Texas Register November 22, 2024 Volume: 49 Number: 47

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 Texas Department of State Health Services
- - 2.0.1 Proposed Rules Re:
    - 2.0.1.1 Amending 25 TAC §§221.11 – 221.16, to revise the exemption for 9 Code of Federal Regulations (CFR) §303; add definitions; provide additional examples of violations for severity levels I-V; reorganize and consolidate rules; and remove various subsections.
  - 2.0.2 Adopted Rule Reviews Re:
    - 2.0.2.1 Adopting Title 25, Part 1, concerning Retail Food Establishments.
3 Texas Department of Licensing and Regulation
- - 3.0.1 Adopted Rules Re:
4 Texas Optometry Board
- - 4.0.1 Adopted Rules Re:
    - 4.0.1.1 Adopting 22 TAC §§275.1 – 275.3, to update the rule such that all licenses expire on a biennial basis, clarify the continuing education requirements for licensees, and provide non-substantive grammatical changes to ensure consistency.

Texas Health and Human Services Commission

Proposed Rules Re:

Amending 1 TAC §355.8052, §355.8061, to add a paragraph with a list of services exempt from the inpatient hospital reimbursement methodology, amend language, and correct punctuation.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER J. PURCHASED HEALTH SERVICES
DIVISION 4. MEDICAID HOSPITAL SERVICES
1 TAC §355.8052, §355.8061

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §355.8052, concerning Inpatient Hospital Reimbursement, and §355.8061, concerning Outpatient Hospital Reimbursement.

BACKGROUND AND PURPOSE

The purpose of this proposal is to specify that High-Cost Clinician Administered Drugs and Biologics (HCCADs), Long-Acting Reversible Contraceptive (LARC) devices, and Donor Human Milk Services will be reimbursed outside the all-patient refined diagnosis-related group (APR-DRG) inpatient reimbursement and filed on a separate outpatient claim. The non-risk payment will be paid at the lesser of billed charges or the fee-for-service reimbursement amount with the fee schedule acting as the upper-payment limit. For more information regarding payment methodology, please refer to §355.8085, concerning Reimbursement Methodology for Physicians and Other Practitioners. This rule update increases efficiency in the delivery of HCCADs, LARCs and Human Breast milk. A hospital administering these services will be reimbursed separately from the Inpatient Hospital APR-DRG reimbursement methodology. DRG payments exclude separate reimbursement for HCCADs, LARCS and Human Breast milk, all which can range from hundreds of dollars to millions of dollars per client.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §355.8052(b) adds definitions for “Donor Human Milk Services,” “High-Cost Clinician Administered Drugs and Biologics (HCCADS),” and “Long-Acting Reversible Contraceptive (LARC) devices.” The definition for “Impact file” is amended for clarity. The definition for “Mean length of stay” is amended to correct punctuation. The subsection is renumbered to account for the addition and deletion of paragraphs.

The proposed amendment to §355.8052(i) adds a new paragraph with a list of services exempt from the inpatient hospital reimbursement methodology. The paragraphs are renumbered to account for the addition and a reference is updated in new paragraph (5).

The proposed amendment to §355.8061 updates the term “Human Breast Milk Processing, Storage and Distribution” to “Donor Human Milk Services.” New subsection (e) is added to list the inpatient services that will be reimbursed on a separate outpatient claim. The following subsection is renumbered to account for the addition.

Adopted Rules Re:

Adopting 26 TAC §745.8401, §745.8411, to add requirements for HHSC in investigating allegations of abuse, neglect, or exploitation of elderly adults or adults with disabilities and make non-substantive changes for improved clarity.

CHAPTER 745. LICENSING
SUBCHAPTER K. INSPECTIONS, INVESTIGATIONS, AND CONFIDENTIALITY
DIVISION 1. OVERVIEW OF INSPECTIONS AND INVESTIGATIONS
26 TAC §745.8401, §745.8411

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts amendments to §745.8401, concerning Who is responsible for inspecting or investigating an operation under this division, and §745.8411, concerning What are an operation’s responsibilities when an authorized representative inspects or investigates the operation.

