter 376 identified by HHSC in the rule review will be proposed in a future issue of the Texas Register.
Adopting Title 26, Part 1, concerning Home and Community-Based Services (HCS) Program and Community First Choice (CFC).
The Texas Health and Human Services Commission (HHSC) adopts the review of the chapter below in Title 26, Part 1, of the Texas Administrative Code (TAC):
CHAPTER 263, Home and Community-Based Services (HCS) Program and Community First Choice (CFC)
Notice of the review of this chapter was published in the February 20, 2026, issue of the Texas Register (51 TexReg 1175). HHSC received no comments concerning this chapter.
HHSC has reviewed Chapter 263 in accordance with Texas Government Code §2001.039, which requires state agencies to assess, every four years, whether the initial reasons for adopting a rule continue to exist.
The agency determined that the original reasons for adopting all rules in the chapter continue to exist and readopts Chapter 263. Any amendments, if applicable, to Chapter 263 identified by HHSC in the rule review will be proposed in a future issue of the Texas Register.
In Addition Re:
Notice of Public Hearing on Proposed Payment Rate Actions for the Comprehensive Rehabilitation Services (CRS) Program and the STAR Kids/STAR Health Prescribed Pediatric Extended Care Center (PPECC), Effective September 1, 2026.
The Texas Health and Human Services Commission (HHSC) will conduct a public hearing to receive public comments on the proposed payment rate actions for the Comprehensive Rehabilitation Services (CRS) Program and the STAR Kids/STAR Health Prescribed Pediatric Extended Care Center (PPECC) on May 26, 2026, at 9:00 a.m. CDT.
This hearing will be conducted both in-person and online. To join the hearing from your computer, tablet, or smartphone, register for the hearing in advance using the following registration URL: https://register.gotowebinar.com/register/5703367378165398613. After registering, you will receive a confirmation email containing information about joining the webinar. Instructions for dialing in by phone will be provided via email after you complete registration.
Members of the public may attend the rate hearing in person, which will be held in the North Austin Complex Building, Public Hearing Room 1.401 at 4601 W. Guadalupe St., Austin, Texas 78751. A recording of the hearing will be archived and accessible on demand at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings under the “Archived” tab. The hearing will be held in compliance with Texas Human Resources Code section 32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.
Any updates to the hearing details will be posted on the HHSC website at https://www.hhs.texas.gov/about/meetings-events.
HHSC proposes payment rate actions for the CRS Program, Home Delivered Meals (HDM), and STAR Kids/STAR Health PPECC program. The proposed rates will be effective September 1, 2026.
HHSC proposes payment rate actions and revisions to the rate methodology resulting from the Provider Finance Department (PFD) LTSS Biennial Fee Review (BFR) process, which requires staff to review all reimbursement rates at least every two years.
The proposed STAR Kids/STAR Health PPECC payment rate was calculated in accordance with 1 Texas Administrative Code Section 355.9080.
The proposed CRS payment rate was calculated in accordance with Title 1 of the 1 Texas Administrative Code Section 355.9040.
A briefing packet describing the proposed payment rates will be made available no later than May 12, 2026, at https://pfd.hhs.texas.gov/rate-packets. Interested parties may obtain a copy of the briefing packet on or after that date by contacting Provider Finance by phone at (512) 730-7401, by fax at (512) 730-7475, or by email at PFD-LTSS@hhs.texas.gov.
Written comments regarding the proposed payment rates may be submitted instead of oral testimony until 5:00 p.m. on the day of the hearing. Written comments may be sent by U.S. mail to the Texas Health and Human Services Commission, Attention: Provider Finance, Mail Code H-400, P.O. Box 149030, Austin, Texas 78714-9030; by fax to Provider Finance at (512) 730-7475; or by email to PFD-LTSS@hhs.texas.gov.
Texas Higher Education Coordinating Board
Adopted Rules Re:
Repealing 19 TAC §§6.210-6.218, to shift administration of the Autism Grant Program to general grant rules in Chapter 10, Subchapter A.
CHAPTER 6. HEALTH EDUCATION, TRAINING, AND RESEARCH FUNDS
SUBCHAPTER K. AUTISM GRANT PROGRAM
19 TAC §§6.210 – 6.218
OVERVIEW
The Texas Higher Education Coordinating Board (Coordinating Board) adopts repeal of Title 19, Part 1, Chapter 6, Subchapter K, §§6.210 – 6.218, Autism Grant Program, without changes to the proposed text as published in the January 16, 2026, issue of the Texas Register (51 TexReg 242). The rules will not be republished.
