Texas Register Table of Contents
- 1 Texas Health and Human Services Commission
- 2 Texas Department of State Health Services
- 2.0.1 Adopted Rules Re:
- 2.0.1.1 Repealing §§98.1 – 98.13, concerning the Texas HIV State Pharmacy Assistance Program.
- 2.0.1.2 Repealing §§98.101 – 98.109 and new §§98.101 – 98.115, 98.117 – 98.119 to update the THMP eligibility criteria, THMP benefits, limitations and cost containment, and nondiscrimination and confidentiality requirements for the THMP program.
- 2.0.1.3 New 25 TAC §§98.101 – 98.109, updating the THMP program operations.
- 2.0.1 Adopted Rules Re:
- 3 Texas Department of Licensing and Regulation
- 4 Legislative Budget Board
Texas Health and Human Services Commission
Adopted Rules Re:
Amending 1 TAC §353.4, §353.7, concerning Managed Care Organizations and Continuity of Care with out-of-network providers.
CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER A. GENERAL PROVISIONS
1 TAC §353.4, §353.7
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts amendments to §353.4, concerning Managed Care Organization Requirements Concerning Out-of-Network Providers, and §353.7, concerning Continuity of Care with Out-of-Network Specialty Providers.
The amendments to §353.4 and §353.7 are adopted without changes to the proposed text as published in the April 29, 2022, issue of the Texas Register (47 TexReg 2389). These rules will not be republished.
BACKGROUND AND JUSTIFICATION
The adoption of §353.4 and §353.7 implements Senate Bill (S.B.) 1648, 87th Texas Legislature, Regular Session, 2021 that amended Texas Government Code §533.038(g) and added new subsections (h) and (i) to §533.038.
The amendment to §533.038(g) clarifies a member is not required to have primary health benefit plan coverage in addition to Medicaid coverage to utilize the specialty provider provision in §533.038(g).
New Section 533.038(h) requires a managed care organization (MCO) to develop a simple, timely, and efficient process and make a good faith effort to negotiate a single-case agreement with a specialty provider. Until an MCO and the specialty provider enter into a single-case agreement, the specialty provider shall be reimbursed in accordance with the applicable reimbursement methodology specified in §353.4.
New Section 533.038(i) provides that a single-case agreement with a specialty provider is not considered accessing an out-of-network provider for the purposes of Medicaid MCO network adequacy requirements.
Texas Department of State Health Services
Adopted Rules Re:
Repealing §§98.1 – 98.13, concerning the Texas HIV State Pharmacy Assistance Program.
CHAPTER 98. TEXAS HIV MEDICATION PROGRAM
SUBCHAPTER A. TEXAS HIV STATE PHARMACY ASSISTANCE PROGRAM
25 TAC §§98.1 – 98.13
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of Texas Administrative Code Title 25, Chapter 98, Subchapter A, §§98.1 – 98.13 and Subchapter C, Division 1, §§98.101 – 98.115, 98.117 – 98.119, and adopts new Subchapter C, Division 1, §§98.101 – 98.109, concerning the Texas HIV Medication Program (THMP).
New §98.108 is adopted with changes to the proposed text as published in the June 10, 2022, issue of the Texas Register (47 TexReg 3399). This rule will be republished.
The repeal of §§98.1 – 98.13, 98.101 – 98.115, 98.117 – 98.119 and new §§98.101 – 98.107 and 98.109 are adopted without changes to the proposed text as published in the June 10, 2022, issue of the Texas Register (47 TexReg 3399). These rules will not be republished.
DSHS Rider 26 requires DSHS notify providers and other relevant stakeholders at least 60 days before implementing any cost containment measures for the Texas HIV Medication Program. Therefore, DSHS will implement the repeal of §§98.101 – 98.107 and 98.109, and new §§98.101 – 98.109, on April 1, 2023.
BACKGROUND AND JUSTIFICATION
The adoption of the rules allows the THMP to comply with the findings and program improvement recommendations noted in the December 2019 program review conducted by the Health Resources and Services Administration (HRSA), the agency that provides federal funding, and the Medication Advisory Committee (MAC) recommendations.
