Texas Register Table of Contents
- 1 State Board of Dental Examiners
- 1.0.1 Proposed Rules Re:
- 1.0.1.1 Amending 22 TAC §101.14 to update requirements related to the exemption from licensure for certain military spouses.
- 1.0.1.2 Amending 22 TAC §103.10 to describe requirements concerning the exemption from licensure for certain military spouses.
- 1.0.1.3 New 22 TAC §108.74, listing minimum requirements related to call coverage agreements.
- 1.0.1 Proposed Rules Re:
- 2 Texas Health and Human Services Commission
- 3 Texas Board of Nursing
State Board of Dental Examiners
Proposed Rules Re:
CHAPTER 101. DENTAL LICENSURE
22 TAC §101.14
The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §101.14, concerning exemption from licensure for certain military spouses. The proposed amendment lists what a military spouse must submit to establish residency in Texas, and the rule is proposed in accordance with House Bill 139 of the 87th Texas Legislature, Regular Session (2021), and Chapter 55, Texas Occupations Code.
Amending 22 TAC §103.10 to describe requirements concerning the exemption from licensure for certain military spouses.
CHAPTER 103. DENTAL HYGIENE LICENSURE
22 TAC §103.10
The State Board of Dental Examiners (Board) proposes this amendment to 22 TAC §103.10, concerning exemption from licensure for certain military spouses. The proposed amendment lists what a military spouse must submit to establish residency in Texas, and the rule is proposed in accordance with House Bill 139 of the 87th Texas Legislature, Regular Session (2021), and Chapter 55, Texas Occupations Code.
CHAPTER 108. PROFESSIONAL CONDUCT
SUBCHAPTER F. CONTRACTUAL AGREEMENTS
22 TAC §108.74
The State Board of Dental Examiners (Board) proposes a new rule, 22 TAC §108.74, concerning call coverage agreements. The proposed rule sets forth minimum requirements relating to a dentist’s provision of call coverage services for another dentist’s established patients, and is implemented pursuant to House Bill 2056 of the 87th Texas Legislature, Regular Session (2021), and Chapter 254, Texas Occupations Code.
Texas Health and Human Services Commission
Adopted Rules Re:
Amending 1 TAC §355.30 and new §355.316 to update and clarify reimbursement methodology for nursing facilities.
CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER C. REIMBURSEMENT METHODOLOGY FOR NURSING FACILITIES
1 TAC §355.307, §355.316
OVERVIEW
The Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.307, concerning Reimbursement Setting Methodology, and new §355.316, concerning Reimbursement Methodology for Pediatric Care Facilities. Section 355.307 and §355.316 are adopted without changes to the proposed text as published in the August 6, 2021, issue of the Texas Register (46 Tex Reg 4765). The rules will not be republished.
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.307, concerning Reimbursement Setting Methodology; and new §355.316, concerning Reimbursement Methodology for Pediatric Care Facilities.
BACKGROUND AND JUSTIFICATION
The rules are necessary to comply with the 2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 40), which requires HHSC to revise the reimbursement methodology for pediatric long-term care facilities to mirror that of Medicare reimbursement.
The rule removes language related to the pediatric nursing facility rate methodology currently in §355.307(c)(1) – (c)(4) and moves it to new §355.316. The creation of new §355.316 improves clarity as it separates the pediatric care facility reimbursement methodology from the reimbursement methodology used for nursing facilities in general. The language in new §355.316 is updated to meet the requirements of the new reimbursement methodology.
In Addition Re:
Public Notice: Amendment to the Texas Healthcare Transformation Quality Improvement Program (THTQIP) Waiver Under Section 1115 of the Social Security Act Effective October 1, 2021.
OVERVIEW
The Health and Human Services Commission (HHSC) is submitting a request to the Centers for Medicare & Medicaid Services (CMS) to amend the Texas Healthcare Transformation Quality Improvement Program (THTQIP) waiver under section 1115 of the Social Security Act. The current waiver is approved through September 2030. The proposed effective date for this amendment is October 1, 2021.
HHSC is seeking approval of a one-year extension of the Delivery System Reform Incentive Payment (DSRIP) program. Authority for the DSRIP pool expires September 30, 2021. However, CMS offered to continue the program until September 30, 2022, and to accept an amendment request submitted less than 120 days prior to implementation.
PROPOSED CHANGES
HHSC is proposing an 1115 waiver amendment to extend DSRIP for one-year, Demonstration Year (DY) 11 (October 1, 2021 – September 30, 2022). DSRIP is designed to drive health system improvements and health outcome quality; providers earn incentive payments for demonstrating achievement on selected outcome measures. The DY11 DSRIP pool amount will be the same as DY10 at $2,490,000,000. Current DSRIP providers will continue into DY11 with the same DSRIP valuations and measure selections as in DY10. However, current providers will have an opportunity to withdraw from the program. HHSC will propose new Category C measure goals for DY11.
According to CMS, the DY11 DSRIP pool is subject to a 20 percent reduction if HHSC does not report certain health equity measures. The health equity measures, data stratification, and timing of reporting will be proposed in the Waiver Special Terms and Conditions (STCs) and related attachments’ and finalized in negotiations with CMS.
The amendment to extend DSRIP for one-year aligns with the following three 1115 waiver objectives:
- Support the development and maintenance of a coordinated care delivery system;
- Improve outcomes while containing cost growth; and
- Transition to quality-based payment systems across managed care and providers.
An additional year of DSRIP allows providers to continue delivery system reforms that increase access to health care, improve the quality of care, and enhance the health of Medicaid and low-income or uninsured individuals they serve.
Extending DSRIP will not provide new Medicaid benefits; DSRIP payments are earned incentives and not reimbursements for services.
Texas Board of Nursing
Review of Agency Rules
Adopted Rule Review of Title 22, Part 11
OVERVIEW
In accordance with Government Code §2001.039, the Texas Board of Nursing (Board) filed a notice of intention to review and consider for re-adoption, re-adoption with amendments, or repeal, the following chapter contained in Title 22, Part 11, of the Texas Administrative Code, pursuant to the 2019 rule review plan adopted by the Board at its July 2018 meeting. The notice appeared in the September 3, 2021, edition of the Texas Register (46 Tex Reg 5597).
Chapter 227. Pilot Programs for Innovative Applications to Vocational and Professional Nursing Education, §§227.1 – 227.4.
The Board did not receive any public comments on the above rules. The Board has completed its review and has determined that the reasons for originally adopting the above rules continue to exist. The rules were also reviewed to determine whether they were obsolete, whether they reflected current legal and policy considerations and current procedures and practices of the Board, and whether they were in compliance with Texas Government Code Chapter 2001 (Texas Administrative Procedure Act). The Board finds that the rules are not obsolete, reflect current legal and policy considerations, current procedures and practices of the Board, and that the rules are in compliance with the Texas Administrative Procedure Act.
The Board readopts the rules in Chapter 227 without changes, pursuant to the Texas Government Code §2001.039 and Texas Occupations Code §301.151, which authorizes the Board to adopt, enforce, and repeal rules consistent with its legislative authority under the Nursing Practice Act. This concludes the rule review of Chapter 227 under the 2019 rule review plan adopted by the Board.