Texas Register September 8, 2023 Volume: 48 Number: 36

Texas Register Table of Contents

1 Texas Health and Human Services Commission
2 Texas Board of Physical Therapy Examiners
- - 2.0.1 Proposed Rules Re:
    - 2.0.1.1 Amending 22 TAC §329.1, to clarify changes in contact information that need to be reported to the board and requests for name changes.
    - 2.0.1.2 Amending 22 TAC §329.6, §329.7, to allow military service members licensed and in good standing in another jurisdiction to engage in the practice of physical therapy without obtaining a license as a physical therapist or physical therapist assistant.
3 Texas Department of State Health Services
- - 3.0.1 Review of Agency Rules Re:
    - 3.0.1.1 Title 25, Part 1

Texas Health and Human Services Commission

Proposed Rules Re:

New 1 TAC §353.425, §353.427, implementing standards for Managed Care Organizations with regard to review of, and accessibility of requirements for, incomplete or insufficient prior authorization requests.

CHAPTER 353. MEDICAID MANAGED CARE
SUBCHAPTER E. STANDARDS FOR MEDICAID MANAGED CARE
1 TAC §353.425, §353.427

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes new §353.425, concerning MCO Processing of Prior Authorization Requests Received with Incomplete or Insufficient Documentation; and §353.427, concerning Accessibility of Information Regarding Medicaid Prior Authorization Requirements in Title 1, Part 15, Chapter 353, Subchapter E, Standards for Medicaid Managed Care.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to comply with Texas Government Code §533.00282, §533.00284, §533.002841, and §531.024163 added by Senate Bill 1207, 86th Legislature, Regular Session, 2019. These sections of the Government Code require HHSC to establish a uniform process and timeline for a prior authorization (PA) request submitted with incomplete or insufficient information or documentation and require Medicaid managed care organizations (MCOs) to improve website accessibility of information related to PA requirements.

SECTION-BY-SECTION SUMMARY

Proposed new §353.425 describes a uniform timeline and process for an MCO to use when reviewing a PA request submitted with incomplete or insufficient documentation for a member who is not hospitalized at the time of the request. The proposed rule defines “incomplete prior authorization request” and describes a standard process for MCOs to allow a provider to submit missing information and documentation necessary to establish medical necessity as listed in the PA requirements on the MCO’s website. The proposed rule sets forth requirements for MCOs to communicate with providers and Medicaid members regarding incomplete or insufficient information or documentation, offers an opportunity for a peer-to-peer physician consultation, and creates a standard timeline for making a final determination on a PA request.
Proposed new §353.427 requires an MCO to maintain on its website in an easily searchable and accessible format the items listed in the proposed rule. Specifically, the items listed in the rule are applicable timelines for prior authorization requirements, an accurate and up-to-date catalogue of coverage criteria and prior authorization requirements, and the process and contact information for a provider or member to contact the MCO for the reasons described in the proposed rule. The proposed rule also defines what “accessible” means when used in the section.

Amending 1 TAC §§354.4001 and 354.4003, and new 1 TAC §§ 354.4005 – 354.4007, 354.4009, 354.4011, 354.4013, 354.4015, 354.4017, 354.4019, 354.4021, 354.4023, 354.4025, to outline the requirements and processes for using an Electronic Visit Verification (EVV) system.

CHAPTER 354. MEDICAID HEALTH SERVICES
SUBCHAPTER O. ELECTRONIC VISIT VERIFICATION
1 TAC §§354.4001, 354.4003, 354.4005 – 354.4007, 354.4009, 354.4011, 354.4013, 354.4015, 354.4017, 354.4019, 354.4021, 354.4023, 354.4025

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes amendments to §354.4001, concerning Purpose and Authority; and §354.4003, concerning Definitions; the repeal of §354.4005, concerning Applicability; §354.4007, concerning EVV System; §354.4009, concerning Requirements for Claims Submission and Approval; §354.4011, concerning Member Rights and Responsibilities; and §354.4013, concerning Additional Requirements; and new §354.4005, concerning Personal Care Services that Require the Use of EVV; §354.4006, concerning Home Health Care Services that Require the Use of EVV; §354.4007, concerning EVV System; §354.4009, concerning EVV Visit Transaction and EVV Claim; §354.4011, concerning Visit Maintenance; §354.4013, concerning HHSC and MCO Compliance Reviews and Enforcement Actions; §354.4015, concerning EVV Training Requirements; §354.4017, concerning Process to Request Approval of a Proposed EVV Proprietary System and Additional Requirements for a PSO; §354.4019, concerning Access to EVV System and EVV Documentation; §354.4021, concerning Additional Requirements; §354.4023, concerning Sanctions; and §354.4025, concerning Administrative Hearing.

