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Below is a spotlight on the proposed, adopted, and withdrawn rules from the September 27 edition of the Texas Register.

 Education

Texas Education Agency – Charter Schools 

Adopted

  • Chapter 100, General Provisions – The Texas Education Agency (TEA) adopts amendments and reorganizes sections related to the general provisions governing charter schools. These updates streamline the application procedures and operational requirements for open-enrollment charter schools, ensuring compliance with updated state laws. High-performing charter school operators benefit from simplified processes for expansion and renewal, while enhanced financial and governance accountability measures are enforced. The changes provide clearer guidelines regarding reporting requirements and operational procedures. Effective date: October 27, 2024.
  • Chapter 100, Commissioner Action and Intervention – The amendments expand the commissioner’s authority to intervene in the operations of charter schools that are not meeting academic or financial accountability standards. These provisions outline the processes for performance monitoring, interventions, and revocation or amendment of charters due to non-compliance or poor performance. The updates are to make sure that charter schools are held accountable for meeting state standards, with more stringent oversight for those failing to comply. Effective date: October 27, 2024.
  • Chapter 100, Property of Open-Enrollment Charter Schools – New rules regulate how charter schools manage the acquisition, use, and disposal of state-funded property. Charter holders are required to report all transactions involving state and federally funded property to prevent misuse and add transparency. The rules mandate detailed documentation for purchasing, leasing, or disposing of property and require strict adherence to reporting protocols. Effective date: October 27, 2024.
  • Chapter 100, Charter School Governance – Governance-related amendments strengthen the responsibilities of charter school governing boards, including conflict of interest policies, financial oversight, and training requirements. Board members must follow enhanced documentation and reporting standards for effective leadership and financial accountability. These changes emphasize transparency and ethical governance, that charter boards uphold the academic and financial integrity of their schools. Effective date: October 27, 2024.
  • Chapter 100, Charter School Operations and Attendance – Amendments to operational rules focus on improving enrollment and attendance policies for charter schools. These updates streamline processes for enrolling at-risk and special needs students and enhance attendance reporting protocols that affect state funding. Schools must maintain accurate documentation for audits and comply with state requirements for student record-keeping. The updates to the Student Attendance Accounting Handbook for the 2024-2025 school year are adopted by reference. Effective date: October 27, 2024.

Texas Education Agency

Adopted

  • Chapter 129, Student Attendance – The Texas Education Agency (TEA) adopts amendments to the student attendance accounting system for the 2024-2025 school year. The rule updates the Student Attendance Accounting Handbook to incorporate changes to attendance reporting, eligibility requirements for the Foundation School Program (FSP), and necessary documentation for audits. These changes are designed for school districts and charter schools comply with state regulations and report attendance accurately for funding purposes. The amendments streamline reporting processes and introduce new requirements for students in special programs, including virtual learning and remote attendance. Effective date: October 1, 2024.
  • Chapter 150, Commissioner’s Rules Concerning Educator Appraisal – The Texas Education Agency adopts amendments to the commissioner’s rules on educator appraisal systems. The revisions provide more flexibility for school districts and charter schools to implement local teacher designation systems. The amendments update procedures for resubmitting applications, extend deadlines for districts facing extenuating circumstances, and modify the terminology used in educator appraisals. Additionally, the rule introduces a new definition of the “data capture year” and outlines renewal application requirements in the fourth year after a system is accepted. Effective date: October 1, 2024.

Energy

Public Utility Commission of Texas

Adopted

  • Chapter 25, Reliability Standard for ERCOT Region – The PUCT adopts new rules regarding the reliability standards for the Electric Reliability Council of Texas (ERCOT) power region. These rules establish reliability metrics for frequency, duration, and magnitude of load-shedding events to ensure ERCOT’s system meets state reliability goals. The rule outlines a probabilistic model that will be used to assess if the system meets the standard and requires periodic evaluations of ERCOT’s system. Key elements include defining loss of load events, setting an exceedance tolerance, and requiring ERCOT to report annually on the maximum megawatts of load that can be safely rotated. Effective date: September 29, 2024.
  • Chapter 25, Texas Energy Fund In-ERCOT Generation Loan Program – The PUCT adopts amendments to correct an omission related to formulas used in the Texas Energy Fund In-ERCOT Generation Loan Program. The changes are for accuracy in the calculation formulas used to determine loan amounts for in-ERCOT generation projects, supporting the enhancement of energy reliability and generation capacity within the ERCOT region. Effective date: September 29, 2024.

