Texas Hospital Association

Health Care Advocate: April 2, 2026

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Advocacy News 
If you have questions or comments about the articles below, please contact [email protected].

Senate Releases Second Round of Interim Charges

On Friday, the Senate released a second batch of interim charges shortly after announcing Interim Committee assignments and following the House’s release of its interim charges and Health Care Affordability Select Committee. Similar to the House, health care and insurance costs were a focal point of interim priorities. Additionally, legislators are tasked with examining the societal impacts of THC, mental health, rising health care costs, the exploitation of surrogacy and monitoring the implementation of several bills from the 89th Legislative Session.

THA was happy to see some of its interim recommendations – including health care affordability as it relates to insurance and mental health – reflected in the Senate’s priorities. Facility fees, however, were featured in a Senate Health and Human Services Committee charge, confirming that this long-discussed issue will continue to be at the forefront of legislative scrutiny. As the interim progresses, THA is committed to uplifting the critical work Texas hospitals are doing and to working with legislators to address rising costs and identify solutions that strengthen access to care for all Texans. (Carrie Kroll/Sara González/Ben Williams/Will Holleman/Anna Stelter/Matt Turner, Ph.D./Erika Ramirez-Wright)  

$1M in Funding to Expand Health Care Apprenticeships

The Texas Workforce Commission and Texas Department of State Health Services announced a partnership providing $1 million in apprenticeship grant funding dedicated to strengthening the state’s health care workforce. Through this initiative, $500,000 will be available in fiscal years 2026 and 2027 – as outlined by Senate Bill 1 – to support the creation or expansion of health care apprenticeship programs.

This investment aims to create new career paths to health care careers and will support the Disproportionate Share Hospital Program, which provides essential care to communities across Texas. Interested hospitals and health care facilities can learn more and find application information on the Apprenticeship Texas Website.(Matt Turner Ph.D./Ben Williams/Laura Cornelson, MSN, RN)

THA Urges Partnership between CMS, Hospitals on Curbing Fraud, Waste & Abuse

On Monday, THA responded to the Centers for Medicaid and Medicare’s (CMS) request for information regarding Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). CRUSH solicited stakeholder feedback on “programmatic changes that could be implemented to make CMS more effective in crushing fraud” in Medicaid, CHIP, Medicare, Medicare Advantage and the health insurance marketplace. THA emphasized the dangers of fraud, waste and abuse in health care, and how Texas hospitals are partners in eliminating improper activity in public health care programs. THA also highlighted concerns about the misuse of prior authorization and utilization review by Medicare Advantage organizations, noting that inconsistent approvals and cost-shifting are a source of waste and add cost to the health care system.

THA also highlighted aspects of Texas Medicaid that make it a national model of lean program administration and transparency in supplemental funding. Further, THA cautioned CMS against mislabeling permissible financing and payment arrangements as fraud, waste or abuse and overreaching to limit permissible arrangements. THA’s letter highlights numerous legitimate opportunities for CMS to focus on reducing waste and abuse, including provider enrollment and managed Medicare and Medicaid health plan practices. (Anna Stelter)

Member Listening Sessions: DFW April 16

During the interim, the THA advocacy team is hosting a series of listening sessions across the state to better understand the challenges hospitals face and discuss the increased cost of providing health care. Dallas-Fort Worth hospitals are invited to attend the first session — on April 16 in Arlington, TX — an opportunity to share insights, experiences and concerns related to the rising costs of health care and other issues impacting your facility/system’s ability to serve your patients and communities effectively. Your feedback will inform THA’s advocacy efforts and the development of THA’s policy priorities for the 90th Legislature.

More information is available here. Please RSVP to [email protected] by April 10. (Mackenzie Watson)

DSHS Reopens RSV Immunization Orders

The Texas Department of State Health Services reopened orders on April 1 for RSV immunization products nirsevimab (Beyfortus®) and clesrovimab (ENFLONSIA™). Providers must submit orders through the Texas Vaccine Allocation and Ordering System (VAOS) by April 17. When placing orders, providers should review the maximum stock levels and the suggested quantities displayed in VAOS and check the expiration dates in their current inventory to determine the appropriate request amount.

Administration of RSV immunizations is typically recommended from Oct. 1 through March 31. However, due to ongoing RSV transmission beyond the typical season in Texas, health care providers may continue administering these products through April 30, using clinical judgment and shared clinical decision-making with patients. For additional questions, contact [email protected].(Erika Ramirez-Wright/Will Holleman/Nicole Lusardi, J.D.)

BON Proposes New Rules for Continuing Education, Adopts Amendments

Last week, the Texas Board of Nursing (BON) proposed and published a new rule that impacts continuing education (CE) requirements for licensed nurses in Texas to effectively implement Senate Bill 912, which passed during the 88th legislative session. SB 912 added new sections to Chapter 112 of the Texas Occupations Code, (§§112.101-112.106) which requires the BON to establish a tracking system to verify that nurses pursuing a licensure renewal have complied with all continuing competency requirements. The BON is currently developing a module in the Texas Nurse Portal for nurses to upload their CE certificates and will release a step-by-step guide and detailed instructions as this new process rolls out.