BACKGROUND AND JUSTIFICATION

In accordance with Section 1903(l) of the Social Security Act (42 U.S.C. §1396b(l)), HHSC requires that electronic visit verification (EVV) be used to document the provision of certain personal care services provided through Medicaid. One purpose of the proposed rules is to ensure that HHSC complies with the requirement in Section 1903(l) that EVV be used to document the provision of Medicaid home health care services. Although Section 1903(l) requires the use of EVV for Medicaid home health services to have begun January 1, 2023, the Centers for Medicare & Medicaid Services granted HHSC an extension allowing HHSC to implement this requirement by January 1, 2024.

Another purpose of the proposed rules is to codify in rules current policies and procedures related to EVV including training requirements, visit maintenance requirements, compliance reviews, and the process for HHSC to recognize a health care provider’s proprietary EVV system as described in Texas Government Code §531.024172(g).

The proposed rules repeal several rules and replace them with new rules.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §354.4001, Purpose and Authority, makes minor editorial changes to terminology, deletes language for brevity and clarity, and corrects a statutory reference.
The proposed amendment to §354.4003, Definitions, reformats some of the defined terms and makes edits to some of the definitions for clarity. In addition, the proposed amendment adds definitions for the following new terms: EVV claim; EVV portal; EVV portal user; EVV system user; home health aide; ICF/IID–intermediate care facility for individuals with an intellectual disability or related conditions; IMD–institution for mental diseases; LVN–licensed vocational nurse; nursing facility; occupational therapist; PCS–personal care services; PDN–private duty nursing; physical therapist; PSO–proprietary system operator; RN–registered nurse; vendor hold; and visit maintenance.
Proposed new §354.4005, Personal Care Services that Require the Use of EVV, requires a program provider to ensure that a service provider uses EVV to document the provision of certain specified personal care services by the program provider. The new section also requires a consumer directed services (CDS) employer to ensure that a service provider uses EVV to document the provision of certain specified personal care services through the CDS option. One of the specified services in this section is in-home individualized skills and socialization, which replaces day habilitation provided in a member’s residence.
Proposed new §354.4006, Home Health Care Services that Require the Use of EVV, requires a program provider to ensure that a service provider uses EVV to document the provision of certain specified home health care services by the program provider on or after January 1, 2024. The new section also requires a CDS employer to ensure that a service provider uses EVV to document the provision of certain specified home health care services using the CDS option on or after January 1, 2024.
Proposed new §354.4007, EVV System, provides that a program provider or a financial management services agency (FMSA) must use either an EVV vendor system or EVV proprietary system to document the provision of a service and requires a CDS employer to use the EVV system selected by their FMSA. The proposed new rule requires that, except as provided in subsection (d), a program provider, an FMSA, and a CDS employer ensure that a service provider uses an EVV system to electronically document the provision of a service described in proposed new §354.4005 or §354.4006. The proposed new rule describes the action a program provider, FMSA or a CDS employer must take if a service provider fails to use an EVV system to document the provision of a service described in proposed new §354.4005 or §354.4006 or if a service provider cannot use an EVV system because the EVV system is unavailable. The proposed new rule provides that HHSC may take certain actions if a program provider or an FMSA does not comply with subsections (a), (c), or (d) of this section. The proposed new rule also provides that HHSC or managed care organization (MCO) may take certain actions if a CDS employer does not comply with subsections (b), (c), or (d) of this section.