The Texas Administrative Code, Title 25, Chapter 98 provides governing rules for the THMP, which provides medication for the treatment of HIV and its related complications for low-income Texans. Subchapter A establishes the Texas HIV State Pharmacy Assistance Program (SPAP). Subchapter C, Division 1 establishes the general provisions of THMP. DSHS adopts the repeals and replaces Subchapter A and Subchapter C, Division 1 to update eligibility requirements for THMP.
Repealing §§98.101 – 98.109 and new §§98.101 – 98.115, 98.117 – 98.119 to update the THMP eligibility criteria, THMP benefits, limitations and cost containment, and nondiscrimination and confidentiality requirements for the THMP program.
CHAPTER 98. TEXAS HIV MEDICATION PROGRAM
SUBCHAPTER C. TEXAS HIV MEDICATION PROGRAM
25 TAC §§98.101 – 98.115, 98.117 – 98.119
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of Texas Administrative Code Title 25, Chapter 98, Subchapter A, §§98.1 – 98.13 and Subchapter C, Division 1, §§98.101 – 98.115, 98.117 – 98.119, and adopts new Subchapter C, Division 1, §§98.101 – 98.109, concerning the Texas HIV Medication Program (THMP).
New §98.108 is adopted with changes to the proposed text as published in the June 10, 2022, issue of the Texas Register (47 TexReg 3399). This rule will be republished.
The repeal of §§98.1 – 98.13, 98.101 – 98.115, 98.117 – 98.119 and new §§98.101 – 98.107 and 98.109 are adopted without changes to the proposed text as published in the June 10, 2022, issue of the Texas Register (47 TexReg 3399). These rules will not be republished.
DSHS Rider 26 requires DSHS notify providers and other relevant stakeholders at least 60 days before implementing any cost containment measures for the Texas HIV Medication Program. Therefore, DSHS will implement the repeal of §§98.101 – 98.107 and 98.109, and new §§98.101 – 98.109, on April 1, 2023.
BACKGROUND AND JUSTIFICATION
The adoption of the rules allows the THMP to comply with the findings and program improvement recommendations noted in the December 2019 program review conducted by the Health Resources and Services Administration (HRSA), the agency that provides federal funding, and the Medication Advisory Committee (MAC) recommendations.
The Texas Administrative Code, Title 25, Chapter 98 provides governing rules for the THMP, which provides medication for the treatment of HIV and its related complications for low-income Texans. Subchapter A establishes the Texas HIV State Pharmacy Assistance Program (SPAP). Subchapter C, Division 1 establishes the general provisions of THMP. DSHS adopts the repeals and replaces Subchapter A and Subchapter C, Division 1 to update eligibility requirements for THMP.
New 25 TAC §§98.101 – 98.109, updating the THMP program operations.
CHAPTER 98. TEXAS HIV MEDICATION PROGRAM
SUBCHAPTER C. TEXAS HIV MEDICATION PROGRAM
§§98.101 – 98.109
OVERVIEW
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts the repeal of Texas Administrative Code Title 25, Chapter 98, Subchapter A, §§98.1 – 98.13 and Subchapter C, Division 1, §§98.101 – 98.115, 98.117 – 98.119, and adopts new Subchapter C, Division 1, §§98.101 – 98.109, concerning the Texas HIV Medication Program (THMP).
New §98.108 is adopted with changes to the proposed text as published in the June 10, 2022, issue of the Texas Register (47 TexReg 3399). This rule will be republished.
The repeal of §§98.1 – 98.13, 98.101 – 98.115, 98.117 – 98.119 and new §§98.101 – 98.107 and 98.109 are adopted without changes to the proposed text as published in the June 10, 2022, issue of the Texas Register (47 TexReg 3399). These rules will not be republished.
DSHS Rider 26 requires DSHS notify providers and other relevant stakeholders at least 60 days before implementing any cost containment measures for the Texas HIV Medication Program. Therefore, DSHS will implement the repeal of §§98.101 – 98.107 and 98.109, and new §§98.101 – 98.109, on April 1, 2023.
BACKGROUND AND JUSTIFICATION
The adoption of the rules allows the THMP to comply with the findings and program improvement recommendations noted in the December 2019 program review conducted by the Health Resources and Services Administration (HRSA), the agency that provides federal funding, and the Medication Advisory Committee (MAC) recommendations.
