Texas 2025 - 89th Regular

Texas House Bill HB4503 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R6209 EAS-F
2	2	By: Bonnen H.B. No. 4503
3	3
4	4
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to electronic health record requirements.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Subtitle I, Title 2, Health and Safety Code, is
12	12	amended by adding Chapter 183 to read as follows:
13	13	CHAPTER 183. ELECTRONIC HEALTH RECORDS
14	14	Sec. 183.001. DEFINITIONS. In this chapter:
15	15	(1) "Biological sex" means the biological trait that
16	16	determines whether a sexually reproducing organism produces male or
17	17	female gametes.
18	18	(2) "Female" means an individual whose reproductive
19	19	system is developed to produce ova.
20	20	(3) "Governmental entity" means this state, an agency
21	21	of the executive, legislative, or judicial branch of state
22	22	government, or a political subdivision of this state. The term
23	23	includes a local health department.
24	24	(4) "Health care practitioner" means an individual who
25	25	is licensed, certified, or otherwise authorized to provide health
26	26	care services in this state.
27	27	(5) "Male" means an individual whose reproductive
28	28	system is developed to produce sperm.
29	29	(6) "Medical facility" means:
30	30	(A) a facility licensed or registered by a state
31	31	agency to provide medical care and other health care services; or
32	32	(B) a health care facility in this state that
33	33	provides medical care and other health care services and that
34	34	receives reimbursement under the state Medicaid program or receives
35	35	any other state funding, including pass-through federal money
36	36	provided to a state agency for grant awards.
37	37	(7) "Sexual development disorder" means a congenital
38	38	condition associated with atypical development of internal or
39	39	external genital structures. The term includes a chromosomal,
40	40	gonadal, and anatomic abnormality.
41	41	Sec. 183.002. REQUIREMENTS FOR ELECTRONIC HEALTH RECORD
42	42	STORAGE. (a) Each medical facility, health care practitioner, and
43	43	governmental entity shall store all electronic health record
44	44	information of residents of this state only at a location in the
45	45	United States.
46	46	(b) Each medical facility, health care practitioner, and
47	47	governmental entity shall ensure electronic health record
48	48	information of residents of this state, other than open data, is
49	49	inaccessible to any person located outside of the United States.
50	50	Sec. 183.003. REQUIRED MEDICAL HISTORY INFORMATION IN
51	51	ELECTRONIC HEALTH RECORD. A medical facility, health care
52	52	practitioner, or governmental entity shall ensure each electronic
53	53	health record maintained for an individual includes the
54	54	individual's medical history and any communications between the
55	55	practitioner and a specialty health care practitioner related to
56	56	the individual's metabolic health and diet in the treatment of a
57	57	chronic disease or illness.
58	58	Sec. 183.004. INFORMATION RESTRICTIONS IN ELECTRONIC
59	59	HEALTH RECORD. A medical facility, health care practitioner, or
60	60	governmental entity may not collect or store any information
61	61	regarding an individual's credit score or voter registration status
62	62	in the individual's electronic health record.
63	63	Sec. 183.005. ARTIFICIAL INTELLIGENCE IN ELECTRONIC HEALTH
64	64	RECORD. A health care practitioner who uses artificial
65	65	intelligence for diagnostic or other purposes, including the use of
66	66	artificial intelligence for recommendations on a diagnosis or
67	67	course of treatment based on a patient's medical record, shall
68	68	review all information obtained through the artificial
69	69	intelligence process to ensure the accuracy of the information for
70	70	that patient before entering the information in the patient's
71	71	electronic health record.
72	72	Sec. 183.006. ACCESS TO ELECTRONIC HEALTH RECORD OF MINOR.
73	73	(a) In this section, "minor" means an individual under 18 years of
74	74	age who has not had the disabilities of minority removed for general
75	75	purposes.
76	76	(b) A medical facility, health care practitioner, or
77	77	governmental entity shall ensure each electronic health record
78	78	system the facility, practitioner, or entity uses to store
79	79	electronic health records of minors automatically allows a minor's
80	80	parent, guardian, or conservator to fully access the minor's
81	81	electronic health record unless access to all or a portion of the
82	82	record is restricted under state or federal law or by a court order.
83	83	Sec. 183.007. ELECTRONIC HEALTH RECORD REQUIREMENTS
84	84	REGARDING BIOLOGICAL SEX. (a) Notwithstanding any other law, the
85	85	commission, the Texas Medical Board, and the Texas Department of
86	86	Insurance shall jointly ensure that:
87	87	(1) each electronic health record prepared or
88	88	maintained by a medical facility, health care practitioner, or
89	89	governmental entity in this state includes a separate space for the
90	90	health care practitioner to document:
91	91	(A) an individual's biological sex as either male
92	92	or female based on the individual's observed biological sex
93	93	recorded by a health care practitioner at birth; and
94	94	(B) information on any sexual development
95	95	disorder of the individual, whether identified at birth or later in
96	96	the individual's life; and
97	97	(2) any algorithm or decision assistance tool included
98	98	in an electronic health record to assist a health care practitioner
99	99	in making medical treatment decisions is based on an individual's
100	100	biological sex as recorded in the space described by Subdivision
101	101	(1)(A).
102	102	(b) This section does not prohibit an electronic health
103	103	record from including spaces for recording other information
104	104	related to an individual's biological sex or gender identity.
105	105	Sec. 183.008. AMENDING CERTAIN BIOLOGICAL SEX INFORMATION
106	106	IN ELECTRONIC HEALTH RECORDS. (a) A medical facility, health care
107	107	practitioner, or governmental entity may amend on an electronic
108	108	health record an individual's biological sex as recorded in the
109	109	space described by Section 183.007(a)(1)(A) only if:
110	110	(1) the amendment is to correct a clerical error; or
111	111	(2) the individual is diagnosed with a sexual
112	112	development disorder and the amendment changes the individual's
113	113	listed biological sex to the opposite biological sex.
114	114	(b) If an individual's biological sex is amended under
115	115	Subsection (a)(2), the medical facility, health care practitioner,
116	116	or governmental entity shall include in the individual's electronic
117	117	health record information on the individual's sexual development
118	118	disorder in the space described by Section 183.007(a)(1)(B).
119	119	Sec. 183.009. DISCIPLINARY ACTION BY LICENSING AGENCY;
120	120	MEDICAID REIMBURSEMENT INELIGIBILITY. (a) The appropriate state
121	121	licensing agency may take disciplinary action against a medical
122	122	facility or health care practitioner that violates this chapter as
123	123	if the medical facility or health care practitioner violated an
124	124	applicable licensing law.
125	125	(b) The commission may not provide Medicaid reimbursement
126	126	to a medical facility or health care practitioner that violates
127	127	this chapter and shall disenroll the medical facility or health
128	128	care practitioner from participation as a Medicaid provider.
129	129	Sec. 183.010. RULES. The commission, the Texas Medical
130	130	Board, and the Texas Department of Insurance shall adopt rules as
131	131	necessary to implement this chapter.
132	132	SECTION 2. (a) Except as provided by Subsection (b) of this
133	133	section, Chapter 183, Health and Safety Code, as added by this Act,
134	134	applies only to an electronic health record prepared on or after the
135	135	effective date of this Act.
136	136	(b) Section 183.002, Health and Safety Code, as added by
137	137	this Act, applies to the storage of an electronic health record on
138	138	or after January 1, 2026, regardless of the date on which the
139	139	electronic health record was prepared.
140	140	SECTION 3. This Act takes effect September 1, 2025.