Gaming

Texas Lottery Commission

Proposed

  • Chapter 401, Administration of State Lottery Act – The Texas Lottery Commission proposes amendments to strengthen penalties for lottery retailers who sell tickets to minors. Under the revised rules, any retailer who knowingly or intentionally sells a lottery ticket to a person under the age of 18 will face automatic revocation of their license. These amendments reinforce the Commission’s zero-tolerance policy and aim to prevent the sale of lottery tickets to minors. Additionally, the Standard Penalty Chart in 16 TAC §401.160 will reflect these changes, establishing license revocation as the penalty for such violations. The earliest possible adoption date is October 27, 2024.

Healthcare

Department of State Health Services

Adopted

  • Chapter 289, Radiation Control – DSHS has adopted amendments to §289.229, which pertains to radiation safety requirements for accelerators, therapeutic radiation machines, simulators, and electronic brachytherapy (EBT) devices. The amendments aim to update and clarify safety regulations for compliance with current industry standards, particularly regarding equipment used in therapeutic and diagnostic radiation. Key changes include the addition of Equipment Performance Evaluation (EPE) requirements for Computed Tomography (CT) units used in simulation, reinforcing safety through proper evaluation and verification of equipment performance. Further, new safety interlock requirements have been introduced for add-on equipment to enhance patient and operator protection. The rule also reorganizes the structure of the document to enhance readability and accessibility, including relocating Electronic Brachytherapy (EBT) requirements to the general provisions section, making the overall rule easier to navigate. This reorganization and the updated safety protocols aim to maintain high standards for radiation protection in medical settings. Effective date: September 27, 2024.

Health and Human Services Commission

Adopted

  • Chapter 550, Licensing Standards – HHSC adopts amendments to rules governing the licensing and operation of Prescribed Pediatric Extended Care Centers (PPECCs) to comply with House Bill 1009 and House Bill 3550, passed during the 88th Legislature. These amendments address requirements for suspending employees found to have engaged in reportable conduct, transportation services coordination, and updates to the licensing application and maintenance process. The rules are for enhanced safety for minors, setting clear guidelines on employee suspensions, transportation, and operational compliance. Effective date: October 16, 2024.
  • Chapter 550, Operations and Safety Provisions – These rules update operational and safety provisions for PPECCs. Facilities are required to meet updated standards for daily operations, including patient safety measures and the coordination of care with parents or guardians. Amendments also include enhanced protocols for facility safety, ensuring PPECCs provide a secure environment for the children in their care. Effective date: October 16, 2024.
  • Chapter 550, Administration and Management – Changes to administration and management standards focus on ensuring that PPECCs adhere to strict governance practices. These rules mandate clear roles and responsibilities for administrators, require robust documentation and record-keeping practices, and outline procedures for compliance with state health and safety standards. Effective date: October 16, 2024.
  • Chapter 550, Nursing and Staffing Requirements – Amendments to nursing and staffing requirements are meant that PPECCs maintain adequate staff-to-patient ratios, and that nursing staff meet updated certification and training standards. These changes reinforce the need for well-trained staff to provide high-quality care to minors with complex medical needs. Effective date: October 16, 2024.
  • Chapter 550, General Services – Revisions to general services rules specify the provision of non-medical services, such as facility cleanliness, maintenance, and security, to create a safe and comfortable environment for minors. The rules also clarify the requirements for PPECCs to offer supportive services essential to daily operations. Effective date: October 16, 2024.
  • Chapter 550, Admission, Assessment, and Care – New rules establish clear criteria for admitting children to PPECCs, including detailed requirements for care assessments, interdisciplinary plans of care, and discharge or transfer protocols. These provisions make that minors receive comprehensive evaluations and customized care plans. Effective date: October 16, 2024.
  • Chapter 550, Physician, Pharmacy, and Medication Services – These amendments update the standards for physician oversight, medication administration, and pharmacy services within PPECCs. The rules state that all medications and treatments are administered under the supervision of qualified healthcare professionals and that records are accurately maintained. Effective date: October 16, 2024.
  • Chapter 550, Care Policies and Coordination – Updated care policies emphasize the coordination of services between the PPECC, families, and healthcare providers. The rules make certain that PPECCs maintain accurate census records and coordinate with external providers to deliver high-quality care. Effective date: October 16, 2024.
  • Chapter 550, Rights and Responsibilities, Abuse, and Reporting – Revised rules outline the rights and responsibilities of minors and their guardians, addressing critical issues like advance directives, abuse prevention, and neglect reporting. Facilities are required to have robust protocols in place for investigating and reporting abuse, neglect, or exploitation, along with clear death reporting procedures. Effective date: October 16, 2024.
  • Chapter 550, Medical Records and Quality Improvement – Amendments to medical recordkeeping and quality assessment protocols secure that PPECCs maintain comprehensive and accurate records. These provisions also mandate the implementation of quality improvement programs to monitor and enhance service delivery. Effective date: October 16, 2024.
  • Chapter 550, Transportation, Building Requirements, and Inspections – Updates to transportation services outline procedures for coordinating transportation for minors, while changes to building requirements warrant that PPECC facilities meet updated safety and accessibility standards. Regular inspections are mandated with ongoing compliance with state regulations. Effective date: October 16, 2024.

