Health and Human Services Rulemaking

Rules are developed to show how Texas Health and Human Services (HHS) implements state and federal law. To be good stewards of the public trust, HHS takes into account stakeholder input when rules are being written or updated to ensure interested parties have a chance to contribute to the process.

Administrative Rule Transfers

HHS rules in the Texas Administrative Code (TAC) Title 1, Title 25, and Title 40 are moving, as a result of the changes in system structure made by the Texas Legislature to the HHS System in 2015 and 2017. To accommodate the large volume of new and old rules, the Secretary of State created new Title 26, Health and Human Services. The move will put all HHS rules in one place and make them easier to find. Stay up to date on new rules locations in the TAC.

How Can I Participate in the Process?

Engaging the public and stakeholders is an important element of the HHS rulemaking process. HHS provides informal and formal opportunities for the public and stakeholders to participate in the process.

Interested parties can participate by:

  • offering informal comments.
  • commenting on proposed rules published in the Texas Register.
  • providing input to an advisory committee.
  • attending an HHSC Executive Council meeting.

Informal Comments

Informal opportunities to comment occur before a rule is published in the Texas Register. HHS staff may solicit informal public and stakeholder input by:

  • inviting stakeholders to submit comments on potential rule changes during rule development.
  • sharing a draft rule with stakeholders for review.
  • using existing HHS advisory committees to comment on rules.

The following are draft rules on which HHS is accepting informal public or stakeholder input.

Draft Rules
Rule Title, Contact Person, and Rule Project Number Draft Rule - Comment Period Start Date Draft Rule - Comment Period End Date

Managed Care Organizations (MCO) Audit Coordination, concerning Chapter 353 Medicaid Managed Care
Contact: HHS Rules Coordination Office

Project # 18R019
August 21, 2019 September 4, 2019

MCO Audit Coordination, concerning Chapter 371 Medicaid and Other Health and Human Services Fraud and Abuse Program Integrity
Contact: Office of Inspector General

Project # 18R019
August 21, 2019 September 4, 2014

Medicaid and Children’s Health Insurance Program (CHIP) Provider Enrollment
Contact: Erin McManus

Project # 18R045
August 21, 2019 September 4, 2014

Medicaid Substance Use Disorder
Contact: HHS Rules Coordination Office

Project # 19R017
August 20, 2019 September 3, 2019

Formal Comments via the Texas Register

To let the public know about a rulemaking action – such as new, amended or repealed rules – HHS publishes a notice in the Texas Register, a publication of the Texas Secretary of State. Interested parties then can review and comment on the proposed rule. The Secretary of State publishes a new issue of the Texas Register each Friday.

The Administrative Procedure Act (Texas Government Code, Chapter 2001) requires the notice published in the Texas Register to include a brief explanation of the proposed rule and a request for comments from any interested person. The notice also includes instructions for submitting comments regarding the rule to the agency, including the date by which comments must be submitted. Agencies must give interested persons "a reasonable opportunity" to submit comments. The public comment period begins on the day after the notice of a proposed rule is published in the Texas Register and lasts for a minimum of 30 calendar days.

Below is a list of proposed rules that have been published in the Texas Register. The proposed rules that are published in the Texas Register are open for public comment until the end of the comment period.

Proposed Rules
Chapter Number, Rule Title Project Number, Project Description Contact Person Comment Period End Date
Title 26, Chapter 553, Licensing Standards for Assisted Living Facilities Project # 19R006 Assisted Living Facility – Emergency Preparedness HHS Rules Coordination Office September 16, 2019
Title 25, Chapter 229, Food and Drug Project # 19R040 Drug Manufacturer's Prescription and Nonprescription Licensure Fees HHSC Consumer Protection Division September 3, 2019
Title 1, Chapter 355, Reimbursement Rates Project # 19R039 Local Provider Participation Fund Reporting April Ferrino, Project Manager September 3, 2019 
Title 1, Chapter 354, Medicaid Health Services Project # 19R041 DSRIP Program Demonstration Years 7-8 HHSC Healthcare Transformation September 3, 2019 
Title 1, Chapter 355, Reimbursement Rates Project # 19R041 DSRIP Program Demonstration Years 9-10 HHSC Healthcare Transformation September 3, 2019 

Advisory Committees

Some rules may require approval of an advisory committee before being proposed in the Texas Register. For more information about HHS advisory committees, please visit the advisory committee web page.