The legislation now requires nurses to proactively upload sufficient documentation and/or information that verifies their completion of a continuing competency course. Prior to the legislation, a nurse was only required to provide documentation if selected through a random audit. SB 912 prohibits the BON from renewing a nursing license unless the BON verifies compliance with continuing education requirements for renewal. The proposed rule would make nurses who fail to demonstrate compliance after an audit, falsely attest to compliance or provide false information to the BON liable for unprofessional conduct and potentially subject to disciplinary action. Comments on the proposed rule must be submitted by April 20 to James W. Johnston, General Counsel, Texas Board of Nursing by mail or by e-mail to [email protected].

Additionally, the BON adopted amendments to Rule 213.13 relating to Complaint Investigation and Disposition without making any changes to the proposed amendments that were originally published in the. The proposed amendments came as a result of an internal audit which found that the previous Rule 213.13 was outdated and did not conform to current enforcement practices and procedures. The adopted rule modernizes the complaint submission process to the BON by adding that complainants may use the BON’s online complaint portal and changes the required complainant’s information to align with reasonable expectations regarding what information complainants know and/or have available. The amendments also update the priority system by removing the Priority Four designation, which is no longer used. Finally, the amendments seek to align the rule with Tex. Occ. Code §301.457 outlines when a preliminary investigation will be conducted, establishes the priority designation and notifies the parties to the complaint. This rule is effective as of March 29. (Laura Cornelson, MSN, RN/Heather De La Garza-Barone, J.D./Benjamin Williams)

HHSC Publishes Updated Human Trafficking Signage

The Texas Health and Human Services Commission published long-awaited updated human trafficking signage in compliance with House Bills 742 and 754. This updated signage – which will replace existing signage – is required for ambulatory surgical centers, birthing centers, freestanding emergency medical care facilities, general hospitals and special hospitals, and must be displayed by May 1. Signage was drafted in English and Spanish. (Ben Williams/Erika Ramirez-Wright/Nicole Lusardi J.D.)

THA Annual Conference: Early-Bird Pricing Ends Friday

Registration is open for THA’s 2026 Annual Conference. From Sept. 23-24 at the Omni in Fort Worth, THA’s largest event of the year is poised to provide Texas hospital leaders with the latest legislative and regulatory updates impacting health care in our state.

Attendees will have the opportunity to hear from experts on the most pressing issues in health care, gain legislative insights, access key leadership development opportunities and network with their peers from hospitals and health systems across Texas. Early-bird registration pricing ends on Friday, April 3. Registration and more information are available on the conference webpage. (Lindsay Thompson/Alex Ratcliff)

This Week on The Scope

Focused on THA member hospitals/health systems and the issues they face, The Scope is the No. 1 source for news, information and thought leadership related to Texas hospitals and priority issues impacting health care. Featured this week:

More content is available on The Scope. (Julia Mann)

Texas Register Highlights

The Texas State Board of Pharmacy proposed a new rule 22 TAC 291.13, concerning Telehealth Services Provided by a Pharmacist. If adopted, the new rule would establish documentation and retention requirements regarding a patient’s consent to treatment, data collection and data sharing for telehealth services provided by a pharmacist in accordance with House Bill 1700 (89R). Comments on the proposed rule must be submitted no later than April 27. (March 27)

The Health and Human Services Commission (HHSC) proposed amendments to 26 TAC Chapter 561, concerning the Employee Misconduct Registry. Proposed amendments include: §561.1, concerning Purpose; §561.2, concerning Definitions; §561.3, concerning Employment and Registry Information; §561.4, concerning Investigations; §561.5, concerning Preliminary Results of Investigation and Notice to Employee; §561.6, concerning Informal Review; §561.7, concerning Reportable Conduct Finding and Notice and Opportunity for Administrative Hearing; §561.8, concerning Entering Information in the EMR and §561.9, concerning Removing Information from the Employee Misconduct Registry (EMR). The proposed amendments are necessary to implement Senate Bill 1849 (88R) and House Bill 3560 (89R). SB 1849 amended the Tex. Health & Safety Code §253.010, which allows HHSC to amend rules pertaining to the EMR to establish criteria to submit a request to be removed from the EMR and to create a process to determine whether a person meets the requirements for inclusion in the EMR. SB 1849 also created the new Tex. Health & Safety Code Chapter 810, Interagency Reportable Conduct Search Engine, which is known as Search Engine for Multi-Agency Reportable Conduct (SEMARC). SEMARC requires HHSC to amend rules to incorporate information and requirements established by the new Chapter 810. HB 3560 amended the definition of “facility” regarding the EMR in Tex. Health & Safety Code §253.001(4) to include facilities licensed under Chapter 577, Private Mental Hospitals and Other Mental Health Facilities. Comments on the proposed amendment must be submitted no later than April 27. (March 27)