Proposed new §354.4009, EVV Visit Transaction and EVV Claim, requires a program provider and an FMSA to ensure that an EVV visit transaction contains certain specified data elements required by the EVV system and that the data elements are accurate. The proposed new rule also includes a similar requirement for a CDS employer who elects to complete visit maintenance on the HHSC Employer’s Selection for Electronic Visit Verification Responsibilities form. The proposed new rule requires a program provider and an FMSA to make certain assurances before submitting an EVV claim including that the EVV visit transaction is transmitted to and accepted by the EVV Portal, and to submit the EVV claim in accordance with HHSC or MCO billing requirements and the EVV Policy Handbook. Further, the proposed new rule provides that HHSC or an MCO denies an EVV claim or recoups a payment made to a program provider or an FMSA if the EVV claim does not meet requirements described in the EVV Policy Handbook.
Proposed new §354.4011, Visit Maintenance, requires a program provider and an FMSA to complete visit maintenance in accordance with the EVV Policy Handbook. The proposed new rule also includes a similar requirement for a CDS employer who elects to complete visit maintenance on the HHSC Employer’s Selection for Electronic Visit Verification Responsibilities form. In addition, the proposed new rule allows the program provider, FMSA, and CDS employer to complete visit maintenance after the visit maintenance time frame has expired only if the program provider, FMSA, or CDS employer submits a Visit Maintenance Unlock Request in accordance with the EVV Policy Handbook and HHSC or an MCO approves the Visit Maintenance Unlock Request.
Proposed new §354.4013, HHSC and MCO Compliance Reviews and Enforcement Actions, describes the types of compliance reviews conducted by HHSC and an MCO of a program provider, FMSA, and CDS employer and the circumstances under which certain action may be taken based on a review, including recoupment of payment, imposition of a vendor hold, or termination of a member’s participation in the CDS option.
Proposed new §354.4015, EVV Training Requirements, describes the requirements for a program provider, an FMSA, and a proprietary system operator (PSO) regarding EVV System Training, EVV Policy Training, and EVV Portal Training; the requirements for a CDS employer regarding EVV System Training and EVV Policy Training; and the requirements for a program provider and CDS employer on training a service provider on the clock in and clock out portion of the EVV System Training. In addition, the proposed new rule describes the documentation requirements to demonstrate compliance with the training requirements and the actions that may be taken by HHSC, an MCO, or an FMSA if a program provider, FMSA, PSO, or CDS employer does not comply with the training requirements.
Proposed new §354.4017, Process to Request Approval of a Proposed EVV Proprietary System and Additional Requirements for a PSO, describes the process by which a program provider or FMSA seeks HHSC’s approval of a proposed proprietary system and the basis on which HHSC approves a proposed proprietary system. In addition, the proposed new rule describes the requirements of a PSO, allows HHSC to conduct an audit of a proprietary system, and describes the actions HHSC may take if a PSO is not in compliance with the requirements in the proposed rule.
Proposed new §354.4019, Access to EVV System and EVV Documentation, requires a program provider and an FMSA to allow HHSC and the MCO with which the program provider or FMSA has a contract access to the EVV system the program provider or FMSA uses and to allow HHSC and the MCO to review EVV system documentation or obtain a copy of that documentation at no charge to HHSC or the MCO.
Proposed new §354.4021, Additional Requirements, requires a program provider, FMSA, CDS employer, service provider, member, and MCO to comply with applicable state and federal laws, rules, regulations, and the EVV Policy Handbook.
Proposed new §354.4023, Sanctions, provides that HHSC or an MCO may propose to recoup funds, impose a vendor hold, or propose to terminate the contract of a program provider or FMSA as described in proposed §354.4007, §354.4009, and §354.4013.
Proposed new §354.4025, Administrative Hearing, provides that a program provider or FMSA may request an administrative hearing in accordance with 26 TAC §357.484, Request for a Hearing, to appeal a proposed contract termination or recoupment or imposition of a vendor hold by HHSC and may appeal a proposed contract termination or recoupment or imposition of a vendor hold by an MCO in accordance with the MCO’s policy.

Repealing 1 TAC §§354.4005, 354.4007, 354.4009, 354.4011, 354.4013, to remove and replace outdated rules pertaining to EVV.

CHAPTER 354. MEDICAID HEALTH SERVICES
SUBCHAPTER O. ELECTRONIC VISIT VERIFICATION
1 TAC §§354.4005, 354.4007, 354.4009, 354.4011, 354.4013

OVERVIEW

BACKGROUND AND JUSTIFICATION

The proposed rules repeal several rules and replace them with new rules.

