Texas Register Table of Contents
- 1 Office of the Attorney General
- 2 Texas Department of State Health Services
- 3 Texas Department of State Health Services
- 4 Texas Department of State Health Services
- 5 Texas Health and Human Services Commission
- 6 Texas Health and Human Services Commission
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- 9
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Office of the Attorney General
Opinions
The practice of medicine includes the provision of anesthesia by a licensed physician. However, pursuant to subsection 301.002(2)(G) of the Occupations Code, when a certified registered nurse anesthetist administers anesthesia pursuant to a physician’s delegation, such act falls within the scope of professional nursing.The Legislature authorized the Texas Medical Board to take disciplinary action against a physician who delegates professional medical acts to a person whom the physician knows or should know is unqualified to perform the acts. Thus, the Board possesses regulatory authority over a physician’s decision to delegate the providing and administration of anesthesia to a certified registered nurse anesthetist.A certified registered nurse anesthetist does not possess independent authority to administer anesthesia without delegation by a physician.
Texas Department of State Health Services
Proposed Rules
Chapter 157 (Emergency Medical Care): Certification, Recertification, and Requirements for Trauma Facility Designation
CHAPTER 157. EMERGENCY MEDICAL CAREThe Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), proposes amendments to §157.33, concerning Certification, §157.34, concerning Recertification, and §157.125, concerning Requirements for Trauma Facility Designation.BACKGROUND AND PURPOSEThe proposal is necessary to comply with House Bill (H.B.) 871 and H.B. 1418, 86th Legislature, Regular Session, 2019, which requires the adoption of rules to implement the legislation.H.B. 871, 86th Legislature, Regular Session, 2019, amended Texas Health and Safety Code, §773.1151, which authorizes a hospital located in a county with a population of less than 30,000 to utilize telemedicine medical services to comply with the physician requirement for Level IV Trauma Designation. DSHS is directed to adopt rules not later than December 1, 2019.H.B. 1418, 86th Legislature, Regular Session, 2019, amended Texas Health and Safety Code, §773.0551, which requires emergency services personnel receive their immunization status during certification or recertification. H.B. 1418 also requires that emergency personnel be provided information about certain risks of exposure to serious or deadly communicable disease when responding to an emergency that an immunization may prevent.During Hurricane Harvey, lack of clarity for first responders concerning their vaccine history caused certain individuals to either duplicate previous vaccinations or be required to wait for vaccinations due to high demand for the vaccines in the disaster-declared region. DSHS is directed to adopt rules as soon as practicable.SECTION-BY-SECTION SUMMARYThe proposed amendments to §157.33(l) and §157.34(d) add the applicant’s immunization history, which require DSHS to provide the emergency services personnel their immunization status during certification or recertification. The proposed amendments add that DSHS will provide information about certain vaccine preventable diseases when responding to an emergency that an immunization may prevent. The rule references in §157.33 and §157.34 are also revised to reflect the addition of new text.The proposed amendment to §157.125 adds text for a hospital located in a county with a population of less than 30,000 to utilize telemedicine medical services to comply with the physician requirement for a Level IV trauma facility designation. The new text is added to the basic Level IV trauma facility criteria in the Figure for §157.125(y).
Texas Department of State Health Services
Proposed Rules
Chapter 157 (Emergency Medical Care): Certification, Recertification, and Requirements for Trauma Facility Designation
SUBCHAPTER C. EMERGENCY MEDICAL SERVICES TRAINING AND COURSE APPROVAL25 TAC §157.33, §157.34The proposed amendment adds subsections addressing “Immunization History” to the certification and recertification provisions. The amendments implement Texas Health and Safety Code, Chapter 773.
Texas Department of State Health Services
Proposed Rules
Subchapter G (Emergency Medical Services Trauma Systems): Level IV Trauma Designation and Telemedicine
DSHS proposes an amendment to 25 TAC §157.125: “A health care facility located in a county with a population of less than 30,000 may satisfy a Level IV trauma facility designation requirement relating to physicians through the use of telemedicine medical service in which an on-call physician who has special competence in the care of critically injured patients provides patient assessment, diagnosis, consultation, or treatment, or transfers medical data to a physician, advanced practiceregistered nurse, or physician assistants located at the facility.”
Texas Health and Human Services Commission
Adopted Rules
Amendment to §355.8097, concerning Reimbursement Methodology for Physical, Occupational, and Speech Therapy Services
CHAPTER 355. REIMBURSEMENT RATESSUBCHAPTER J. PURCHASED HEALTH SERVICESDIVISION 5. GENERAL ADMINISTRATION1 TAC §355.8097The Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.8097, concerning Reimbursement Methodology for Physical, Occupational, and Speech Therapy Services, with changes to the proposed text as published in the July 12, 2019, issue of the Texas Register (44 TexReg 3489). The commission updated a section title that is referenced in subsection (f), and therefore the rule will be republished.BACKGROUND AND JUSTIFICATIONThe adopted amendment is necessary to comply with House Bill (H.B.) 1, General Appropriations Act, 86th Legislature, Regular Session, 2019 (Article II, HHSC, Rider 47).The amendment to §355.8097 sets the reimbursement percentage for services provided by therapy assistants at 80 percent of the rate paid to a licensed therapist. Medicaid currently reimburses 70 percent of the rate paid to a licensed therapist for services provided by physical, occupational, and speech therapy assistants.
Texas Health and Human Services Commission
In Addition
Revised Notice of Public Hearing on Revised Reimbursement Rates
Hearing. The Texas Health and Human Services Commission (HHSC) will conduct a public hearing on September 23, 2019, at 9:00 a.m., to receive comments on proposed proxy rates for various managed care attendant services.The public hearing will be held in HHSC’s Public Hearing Room at the Brown-Heatly Building, located at 4900 North Lamar Boulevard, Austin, Texas. Entry is through Security at the main entrance of the building, which faces Lamar Boulevard. HHSC will broadcast the public hearing. Persons watching remotely can submit written comments. The broadcast can be accessed at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings, and it will be archived for access on demand at the same website. The public hearing will be held in compliance with Texas Human Resources Code §32.0282, which requires public notice of and hearings on proposed Medicaid reimbursements.Proposal. HHSC proposes to increase the attendant base wage to $8.11 for the attendant cost component for the attendant services listed above in accordance with the 2020-21 GAA (Article II, HHSC, Rider 45). These proxy rates are proposed to be effective September 1, 2019.