Texas Hospital Association

Health Care Advocate: Feb. 26, 2026

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

THA Recommends Health Care Cost Topics for Interim

THA recently shared its thoughts with key state lawmakers on what legislative committees should study during the Texas Legislature’s interim work for 2026. A letter sent to leadership in the Senate Committee on Health and Human Services outlined THA’s recommendations for topics to study in the areas of health care costs, public health, health plans’ utilization review tactics and other key categories. An identical set of recommendations was also shared with House leadership and key committee members. Some of THA’s recommendations included examining:

  • Mandates on both providers and insurers, including provider and overall health care cost benefits that may be realized by reducing mandates on hospitals and physicians.
  • Workforce costs, including a look at workforce shortages.
  • The impact of prior authorization, concurrent reviews and retrospective denials.
  • The state’s response to public health events, including outbreaks of vaccine-preventable diseases and natural disasters.
  • The continuum of care in mental health as it relates to crisis response on the front lines.

After receiving their study topics – known as interim charges – legislative committees hold hearings during the year and produce a report on those topics ahead of the next legislative session. The speaker of the House sets that chamber’s interim charges, while the lieutenant governor assigns the topics for the Senate. (Carrie Kroll)

AHA Looks for Participants on Postpartum Hemorrhage Initiative

The American Hospital Association is asking for help in its collaboration with electronic health record (EHR) producer Epic to raise awareness of EHR tools that can help detect postpartum hemorrhage “no matter what software platform” a clinician is using. The AHA/Epic collaboration is outlined on an AHA webpage with detailed materials, including a two-page report, on how to use EHR tools to assess patient risk, be prepared for postpartum hemorrhage and improve detection of this common and serious childbirth complication. The AHA webpage also includes a form for joining the collaborative effort between AHA and Epic. Postpartum hemorrhage occurs in 3-5% of all deliveries and accounts for 11.2% of maternal deaths in the U.S. (Erika Ramirez Wright/Laura Cornelson, MSN, RN)

CMS Issues Updated Medicare Outpatient Observation Notice

The Centers for Medicare & Medicaid Services (CMS) has released an updated Medicare Outpatient Observation Notice (MOON) form, and providers have until April 20 to transition to the updated version. Hospitals and critical access hospitals must provide a MOON to Medicare beneficiaries who are receiving outpatient observation services but are not admitted as inpatients. The updated MOON makes no changes to delivery or time frame requirements, but CMS made “readability and design improvements for consistency with other Medicare notices.” The new MOON form will be effective through Feb. 28, 2029. A link to download the updated form in English and Spanish, as well as FAQs, are available on CMS’ MOON webpage. Full instructions for the MOON are available in Section 400 of Chapter 30 of the CMS Claims Processing Manual. (Matt Turner, Ph.D./Heather De La Garza-Barone, J.D.)

Register for THA’s Managed Care and Finance Summit

THA will host its inaugural Managed Care and Finance Summit on April 8 and 9 at the THA offices in Austin. The summit seeks to convene health care leaders serving in finance, contracting and reimbursement roles to garner insights from industry thought leaders, as well as network, share experiences and learn best practices with colleagues from around the state.

Programming will include presentations on payer challenges and accountability, emerging concerns in hospital cost reports, and charity care and community benefits, among other topics. Attendees will also learn how THA’s advocacy team is approaching the upcoming Texas legislative session, where health care cost and affordability will be front of mind. Event and hotel information are available on the event’s webpage. (Matt Turner, Ph.D.)

Get Out the Vote: Early Voting Ends Friday

With early voting in Texas’ primary election season closing this week, THA is stressing the importance of its member hospitals getting out the vote and encouraging non-partisan voter registration efforts throughout hospitals. THA’s Get Out the Vote: 2026 Primary Election webpage contains resources to support voter mobilization in hospitals, with new digital resources available to download:

  • Social media content, with graphics in English and Spanish
  • Ready-to-print posters in English and Spanish
  • Sample emails to send to staff encouraging voter participation

Many underestimate the power of voting in the primary election: In Texas, primaries often determine the ultimate outcomes of the general election. Participation can influence key health care policies and leadership decisions that affect the hospital community and the health care system. Texas requires eligible voters to register to vote. Voter registration confirmation is available at www.votetexas.gov. Following Friday’s end to early voting, Primary Election Day is Tuesday, March 3.

