Texas Register Table of Contents
- 1 Texas Health and Human Services Commission
- 2 Texas Medical Board
- 3 Texas Medical Disclosure Panel
- 4 Texas Medical Board
- 5 Texas Medical Board
- 6 Texas Medical Board
- 7 Texas Department of State Health Services
- 8 Texas Department of State Health Services
- 9 Texas Health and Human Services Commission
- 10 Texas Health and Human Services Commission
- 11 Texas Health and Human Services Commission
- 12 Texas Health and Human Services Commission
- 13 Texas Health and Human Services Commission
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Texas Health and Human Services Commission
Proposed Rules
Reimbursement for Clinical Laboratory Services
CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER J. PURCHASED HEALTH SERVICESDIVISION 32. CLINICAL LABORATORY SERVICES1 TAC §355.8610The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §355.8610, concerning Reimbursement for Clinical Laboratory Services.BACKGROUND AND PURPOSEHHSC proposes to amend the rule governing Clinical Laboratory Services reimbursement. This amendment updates the rule to allow HHSC to establish fees based on a percentage of the Medicare fee schedule and removes the limitation that would not allow payments to exceed the Medicare fee schedule. Currently, HHSC Medicaid fees for clinical laboratory services provided by the Department of State Health Services (DSHS) Laboratory are set at 100 percent of the Medicare fee. The Medicare fee schedule may adjust fees more frequently or in a manner that could negatively impact the DSHS Laboratory. Of particular concern is the series of tests that comprise the newborn screening, which are provided solely by the DSHS laboratory for all Texas newborns.This amendment allows HHSC to reimburse for clinical laboratory services at a percentage of the Medicare fee schedule, which still permits flexibility for HHSC to maintain existing funding for the DSHS Laboratory and their ability to continue to provide newborn screenings for Medicaid newborns.SECTION-BY-SECTION SUMMARYThe proposed amendment to §355.8610 updates language to specify that fees will be esta
Texas Medical Board
Proposed Rules
Amends and repeals multiple sections re Use of Experts for the purpose of restructuring Chapter 182
CHAPTER 182. USE OF EXPERTSThe Texas Medical Board (Board) proposes amendments to Chapter 182, Use of Experts, 22 TAC §§182.1, 182.3, 182.5, and 182.8. The Board also proposes the repeal of §§182.2, 182.4, 182.6, and 182.7, for the purpose of restructuring Chapter 182.Amendments and repeals in Chapter 182 are proposed as follows:Section 182.1, relating to Purpose, is amended to clarify the scope of the rule and its applicability.Section 182.2, relating to Board’s Role, is repealed.Section 182.3, relating to Definitions, is amended to clarify definitions relating to role, purpose, and scope of various professionals utilized by the board.Section 182.4, relating to Use of Consultants, is repealed.Section 182.5, relating to Expert Panel, is renamed “Expert Reviewer Qualifications” and amended to delete obsolete language and to change the order of identified certifying boards.Section 182.6, relating to Use of expert witnesses, is repealed.Section 182.7, relating to Interim Appointment, is repealed.Section 182.8, relating to Expert Physician Reviewers, is amended to delete obsolete language regarding the processes and procedures applicable to the expert physician reviewers. The amendments to §182.8 implement the legislative mandate passed in HB 1504 (86th Regular Legislative Session) relating to expert panel reports and providing each reviewer report to the affected licensee and the content of each report. This amendment also adds language requiring notice to the panel when a case involves Complementary and Alternative Medicine.
Texas Medical Disclosure Panel
Proposed Rules
Amendment to §601.9, concerning informed consent of patients
CHAPTER 601. INFORMED CONSENT25 TAC §601.9The Texas Medical Disclosure Panel (panel) proposes an amendment to §601.9, concerning informed consent of patients.BACKGROUND AND PURPOSEThe amendment is proposed in accordance with the Texas Civil Practice and Remedies Code, §74.102, which requires the panel to determine which risks and hazards related to medical care and surgical procedures must be disclosed by health care providers or physicians to their patients or persons authorized to consent for their patients and to establish the general form and substance of such disclosure. Section 601.9 contains the disclosure and consent form for anesthesia and/or perioperative pain management (analgesia).SECTION-BY-SECTION SUMMARYLanguage is being revised in §601.9 to update language that replaces the legacy agency from the “Department of State Health Services” to the “Health and Human Services Commission.”The proposed amendment to §601.9 revises the disclosure and consent form in English and Spanish for anesthesia and/or perioperative pain management (analgesia) to modify language ensuring the physician delegating/supervising or performing the anesthetic will be privileged with the rebuttable presumption intended.