The amendment to §745.8401 is adopted without changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5312). This rule will not be republished.

The amendment to §745.8411 is adopted with changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5312). This rule will be republished.

BACKGROUND AND JUSTIFICATION

The amendments are necessary to implement House Bill (H.B.) 4696, 88th Legislature, Regular Session, 2023. H.B. 4696 placed the responsibility for investigating an allegation of abuse, neglect, and exploitation of an elderly person or adult with a disability who resides in a residential child-care facility in Texas Human Resources Code (HRC) §48.251(a)(3) and §48.252(b) and (c), which correspond with the investigatory authority of HHSC Long-Term Care Regulation Provider Investigations. Accordingly, because HHSC Child Care Regulation (CCR) also conducts investigations at residential child-care facilities, CCR is adopting amended rules that clarify what authorized entities may inspect or investigate according to Title 26, Chapter 745, Subchapter K, Division 1, and responsibilities an operation has when an authorized entity conducts an inspection or investigation.

Adopting 26 TAC §748.303, to clarify the reporting requirements for a general residential operation and makes non-substantive changes for increased readability and understanding.

CHAPTER 748. MINIMUM STANDARDS FOR GENERAL RESIDENTIAL OPERATIONS
SUBCHAPTER D. REPORTS AND RECORD KEEPING
DIVISION 1. REPORTING SERIOUS INCIDENTS AND OTHER OCCURRENCES
26 TAC §748.303

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §748.303, concerning When must a general residential operation (GRO) report and document a serious incident.

The amendment to §748.303 is adopted with changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5317). This rule will be republished.

BACKGROUND AND JUSTIFICATION

The amendment is necessary to implement House Bill (H.B.) 4696, 88th Legislature, Regular Session, 2023. H.B. 4696 placed the responsibility for investigating an allegation of abuse, neglect, and exploitation of an elderly person or adult with a disability who resides in a residential child-care facility in Texas Human Resources Code (HRC) §48.251(a)(3) and §48.252(b) and (c), which correspond with the investigatory authority of HHSC Long-Term Care Regulation Provider Investigations. Accordingly, because HHSC Child Care Regulation (CCR) also conducts investigations at residential child-care facilities, CCR is adopting an amended rule to clarify that a report must be made to HHSC through the Texas Abuse and Neglect Hotline if there is reason to believe an adult resident has been abused, neglected, or exploited.

Adopting 26 TAC §749.503, to clarify the reporting requirements of a child-placing agency and makes non-substantive changes to the rule for better readability and understanding.

CHAPTER 749. MINIMUM STANDARDS FOR CHILD-PLACING AGENCIES
SUBCHAPTER D. REPORTS AND RECORD KEEPING
DIVISION 1. REPORTING SERIOUS INCIDENTS AND OTHER OCCURRENCES
26 TAC §749.503

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §749.503, concerning When must a child-placing agency (CPA) report and document a serious incident.

The amendment to §749.503 is adopted with changes to the proposed text as published in the July 19, 2024, issue of the Texas Register (49 TexReg 5318). This rule will be republished.

BACKGROUND AND JUSTIFICATION

Adopted Rule Reviews Re:

Adopting Title 1, Part 15, concerning Medicaid Health 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 354, Medicaid Health Services

In Addition Re:

Public Notice – Methodology for Determining Caseload Reduction Credit for the Temporary Assistance for Needy Families (TANF) Program for Federal Fiscal Year 2025

The Texas Health and Human Services Commission (HHSC) announces its intent to seek comments from the public on its estimate and methodology for determining the Temporary Assistance for Needy Families (TANF) Program caseload reduction credit for Federal Fiscal Year (FFY) 2025. HHSC will base the methodology on caseload reduction occurring from FFY 2005 to FFY 2024. This methodology and the resulting estimated caseload reduction credit will be submitted for approval to the United States Department of Health and Human Services, Administration for Children and Families.

