Hearing Instrument Fitters and Dispensers

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News and Updates

Over-the-Counter Category Coming for Hearing Instruments

Hearing instruments or hearing aids are regulated at the federal level as medical devices by the U.S. Food and Drug Administration (FDA). Changes are being made at the federal level regarding hearing instruments that will affect two of TDLR’s programs, the Hearing Instrument Fitters and Dispensers program and the Speech-Language Pathologists and Audiologists program. These two programs regulate the fitting and dispensing of hearing instruments by Texas licensees.

In August 2017, the U.S. Congress passed the FDA Reauthorization Act of 2017 (FDARA) | FDA, which in part defined “over-the-counter hearing aid,” required the FDA to establish a category of over-the-counter (OTC) hearing aids, and specified certain requirements that must be included in the FDA regulations. On October 20, 2021, the FDA published proposed regulations for public comment. These proposed regulations establish the OTC category and realign other regulations for hearing aids. The FDA will eventually publish final regulations, taking public comments into account.

You will find the proposed regulations published in the Federal Register, 86 FR 58150. Electronic or written comments on the proposed regulations must be submitted to the FDA by January 18, 2022. The Federal Register notice includes all the details about submitting public comments.

The FDA has issued a letter clarifying that the over-the-counter category of hearing aids does not exist until the effective date of published final regulations. Licensed Hearing Instrument Fitters and Dispensers and licensed Audiologists may wish to visit the FDA’s website on hearing aids for additional information. 

Continuing Education Requirements

HB 1560, the Sunset legislation for the Texas Department of Licensing and Regulation, repealed Occupations Code §402.303 and amended Occupations Code §402.207(c) and §402.305 under the Hearing Instrument Fitters and Dispensers statute, and transferred authority regarding the continuing education requirements to TDLR’s enabling statute, Chapter 51 of the Texas Occupations Code.

Please note that Hearing Instrument Fitter and Dispenser license holders and apprentice permit holders are still required to obtain continuing education (CE) credits as specified in the program rules.

Proposed Rule Changes

The Texas Department of Licensing and Regulation proposes amendments to an existing rule at 16 Texas Administrative Code, Chapter 112, Subchapter A, §112.2; proposes new rules at Subchapter N, §112.130 and §112.132; and proposes the repeal of an existing rule at Subchapter P, §112.150, regarding the Hearing Instrument Fitters and Dispensers program. The proposed rules implement the telehealth emergency rules on a permanent basis; implement SB 40, 87th Legislature, Regular Session (2021); and include changes as a result of the four-year rule review related to telehealth. The proposed rules also reorganize the existing provisions.

The proposed rules were published in the September 10, 2021, issue of the Texas Register (46 TexReg 5713). The Department will accept comments on the proposal until October 11, 2021.

The Department encourages anyone interested in the Hearing Instrument Fitters and Dispensers Program to review the rule proposal online. Comments may be submitted electronically on the Department’s website.

Commission Adopts Emergency Rule

The Texas Commission of Licensing and Regulation adopted emergency amendments to an existing rule at 16 Texas Administrative Code, Chapter 112, Subchapter P, §112.150, regarding the Hearing Instrument Fitters and Dispensers program.

The adopted emergency amendments (emergency rule) reflect the waivers that were granted by the Governor during the COVID-19 pandemic to remove restrictions and to expand the provision of services to clients through telehealth. These waivers are terminated effective September 1, 2021, and the emergency rule will ensure that services to clients may continue to be provided through telehealth as was allowed under the waivers until permanent rules are adopted. The emergency rule also reflects the change in the statutory authority regarding telehealth. The emergency rule is necessary to protect the public health, safety, and welfare. The emergency rule is effective September 1, 2021.

The emergency adoption justification was published in the August 27, 2021, issue of the Texas Register (46 TexReg 5327). The emergency adoption justification and the emergency rule may be viewed in the Texas Register or on the Department’s website.