Texas Medical Board 

Proposed

  • Licensure and Certification for Healthcare Professionals, 22 TAC §§161.1 – 161.73, §§163.1 – 163.13, §§184.1 – 184.27, §§183.1 – 183.27, §§186.1 – 194.34, §§188.1 – 188.30, §§186.1 – 186.30, §§172.1 – 172.21 – The Texas Medical Board proposes amendments affecting licensure and certification for physicians, surgical assistants, radiologic technologists, acupuncturists, perfusionists, and respiratory care practitioners. These changes streamline qualifications for obtaining, renewing, and maintaining licenses, with updated educational and continuing education requirements to reflect advancements in medical practice and technology. For all professions, the amendments emphasize maintaining competency through ongoing education and compliance with professional standards. The rules clarify the scope of practice for surgical assistants, radiologic technologists, and acupuncturists, ensuring they operate under appropriate supervision. Temporary and limited licenses have been revised to ensure short-term practitioners meet necessary qualifications. The earliest possible adoption date for these changes is October 13, 2024.
  • Disciplinary Actions and Compliance, 22 TAC §§177.1 – 178.9, §§179.1 – 179.8, §§187.1 – 187.89, §§190.1 – 190.16, §§180.1 – 180.5 – The Texas Medical Board proposes updates to its disciplinary procedures, investigations, and compliance programs across various healthcare professions. These changes streamline the processes for handling complaints, investigations, and disciplinary actions against healthcare providers. The amendments introduce guidelines for determining sanctions based on the severity of violations, repeat offenses, and risks to patient safety. The revisions enhance the complaint filing process, for accessibility and transparency, and emphasize the timely resolution of investigations. Additionally, the rules clarify the role of the Texas Physician Health Program (TXPHP) in supporting physicians with mental health, substance abuse, or physical impairments, offering confidential rehabilitation while maintaining public safety. The earliest possible adoption date is October 13, 2024.
  • Delegation and Supervision, 22 TAC §§169.1 – 169.28, §§162.1 – 162.2, §§193.1 – 193.13 – The Texas Medical Board proposes amendments to the rules regarding the delegation of medical tasks and the supervision of healthcare professionals and students. These changes clarify the types of tasks that physicians can delegate to non-physicians, such as physician assistants and nurses, as well as the responsibilities of supervising physicians. The amendments confirm that delegated tasks are performed under appropriate oversight and that all medical staff comply with state regulations. Additionally, the revisions specify the supervision requirements for medical school students, ensuring they receive proper guidance during their clinical training. The rules also address the need for written agreements between physicians and those to whom tasks are delegated for accountability and clear communication. The earliest possible adoption date is October 13, 2024.
  • Prescription and Drug-Related Regulations, 22 TAC §§169.1 – 169.8, §§170.1 – 170.10, §§195.1 – 195.5 – The Texas Medical Board proposes amendments to regulations concerning the prescription of controlled substances, drug dispensing by physicians, and the operation of pain management clinics. The changes emphasize strict oversight on the prescription of opioids and other controlled substances, requiring thorough patient assessments, compliance with prescription drug monitoring programs (PDMPs), and detailed documentation to prevent misuse. The amendments also clarify physicians’ authority to supply drugs directly to patients, ensuring compliance with state and federal laws. Pain management clinics face updated operational standards to address the opioid crisis, with a focus on ensuring that clinics maintain rigorous regulatory compliance to prevent the overprescription of pain medications. The earliest possible adoption date is October 13, 2024.
  • Patient Care and Safety, 22 TAC §192.1 – 192.6, §§198.1 – 198.6, §§200.1 – 200.3 – The Texas Medical Board proposes amendments aimed at enhancing patient care and safety in specialized areas. These changes include updates to the rules for office-based anesthesia services, emphasizing proper qualifications, equipment standards, and emergency protocols to make sure patient safety during anesthesia procedures outside hospital settings. Additionally, new standards for the use of investigational agents in clinical trials are proposed, focusing on patient consent, safety monitoring, and compliance with federal regulations. The amendments also introduce updated guidelines for physicians practicing complementary and alternative medicine (CAM), requiring transparency about risks, benefits, and scientific support for treatments. The earliest possible adoption date is October 13, 2024.