Texas Medical Board
Adopted Rules
Retention of forensic medical examination records of a sexual assault victim
CHAPTER 165. MEDICAL RECORDS22 TAC §165.1The Texas Medical Board (Board) adopts amendments to Title 22, Part 9, §165.1, concerning Medical Records with changes, described below, to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4817). The rule will be republished.The adopted amendment to §165.1 adds a requirement that physicians must retain forensic medical examination records of a sexual assault victim for 20 years from the date of examination. This change is in accordance with and pursuant to the passage of HB531 (86th Reg. Session) which amended Section 153.003 of the Texas Occupations Code.
Texas Medical Board
Adopted Rules
Amendments concerning Application and Administrative Fees and Registration and Renewal Fees
CHAPTER 175. FEES AND PENALTIES22 TAC §175.1, §175.2The Texas Medical Board (Board) adopts amendments to rule §175.1, concerning Application and Administrative Fees, and §175.2, concerning Registration and Renewal Fees. The amendments to §175.1 and §175.2 are being adopted without changes to the proposed text as published in the July 26, 2019, issue of the Texas Register (44 TexReg 3757). The adopted rules will not be republished.The adopted amendments to §175.1 and §175.2 reinstate fees for initial and renewal approval for instructor and medical radiologic technology and non-certified technician (NCT) training programs, in anticipation for approval processes to be implemented in accordance with recently adopted rules by the Texas Board of Medical Radiologic Technology (MRT Board). The amendments proposed for §175.1 and §175.2 seek to reinstate initial and renewal fees for instructor approval at $50, which is not an increase or decrease from initial approval fees required by the Department of State Health Services (DSHS). However, for both Limited MRT and NCT programs the proposed instructor approval fee represents a decrease from fees formerly imposed by DSHS, as renewal will be required every three years rather than every two (for Limited MRT programs) or annually (for NCT programs).The adopted amendments under §175.1 set forth a $500 fee for initial approval of limited curriculum training programs, with proposed amendments to §175.2 requiring a $500 renewal fee every three years, a decrease from $900 (for a two-year term) fee formerly in effect under DSHS. A fee of $500 is proposed under §175.1 for initial approval for NCT training programs, with a triennial renewal fee of $500 proposed under §175.2. While an increase from the $350 approval fee formerly in place under DSHS, the proposed fees will overall represent a decrease in cost for NCT training programs, as renewal of approval will be required triennially, rather than annually.Finally, the adopted amendments to §175.1 and §175.2 repeal language setting forth obsolete fees related to a secondary permit no longer required for NCTs employed by physicians.
Texas Medical Board
Adopted Rules
Amendments concerning Application and Administrative Fees and Registration and Renewal Fees
CHAPTER 175. FEES AND PENALTIES22 TAC §175.1, §175.2The Texas Medical Board (Board) adopts amendments to rule §175.1, concerning Application and Administrative Fees, and §175.2, concerning Registration and Renewal Fees. The amendments to §175.1 and §175.2 are being adopted without changes to the proposed text as published in the July 26, 2019, issue of the Texas Register (44 TexReg 3757). The adopted rules will not be republished.The adopted amendments to §175.1 and §175.2 reinstate fees for initial and renewal approval for instructor and medical radiologic technology and non-certified technician (NCT) training programs, in anticipation for approval processes to be implemented in accordance with recently adopted rules by the Texas Board of Medical Radiologic Technology (MRT Board). The amendments proposed for §175.1 and §175.2 seek to reinstate initial and renewal fees for instructor approval at $50, which is not an increase or decrease from initial approval fees required by the Department of State Health Services (DSHS). However, for both Limited MRT and NCT programs the proposed instructor approval fee represents a decrease from fees formerly imposed by DSHS, as renewal will be required every three years rather than every two (for Limited MRT programs) or annually (for NCT programs).The adopted amendments under §175.1 set forth a $500 fee for initial approval of limited curriculum training programs, with proposed amendments to §175.2 requiring a $500 renewal fee every three years, a decrease from $900 (for a two-year term) fee formerly in effect under DSHS. A fee of $500 is proposed under §175.1 for initial approval for NCT training programs, with a triennial renewal fee of $500 proposed under §175.2. While an increase from the $350 approval fee formerly in place under DSHS, the proposed fees will overall represent a decrease in cost for NCT training programs, as renewal of approval will be required triennially, rather than annually.Finally, the adopted amendments to §175.1 and §175.2 repeal language setting forth obsolete fees related to a secondary permit no longer required for NCTs employed by physicians.