HHSC Executive Council

The HHSC Executive Council reviews proposed rules at a scheduled meeting. Visit the HHS meetings and events page to learn about upcoming meetings.

How to Submit Comments

The Health and Human Services Rules Coordination Office coordinates the rulemaking process and assists health and human services staff involved in developing and publishing rules. For more information about how to submit comments or questions about HHS rulemaking, please email the Rules Coordination Office.

Tips for Submitting Public Comments

HHSC knows that our stakeholders spend a lot of time and energy thoughtfully considering proposed rules and policies, so we want to make sure that we are able to fully understand and consider each comment submitted. With that in mind, here are some tips for submitting comments.

Point to a specific rule or policy section

For example, "These rules/policies are too prescriptive" may be a valid comment, but it doesn't tell HHSC staff what the commenter thinks should be changed.

Consider pointing to specific requirements: "§597.201(a) states that foster children must play outside at least 2 hours per day. This seems too prescriptive."

Suggest an alternative

In the example above, the commenter thinks the requirement is too prescriptive, but doesn't offer any specific suggestions. HHSC staff can't be sure how the commenter would like the rule/policy changed to be less prescriptive.

The commenter may want to add, "Consider an 'average' of 2 hours per day" or "Consider exceptions for children with medical conditions as well as extreme weather, such as a hurricane."

Cite your sources

For example, a rule or policy requires facility staff to have 50 hours of annual training, but you would like to suggest 30 hours. HHSC chooses these types of requirements based on research, such as federal requirements, national association recommendations, industry standards, requirements for staff in similar settings, etc.

If a commenter suggests that a requirement be reduced, the comment is stronger if it includes a research source as validation for the suggestion.

Comment on rule/policy with which you agree

A rule/policy may be revised because 20 commenters asked for a change, but what if 100 potential commenters liked the proposed rule/policy and chose not to submit a comment?

Particularly for situations in which stakeholders may disagree, commenting on your support for a rule/policy may provide a valuable counterweight to other commenters who request a change.

What Happens Once A Rule Is Adopted?

After a rule is adopted by the Executive Commissioner of the Health and Human Services Commission, the adopted rule is published in the Texas Register. Once effective, rules are codified into the TAC, which is maintained by the Secretary of State.

To be notified when rules are adopted in the Texas Register, visit the Secretary of State site to register for email notification at

Frequently Asked Questions

What is a rule?

A rule is a specific type of state agency statement that implements or interprets law, prescribes policy, or describes the procedure or practice requirements of the agency. State agencies only adopt rules for aspects of their work that affect the public; internal management or organization will not be described in rule.

How is a rule different from a statute?

A Texas statute is created or amended by the Texas Legislature. A rule is adopted by a state agency that has either specific or implied rulemaking authority.

Why are rules needed?

Rules are often needed for a state agency to carry out its statutory duties. Rules hold the force of law and are a state agency's opportunity to give the public more detail about how the agency will implement law.

What is the Texas Register?

The Texas Register is a weekly publication of the Texas Secretary of State that includes proposed, adopted, withdrawn and emergency rule actions; notices of state agency review of agency rules; governor's appointments; attorney general opinions; and miscellaneous documents such as requests for proposals and public hearings.

What is the difference between a proposed rule and an adopted rule?

A proposed rule is a rule that a state agency intends to adopt. The state agency provides notice of this intention by publishing a notice of the proposed rule in the Texas Register. The notice includes a request for comments on the proposed rule. If the state agency has not adopted or actively withdrawn the proposed rule, it is automatically withdrawn six months after the published notice.

An adopted rule is the version of a rule that is adopted by a state agency. A rule may only be adopted after the state agency has given a reasonable opportunity for people to submit comments on the proposed rule. An adopted rule is filed with the Texas Secretary of State for publication in the Texas Register. Adopted rules are codified in the Texas Administrative Code, which is also maintained by the Texas Secretary of State. Health and Human Services system rules are located in Titles 1, 25, 26 and 40 of the Texas Administrative Code.

When does an adopted rule become effective?

Typically, a rule takes effect 20 calendar days after the date the adopted rule is filed with the Texas Secretary of State. A state agency can request a later effective date, as needed, but not an earlier effective date.

How up to date is the Texas Administrative Code?

The Texas Secretary of State updates the Texas Administrative Code daily.

Who can I contact for more information related to Texas Health and Human Services rules?

Keep up with rulemaking actions at HHS by signing up to receive email updates.

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