(a) A clinic may apply to be designated as a "Gold Designated Practice." In order to be eligible for a "Gold Designated Practice" status, a clinic must:
  (1) a Board-approved application form;
  (2) Provide a Medical Home Agreement, written collaborative, coordinated care agreement or memorandum of understanding to provide management and treatments of pain, that describes measures that it provides and may be used for reduction of pain such as, but not limited to:
    (A) multimodal treatment such as surgery, injections, pain pumps, osteopathic manipulation, epidurals, trigger point injections, dry needling, and topical creams or patches;
    (B) multi-disciplinary practices such as medication assisted tapering and weaning, computer-based training pain coaching, acupuncture, chiropractic, physical therapy, massage, and exercise/movement; or
    (C) collaborative care or other behavioral health integration services such as evidenced-based cognitive behavioral therapy interventions for mental health and pain reduction, medication management and opioid weaning, patient-centered education, regular monitoring and assessments of clinical status using validated tools, assessment of treatment adherence, motivational interviewing, and a structured approach to improving the biopsychosocial aspects of pain management; and
  (3) In addition to providing a Medical Home Agreement, written collaborative, coordinated care agreement or memorandum of understanding to provide management and treatments of pain described above, the clinic must either:
    (A) Meet the standards for exemption under Section 168.002(7) of the Act, including the clinic is operated by a majority of physicians who currently hold or previously held ABMS or AOA Board-certification or subspecialty certification in pain management; and
      (i) have a majority of physicians perform or properly supervise delegates in providing other forms of treatment besides qualifying pain management prescriptions to a majority of the patients at the clinic;
      (ii) the clinic's providers utilize a Medical Home Agreement signed by the primary prescriber and the patient; or
      (iii) have a written collaborative, coordinated care agreement or a memorandum of understanding with the patient's primary physician for treating and managing the patient; or
    (B) Be a Certified Pain Management Clinic (PMC) that is operated by physicians who previously held an ABMS or AOA Board-certification or sub-specialty in pain management or hold a ABMS or AOA Board-certification in an area that is eligible for a pain management subspecialty; and
      (i) have a Medical Home Agreement signed by the primary prescriber and the patient; or
      (ii) a written collaborative, coordinated care agreement or memorandum of understanding providing that each physician who prescribes qualifying prescriptions will consult with a pain specialist for the patient.
(b) The designation may be verified by an initial audit and is valid for five years.
(c) No further audits or inspections will be conducted during the five-year "Gold Designated Practice" period, unless:
  (1) A complaint is received or initiated by the Board concerning operation of the clinic or operators at the clinic;
  (2) The clinic changes location; or
  (3) The clinic's ownership structure changes to a majority of new owners.
(d) Practices that only treat pain patients as part of cancer care, or that provide only palliative care, hospice or other end-of-life care, are exempt under the Act from certification requirements as a PMC, but do not qualify for the "Gold Designated Practice" status.

Source Note: The provisions of this §195.2 adopted to be effective November 9, 2022, 47 TexReg 7412