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A BILL TO BE ENTITLED
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AN ACT
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relating to electronic health record requirements. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle I, Title 2, Health and Safety Code, is |
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amended by adding Chapter 183 to read as follows: |
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CHAPTER 183. ELECTRONIC HEALTH RECORDS |
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Sec. 183.001. DEFINITIONS. In this chapter: |
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(1) "Biological sex" means the biological trait that |
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determines whether a sexually reproducing organism produces male or |
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female gametes. |
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(2) "Female" means an individual whose reproductive |
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system is developed to produce ova. |
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(3) "Governmental entity" means this state, an agency |
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of the executive, legislative, or judicial branch of state |
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government, or a political subdivision of this state. The term |
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includes a local health department. |
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(4) "Health care practitioner" means an individual who |
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is licensed, certified, or otherwise authorized to provide health |
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care services in this state. |
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(5) "Male" means an individual whose reproductive |
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system is developed to produce sperm. |
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(6) "Medical facility" means: |
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(A) a facility licensed or registered by a state |
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agency to provide medical care and other health care services; or |
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(B) a health care facility in this state that |
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provides medical care and other health care services and that |
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receives reimbursement under the state Medicaid program or receives |
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any other state funding, including pass-through federal money |
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provided to a state agency for grant awards. |
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(7) "Sexual development disorder" means a congenital |
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condition associated with atypical development of internal or |
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external genital structures. The term includes a chromosomal, |
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gonadal, and anatomic abnormality. |
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Sec. 183.002. REQUIREMENTS FOR ELECTRONIC HEALTH RECORD |
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STORAGE. (a) Each medical facility, health care practitioner, and |
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governmental entity shall store all electronic health record |
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information of residents of this state only at a location in the |
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United States. |
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(b) Each medical facility, health care practitioner, and |
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governmental entity shall ensure electronic health record |
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information of residents of this state, other than open data, is |
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inaccessible to any person located outside of the United States. |
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Sec. 183.003. REQUIRED MEDICAL HISTORY INFORMATION IN |
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ELECTRONIC HEALTH RECORD. A medical facility, health care |
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practitioner, or governmental entity shall ensure each electronic |
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health record maintained for an individual includes the |
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individual's medical history and any communications between the |
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practitioner and a specialty health care practitioner related to |
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the individual's metabolic health and diet in the treatment of a |
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chronic disease or illness. |
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Sec. 183.004. INFORMATION RESTRICTIONS IN ELECTRONIC |
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HEALTH RECORD. A medical facility, health care practitioner, or |
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governmental entity may not collect or store any information |
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regarding an individual's credit score or voter registration status |
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in the individual's electronic health record. |
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Sec. 183.005. ARTIFICIAL INTELLIGENCE IN ELECTRONIC HEALTH |
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RECORD. A health care practitioner who uses artificial |
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intelligence for diagnostic or other purposes, including the use of |
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artificial intelligence for recommendations on a diagnosis or |
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course of treatment based on a patient's medical record, shall |
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review all information obtained through the artificial |
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intelligence process to ensure the accuracy of the information for |
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that patient before entering the information in the patient's |
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electronic health record. |
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Sec. 183.006. ACCESS TO ELECTRONIC HEALTH RECORD OF MINOR. |
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(a) In this section, "minor" means an individual under 18 years of |
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age who has not had the disabilities of minority removed for general |
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purposes. |
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(b) A medical facility, health care practitioner, or |
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governmental entity shall ensure each electronic health record |
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system the facility, practitioner, or entity uses to store |
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electronic health records of minors automatically allows a minor's |
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parent, guardian, or conservator to fully access the minor's |
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electronic health record unless access to all or a portion of the |
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record is restricted under state or federal law or by a court order. |
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Sec. 183.007. ELECTRONIC HEALTH RECORD REQUIREMENTS |
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REGARDING BIOLOGICAL SEX. (a) Notwithstanding any other law, the |
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commission, the Texas Medical Board, and the Texas Department of |
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Insurance shall jointly ensure that: |
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(1) each electronic health record prepared or |
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maintained by a medical facility, health care practitioner, or |
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governmental entity in this state includes a separate space for the |
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health care practitioner to document: |
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(A) an individual's biological sex as either male |
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or female based on the individual's observed biological sex |
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recorded by a health care practitioner at birth; and |
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(B) information on any sexual development |
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disorder of the individual, whether identified at birth or later in |
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the individual's life; and |
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(2) any algorithm or decision assistance tool included |
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in an electronic health record to assist a health care practitioner |
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in making medical treatment decisions is based on an individual's |
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biological sex as recorded in the space described by Subdivision |
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(1)(A). |
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(b) This section does not prohibit an electronic health |
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record from including spaces for recording other information |
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related to an individual's biological sex or gender identity. |
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Sec. 183.008. AMENDING CERTAIN BIOLOGICAL SEX INFORMATION |
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IN ELECTRONIC HEALTH RECORDS. (a) A medical facility, health care |
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practitioner, or governmental entity may amend on an electronic |
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health record an individual's biological sex as recorded in the |
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space described by Section 183.007(a)(1)(A) only if: |
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(1) the amendment is to correct a clerical error; or |
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(2) the individual is diagnosed with a sexual |
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development disorder and the amendment changes the individual's |
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listed biological sex to the opposite biological sex. |
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(b) If an individual's biological sex is amended under |
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Subsection (a)(2), the medical facility, health care practitioner, |
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or governmental entity shall include in the individual's electronic |
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health record information on the individual's sexual development |
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disorder in the space described by Section 183.007(a)(1)(B). |
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Sec. 183.009. DISCIPLINARY ACTION BY LICENSING AGENCY; |
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MEDICAID REIMBURSEMENT INELIGIBILITY. (a) The appropriate state |
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licensing agency may take disciplinary action against a medical |
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facility or health care practitioner that violates this chapter as |
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if the medical facility or health care practitioner violated an |
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applicable licensing law. |
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(b) The commission may not provide Medicaid reimbursement |
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to a medical facility or health care practitioner that violates |
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this chapter and shall disenroll the medical facility or health |
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care practitioner from participation as a Medicaid provider. |
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Sec. 183.010. RULES. The commission, the Texas Medical |
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Board, and the Texas Department of Insurance shall adopt rules as |
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necessary to implement this chapter. |
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SECTION 2. (a) Except as provided by Subsection (b) of this |
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section, Chapter 183, Health and Safety Code, as added by this Act, |
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applies only to an electronic health record prepared on or after the |
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effective date of this Act. |
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(b) Section 183.002, Health and Safety Code, as added by |
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this Act, applies to the storage of an electronic health record on |
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or after January 1, 2026, regardless of the date on which the |
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electronic health record was prepared. |
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SECTION 3. This Act takes effect September 1, 2025. |