Public Notice – Proposed Update to 1 TAC §355.8052, concerning Inpatient Hospital Reimbursement, and §355.8061, concerning Outpatient Hospital Reimbursement

High Cost Drugs Rule Hearing: The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on December 3, 2024, at 9:00 a.m., to receive public comments on proposed rule change that allows for hospitals to be reimbursed for High-Cost Clinician Administered Drugs and Biologics (HCCADs), long-acting reversible contraceptives and Donor Human Milk Services.

Texas Department of State Health Services

Proposed Rules Re:

Amending 25 TAC §§221.11 – 221.16, to revise the exemption for 9 Code of Federal Regulations (CFR) §303; add definitions; provide additional examples of violations for severity levels I-V; reorganize and consolidate rules; and remove various subsections.

CHAPTER 221. MEAT SAFETY ASSURANCE
SUBCHAPTER B. MEAT AND POULTRY INSPECTION
25 TAC §§221.11 – 221.16

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes amendments to §221.11, concerning Federal Regulations on Meat and Poultry Inspection; §221.12, concerning Meat and Poultry Inspection; §221.13, concerning Enforcement and Penalties; §221.14, concerning Custom Exempt Slaughter and Processing; Low-Volume Poultry or Rabbit Slaughter Operations; §221.15, concerning Inspection of Alternate Source Food Animals; and §221.16, concerning Fees.

BACKGROUND AND PURPOSE

The purpose of the proposal is to implement Senate Bill (S.B.) 691, 88th Legislature, Regular Session, 2023, that amended Subchapter A, Chapter 433, Texas Health and Safety Code by adding §433.0065, relating to an animal share exemption for certain meat and meat food products and providing for a civil penalty. The proposed amendments provide guidance regarding how producers may engage in the slaughtering, processing, labeling, and distribution of meat and meat food products produced for members of an animal share while remaining in compliance with state and federal laws and the regulatory requirements of 25 Texas Administrative Code (TAC) §221.14.

The proposed amendments also implement S.B. 664, 88th Legislature, Regular Session, 2023, that amended Subchapter D, Chapter 431, Texas Health and Safety Code, by adding §431.0805, that defines analogue and cell-cultured food products as distinguished from the definitions of “meat,” “poultry,” “meat food products,” and “poultry food products.” The proposed amendments update, correct, improve, and clarify the rule language and incorporate plain language where appropriate.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §221.11 includes a revision to the exemption listed for 9 Code of Federal Regulations (CFR) §303 and the removal of 9 CFR §355, and revises the DSHS Meat Safety website address.

The proposed amendment to §221.12 adds the definitions for “animal share,” “meat,” and “meat food product” as required by S.B. 691, 88th Legislature, Regular Session, 2023, and S.B. 664, 88th Legislature, Regular Session, 2023. This proposal also revises the definitions for “custom exempt operation,” “custom processor,” “custom slaughterer,” “department,” “federal regulations,” “feral swine,” “game animals,” “grant of custom exemption,” “heat-treated,” “meat safety assurance section,” “poultry,” “poultry or rabbit exemption,” and “slaughter” for clarity. Definitions for the terms “humane slaughter,” “livestock producer,” “official slaughter establishments premises,” “poultry product,” and “ritual cut” have been added. Revisions also add to the basic requirements to receive a grant from DSHS. Rules covering the humane treatment of livestock were moved from §221.14 to §221.12. Other minor revisions were made for clarity.

The proposed amendment to §221.13 includes additional examples of violations for severity levels I-V.

The proposed amendment to §221.14 includes combining rules required by both custom slaughter and custom processing establishments into one section for better clarity; consolidating and moving rules for the humane treatment of livestock from §221.14 to §221.12; revising temperature charts for the cooking of custom prepared meat and poultry products and renumbering those related figures, §221.14(c)(10)(B)(i) and §221.14(c)(10)(B)(ii); and updating the requirements for the custom slaughter and processing of co-owned livestock. The rule title is updated to include animal share, “Custom Exempt Slaughter and Processing; Animal Share and Low-Volume Poultry or Rabbit Slaughter Operations.”