SECTION-BY-SECTION SUMMARY

The proposed repeal of §354.4005, Applicability, deletes the rule because it is no longer necessary, and replaces it with proposed new §354.4005, Personal Care Services that Require the Use of EVV.
The proposed repeal of §354.4007, EVV System deletes the rule because it is no longer necessary, and replaces it with proposed new §354.4007, EVV System.
The proposed repeal of §354.4009, Requirements for Claims Submission and Approval deletes the rule because it is no longer necessary, and replaces it with proposed new §354.4009, EVV Visit Transaction and EVV Claim.
The proposed repeal §354.4011, Member Rights and Responsibilities deletes the rule because it is no longer necessary, and replaces it with proposed new §354.4011, Visit Maintenance.
The proposed repeal §354.4013, Additional Requirements deletes the rule because it is no longer necessary, and replaces it with proposed new §354.4013, HHSC and MCO Compliance Reviews and Enforcement Actions.

Amending 26 TAC §555.2, to update definitions and information in the Nursing Facility Administrator rules, such as names and number of educational domains used by the NAB.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER A. GENERAL INFORMATION
26 TAC §555.2

OVERVIEW

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes in Title 26, Part 1, Chapter 555, Nursing Facility Administrators, amendments to §555.2, concerning Definitions, §555.11, concerning Application Requirements, §555.12, concerning Licensure Requirements, §555.13, concerning Internship Requirements, §555.18, concerning Examinations and Requirements to Take the Examinations, §555.32, concerning Provisional License, and §555.35, concerning Continuing Education Requirements for License Renewal.

BACKGROUND AND JUSTIFICATION

The purpose of the proposal is to clarify requirements and provide additional options to qualify for nursing facility administrator (NFA) licensure. The proposal updates definitions and associated references for consistency with changes made by the National Association of Long Term Care Administrator Boards (NAB), regarding both educational domains for testing and the company conducting the NAB examination. The proposal also adds an additional option for persons to qualify for licensure, and a greater degree of flexibility for the administrator-in-training (AIT) internship. Other non-substantive changes are for clarification.

SECTION-BY-SECTION SUMMARY

The proposed amendment to §555.2 revises definitions for NFA rules. Paragraph (8) updates the names and number of educational domains used by the NAB. Paragraph (12) clarifies that HHSC is responsible for NFA licensure in Texas. Paragraph (23) clarifies that NAB is the national authority on NFA licensure, credentialing, and regulation. Paragraph (28) removes extraneous language from the definition of the NFA advisory committee. Paragraph (30) removes the “professional examination services (PES)” name of the company that administers the NAB licensure exam and renumbers the paragraphs accordingly. Paragraph (35) revises the Texas Administrative Code citation for substandard quality of care.

Amending 26 TAC §§555.11 – 555.13, 555.18, to describe the requirements for NFA licensure and to add additional options for licensure requirements.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER B. REQUIREMENTS FOR LICENSURE
26 TAC §§555.11 – 555.13, 555.18

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §555.11 revises the requirements for an NFA licensure application. Subsection (a)(5) reduces the number of academic credits required for NFA candidates who hold a transcript with coursework in the updated NAB domains that is not reflected by the baccalaureate degree. Subsections (b) and (c) have non-substantive edits to update rule citations.
The proposed amendment to §555.12 provides additional options for licensure requirements. Subsection (a)(1)(A) reduces the number of academic credits in long-term care administration required for candidates who hold a baccalaureate degree that includes coursework in the updated NAB domains. Subsection (a)(2) updates the NAB domains referenced for applicants holding a baccalaureate degree in health administration, health services administration, health care administration, or nursing. Subsection (a)(3) provides an additional option for persons to qualify for NFA licensure: holding a baccalaureate degree with coursework in the NAB domains and one year of experience as assistant administration of record or administrator of record at a facility in another state. Subsection (a)(4) and (5) have non-substantive renumbering edits. Subsection (a)(6) describes an option for application for candidates with a license issued by another state.
The proposed amendment to §555.13 provides more flexibility for the AIT internship. Subsection (a)(2) removes the requirement for the internship to be completed in a facility with a minimum of 60 beds and instead allows the internship to be completed in a facility of any size. Subsection (a)(6) and (7) have non-substantive renumbering edits. Subsection (a)(8) requires the internship to be completed at the same facility at which the AIT’s preceptor serves as NFA. Subsection (b)(2) updates the referenced rule.
The proposed amendment to §555.18 makes a minor editorial change, replacing the word “on-line” with “online” and removes a reference to the name of the company that administers the NAB examination.