  • Chapter 160, Medical Physicists – The Texas Medical Board proposes comprehensive amendments regarding medical physicists. These changes address definitions, licensure requirements, renewal processes, continuing education, and disciplinary procedures. The rules aim to clarify the scope of practice for medical physicists and outline specific qualifications necessary for licensure. Furthermore, the amendments detail the peer review process for assessing professional conduct and include new provisions on disciplinary actions such as license suspension or revocation. These changes also bring the regulations in line with the latest technological advances and updates in both federal and state regulatory frameworks. The earliest possible adoption date is October 13, 2024.
  • Chapter 161, General Provisions – Amendments to the general provisions governing the Texas Medical Board are proposed to improve the board’s operations and streamline its rulemaking authority. These changes clarify the responsibilities and powers of the board, including how meetings are conducted and how rulemaking procedures are handled. The amendments also introduce guidelines for handling public petitions for rulemaking and how the board responds to such petitions. The goal is to enhance the transparency and efficiency of the board’s governance processes. The earliest possible adoption date is October 13, 2024.
  • Chapter 162, Physician Profiles – The Texas Medical Board is updating the rules governing physician profiles. These amendments clarify the information that must be included in a physician’s public profile, such as licensure status, disciplinary history, and malpractice claims. The changes aim for transparency and provide patients with access to relevant information about their healthcare providers. The earliest possible adoption date is October 13, 2024.
  • Chapter 163, Medical Records – The proposed amendments to the medical records rules focus on ensuring physicians maintain proper documentation of patient care. These changes outline the requirements for maintaining, storing, and retaining medical records, as well as ensuring that records are accurate and complete. The rules specify the length of time records must be kept and provide guidance on the secure disposal of medical records when they are no longer required. Amendments also address patient access to records, emphasizing timely and secure access for patients or their authorized representatives. The earliest possible adoption date is October 13, 2024.
  • Chapter 164, Physician Advertising – The Texas Medical Board is revising the rules related to physician advertising for transparency and accuracy in the promotion of medical services. The amendments include restrictions on misleading advertising practices, requiring that advertisements reflect the physician’s actual qualifications, specialties, and services. Physicians must avoid making claims that cannot be substantiated or that mislead patients. These rules also address the use of testimonials and guarantees of treatment outcomes. The earliest possible adoption date is October 13, 2024.
  • Chapter 165, Medical Records – The amendments to Chapter 165 provide updates on the handling, maintenance, and transfer of medical records. The rules emphasize the responsibility of physicians to confirm that patient records are kept confidential and secure. This includes safeguarding against unauthorized access and complying with both state and federal regulations regarding patient privacy. The amendments also clarify the procedures for transferring records to another physician or healthcare provider upon a patient’s request or in the case of a physician’s retirement or closure of their practice. The earliest possible adoption date is October 13, 2024.
  • Chapter 166, Physician Registration – Changes to physician registration rules focus on the renewal process, including the documentation and continuing education requirements necessary for maintaining active licensure. The amendments clarify deadlines for renewal submissions and the penalties for late renewal. Physicians who fail to renew their licenses within the prescribed time may face suspension or revocation of their license. These revisions also include updates on verifying licensure and maintaining accurate information in the state’s physician database. The earliest possible adoption date is October 13, 2024.
  • Chapter 167, Reinstatement and Reissuance – The proposed changes to reinstatement and reissuance rules outline the process by which a physician whose license has been revoked or suspended may apply for reinstatement. The amendments specify the conditions under which reinstatement may be granted, including the completion of any required remediation, compliance with disciplinary orders, and submission of supporting documentation. These rules also address the reissuance of licenses after a physician has voluntarily surrendered their license or allowed it to lapse. The earliest possible adoption date is October 13, 2024.
  • Chapter 168, Criminal History Evaluation Letters – Amendments to these sections introduce new guidelines for the Texas Medical Board’s evaluation of criminal history when considering an applicant for licensure. The proposed changes require applicants to submit a criminal history evaluation letter if they have a history of convictions or deferred adjudications. The board will assess the severity and relevance of the criminal history in determining eligibility for licensure. These amendments aim to protect patient safety while providing transparency in the evaluation process. The earliest possible adoption date is October 13, 2024.