The proposed amendment to §221.15 includes the removal of subsection (e), Rabbits, and its reference to 9 CFR §354; subsection (f), Migratory water fowl, game birds, squab, and its reference to 9 CFR §362; and subsection (g), Certified products for dogs, cats, and other carnivora, and its reference to 9 CFR §355. Other minor revisions were made for clarity.

The proposed amendment to §221.16 updates language surrounding fees for clarity and incorporates plain language.

Adopted Rule Reviews Re:

Adopting Title 25, Part 1, concerning Retail Food Establishments.

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), adopts the review of the chapter below in Title 25, Part 1, of the Texas Administrative Code (TAC):

Chapter 228, Retail Food Establishments

Texas Department of Licensing and Regulation

Adopted Rules Re:

Adopting 16 TAC §130.1, §130.2, to change the name of the section from “Authority” to “Authority and Applicability,” update definitions for “Podiatric Medical Radiological Technician” and “Practitioner,” remove unnecessary language, and add clarifying language.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER A. GENERAL PROVISIONS
16 TAC §130.1, §130.2

OVERVIEW

The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code (TAC) Chapter 130, Subchapter A, §130.1 and §130.2; Subchapter B, §§130.20, 130.23, 130.27, and 130.28; Subchapter C, §130.30 and §130.32; Subchapter D, §§130.40 – 130.42; Subchapter E, §§130.50, 130.51, 130.54, 130.55, 130.58, and 130.59; Subchapter F, §130.60; and Subchapter G, §§130.70, 130.72, and 130.73; adopts new rules at Subchapter B, §§130.21, 130.22, and 130.24; Subchapter C, §§130.31 and 130.34 – 130.36; and Subchapter D, §§130.43 – 130.48; and adopts the repeal of existing rules at Subchapter B, §§130.21, 130.22, and 130.24; Subchapter C, §130.31; Subchapter D, §§130.43 – 130.49; and Subchapter E, §130.52 and §130.53, regarding the Podiatric Medicine Program, without changes to the proposed text as published in the June 21, 2024, issue of the Texas Register (49 TexReg 4537). These rules will not be republished.

The Commission also adopts a new rule at 16 TAC Chapter 130, Subchapter C, §130.37; and amendments to an existing rule at Subchapter E, §130.57, regarding the Podiatric Medicine Program, with changes to the proposed text as published in the June 21, 2024, issue of the Texas Register (49 TexReg 4537). These rules will be republished.

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

The rules under 16 TAC, Chapter 130, implement Texas Occupations Code, Chapter 202, Podiatrists; and Chapter 51, the enabling statute of the Texas Commission of Licensing and Regulation (Commission) and the Texas Department of Licensing and Regulation (Department). Specific provisions within this rule chapter also implement the statutory requirements under Texas Occupations Code, Chapters 53, 108, 112, 116, and 601.

Four-Year Rule Review

The adopted rules are necessary to implement changes recommended as a result of the required four-year rule review conducted under Texas Government Code §2001.039. The Department’s Notice of Intent to Review 16 TAC Chapter 130, was published in the September 3, 2021, issue of the Texas Register (46 TexReg 5598). At its meeting on October 18, 2022, the Commission readopted the rule chapter in its entirety without changes. The readoption notice was published in the February 25, 2022, issue of the Texas Register (47 TexReg 988).

In response to the Notice of Intent to Review that was published, the Department received one public comment from one interested party regarding Chapter 130. The comment questioned whether there is a fee for an inactive status license. The comment has been addressed in the adopted rules by explaining that there is not a fee for an inactive license.

The adopted rules also include changes recommended by Department staff during the rule review process to reorganize and streamline the entire chapter. These changes include consolidating the existing rules; reorganizing provisions by subject matter; expanding existing Subchapter C to include multiple license types; eliminating duplicative provisions; and using plain talk language to improve clarity.