Texas Department of State Health Services
Adopted Rules
Adding new abortion complication reporting requirements for freestanding emergency medical care facilities (FEMCs)
CHAPTER 131. FREESTANDING EMERGENCY MEDICAL CARE FACILITIESSUBCHAPTER C. OPERATIONAL REQUIREMENTS25 TAC §131.61The Texas Health and Human Services Commission (HHSC) adopts an amendment to §131.61, concerning Reporting Requirements, in Texas Administrative Code (TAC) Title 25, Part 1, Chapter 131, Subchapter C with changes to the proposed text as published in the July 19, 2019, issue of the Texas Register (44 TexReg 3611) and therefore will be republished.BACKGROUND AND JUSTIFICATIONThis amendment is necessary to implement House Bill (H.B.) 13, 85th Legislature, Special Session, 2017, which amended the Texas Health and Safety Code, Chapter 171 by adding new abortion complication reporting requirements for freestanding emergency medical care facilities (FEMCs). This legislation requires HHSC to adopt rules necessary to implement this chapter.
Texas Department of State Health Services
Adopted Rules
Abortion reporting procedures for abortion facilities
CHAPTER 139. ABORTION FACILITY REPORTING AND LICENSINGSUBCHAPTER A. GENERAL PROVISIONS25 TAC §139.1The Texas Health and Human Services Commission (HHSC) adopts an amendment to §139.1, concerning Purpose and Scope, in Texas Administrative Code Title 25, Part 1, Chapter 139, Subchapter A, without changes to the proposed text as published in the July 19, 2019, issue of the Texas Register (44 TexReg 3613) and therefore will not be republished.BACKGROUND AND JUSTIFICATIONThis amendment is necessary to correct a reference to abortion reporting procedures for abortion facilities and implement House Bill (H.B.) 13, 85th Legislature, Special Session, 2017, which amended the Texas Health and Safety Code Chapter 171. This legislation requires HHSC to adopt rules necessary to implement this chapter.
Texas Health and Human Services Commission
In Addition
Request to amend the Medically Dependent Children Program (MDCP) waiver administered under section 1915(c) of the Social Security Act
Public Notice – Amendment to the Medically Dependent Children Program Effective March 9, 2020The Texas Health and Human Services Commission (HHSC) is submitting to the Centers for Medicare & Medicaid Services (CMS) a request to amend the Medically Dependent Children Program (MDCP) waiver administered under section 1915(c) of the Social Security Act. CMS has approved this waiver through August 31, 2023. The proposed effective date for the amendment is March 9, 2020.The amendment request proposes to make the following changes:Changing interest list procedures for individuals who lose eligibility for the Medically Dependent Children Program, to comply with Senate Bill 1207 of the 86th Texas Legislature.Clarifying the budget authority for participants in the consumer-directed services option around requests to change the budget by the participant.Clarifying that the state offers an external medical review prior to a Fair Hearing.Correcting the data source for performance measure G.b.1, number and percent of individuals free of critical incidents not related to abuse, neglect, or exploitation.
Texas Health and Human Services Commission
In Addition
Request to amend the Community Living Assistance and Support Services (CLASS) waiver administered under section 1915(c) of the Social Security Act
Public Notice – Community Living Assistance and Support Services Waiver Amendment Effective March 9, 2020The Texas Health and Human Services Commission (HHSC) is submitting to the Centers for Medicare & Medicaid Services (CMS) a request to amend the Community Living Assistance and Support Services (CLASS) waiver administered under section 1915(c) of the Social Security Act. CMS has approved this waiver through August 31, 2024. The proposed effective date for the amendment is March 9, 2020.The request proposes to amend the waiver as follows:Appendix BChanging interest list procedures for individuals who lose eligibility for the Medically Dependent Children Program, to comply with Senate Bill 1207 of the 86th Texas Legislature.Appendix CCorrecting the licensing chapter for Behavioral Support service providers.Correcting the licensing chapter for dentists as Dental service providers and adding dental hygienists as Dental service providers.Adding certification from the Certified Horsemanship Association as a qualification to be a service provider of specialized therapies.
Texas Health and Human Services Commission
In Addition
Request to amend the Deaf Blind with Multiple Disabilities (DBMD) waiver administered under section 1915(c) of the Social Security Act
Public Notice – Deaf Blind with Multiple Disabilities Waiver Amendment Effective March 9, 2020The Texas Health and Human Services Commission (HHSC) is submitting to the Centers for Medicare & Medicaid Services (CMS) a request to amend the Deaf Blind with Multiple Disabilities (DBMD) waiver administered under section 1915(c) of the Social Security Act. CMS has approved this waiver through February 28, 2023. The proposed effective date for the amendment is March 9, 2020.The request proposes to amend the waiver as follows:Appendix BChanging interest list procedures for individuals who lose eligibility for the Medically Dependent Children Program, to comply with Senate Bill 1207 of the 86th Texas Legislature.Appendix CCorrecting the licensing chapter for Behavioral Support service providers.Correcting the licensing chapter for dentists as Dental service providers and adding dental hygienists as Dental service providers.Appendix DRemoving performance measure D.e.1, relating to the number and percent of individuals who were afforded choice among waiver providers during enrollment, which is no longer required by CMS.Appendix EClarifying the budget authority for participants in the consumer-directed services option around requests to change the budget by the participant.