TDLR Health Monitor – August 2021 Edition

Articles in this August 2021 edition of The Health Monitor includes updates on:

  • 2021 Legislative Session
  • Commissioner Spotlight
  • Athletic Trainers Mark 50 Years
  • Revised Massage Therapy Sample Consultation Document Available
  • How to File a Complaint

TDLR Health Monitor – May 2021 Edition

Articles in this May 2021 edition of The Health Monitor include updates on:

  • 2021 Legislative Session
  • Emergency License Extensions in Response to COVID-19 Delays
  • Meet Commissioner Callas
  • New Open Records Portal
  • New Way to Pay for Online Applications
  • Fingerprint Reminder for Massage Therapy Licensees

Rule Review Adoption Justification

At its meeting held March 3, 2021, the Texas Commission of Licensing and Regulation adopted the rule review of 16 Texas Administrative Code (TAC) Chapter 112, Hearing Instrument Fitters and Dispensers, effective March 15, 2021.

The rule review adoption was published in the March 26, 2021, issue of the Texas Register (46 TexReg 2050).

TDLR encourages all persons interested in the Hearing Instrument Fitters and Dispensers program to review the rule review adoption. The adoption justification is available online.

Rule Review Adoption Justification

At their meeting held March 3, 2021, the Texas Commission of Licensing and Regulation adopted the rule review of 16 Texas Administrative Code (TAC) Chapter 100, General Provisions for Health-Related Programs, effective March 15, 2021.

The rule review adoption was published in the March 26, 2021 issue of the Texas Register (46 TexReg 2050).

TDLR encourages all persons interested in the General Provisions for Health-Related Programs to review the rule review adoption. The adoption justification is available online.

Call for Subject Matter Experts

TDLR is seeking subject matter experts (SMEs) to assist our Enforcement Division with complaint case reviews. SMEs review complaint cases, generally involving standard of care issues, during the investigation stage of the enforcement process.

We currently have a shortage of Behavior Analyst, Podiatrist, and Speech-Language Pathologist SMEs.

If you are interested in becoming a SME, please complete the Expert Witness Application. Once the application is submitted, you will receive a questionnaire to complete and return. Documents are screened and contracts are issued to approved SMEs.

All SMEs receive training on their role in reviewing complaint cases. Tasks may include the following:

  • Reviewing documents and statements collected by investigators.
  • Writing a report stating an opinion as to whether the respondent violated a rule or law in the provision of care to a client.
  • Answering specific questions from the prosecutor about the case.
  • Testifying as a witness for TDLR at hearings.

Our mission is to protect the citizens of Texas and the hard-working members of your profession. We cannot do that without your specialized knowledge of the complexities of your profession. Please consider becoming a SME today.

TDLR Health Monitor – February 2021 Edition

Articles in this February 2021 edition of The Health Monitor include updates on:

  • 87th Session of the Texas Legislature
  • Emergency License Extensions in Response to COVID-19 Delays
  • Program Rule Changes
  • Call for Subject Matter Experts
  • New HHSC-Approved Human Trafficking Training Courses Available

Notice to prospective licensees, current licensees renewing their licenses, and stakeholders

Applicants can apply for new licenses and renew licenses online. TDLR strongly encourages you to take advantage of the opportunity to apply or renew online. The process is secure and easy to use – and faster than submitting paper-based applications and supporting documents, especially as TDLR deals with significant staffing issues related to COVID-19.

  • Applications submitted online can take 30 days to process once TDLR receives all required documents.
  • Applications submitted by mail may face significant delays, which may take up to 90 days once TDLR receives all required documents.

Access the online licensing system here. If you need to submit a document outside of the online application, please scan the document and send it to TDLR using our online customer service form.

If you need to submit a transcript, please ask your university to send electronic transcripts to TDLR at cs.transcript@tdlr.texas.gov instead of mailing in an original or certified copy of an original transcript. If your need to submit other documents, such as receipt of fingerprint submission, please scan the document and send it electronically to TDLR using our Customer Service form.

Thank you for helping us process your application or renewal more quickly.

86th Legislative Session Update

Notice to Health Care Practitioners of New Training Requirement

House Bill 2059 requires certain health care practitioners to complete a Health and Human Services Commission (HHSC) approved human trafficking prevention training course to renew their license. The bill also requires HHSC to post a list of approved courses on their website. Licensees are required to comply with the training requirements beginning September 1, 2020. For more information, visit our Human Trafficking Prevention Training for Health Care Practitioners webpage.

Governor Approves Regulatory Suspensions to Facilitate Services to Hearing Instrument Fitter and Dispenser Clients During the COVID-19 Pandemic

To help combat the spread of Coronavirus, TDLR requested and received authority from Governor Greg Abbott to suspend certain regulatory requirements, to the extent necessary, to allow licensees of the Hearing Instrument Fitters and Dispensers program to provide more services to clients through telehealth and to ease other licensing restrictions.