In addition, the adopted rules include changes recommended by the Education and Examination Workgroup of the Podiatric Medical Examiners Advisory Board to increase the number of training hours required for Podiatric Medical Radiological Technicians. The updated training requirements apply to persons who apply for the Podiatric Medical Radiological Technician (PMRT) registration on or after the effective date of the adopted rules. The training requirements are prerequisites to applying for the PMRT registration, and the updated training requirements apply prospectively. Persons who applied for or obtained the PMRT registration before the effective date of the adopted rules do not have to obtain additional training hours.

Changes in License Terms

The adopted rules also change the license terms for the Podiatric Medical Radiological Technician Registration, the Hyperbaric Oxygen Certificate, and the Nitrous Oxide/Oxygen Inhalation Conscious Sedation Registration. Beginning January 1, 2025, all three license types change from one-year to two-year terms, and the application and renewal fees have been updated to reflect this change. Existing licenses renewed by the Department will be valid for one year if renewed before January 1, 2025, or for two years if renewed on or after January 1, 2025.

SECTION-BY-SECTION SUMMARY

Subchapter A. General Provisions.

The adopted rules amend §130.1, Authority and Applicability. The adopted rules change the name of the section from “Authority” to “Authority and Applicability.” The adopted rules amend subsection (a) to identify other statutes that are implemented by the rules in Chapter 130. The adopted rules also add new subsection (b) to explain that the Chapters 60 and 100 rules also apply to the Podiatry program.

The adopted rules amend §130.2, Definitions. The adopted rules update the definition of “Podiatric Medical Radiological Technician” to clarify that the term includes a Podiatry X-ray Machine Operator. The adopted rules update the definition of “Practitioner” to clarify that the term is used interchangeably with “podiatrist” and “podiatric physician.” The adopted rules also remove unnecessary language from the definition of “Act” and add clarifying language to the definition of “License.”

Adopting 16 TAC §§130.20 – 130.24, 130.27, 130.28, to streamline references to these sections.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER B. ADVISORY BOARD
16 TAC §§130.20 – 130.24, 130.27, 130.28

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter B. Advisory Board.

The adopted rules amend §130.20, Board Membership. The adopted rules streamline this section by referring to the Occupations Code instead of repeating it verbatim.

The adopted rules add new §130.21, Public Member Eligibility. The adopted rules streamline this section by referring to the Occupations Code instead of repeating it verbatim.

The adopted rules add new §130.22, Membership and Employee Restrictions. The adopted rules streamline this section by referring to the Occupations Code instead of repeating it verbatim.

The adopted rules amend §130.23, Terms; Vacancies. The adopted rules streamline this section by referring to the Occupations Code instead of repeating it verbatim.

The adopted rules add new §130.24, Grounds for Removal. The adopted rules streamline this section by referring to the Occupations Code instead of repeating it verbatim.

The adopted rules amend §130.27, Advisory Board Meetings and Duties of Department. The adopted rules merge subsection (i) into subsection (g).

The adopted rules amend §130.28, Training. The adopted rules streamline this section by referring to the Occupations Code instead of repeating it verbatim.

Adopting 16 TAC §§130.21, 130.22, 130.24, to replace the existing sections with the new sections.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER B. ADVISORY BOARD
16 TAC §§130.21, 130.22, 130.24

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter B. Advisory Board.

The adopted rules repeal existing §130.21, Public Member Eligibility. This section is replaced with new §130.21, Public Member Eligibility.

The adopted rules repeal existing §130.22, Membership and Employee Restrictions. This section is replaced with new §130.22, Membership and Employee Restrictions.

The adopted rules repeal existing §130.24, Grounds for Removal. This section is replaced with new §130.24, Grounds for Removal.

Adopting 16 TAC §§130.30 – 130.32, 130.34 – 130.37, to change chapter names, amend language, and rearrange sections for increased readability.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER C. TEMPORARY RESIDENCY AND OTHER LICENSE TYPES
16 TAC §§130.30 – 130.32, 130.34 – 130.37

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter C. Temporary Residency and Other License Types.