  • Chapter 171, Postgraduate Training Permits – The Texas Medical Board is revising the rules related to postgraduate training permits. These permits allow individuals in residency or fellowship programs to practice under supervision while completing their medical training. The amendments specify the requirements for obtaining and renewing postgraduate training permits, including proof of enrollment in an accredited training program and documentation of progress toward completing training. The revisions also clarify the responsibilities of the training institution and supervising physician in overseeing the permit holder’s activities. The earliest possible adoption date is October 13, 2024.
  • Chapter 172, Pain Management Clinics – The Texas Medical Board is proposing changes to the rules governing the operation of pain management clinics. These amendments focus on tightening oversight of clinic operations, including the qualifications of physicians who operate or staff these clinics. The changes aim to address concerns about the over-prescription of opioids and other controlled substances by ensuring that pain management clinics comply with stricter regulatory standards. The amendments also emphasize the importance of regular inspections and audits to confirm that clinics are adhering to both state and federal laws. The earliest possible adoption date is October 13, 2024.
  • Chapter 173, Physician Profiles – Revisions to the rules governing physician profiles provide updates on the information that must be publicly available about licensed physicians. These changes ensure that patients have access to relevant details about a physician’s qualifications, licensure status, disciplinary actions, and malpractice claims. The amendments also streamline the process for physicians to update their profiles and verify that the information is accurate and up to date. The earliest possible adoption date is October 13, 2024.
  • Chapter 174, Telemedicine – The amendments to the telemedicine rules reflect the increasing role of telemedicine in healthcare delivery. These changes clarify the requirements for practicing telemedicine, including the establishment of a physician-patient relationship, informed consent, and the use of secure technology for consultations. The rules emphasize the importance of maintaining the same standards of care in telemedicine as in in-person consultations, including proper documentation and follow-up care. The amendments also address the limitations on prescribing controlled substances via telemedicine, aligning the rules with federal and state regulations. The earliest possible adoption date is October 13, 2024.
  • Chapter 174, Business Organizations – The proposed amendments clarify the rules regarding business organizations involving physicians. These changes specify the types of business structures that physicians may enter while maintaining compliance with Texas law. The rules emphasize that physicians must avoid business relationships or agreements that could compromise their professional independence or lead to conflicts of interest. Additionally, the amendments provide guidelines for reporting business arrangements and agreements to the Texas Medical Board. The earliest possible adoption date is October 13, 2024.
  • Chapter 175, Fees and Penalties – Amendments to the fees and penalties sections address the costs associated with licensure, renewal, and disciplinary actions. These changes update the fee structure for initial licensure, license renewals, and other administrative actions handled by the Texas Medical Board. Additionally, the amendments clarify the penalties imposed for late renewals, non-compliance with continuing education requirements, and other violations of board rules. The earliest possible adoption date is October 13, 2024.
  • Chapter 176, Health Care Liability Lawsuits and Settlements – The proposed amendments to this section focus on the reporting of healthcare liability lawsuits and settlements involving physicians. The revisions say that physicians are required to report any malpractice claims or settlements to the Texas Medical Board within a specified timeframe. The amendments are intended for transparency and accountability, allowing the board to maintain accurate records of any legal actions taken against licensed physicians. These changes are also designed to protect patient safety, so that the board has the necessary information to assess the competence and professional conduct of physicians. The earliest possible adoption date is October 13, 2024.
  • Chapter 176, Reporting Malpractice Claims – These sections focus on the specific requirements for reporting malpractice claims. The amendments clarify the types of claims that must be reported and the deadlines for submitting reports to the Texas Medical Board. Physicians are required to report any malpractice claims that result in settlements or judgments, and failure to do so may result in disciplinary action. The earliest possible adoption date is October 13, 2024.
  • Chapter 177, Business Organizations and Agreements – The amendments to the rules governing business organizations and agreements provide additional clarity on the types of business structures that physicians may engage in. These changes are intended to prevent conflicts of interest and that physicians maintain their professional independence when entering into business arrangements. The amendments also specify the types of agreements that must be reported to the Texas Medical Board, such as management services agreements and joint ventures. The earliest possible adoption date is October 13, 2024.