In the event of a runoff election – which occurs when no candidate wins over 50% – primary runoff early voting runs from May 12-22 and primary runoff election day will be May 26. (Wendy Thomas/Sara González)

Nominations Open for THA Awards

Each year, THA recognizes hospital programs and individuals whose contributions help advance high-quality health care for Texans. Nominations are now being accepted for these prestigious awards, which will be presented at THA’s annual conference in September and shared across THA platforms. All nominations are due by 5 p.m. CST on Tuesday, March 31. To submit a nomination, visit the THA Awards Webpage. (Sharon Beasley)

THA Hospital Conditions of Participation Webinars Start in March

THA’s comprehensive Hospital Conditions of Participation (CoP) webinar series returns this spring, offering hospital leaders and compliance teams an in‑depth, multi‑session review of the federal regulations every Medicare- and Medicaid-participating hospital must meet. This 11‑part series, beginning March 24, walks through the Centers for Medicare and Medicaid Services’ (CMS) CoP manual (Appendix A), covering critical areas such as infection prevention and control, QAPI, nursing services, patient rights, emergency services, surgical services, pharmacy, medical staff requirements and more. The program also includes the latest regulatory updates through 2025, including areas where CMS interpretive guidelines and survey procedures remain pending. Registration and more information are available here. (Jessie Glas/Lindsay Thompson)

This Week on The Scope

Focused on THA member hospitals/health systems and the issues they face, The Scope is THA’s 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 State Board of Pharmacy adopted amendments to 22 TAC §291.33, concerning Operational Standards for Community Pharmacies (Class A). The amendments allow for written information reinforcing patient counseling to be provided electronically unless requested in a hard-copy format and remove the requirement to document the request. The statutes affected by this adoption include the Texas Pharmacy Act, Chapters 551-569, of the Texas Occupations Code. The amendments were adopted without changes to the proposed text as published in the Dec. 26, 2025, issue of the Texas Register (50 TexReg 8463). The rule will not be republished. The amendments become effective on March 1. (Feb. 20)

The State Board of Pharmacy adopted amendments to 22 TAC §291.104, concerning Operational Standards for Non-Resident Pharmacy (Class E). The amendments allow for written information reinforcing patient counseling to be provided electronically unless required in a hard-copy format and remove the requirement to document the request. The statutes affected by this adoption include the Texas Pharmacy Act, Chapters 551-569, of the Texas Occupations Code. The amendments were adopted without changes to the proposed text as published in the Dec. 26, 2025, issue of the Texas Register (50 TexReg 8474). The rule will not be republished. The amendments become effective on March 1. (Feb. 20)

The State Board of Pharmacy adopted amendments to 22 TAC §291.133, concerning Pharmacies Compounding Sterile Preparations. The amendments update the personnel, environment, compounding process, cleaning and disinfecting, beyond-use dating, cleansing and garbing, environmental testing, sterility testing, recall procedure and recordkeeping for pharmacies compounding sterile preparations. The statutes affected by this adoption include Texas Pharmacy Act, Chapters 551-569, of the Texas Occupations Code. The amendments were adopted with changes to the proposed text as published in the Oct. 3, 2025, issue of the Texas Register (50 TexReg 6416). The rule has been republished. The amendments become effective on March 1. (Feb. 20)

The State Board of Pharmacy adopted amendments to 22 TAC §295.8, concerning Continuing Education Requirements for Pharmacists. The amendments establish an electronic continuing education tracking system in accordance with Senate Bill 912 of the 89th regular session of the Texas Legislature; update continuing education programs in preparation for the statutory continuing education tracking system; specify that record retention requirements apply to all required courses; and make grammatical corrections. The statutes affected by this adoption include the Texas Pharmacy Act, Chapters 551-569, of the Texas Occupations Code. The amendments were adopted without changes to the proposed text as published in the Dec. 26, 2025, issue of the Texas Register (50 TexReg 8478). The rule will not be republished. The amendments become effective on Sept. 1. (Feb. 20)