The adopted rules amend Subchapter C, Temporary Residency and Other License Types. The adopted rules rename Subchapter C from “Temporary Residency” to “Temporary Residency and Other License Types,” which now includes requirements for a Limited Faculty License, for a Podiatric Medical Radiological Technician Registration, for a Hyperbaric Oxygen Certificate, and for a Nitrous Oxide/Oxygen Inhalation Conscious Sedation Registration.

The adopted rules amend §130.30, Temporary Residency License–General Requirements and Application. The adopted rules remove the word “successfully” and replace the word “shall” with “must.”

The adopted rules add new §130.31, Temporary Residency License–License Term; Residency Requirements; Program Responsibilities. The adopted rules rename the section from “Temporary Residency License–Residency Requirements; Program Responsibilities; License Term” to “Temporary Residency License–License Term; Residency Requirements; Program Responsibilities.” The adopted rules rearrange the order of the section to increase readability.

The adopted rules amend §130.32, Temporary Residency License–Final Year of Residency. The adopted rules streamline the section to increase readability, rearrange the order of the section, and establish requirements a resident must follow in their final year of residency.

The adopted rules add new §130.34, Limited Faculty License–Requirements; License Term. The adopted rules create a standalone section for a limited faculty license by relocating existing §130.40(b) and §130.42(d) to this section. The adopted rules explain the requirements for procuring a limited faculty license and establish that the term of this license is up to two years. The adopted rules also establish when a limited faculty license will be terminated, and that termination does not preclude a podiatrist from applying for or holding another license type issued under this subchapter.

The adopted rules add new §130.35, Podiatric Medical Radiological Technicians. The adopted rules relocate existing §130.53 to this section and increase the number of required training hours from 20 hours to 45 hours for podiatric medical radiological technicians. The adopted rules update the didactic and clinical training requirements; increase the number of x-rays to be performed; and reflect the actual time needed to complete the training requirements. The updated training requirements apply to persons who apply for the Podiatric Medical Radiological Technician (PMRT) registration on or after the effective date of the adopted rules. The training requirements are prerequisites to applying for the PMRT registration, and the updated training requirements apply prospectively. Persons who applied for or obtained the PMRT registration before the effective date of the adopted rules do not have to obtain additional training hours.

The adopted rules under new §130.35 also change the length of the registration term from one year to two years. A registration is valid for one year if the registration was issued before January 1, 2025, or two years if the registration was issued on or after January 1, 2025. Similarly, the adopted rules establish that a registration renewed by the department is valid for one year if the renewal was issued before January 1, 2025, and must be renewed annually, or two years if the renewal was issued on or after January 1, 2025, and must be renewed every two years. The adopted rules explain the process for completing a renewal application, establish that human trafficking prevention training is required for each renewal, and explain when the department may refuse to issue or renew a registration.

The adopted rules add new §130.36, Hyperbaric Oxygen Certificate–Application Requirements and Guidelines. The adopted rules relocate existing §130.47 to this section and change the length of the certificate term from one year to two years. A certificate is valid for one year if the certificate was issued before January 1, 2025, or two years if the certificate was issued on or after January 1, 2025. Similarly, the adopted rules establish that a certificate renewed by the Department is valid for one year if the renewal was issued before January 1, 2025, and must be renewed annually, or two years if the renewal was issued on or after January 1, 2025, and must be renewed every two years.

The adopted rules add new §130.37, Nitrous Oxide/Oxygen Inhalation Conscious Sedation-Registration Requirements, Guidelines, and Direct Supervision. The adopted rules relocate existing §130.48 to this section and change the length of the certificate term from one year to two years. A registration is valid for one year if the registration was issued before January 1, 2025, or two years if the registration was issued on or after January 1, 2025. Similarly, the adopted rules establish that a registration renewed by the Department is valid for one year if the renewal was issued before January 1, 2025, and must be renewed annually, or two years if the renewal was issued on or after January 1, 2025, and must be renewed every two years. In response to a public comment, the adopted rules add the Health and Safety Institute as a sponsor of a basic and advanced CPR program that can be utilized by a practitioner. The Health and Safety Institute is a recognized sponsor in addition to the American Heart Association and the American Red Cross. All three entities are listed in the adopted rules.