Amending 26 TAC §555.32, §555.35, to clarify the requirements for a provisional NFA license and the requirements for continuing education.

CHAPTER 555. NURSING FACILITY ADMINISTRATORS
SUBCHAPTER C. LICENSES
26 TAC §555.32, §555.35

OVERVIEW

BACKGROUND AND JUSTIFICATION

SECTION-BY-SECTION SUMMARY

The proposed amendment to §555.32 clarifies requirements for provisional NFA licenses. Subsection (a)(4)(A) removes equivocal language around “substantially similar” licensing requirements in other states. Subsection (e) stipulates that if internship hours in another state do not meet requirements in §555.13, the provisional licensee must complete the required internship hours under the supervision of an HHSC-licensed preceptor.
The proposed amendment to §555.35 makes non-substantive edits to clarify requirements for continuing education for license renewal. Subsection (a)(2) revises the number of NAB domains from five to four, which aligns with NAB consolidation of the domains. Subsection (a)(4) makes non-substantive edits to clarify that at least six hours of continuing education in ethics is required. Subsection (c) replaces “three-semester hour” with “three-semester-hour” in reference to a course requirement.

Adopted Rules Re:

Repealing 1 TAC §355.727, to coincide with the expiration of temporary add-ons, which expire on August 31, 2023.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER F. REIMBURSEMENT METHODOLOGY FOR PROGRAMS SERVING PERSONS WITH MENTAL ILLNESS OR INTELLECTUAL OR DEVELOPMENTAL DISABILITY
1 TAC §355.727

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts the repeal of §355.727, concerning Add-on Payment Methodology for Home and Community-Based Services Supervised Living and Residential Support Services. Section 355.727 is adopted without changes to the proposed repeal as published in the July 21, 2023, issue of the Texas Register (48 TexReg 3964). This repeal will not be republished.

BACKGROUND AND JUSTIFICATION

The rulemaking repeals §355.727, concerning Add-on Payment Methodology for Home and Community-Based Services Supervised Living and Residential Support Services. The temporary add-ons expire on August 31, 2023. Funding associated with the add-ons will be incorporated into the base rates for supervised living and residential support services in the HCS waiver program.

Amending 1 TAC §355.9080, to no longer require that the payment rate not exceed 70 percent of the average hourly Private Duty Nursing rate under the THSteps Program.

CHAPTER 355. REIMBURSEMENT RATES
SUBCHAPTER M. MISCELLANEOUS PROGRAMS
1 TAC §355.9080

OVERVIEW

The Texas Health and Human Services Commission (HHSC) adopts an amendment to §355.9080, concerning Reimbursement Methodology for Prescribed Pediatric Extended Care Centers. Section 355.9080 is adopted without changes to the proposed text as published in the July 21, 2023, issue of the Texas Register (48 TexReg 3965). This rule will not be republished.

BACKGROUND AND JUSTIFICATION

The amendment removes the requirement that the payment rate for Prescribed Pediatric Extended Care Centers (PPECC) cannot be more than 70 percent of the average hourly Private Duty Nursing rate under the Texas Health Steps (THSteps) Program. The amendment would implement a rate methodology change for PPECC reimbursement approved through HHSC’s biennial fee review process and would enable PPECC rate methodology to reflect allowable provider costs.

In Addition Re:

Public Notice: Adult Vaccine Services, to repeal language explicitly excluding vaccines specific for travel to or from foreign countries.

The Texas Health and Human Services Commission (HHSC) announces its intent to submit transmittal number 22-0032 to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act.

