Managing Healthcare Compliance in Texas

Sarah Jones
Outline of Texas over a healthcare photo

Managing healthcare compliance in Texas is nuanced and challenging. Healthcare providers and organizations are tasked with understanding and adhering to a unique set of state-specific regulations and requirements. To offer efficient and ethical healthcare services while mitigating legal and financial risks, these entities must adeptly navigate this intricate regulatory framework.

For successful compliance management in Texas, healthcare organizations need to develop a strong system for tracking and interpreting regulatory changes, and promptly adapt to these modifications. This article offers a comprehensive guide to essential aspects of healthcare compliance pertinent to Texas.

Texas Healthcare Compliance Resources

Let’s start with the important state government agencies you’ll need to work with:

  • The Texas Department of State Health Services (DSHS) plays a crucial role in promoting the health and wellbeing of Texans. With various departments and divisions, such as the Office of Compliance, the DSHS emphasizes ethics, integrity, and compliance with regulations and policies. 
  • The Texas State Board of Examiners of Professional Counselors (TSBEPC) is the regulatory body that oversees professional counselors. The TSBEPC ensures practitioners adhere to licensing requirements and maintain high standards of competence and ethical practice.
  • The Texas Hospital Association (THA) is a networking and leadership organization that advocates for legislation that supports budgeting for Texas hospitals and health care systems.
  • Texas Health and Human Services comprises hundreds of programs that work with federally qualified health clinics (FQHCs), medical associations, community partners, and local governments to help the public find the health care they need. The Texas HHS oversees regulations for Medicare- and state Medicaid-funded services. 
  • The Texas Medical Board safeguards and improves public health, safety, and welfare in Texas by upholding high standards in medical practice regulation and by promoting quality healthcare through licensing, disciplinary actions, and education.

These agencies help maintain the integrity and quality of healthcare services in Texas, protecting the public and promoting patient safety. The resources provided by these Texas state agencies are essential for promoting public health, ensuring access to healthcare, supporting healthcare professionals, and enhancing overall health outcomes for the residents of Texas.

Regulations Unique to Texas

To meet the standards of healthcare compliance in Texas, there are a few additional regulations.

Billing Requirements

Texas Senate Bill 490 went into effect September 1, 2023. The law requires hospitals and healthcare providers to issue detailed, itemized bills in plain-language to patients before seeking payment. This initiative addresses the escalating issue of medical debt across the nation, which is partly attributed to patients’ confusion about the billing process. The intent of the bill is to improve transparency and increase patients’ understanding of their medical charges.

Medical Marijuana and Cannabis Regulations

While Texas has not legalized recreational use of marijuana at the time of this post, Texas’s Compassionate Use Program (CUP) allows certain physicians to prescribe low-tetrahydrocannabinols (low-THC) cannabis for certain medical conditions. These conditions include epilepsy, seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, autism, terminal cancer, and incurable neurodegenerative diseases. Low-THC prescriptions are managed in the Compassionate Use Registry of Texas (CURT) database, provided by the Texas Department of Public Safety. CURT is an online system used by qualified physicians and dispensaries to verify patient information.

Tips To Manage Healthcare Compliance in Texas

Effectively managing healthcare compliance in Texas is a critical responsibility for healthcare organizations, as it ensures the delivery of high-quality care while adhering to legal and regulatory requirements. Here are some key strategies to help healthcare organizations manage compliance effectively:

  • Conduct State-Specific Training: Provide ongoing training and education to staff that is customized to your state’s regulations as well as your facility. If using a learning management system, ensure the vendor offers Texas-approved training.
  • Organize Policies By Requirement: Including “TX” in every document that is required by the state will make it much easier for you to find these documents in an online system when a surveyor is onsite. It is also best practice to include the standard you are meeting for additional clarity.
  • Establish a System for Monitoring Risk: Being able to identify compliance risks before they become incidents or violations can save the entire organization time and money. Identifying trends and consistently reviewing reports can signal issues, such as training not being completed or a large number of incidents in one location.
  • Use Compliance Management Software: Accreditation surveyors say organizations that use compliance software are more prepared for onsite visits and surveys. The software helps to keep documents and policies organized, ensures training content is up to date, and makes reporting easy.

By implementing these strategies and fostering a culture of compliance within your healthcare organization, you can effectively manage healthcare compliance, reduce risks, and provide the best possible care to your patients while staying within legal boundaries.

Credentialing and Licensing Compliance in Texas

The Texas Medical Board oversees medical credentialing and licensing within the state. Providers seeking medical credentialing in Texas are required to submit a completed application for their particular license. In general, provider applicants must graduate from appropriate educational institutions, pass national exams, pass their associated Texas Jurisprudence exam, and have good professional character and standing. The licensure department also processes applications for non-profit organizations to determine whether they meet the criteria to operate in Texas. 

Meet Texas Compliance Requirements With MedTrainer 

While the path may be complex, healthcare providers who prioritize compliance will not only avoid legal troubles but also enhance the quality of care they provide to their patients in Texas

MedTrainer’s all-in-one compliance platform can streamline management of Texas healthcare compliance. MedTrainer seamlessly consolidates your organization’s policies, incident reports, safety plans, HR documents, contracts, and more. This centralized repository ensures all employees have easy access to essential information. The course library is curated to align with regulatory and accreditation requirements, and courses are regularly added and updated to ensure the most current information. Learn more about MedTrainer today!