Adopting 16 TAC §130.31, to replace this section with new §130.31 regarding licensing.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER C. TEMPORARY RESIDENCY
16 TAC §130.31

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter C. Temporary Residency and Other License Types.

The adopted rules repeal existing §130.31, Temporary Residency License–Residency Requirements; Program Responsibilities; License Term. This section is replaced with new §130.31, Temporary Residency License–License Term; Residency Requirements; Program Responsibilities.

Adopting 16 TAC §§130.40 – 130.48, to change the name of some sections, relocate the limited faculty license language to the new section, and streamline the remaining language to improve readability.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER D. DOCTOR OF PODIATRIC MEDICINE
16 TAC §§130.40 – 130.48

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter D. Doctor of Podiatric Medicine.

The adopted rules amend §130.40, Doctor of Podiatric Medicine License–General Requirements and Application; Limited Faculty License. The adopted rules change the name of the section from “Doctor of Podiatric Medicine License–General Requirements and Applications; Limited Faculty License” to “Doctor of Podiatric Medicine License–General Requirements and Application.” The adopted rules relocate the limited faculty license language to new §130.34 and streamline the remaining language to make it easier to read.

The adopted rules amend §130.41, Doctor of Podiatric Medicine License–Jurisprudence Exam. The adopted rules replace the word “shall” with “must.”

The adopted rules amend §130.42, Doctor of Podiatric Medicine License–Term; Renewal. The adopted rules remove language relating to a limited faculty license and relocate it to new §130.34. The adopted rules also remove outdated language and add clarifying language.

The adopted rules add new §130.43, Doctor of Podiatric Medicine License–Provisional License. The adopted rules remove duplicative language located elsewhere in the chapter and streamline the remaining language to make it easier to read.

The adopted rules add new §130.44, Continuing Medical Education–General Requirements. The adopted rules streamline the section and relocate the continuing medical education audit process to new §130.45.

The adopted rules add new §130.45, Continuing Medical Education–Audit Process. The adopted rules relocate audit information from current §130.44 and establish that the Department will select random license holders to ensure compliance with CME hours.

The adopted rules add new §130.46, Continuing Medical Education–Exceptions and Allowances; Approval of Hours. The adopted rules relocate the requirements of existing §130.45 to this new section.

The adopted rules add new §130.47, Inactive Status. The adopted rules relocate the requirements of existing §130.46 to this new section and establish that a practitioner may place a license on inactive status at no cost.

The adopted rules add new §130.48, Voluntary Charity Care Status. The adopted rules relocate the requirements of existing §130.49 to this new section.

Adopting 16 TAC §§130.43 – 130.49, to repeal existing sections and replace them with new versions of the sections.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER D. DOCTOR OF PODIATRIC MEDICINE
16 TAC §§130.43 – 130.49

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter D. Doctor of Podiatric Medicine.

The adopted rules repeal existing §130.43, Doctor of Podiatric Medicine License–Provisional License. This section is replaced with new §130.43, Doctor of Podiatric Medicine License–Provisional License.

The adopted rules repeal existing §130.44, Continuing Medical Education–General Requirements. This section is replaced with new §130.44, Continuing Medical Education–General Requirements.

The adopted rules repeal §130.45, Continuing Medical Education–Exceptions and Allowances; Approval of Hours. The adopted rules relocate the repealed provisions to new §130.46.

The adopted rules repeal §130.46, Inactive Status. The adopted rules relocate the repealed provisions to new §130.47.

The adopted rules repeal §130.47, Hyperbaric Oxygen Certificate–Application Requirements and Guidelines. The adopted rules relocate the repealed provisions to new §130.36.

