(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 § 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.