Texas Health and Human Services Commission
In Addition
Request for and amendment to Home and Community-based Services (HCS) waiver administered under section 1915(c) of the Social Security Act
Public Notice – Texas Home Living Waiver Program Amendment Effective March 9, 2020The Texas Health and Human Services Commission (HHSC) is submitting to the Centers for Medicare & Medicaid Services (CMS) a request for an amendment to the Texas Home Living (TxHmL) waiver program, a waiver implemented under the authority of section 1915(c) of the Social Security Act. CMS has approved this waiver through February 28, 2022. The proposed effective date for this amendment is March 9, 2019.This request proposes to amend the waiver as follows:Appendix B Changing interest list procedures for individuals who lose eligibility for the Medically Dependent Children Program, to comply with Senate Bill 1207 of the 86th Texas Legislature.Revising the terminology for the Medicaid eligibility groups for consistency with payment codes.Appendix CCorrecting the licensing chapter for Behavioral Support service providers.Correcting the licensing chapter for dentists as Dental service providers and add dental hygienist as Dental service providers.Appendix DRemoving measure D.b.1, relating to number and percent of face-to-face utilization reviews conducted according to HHSC policies and procedures, which CMS no longer requires states to report.Removing measure D.e.1, relating to the number and percent of individuals who were afforded choice between waiver services and institutional care during enrollment or service plan renewal, which CMS no longer requires states to report.Replacing references to Consumer Rights and Services/Consumer Rights Intellectual Disabilities (CRS/CRID) with Intellectual and Developmental Disability Ombudsman (IDD Ombudsman) to reflect organizational changes at HHSC.Appendix EClarifying the budget authority for participants in the consumer-directed services option around requests to change the budget by the participant.Appendix FReplacing references to Consumer Rights and Services/Consumer Rights Intellectual Disabilities (CRS/CRID) with Intellectual and Developmental Disability Ombudsman (IDD Ombudsman) to reflect organizational changes at HHSC.Appendix GReplacing the term “adult daycare” with “day activity health services” to reflect a change in state law.Replacing references to Consumer Rights and Services/Consumer Rights Intellectual Disabilities with references to Intellectual and Developmental Disability Ombudsman to reflect organizational changes at HHSC.Appendix HSpecifying the type of survey tool the state uses to measure an individual’s experience of care and quality of life
Texas Health and Human Services Commission
In Addition
Public Notice – Texas Home Living Waiver Program Amendment Effective March 9, 2020The Texas Health and Human Services Commission (HHSC) is submitting to the Centers for Medicare & Medicaid Services (CMS) a request for an amendment to the Texas Home Living (TxHmL) waiver program, a waiver implemented under the authority of section 1915(c) of the Social Security Act. CMS has approved this waiver through February 28, 2022. The proposed effective date for this amendment is March 9, 2019.This request proposes to amend the waiver as follows:Appendix BChanging interest list procedures for individuals who lose eligibility for the Medically Dependent Children Program, to comply with Senate Bill 1207 of the 86th Texas Legislature.Revising the terminology for the Medicaid eligibility groups for consistency with payment codes.Appendix CCorrecting the licensing chapter for Behavioral Support service providers.Correcting the licensing chapter for dentists as Dental service providers and add dental hygienist as Dental service providers.Appendix DRemoving measure D.b.1, relating to number and percent of face-to-face utilization reviews conducted according to HHSC policies and procedures, which CMS no longer requires states to report.Removing measure D.e.1, relating to the number and percent of individuals who were afforded choice between waiver services and institutional care during enrollment or service plan renewal, which CMS no longer requires states to report.Replacing references to Consumer Rights and Services/Consumer Rights Intellectual Disabilities (CRS/CRID) with Intellectual and Developmental Disability Ombudsman (IDD Ombudsman) to reflect organizational changes at HHSC.Appendix EClarifying the budget authority for participants in the consumer-directed services option around requests to change the budget by the participant.Appendix FReplacing references to Consumer Rights and Services/Consumer Rights Intellectual Disabilities (CRS/CRID) with Intellectual and Developmental Disability Ombudsman (IDD Ombudsman) to reflect organizational changes at HHSC.Appendix GReplacing the term “adult daycare” with “day activity health services” to reflect a change in state law.Replacing references to Consumer Rights and Services/Consumer Rights Intellectual Disabilities with references to Intellectual and Developmental Disability Ombudsman to reflect organizational changes at HHSC.Appendix HSpecifying the type of survey tool the state uses to measure an individual’s experience of care and quality of life