BACKGROUND AND JUSTIFICATION
This repeal shifts the grant administration rules for this program to more general rules designed for grant programs that do not have statutory authority for rulemaking and are only required by riders. Moving forward, the Autism Grant Program will be administered using rules in Chapter 10, Subchapter A.
Texas Education Code, §61.027, authorizes the Coordinating Board to adopt and repeal rules. The Coordinating Board has determined that statutory authority for specific rulemaking of this grant program does not exist and therefore the rules are being repealed.
SECTION-BY-SECTION SUMMARY
The repeal of §§6.210 – 6.218 removes the Autism Grant Program rules from Chapter 6 so that the program can be administered under the general grant rules in Chapter 10, Subchapter A.
Adopted Rule Reviews Re:
Adopting Title 19, Part 1, Chapter 23, Subchapter C, concerning the Physician Education Loan Repayment Assistance Program.
The Texas Higher Education Coordinating Board (Coordinating Board) adopts the review of Title 19, Part 1, Chapter 23, Subchapter C, Physician Education Loan Repayment Assistance Program, §§23.62, 23.66, 23.68, 23.70, and 23.71 without changes, and §23.65, and §23.67, with changes as published concurrently with this notice.
The proposed notice of review was published in the January 16, 2026, issue of the Texas Register (51 TexReg 291). No comments were received regarding the review of this chapter. During its review, the Coordinating Board determined that the initial reasons for adopting these sections continue to exist. Sections 23.62, 23.66, 23.68, 23.70, and 23.71 are readopted, and §23.65, and §23.67 are readopted with amendments in accordance with the requirements of the Government Code, §2001.039.
Adopting Title 19, Part 1, Chapter 23, Subchapter D, concerning the Mental Health Professionals Loan Repayment Assistance Program.
The Texas Higher Education Coordinating Board (Coordinating Board) adopts the review of Title 19, Part 1, Chapter 23, Subchapter D, Mental Health Professionals Loan Repayment Assistance Program, §§23.93, 23.95, and 23.101 – 23.103, without changes, and §§23.94, 23.96, 23.97, and 23.100, with changes as published concurrently with this notice.
The proposed notice of review was published in the January 16, 2026, issue of the Texas Register (51 TexReg 291). No comments were received regarding the review of this chapter. During its review, the Coordinating Board determined that the initial reasons for adopting these sections continue to exist. Sections 23.93, 23.95, and 23.101 – 23.103 are readopted, and §§23.94, 23.96, 23.97, and 23.100 are readopted with amendments in accordance with the requirements of the Government Code, §2001.039.
Adopting Title 19, Part 1, Chapter 23, Subchapter K, concerning the Nurse Loan Repayment Assistance Program.
The Texas Higher Education Coordinating Board (Coordinating Board) adopts the review of Title 19, Part 1, Chapter 23, Subchapter K, Nurse Loan Repayment Assistance Program, §§23.300, 23.304, and 23.305, without changes, and §§23.301 – 23.303, with changes as published concurrently with this notice.
The proposed notice of review was published in the January 16, 2026, issue of the Texas Register (51 TexReg 291). No comments were received regarding the review of this chapter. During its review, the Coordinating Board determined that the initial reasons for adopting these sections continue to exist. Sections 23.300, 23.304, and 23.305, are readopted, and §§23.301 – 23.303, are readopted with amendments in accordance with the requirements of the Government Code, §2001.039.
Texas Board of Physical Therapy Examiners
Adopted Rules Re:
Amending 22 TAC §341.2, to use generic language describing professional physical therapy code of ethics and standards in the jurisprudence assessment module.
CHAPTER 341. LICENSE RENEWAL
22 TAC §341.2
OVERVIEW
The Texas Board of Physical Therapy Examiners adopts the amendment to 22 TAC §341.2 relating to the components of the jurisprudence assessment module that must be completed as part of a licensee’s total continuing competence requirement. The amendment is adopted without changes to the proposed text as published in the March 6, 2026 issue of the Texas Register (51 TexReg 1368). The rule will not be republished.
BACKGROUND AND JUSTIFICATION
The adopted amendment is necessary to implement changes made by the American Physical Therapy Association’s adoption of a new Code of Ethics for the Physical Therapy Profession that combines the Code of Ethics for the Physical Therapist and the Standards of Ethical Conduct for the Physical Therapist Assistant into one comprehensive document that went into effect on January 1, 2026. The proposal utilizes generic language to describe professional physical therapy code of ethics and standards to avoid the need for additional amendments if documents are changed and renamed in the future.
SECTION-BY-SECTION SUMMARY
No comments were received regarding the adoption of the amendment.