Comment on Proposed and Draft Rules

The proposal updates application and registration processes for lasers and intense-pulsed light devices to match requirements in §289.226. Several definitions were updated to provide clarity. Additional changes were made to update signage requirements to match the American National Standards Institute (ANSI) standards. Signage requirements include “Danger,” “Warning,” and “Caution.” The added reference to the ANSI standard provides the most current safety standards for stakeholders.

Statute: Texas Government Code §531.0055, Texas Health and Safety Code §1001.075 and Chapter 401 (the Texas Radiation Control Act)

The rules show the change in law for competency restoration services in jails for people who are incompetent. The rules remove the pilot program and change the number of evaluations. The rules let people get services for a longer time if there is not a bed open at a facility or a community program. The rules update what the program’s providers must do and what data the program must send to HHSC. The rules also add new policies and procedures for the program.

Required by: Senate Bill 49, 87th Legislature, Regular Session, 2021

HHSC is changing the rules about services in state hospitals. As changed, the rules say how the hospitals and local mental health authorities (LMHAs) must coordinate admission, treatment, and discharge services. The rules also say when providers may deliver services by video or phone.

Required by: Senate Bill 26, 88th Legislature, Regular Session, 2023 
and House Bill 4, 87th Legislature, Regular Session, 2021

HHSC is amending rules to match the language in House Bill 44. House Bill 44 prohibits providers who participate in Medicaid or the child health plan program from refusing to provide health care services based solely on the recipient's failure to obtain a vaccine or immunization. This rule project will correct outdated information, improve processes for Early Childhood Intervention programs, and better explain program requirements. HHSC is also repealing 11 rules because the language is provided in the Code of Federal Regulations and is not necessary to repeat in the rules.

Statute: Texas Government Code §531.02119  

Required by: House Bill 44, 88th Regular Session, 2023

The proposed rules create a new requirement for insulin drug makers to tell the Health and Human Services Commission (HHSC) why a generic version of insulin is not available. The benefit is to make sure they are correctly telling HHSC about generic insulin availability.

The proposed rules create a new and faster way to add drugs to the Texas Drug Code Index. The rules also refer to Texas Government Code language about Preferred Drug List prior authorization exception criteria. The benefit is that Medicaid members may get drugs more quickly after the Federal Drug Administration approves them, and members may have more access to some non-preferred drugs.

Statute: Texas Government Code §531.0691 and Chapter 533, Section 533.071; and Texas Health and Safety Code, Subchapter D

Required by: House Bill 3286, 88th Regular Session, 2023, and Senate Bill 241, 88th Regular Session, 2023

The rule changes relate to the licensure of administrators for general residential operations and child-placing agencies, including an application by a military member, spouse, or veteran, and when an administrator needs such a license. The changes make the rules consistent with current policies, practices, and other Texas Health and Human Services Commission (HHSC rules); consolidate rules; update citations and titles; and improve the readability and understanding of the rules. Some of the rule changes relate specifically to Senate Bill 422, while others are not related.

Statute: Texas Occupations Code §§55.004, 55.0041, and 55.005 and Texas Human Resources Code §43.005

Required by: Senate Bill 422, 88th Legislature, Regular Session, 2023

HHSC is making the following changes:
The change to the Comprehensive Hospital Increase Reimbursement Program rule changes the way the average commercial reimbursement gap is calculated and updates the maximum potential payments providers may receive under the average commercial reimbursement component of the Comprehensive Hospital Increase Reimbursement Program.
The change to the disproportionate share hospital rule makes it easier for rural hospitals to qualify for funds.
The change to the uncompensated care rule increases the funds available to hospitals that serve a high number of patients who cannot pay all or part of their bills.
The change to the Hospital Augmented Reimbursement Program rule defines nominal charge providers. Inpatient Medicaid payments will not exceed inpatient Medicaid charges for non-nominal charge providers.

HHSC is making the following changes:
The change to the Comprehensive Hospital Increase Reimbursement Program rule changes the way the average commercial reimbursement gap is calculated and updates the maximum potential payments providers may receive under the average commercial reimbursement component of the Comprehensive Hospital Increase Reimbursement Program.
The change to the disproportionate share hospital rule makes it easier for rural hospitals to qualify for funds.
The change to the uncompensated care rule increases the funds available to hospitals that serve a high number of patients who cannot pay all or part of their bills.
The change to the Hospital Augmented Reimbursement Program rule defines nominal charge providers. Inpatient Medicaid payments will not exceed inpatient Medicaid charges for non-nominal charge providers.

HHSC is updating the rule to change the "base year average per resident amount" for state teaching hospitals to be based on the most recent final audited cost report. Also, cost report line references will be updated based on current calculation method.