  • Chapter 178, Complaints – The amendments to the complaints rules focus on streamlining the process for patients and the public to file complaints against physicians. These changes clarify the types of complaints that the Texas Medical Board will investigate, and the steps involved in filing a complaint. The amendments also provide guidelines for how the board will handle anonymous complaints and complaints involving multiple physicians or healthcare providers. The goal of the changes is to make the complaints process more accessible and transparent for the public. The earliest possible adoption date is October 13, 2024.
  • Chapter 179, Investigations – These sections detail the procedures for conducting investigations into allegations of misconduct or violations of board rules by physicians. The amendments specify the types of evidence that may be collected during an investigation, the role of the board’s investigators, and the rights of the physician being investigated. The revisions also include guidelines for handling sensitive information, such as patient records, during the investigation process. The changes are intended that investigations are conducted fairly and efficiently, while protecting the rights of both patients and physicians. The earliest possible adoption date is October 13, 2024.
  • Chapter 181, Contact Lens Prescriptions – The amendments to the contact lens prescription rules clarify the responsibilities of physicians when prescribing contact lenses. These changes emphasize the importance of conducting thorough eye examinations and ensuring that prescriptions are accurate and in compliance with federal regulations. The revisions also address the proper documentation of contact lens prescriptions and the timelines for issuing prescriptions to patients. The earliest possible adoption date is October 13, 2024.
  • Chapter 181, Compliance Program – The proposed changes to the compliance program rules focus on ensuring that physicians adhere to board regulations and state laws. These amendments provide clearer guidelines for the implementation of compliance programs within medical practices, emphasizing the importance of regular audits and self-assessments to identify potential areas of non-compliance. The revisions also outline the responsibilities of physicians in correcting any compliance issues that are identified during audits. The earliest possible adoption date is October 13, 2024.
  • Chapter 182, Use of Experts – These sections provide guidelines for the use of expert witnesses in investigations and disciplinary proceedings. The amendments clarify the qualifications required for expert witnesses, as well as the procedures for selecting and appointing experts to review cases. The changes also outline the role of experts in providing testimony and their responsibilities in ensuring that their opinions are based on sound medical knowledge and evidence. The earliest possible adoption date is October 13, 2024.
  • Chapter 183, Physician Assistants – The proposed changes to the physician assistant (PA) rules focus on licensure, supervision, and scope of practice. The amendments clarify the qualifications required for licensure, including the educational and certification requirements. The rules also emphasize the importance of maintaining proper documentation and ensuring that PAs work under the supervision of licensed physicians in accordance with state law. The changes include guidelines for the delegation of medical tasks and responsibilities to PAs, ensuring that they operate within their scope of practice. The earliest possible adoption date is October 13, 2024.
  • Chapter 189, Compliance Program – The proposed amendments to the compliance program rules clarify the responsibilities of physicians and medical practices in adhering to state laws and Texas Medical Board regulations. The compliance program emphasizes regular audits, self-assessments, and corrective actions that practices to maintain compliance with the rules. The amendments also address the procedures for identifying and correcting non-compliance issues, with a focus on preventing future violations. These revisions aim to promote greater accountability and transparency within medical practices. The earliest possible adoption date is October 13, 2024.
  • Chapter 189, Medical Physicists, Chapter 194 Medical Radiologic Technology, Chapter 197 Emergency Medical Service – Amendments to the medical physicists, medical radiologic technology, and emergency medical service rules provide updates on the licensure, practice standards, and continuing education requirements for working in Texas. The changes clarify the qualifications necessary for licensure, as well as the procedures for renewing licenses and completing required continuing education credits. The revisions also address the scope of practice for medical physicists, ensuring that they adhere to established professional standards and work within the boundaries of their certification. The earliest possible adoption date is October 13, 2024.