The Texas Administrative Code, Title 25, Chapter 98 provides governing rules for the THMP, which provides medication for the treatment of HIV and its related complications for low-income Texans. Subchapter A establishes the Texas HIV State Pharmacy Assistance Program (SPAP). Subchapter C, Division 1 establishes the general provisions of THMP. DSHS adopts the repeals and replaces Subchapter A and Subchapter C, Division 1 to update eligibility requirements for THMP.
Texas Department of Licensing and Regulation
Adopted Rule Reviews Re:
Readopting 16 TAC, Chapter 117, Massage Therapy; Chapter 121, Behavior Analyst; and Chapter 130, Podiatric Medicine Program, following a review of public comments.
OVERVIEW
The Texas Department of Licensing and Regulation (Department) filed a Notice of Intent to Review to consider for readoption, revision, or repeal the rule chapters listed below, in their entirety, under Title 16, Part 4, of the Texas Administrative Code (TAC). This review was conducted in accordance with Texas Government Code §2001.039.
The Department reviewed the following rule chapters:
- Chapter 117, Massage Therapy
- Chapter 121, Behavior Analyst
- Chapter 130, Podiatric Medicine Program
PUBLIC COMMENTS
Chapter 117, Massage Therapy
The Department received comments from 24 interested parties in response to the Notice of Intent to Review for Chapter 117, Massage Therapy. The interested parties included the Federation of State Massage Therapy Boards, massage establishments, a college, and individuals. Of the comments that were received, the Department received two comments in support and one in opposition of re-adoption of the rules. The Department has taken these comments into consideration as part of this review. The Department received 21 comments requesting amendments to the rules with two comments containing multiple requests for amendments to various rules. The request for amendments includes but is not limited to: 1) allowing massage therapy students to obtain licensure after completing a university-level massage therapy program; 2) providing additional rules relating to the prevention of human trafficking; 3) requiring massage establishments to post their license number at the entrance to the establishment; 4) allowing continuing education requirements to be met by virtue of age or length of time as a licensee; 5) removing minimum education requirements from licensure requirements for all licensees; 6) updating existing rules relating to licensing exams, enrollment procedures at massage schools, and student progress reports; 7) changing continuing education requirements; 8) changing massage school curriculum; and 9) amending definitions and omitting the use of the word “female” in favor of language applicable to all genders. The Department will take these comments under consideration for a possible future rulemaking because any amendments must be made using the standard rulemaking process. Additionally, the Department received one public comment unrelated to the rules under review and two comments that related to statutory changes. These comments were directed to the appropriate division for consideration. The Department will not take any further rulemaking action as result of these unrelated comments.
Chapter 121, Behavior Analyst
The Department received comments from one interested party in response to the Notice of Intent to Review for Chapter 121, Behavior Analyst. The Department received a comment from the Texas Association for Behavior Analysis, Public Policy Group, in support of re-adoption of the rules. The Department has taken this comment into consideration as part of this review. The comment submitted also included a request to amend the rules. The comment requested addition of the statutory definition of “applied behavioral analysis”; and consideration by the Department to define or clarify what alternatives would not be considered as “equivalent” certifications for licensure. The Department will take these comments under consideration for a possible future rulemaking because any amendments must be made using the standard rulemaking process.
Chapter 130, Podiatric Medicine Program
The Department received comments from one interested party in response to the Notice of Intent to Review for Chapter 130, Podiatric Medicine Program. The Department received a comment from an individual regarding the fees for an inactive status license. The Department will take this comment under consideration for a possible future rulemaking because any amendments must be made using the standard rulemaking process.
Legislative Budget Board
In Addition Re:
Budget Execution Proposal: Transferring $100,000,000 from appropriations made to the Department of State Health Services to the Texas Division of Emergency Management to fund COVID-19 response expenses.
OVERVIEW
From appropriations made to the Department of State Health Services by Senate Bill No. 8, Acts of the 87th Legislature, Third Called Session, 2021, the amount of $100,000,000 appropriated for the 2022-23 state fiscal biennium shall be transferred to the Texas Division of Emergency Management to fund remaining COVID-19 response expenses.
BACKGROUND AND JUSTIFICATION
Pursuant to Texas Government Code, Section 317.002, this budget execution order is proposed for the following action affecting items of appropriation made by Senate Bill No. 1, General Appropriations Act, Acts of the 87th Legislature, Regular Session, 2021 and Senate Bill No. 8, Acts of the 87th Legislature, Third Called Session, 2021.