The Texas Health and Human Services Commission (HHSC) proposes amendments to the Texas State Plan for Medical Assistance under Title XIX of the Social Security Act to repeal language explicitly excluding vaccines specific for travel to or from foreign countries. The Social Security Act was amended to provide that, effective October 1, 2023, state Medicaid programs must cover items and services described in Section 1905(a)(13)(B) of the Act, including adult vaccines approved by the Food and Drug Administration and recommended by the Advisory Committee on Immunization Practices (ACIP) and their administration. On June 27, 2023, the Centers for Medicare and Medicaid Services issued a letter interpreting the reference to ACIP recommendations in Section 1905(a)(13)(B) to include any category of ACIP vaccine recommendations. Because of this interpretation, Medicaid programs must cover all adult vaccines recommended by ACIP, including those recommended solely for occupation or travel to or from foreign countries.

Public Notice – Texas State Plan for Medical Assistance Amendment, to update the fee schedules for Early and Periodic Screening, Diagnostic and Treatment Services and Physicians and Other Practitioners

The Texas Health and Human Services Commission (HHSC) announces its intent to submit amendments to the Texas State Plan for Medical Assistance, under Title XIX of the Social Security Act. The proposed amendments will be effective October 1, 2023.

The purpose of the amendments is to update the fee schedules in the current state plan by adjusting fees, rates, or charges for the following services:

Early and Periodic Screening, Diagnostic and Treatment Services; and

Physicians and Other Practitioners

Texas Board of Physical Therapy Examiners

Proposed Rules Re:

Amending 22 TAC §329.1, to clarify changes in contact information that need to be reported to the board and requests for name changes.

CHAPTER 329. LICENSING PROCEDURE
22 TAC §329.1

OVERVIEW

The Texas Board of Physical Therapy Examiners proposes amending 22 TAC §329.1. General Licensure Requirements and Procedures to clarify changes in contact information that need to be reported to the board and requests for name changes.

BACKGROUND AND JUSTIFICATION

The amendment eliminates reference to an address of record, changes the wording from residential to home address, and adds phone numbers and email addresses to the change of information that a licensee is required to report to the board. Additionally, the amendment clarifies that name changes must be submitted on a form prescribed by the board with the appropriate fee and a copy of legal documentation enacting the name change, and eliminates the requirement of making a name change with the renewal application.

Amending 22 TAC §329.6, §329.7, to allow military service members licensed and in good standing in another jurisdiction to engage in the practice of physical therapy without obtaining a license as a physical therapist or physical therapist assistant.

CHAPTER 329. LICENSING PROCEDURE
22 TAC §329.6, §329.7

OVERVIEW

The Texas Board of Physical Therapy Examiners proposes amending 22 TAC §329.6. Licensure by Endorsement and §329.7. Exemptions from Licensure pertaining to military service member exemption pursuant to SB 422 amendment of Sec. 55.0041. RECOGNITION OF OUT-OF-STATE LICENSE OF MILITARY SERVICE MEMBERS AND MILITARY SPOUSES, of Chapter 55, Occupations Code during the 88th Legislative Session.

BACKGROUND AND JUSTIFICATION

The amendment is proposed in order to authorize a military service member to engage in the practice of physical therapy without obtaining a license as a physical therapist or physical therapist assistant if the military service member is currently licensed in good standing by another jurisdiction that has licensing requirements that are substantially equivalent to the requirements for the licensure in this state and the military service member is stationed at a military installation in this state.

Texas Department of State Health Services

Review of Agency Rules Re:

Title 25, Part 1

The Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes to review and consider for readoption, revision, or repeal the chapter listed below, in its entirety, contained in Title 25, Part 1, of the Texas Administrative Code:

Chapter 289, RADIATION CONTROL

SUBCHAPTER C, TEXAS REGULATIONS FOR CONTROL OF RADIATION

SUBCHAPTER D, GENERAL

SUBCHAPTER E, REGISTRATION REGULATIONS

SUBCHAPTER F, LICENSE REGULATIONS

SUBCHAPTER G, REGISTRATION REGULATIONS

This review is conducted in accordance with the requirements of Texas Government Code §2001.039, which requires state agencies, every four years, to assess whether the initial reasons for adopting a rule continue to exist. After reviewing its rules, the agency will readopt, readopt with amendments, or repeal its rules.