These suspensions are in effect until terminated by the Office of the Governor or until the March 13, 2020 disaster declaration is lifted or expires. In accordance with Section 418.016 of the Texas Government Code, the Office of the Governor has granted TDLR’s request to suspend the following provisions:

Supervision:

  • A supervisor of a temporary training permit holder is no longer required to be working in an established place of business (suspension of Texas Occupations Code §402.255(a)(2)).

Practice:

  • For those licensees approved to provide telehealth services:
    • A smart phone, or any audio-visual, real-time, or two-way interactive communication system, qualifies as telecommunications technology and may now be used to provide telehealth services, as well as telehealth services related to fitting and dispensing hearing instruments (suspension of 16 TAC §§112.150(b)(8)-(11), (d), (f), and (k)).
    • Hearing instrument fitters and dispensers are no longer required to conduct an initial professional contact in person at the same physical location as the client (suspension of 16 TAC §112.150(l)).
    • Services provided through telehealth must be performed at the same standard of care as in-person health care and within the licensee’s scope of practice and competence, and the equipment used must be appropriate for the situation and properly working as required under 16 TAC112.150(j) and (k).

Facilitators:

  • If a facilitator assists with the provision of telehealth services, no prior training is necessary if the provider determines that the facilitator has the competence needed to assist with the services given (suspension of 16 TAC §150(g) and (h)(1).

Licensees who need additional information on billing policies relating to the provision of telehealth services during the COVID-19 pandemic should contact Texas Health and Human Services Medicaid or managed care organizations (MCOs), as policies are changing rapidly. It is critical to check with your payor before initiating a new type of service or service delivery model, such as telehealth.

Before providing telehealth services, licensees should verify the applicability of other requirements and obligations, such as HIPAA and other medical and personal privacy requirements.

COVID-19: Continuing Education Waived

TDLR continuing education requirements are waived for all individual licenses expiring in March, April, and May 2020. Licensees still need to submit their renewal applications, pay the required fees, and TDLR will check their criminal histories, but they will not need to complete any TDLR-required continuing education this licensing cycle. (§51.405, Occupations Code)

Note: TDLR is not authorized to waive continuing education requirements imposed by a certifying or credentialing entity other than TDLR. If a certifying entity requires continuing education to maintain certification, and certification is required for Texas licensure, then that continuing education must be completed. If the certifying entity waives continuing education or allows it to be completed on a delayed basis due to COVID-19, then you may follow the certifying entity’s policy.

Please check the TDLR COVID-19 webpage for the most up-to-date information.

Guidance Statement on TDI Rules Related to Senate Bill 1264

The Texas Department of Insurance (TDI) has adopted emergency rules interpreting Senate Bill (SB) 1264’s prohibitions related to “surprise billing” (or “balance billing”). This Guidance Statement is intended to provide clear information concerning SB 1264 to Texas patients, clients, and health care providers under the regulatory authority of the Texas Department of Licensing and Regulation (TDLR).

SB 1264 prohibits surprise billing, with certain exceptions. Health care providers under TDLR’s regulatory authority who seek to exercise the exceptions to SB 1264’s prohibitions against balance billing must comply with all provisions of SB 1264, including as interpreted by TDI rules. See the TDI SB 1264 webpage for additional information. SB 1264 applies to a health care or medical service or supply provided on or after January 1, 2020.

TDLR will be responsible for investigating complaints and taking disciplinary action against TDLR licensees for violations of SB 1264, including as interpreted by TDI rules. Any person who believes that a TDLR-licensed health care provider has committed a balance billing-related violation may file a complaint online with TDLR. Additionally, TDLR and TDI will work together to ensure that any complaints filed with TDI regarding TDLR licensees will be referred to TDLR and investigated.

TDLR will be working on the development of enforcement rules consistent with SB 1264 and TDI’s rules interpreting the statute. As rulemaking moves ahead, we look forward to a transparent process and engaging the public and stakeholders on this important issue.


Advisory Board Meetings

November 9, 2021

The Hearing Instrument Fitters and Dispensers Advisory Board met November 9, 2021 via videoconference. The agenda and staff reports are available online. The meeting was archived and is available on TDLR's YouTube channel.