The Health and Human Services Commission proposed the repeal of 26 TAC §§711.1401-711.1404; 711.1406-711.1408; 711.1413-711.1415; 711.1417; 711.1419; 711.1421; 711.1423; 711.1425-711.1427; 711.1429-711.1431; 711.1432; and 711.1434, concerning the Employee Misconduct Registry. The repeal is proposed to remove duplicate rules from the Texas Administrative Code and consolidate them into one chapter relating to the Employee Misconduct Registry in 26 TAC 561. The relevant information in these rules is incorporated into the rules in Chapter 561 with updates for clarification and to align with statute. Comments on the proposed repeal must be submitted no later than April 27. (March 27)

The Health and Human Services Commission proposed to review and consider for readoption, revision, or repeal Chapter 386, Disaster Assistance Program, found in Title 1, Part 15, of the Texas Administrative Code. The review is to be conducted pursuant to the requirements of Tex. Gov. Code §2001.039. After the review, the agency will readopt, readopt with amendments or repeal its rules. Comments on the review of Chapter 386 must be submitted no later than April 27. (March 27) (Michael Sipes)

Federal Register Highlights

The Centers for Medicare & Medicaid Services announced an opportunity for the public to comment on its intention to collect information from the public concerning the Initial Plan Data Collection to Support Quality Health Plan Certification and Other Financial Management and Exchange operations. Pursuant to the rule Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers, each Exchange is responsible for the certification and offering of Qualified Health Plans (QHPs). The Exchange is also responsible for ensuring that QHPs meet the minimum exchange standards of network adequacy, inclusion of Essential Community Providers, and non-discrimination, as described in the Exchange rule under 45 CFR 155 and 156, based on the Patient Protection and Affordable Care Act and other standards determined by the Exchange. The information collection request is a formal request for the revision of the data collection clearance. The instruments in the information collection will be used for the 2025 certification process and beyond. Comments on the information collection must be submitted no later than April 27. (March 26)

The Centers for Medicare & Medicaid Services (CMS) announced an opportunity for the public to comment on its intention to collect information from the public concerning the Submission of 1135 Waiver Request Automated Process. This is a revision of an already approved information collection request. Waivers under Section 1135 of the Social Security Act and other flexibilities allow CMS to relax the Conditions of Participation or Conditions of Coverage to promote the health and safety of beneficiaries. Under Section 1135 of the Act, CMS may temporarily waive or modify certain Medicare, Medicaid, and Children’s Health Insurance Program requirements to ensure that sufficient health care services are available to meet the needs of individuals enrolled in Social Security Act programs in the emergency area and time periods. The collection of the information surrounding 1135 Waiver requests/inquiries is based on a case-by-case basis and regularly scheduled. The collection of information only occurs when the healthcare entity, impacted by an emergency, is requesting waivers or flexibilities under Section 1135 or inquiring about Public Health Emergencies. CMS is enhancing the information collection to better support emergency response by capturing the emergency date, simplifying ongoing status updates for stakeholders, and providing a more comprehensive view of cybersecurity incidents through expanded reporting on patient and operational impacts. The automated process will continue to consist of a public facing web form as well as a process for providers to submit data using extracts (CSV or Excel) on emergent events impacting Health Care Facilities via an automated mail handler system. Comments on the collection of information must be submitted no later than June 1. (March 31)

The Executive Office of the President issued Executive Order 14398, Addressing DEI Discrimination by Federal Contractors. The executive order requires, within 30 days of the date of the order, executive departments and agencies to ensure that contracts and contract-like instruments, including contractors’ subcontracts and subcontractors’ lower-tier subcontracts, include a clause specifying that the contractor will not engage in any racially discriminatory DEI activities. It further requires federal contractors and subcontractors to furnish all information and reports, including providing access to books, records, and accounts, as required by the contracting agency, for the purpose of ascertaining compliance with the EO. In the event of noncompliance, the contractor or subcontractor may be subject to cancellation, termination, or suspension, in whole or in part, of the contract. The contractor or subcontractor may also be declared ineligible for further Government contracts. The Federal Acquisition Regulatory Council is directed to amend the Federal Acquisition Regulation to comport with the EO. (March 31) (Michael Sipes)

The Health Care Advocate is a publication of the Texas Hospital Association, 1108 Lavaca, Austin Tx 78701. Telephone 512/465-1570 for information. For additional information regarding specific articles, please contact the THA staff member(s) listed at the bottom of each full article. According to Texas Government Code 305.027, this material may be considered “legislative advertising.” Authorization for its publication is made by Carrie Kroll, Texas Hospital Association, 1108 Lavaca, Suite 700, Austin, Texas 78701-2180.