The adopted rules repeal §130.48, Nitrous Oxide/Oxygen Inhalation Conscious Sedation–Registration Requirements, Guidelines, and Direct Supervision. The adopted rules relocate the repealed provisions to new §130.37.

The adopted rules repeal §130.49, Voluntary Charity Care Status. The adopted rules relocate the repealed provisions to new §130.48.

Adopting 16 TAC §§130.50, 130.51, 130.54, 130.55, 130.57 – 130.59, to streamline the section and improve readability.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER E. PRACTITIONER RESPONSIBILITIES AND CODE OF ETHICS
16 TAC §§130.50, 130.51, 130.54, 130.55, 130.57 – 130.59

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter E. Practitioner Responsibilities and Code of Ethics.

The adopted rules amend §130.50, Practitioner Identification; Professional Corporations or Associations. The adopted rules remove redundant and unnecessary language regarding the purpose of this section and streamline the rest of the section to make it easier to read.

The adopted rules amend §130.51, Advertising. The adopted rules streamline the section and remove language relating to certifying boards that are not recognized by the Council of Podiatric Medical Education of the American Podiatric Medical Association.

Adopting 16 TAC §130.52, §130.53, to relocate the repealed provisions to the new §130.35.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER E. PRACTITIONER RESPONSIBILITIES AND CODE OF ETHICS
16 TAC §130.52, §130.53

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter E. Practitioner Responsibilities and Code of Ethics.

The adopted rules repeal §130.52, Medical Offices, because the Department does not regulate medical offices, but individual licensees.

The adopted rules repeal §130.53, Podiatric Medical Radiological Technicians. The adopted rules relocate the repealed provisions to new §130.35.

Adopting 16 TAC §130.60, to update the fees for the hyperbaric oxygen certificate, the nitrous oxide registration, and the podiatric medical radiological technician registration.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER F. FEES
16 TAC §130.60

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter F. Fees.

The adopted rules amend §130.60, Fees. The adopted rules update the fees for the hyperbaric oxygen certificate, the nitrous oxide registration, and the podiatric medical radiological technician registration, because the certificate and registration terms are changed from one year to two years. The fees are $25 if the certificate or registration is issued or renewed before January 1, 2025, or $50 if the certificate or registration is issued or renewed on or after January 1, 2025. The adopted rules add a $0 fee for an Inactive Status License (Initial and Renewal). The adopted rules also make clean-up changes to the cross-referenced fees under Chapter 60.

Adopting 16 TAC §§130.70, 130.72, 130.73, to streamline the section to improve readability and clarify the consequences for a violation of the Occupations Code.

CHAPTER 130. PODIATRIC MEDICINE PROGRAM
SUBCHAPTER G. ENFORCEMENT
16 TAC §§130.70, 130.72, 130.73

OVERVIEW

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

Four-Year Rule Review

Changes in License Terms

SECTION-BY-SECTION SUMMARY

Subchapter G. Enforcement.

The adopted rules amend §130.70, Complaints and Claims. The adopted rules replace the word “shall” with “must” and streamline the section to make it easier to read.

The adopted rules amend §130.72, Administrative Penalties and Sanctions. The adopted rules clarify that a person or entity who violates or attempts to violate the Occupations Code, this chapter, or any rule of the commission may face proceedings against them.

The adopted rules amend §130.73, Conditions of Suspension of License. The adopted rules streamline the section to make it easier to read.
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Texas Optometry Board

Adopted Rules Re:

Adopting 22 TAC §§275.1 – 275.3, to update the rule such that all licenses expire on a biennial basis, clarify the continuing education requirements for licensees, and provide non-substantive grammatical changes to ensure consistency.

CHAPTER 275. CONTINUING EDUCATION
22 TAC §§275.1 – 275.3

The Texas Optometry Board (Board) adopts amendments to 22 TAC Title 14 Chapter 275 Continuing Education without changes to the proposed text as published in the September 20, 2024 issue of the Texas Register (49 TexReg 7573). The rules will not be republished.