(a) If the Texas Health and Human Services Commission (HHSC) has reason to believe that a person or facility may be providing emergency medical care services as defined in this chapter without a license, HHSC will notify the person or facility in writing by certified mail, return receipt requested. Not later than 20 calendar days after the date the person or facility receives the notice, the person or facility shall submit to HHSC either:
  (1) an application for a license and the nonrefundable license fee;
  (2) a claim for exemption under §509.22 of this subchapter (relating to Exemptions from Licensure); or
  (3) documentation sufficient to establish that freestanding emergency medical care services are not being provided, including a notarized statement that freestanding emergency medical care services are not being provided and listing the types of services that are provided.
(b) If a person or facility submits an application for a license, HHSC will process the application in accordance with §509.25 of this subchapter (relating to Application and Issuance of Initial License).
(c) If the person or facility submits a claim for exemption, HHSC shall evaluate the claim for exemption and notify the person or facility in writing of the proposed decision within 30 calendar days following receipt of the claim for exemption.
(d) If the person or facility submits sufficient documentation, under subsection (a)(3) of this section, to establish that the facility does not provide freestanding emergency medical services, HHSC shall notify the person or facility in writing that no license is required not later than 30 calendar days after HHSC receives the documentation.
(e) If HHSC determines the documentation submitted under subsection (a)(3) of this section is insufficient, HHSC shall notify the person or facility in writing not later than 30 calendar days after HHSC received the documentation. The person or facility shall have the opportunity to respond not later than 10 calendar days after the date the facility receives the notice. Not later than 10 calendar days after the date HHSC receives the facility's response, HHSC shall notify the person or facility in writing of HHSC's determination.

Source Note: The provisions of this §509.23 adopted to be effective December 4, 2023, 48 TexReg 7064