The State Board of Pharmacy adopted amendments to 22 TAC §297.8, concerning continuing education requirements for pharmacy technicians and pharmacy technician trainees. The amendments establish an electronic continuing education tracking system in accordance with Senate Bill 912 in the 89th regular session of the Texas Legislature; update continuing education programs in preparation for the statutory continuing education tracking system; specify the record retention requirements apply to all required courses; and make grammatical corrections. The statutes affected by this adoption include the Texas Pharmacy Act, Chapters 551-569, of the Texas Occupations Code. The amendments were adopted without changes to the proposed text as published in the Dec. 26, 2025, issue of the Texas Register (50 TexReg 8482). The rule will not be republished. The amendments become effective on Sept. 1. (Feb. 20)

The Health and Human Services Commission adopted the repeal of 26 TAC §507.516, concerning staffing tables for end stage renal disease facilities. The adopted repeal removes the staffing table located in TAC 26, Chapter 507, End Stage Renal Disease Facilities, Subchapter Z, Physical Plant and Construction Requirements. A new staffing table was adopted in 26 TAC §507.60 and became effective on Dec. 23, 2025. The repeal became effective on Feb. 23. (Feb. 20)

The Health and Human Services Commission proposed to review and consider for readoption, revision or repeal 26 TAC, Chapter 511, concerning Limited Services Rural Hospitals. The review will be conducted in accordance with Tex. 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 the rule review, the agency will readopt, readopt with amendments or repeal its rules. Comments on the review of Chapter 511 must be submitted no later than 5 p.m. CT on March 23. (Feb. 20)

The Health and Human Services Commission (HHSC) adopted the review of Chapter 371, concerning Medicaid and Other Health and Human Services Fraud and Abuse Program Integrity, found in Title 1, Part 15, of the Texas Administrative Code. Notice of the review of the chapter was published in the Nov. 28, 2025, issue of the Texas Register (50 TexReg 7739). The agency determined that the original reasons for adopting rules in the chapter continue to exist and readopts Chapter 371 except for: §371.33, On-Site Reviews of Prospective Providers. The repeal and any amendments identified by HHSC in the rule review and any amendments, if applicable, to Chapter 371 will be proposed in a future issue of the Texas Register. (Feb. 20)

The Texas State Board of Pharmacy adopted the review of Chapter 291, Subchapter C (§§291.51-291.55), concerning Pharmacies (Nuclear Pharmacy [Class B]), found in Title 22, Part 15 of the Texas Administrative Code. The proposed rule review was published in the Dec. 26, 2025, issue of the Texas Register (50 TexReg 8631). The agency finds the reasons for adopting the rules contained in Chapter 291 continue to exist. (Feb. 20)

The Texas State Board of Pharmacy adopted the review of Chapter 309, Subchapter C (§§309.1-309.8), concerning Substitution of Drug Products found in Title 22, Part 15 of the Texas Administrative Code. The proposed rule review was published in the Dec. 26, 2025, issue of the Texas Register (50 TexReg 8631). The agency finds the reasons for adopting the rules contained in Chapter 291 continue to exist. (Feb. 20)

The Health and Human Services Commission (HHSC) adopted the review of Chapter 110, concerning Hearings Under the Administrative Procedure Act, found in Title 26, Part 1, of the Texas Administrative Code. Notice of the review was published in the Nov. 28, 2025, issue of the Texas Register (50 TexReg 7739). The agency determined that the original reasons for adopting all rules in the chapter continue to exist and readopted Chapter 110. Any amendments, if applicable, to Chapter 110 identified in HHSC in the rule review will be proposed in a future issue of the Texas Register. (Feb. 20)

The Texas Workforce Commission proposed amendments to Subchapter A. General Purpose and Definitions, §838.2; Subchapter B. Grant Program, §838.12; and Subchapter C. Program Administration, §838.21 and 838.24 of Chapter 838 of the Texas Administrative Code. The purpose of the proposed Chapter 838 rule change is to implement House Bill 3260, enacted by the 89th Texas Legislature, Regular Session, 2025, relating to the Texas Industry-Recognized Apprenticeship Grant Program. Comments on the proposed amendments must be submitted no later than March 23. (Feb. 20) (Michael Sipes)

