Sec. 241.1865. WAIVER FROM LEVEL OF CARE DESIGNATION REQUIREMENTS; CONDITIONAL DESIGNATION. (a) The department shall develop and implement a process through which a hospital may request and enter into an agreement with the department to: (1) receive or maintain a level of care designation for which the hospital does not meet all requirements conditioned on the hospital, in accordance with a plan approved by the department and outlined under the agreement, satisfying all requirements for the level of care designation within a time specified under the agreement, which may not exceed the first anniversary of the effective date of the agreement; or (2) waive one specific requirement for a level of care designation in accordance with Subsection (c). (b) The process developed and implemented under this section must: (1) subject to Subdivision (2), allow a hospital to submit a written request under Subsection (a) at any time; (2) require a hospital to: (A) before submitting the request, provide notice of the hospital's intention to seek a waiver under this section to the hospital's medical staff who practice in a specialty service area affected by the waiver; (B) provide the notice required by Paragraph (A) in accordance with the hospital's process for communicating information to medical staff; and (C) document the provision of the notice required by Paragraph (A); and (3) allow the department to make a determination on the request at any time. (c) The department may enter into an agreement with a hospital to waive a requirement under Subsection (a)(2) only if the department determines the waiver is justified after considering: (1) the expected impact on: (A) the accessibility of care in the geographical area served by the hospital if the waiver is not granted; and (B) quality of care and patient safety; or (2) whether health care services related to the requirement can be provided through telemedicine medical services under Section 241.1835 . (d) A waiver agreement entered into under Subsection (a): (1) must expire not later than at the end of each designation cycle but may be renewed on expiration by the department under the same or different terms; and (2) may specify any conditions for ongoing reporting and monitoring during the agreement. (e) A hospital that enters into a waiver agreement under Subsection (a) is required to satisfy all other requirements for a level of care designation that are not waived in the agreement. (f) The department shall post on the department's Internet website and periodically update: (1) a list of hospitals that enter into an agreement with the department under this section; and (2) an aggregated list of the requirements conditionally met or waived in agreements entered into under this section. (g) A hospital that enters into an agreement with the department under this section shall post on the hospital's Internet website the nature and general terms of the agreement.
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