Federal Register Highlights

The Centers for Medicare & Medicaid Services published a correction of technical errors in the final rule with comment period that appeared in the Nov. 25, 2025 issue of the Federal Register titled “Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Overall Hospital Quality Star Rating; Hospital Price Transparency; and Notice to Closure of Teaching Hospital and Opportunity To Apply for Available Slots.” The effective date of the final rule with comment period was Jan. 1. The correction document extended the effective date to Feb. 23. (Feb. 23)

The Centers for Medicare & Medicaid Services announced an opportunity for public comment on their intention to collect information from the public concerning Add-On Payments for New Medical Services and Technologies Paid Under the Inpatient Prospective Payment System; and Medicare Advantage Appeals and Grievance Data Form. Comments on the collections of information must be submitted no later than April 24. (Feb. 23)

The Department of Health and Human Services published a correction of references in a final rule that appeared in the Feb. 2, 2024 Federal Register titled “Medications for the Treatment of Opioid Use Disorder,” specifying final modified and updated certain provisions related to Opioid Treatment Program (OTP) accreditation, certification and standards for the treatment of Opioid Use Disorder Medications for Opioid Use Disorders in OTPs. The effective date of the final rule was April 2, 2024 and the compliance date was Oct. 2, 2024. The effective date of the corrections was Feb. 23. (Feb. 23)

The Health Resources and Services Administration announced a correction for a published document in the Federal Register of Dec. 2, 2025, concerning the Medical Student Education Program Non-Competitive Supplement. The correct project period is July 1, 2025, to June 30, 2026. (Feb. 24)

The Centers for Disease Control and Prevention announced an opportunity for public comment on a proposed information collection project titled “Developmental Studies to Improve the National Health Care Surveys.” The project will cover new survey research that will evaluate and improve upon survey design and operations, as well as examine feasibility and address challenges that may arise with future expansions of the National Health Care Surveys. Comments on the collection of information must be submitted no later than April 27. (Feb. 24)

The Internal Revenue Service, Department of Labor and the Department of Health and Human Services announced an extension of the comment period for the proposed rule that appeared in the Federal Register on Dec. 23, 2025, titled “Transparency in Coverage.” The comment period for the proposed rule was to end on Feb. 23, has been extended to March 2. The proposed rule would create requirements that would amend the regulations under the Public Health Service Act, the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code regarding price transparency disclosure requirements for non-grandfathered group and individual health insurance coverage. The rule also proposed improvements in the standardization, accuracy and accessibility of public pricing disclosures in line with the goals of Executive Order 14221. Comments on the proposed rule must be submitted no later than March 2. (Feb. 25)

The National Institutes of Health announced an opportunity for public comment on a proposed data collection project concerning the Clinical Trials Reporting Program (CTRP) Database. The CTRP is an electronic resource that serves as a single source of information about all National Cancer Institute (NCI)-supported clinical research. This resource allows the NCI to consolidate reporting, aggregate data and reduce redundant submissions. Clinical research administrators submit information as designees of clinical investigators who conduct NCI-supported clinical research. Comments on the collection of information must be submitted no later than March 27. (Feb. 25)

The Department of Labor (DOL) has proposed amendments to two separate electronic disclosure safe harbors for purposes of implementing section 338 of the SECURE 2.0 Act of 2022. The two existing safe harbors permit the broad use of electronic disclosure under prescribed conditions for the furnishing of required disclosures under Title I of the Employee Retirement Income Security Act of 1974 (ERISA). Section 338 of SECURE 2.0 amended section 105(a)(2) of ERISA to require retirement plans to provide paper benefit statements in certain cases and instructed the DOL to update its electronic disclosure safe harbors in connection with statutory changes. The proposed amendments would implement these congressional mandates. Comments on the proposed amendments must be submitted no later than April 27. (Feb. 25) (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.