Electronic Health Record (EHR)

Texas Law Requires Practitioners to Disclose AI Use

Texas is imposing new transparency regulations on electronic health records (EHRs) and the diagnostic use of artificial intelligence (AI) under a new state law physicians must begin complying with as of Sept. 1.

Texas Senate Bill 1188, passed during Texas’ 2025 regular legislative session, requires physicians and health care practitioners who use AI for diagnostic purposes – including for any recommendations on a diagnosis or course of treatment based on a patient’s medical records – to, effective Sept. 1:

Disclose such use of AI to their patients; and

Review all records created by AI in a manner consistent with medical records standards.

Additionally, entities covered by the bill – businesses, including physician practices, that assemble, collect, analyze, use, evaluate, store, or transmit protected health information – to:

Automatically allow a minor patient’s parent, guardian, or conservator to obtain “complete and unrestricted access” to the minor’s EHR, unless access to all or part of the record is restricted under state or federal law or by court order, also effective Sept. 1; and

Physically maintain their EHRs only within the U.S. or a territory of the U.S. and only allow their data to be accessed by those who require the information to perform duties within their scope of their job related to treatment, payment, and other health care operations by Jan. 1, 2026. Covered entities have until Jan. 1, 2026 to ensure compliance relating to EHRs prepared before Sept. 1.

However, Texas physicians are now allowed three days to communicate the results of certain sensitive or serious test results to patients, including minors and their guardians, before they are made available via EHRs thanks to the passage of Senate Bill 922.

SB 1188 also prohibits covered entities from amending on an EHR an individual’s biological sex as recorded by a health care practitioner at birth and documented in the EHR, except to correct a clerical error, or, if the individual is diagnosed with a sexual development disorder, to change the individual’s listed biological sex to the opposite biological sex, in which case, information on the disorder must be also included in the EHR.

SB 1188 states regulatory agencies – including the Texas Medical Board, the Texas Department of Licensing and Regulation, and the Texas Department of Insurance – may take disciplinary action against a covered entity that violates the order three or more times in the same manner. The disciplinary action may include “license, registration, or certification suspension or revocation for a period the agency determines appropriate,” per the law.

Violations of SB 1188 can also result in civil penalties ranging from $5,000 to $250,000 per violation, depending on the violator’s intent and whether the violator used protected health information for financial gain.

Physicians should monitor for future guidance and check with their EHR vendor about compliance, especially as related to where patient data is stored, says Shannon Vogel, the Texas Medical Association’s associate vice president of health information technology.  

For more information on health information technology, visit TMA’s related webpage.

Putting Patient Care Before Paperwork

Do you spend two hours completing documentation and EHR management for every one hour of treating patients?
Do you feel Administrative work is causing increased burnout?
Are you completing EHR work at home?
Are you looking to take steps to reduce the myriad of bureaucratic burdens?

WHO OWNS THE CHART?

Article by John Zelem, MD, FACS and Henry Draughon

Have You Paid Your Fee for PMP?

If you haven’t paid your fees to keep your electronic health record (EHR) integrated with Texas’ prescription monitoring program (PMP), the state’s PMP vendor may have deactivated your connection, in which case you’ll need to pay to reactivate it.

TX Prescription Monitoring Program

TX Prescription Monitoring Program, No Longer a Freebie!!

When Texas started requiring that physicians check the state’s prescription monitoring program (PMP), the state appropriated funds to cover the licensing fee for the first two years. Effective Sept. 1, however, that fee is no longer covered by the state, and Appriss, the state’s PMP vendor, has begun billing physicians for the annual PMP licensing fee.

TMA is exploring options with the governor’s office, Texas State Board of Pharmacy, and Appriss to tap into the opioid settlement funds to defray the cost of the PMP. However, it does not appear that funding will be available prior to Sept. 1, TMA officials say.

The association has reached out to Appriss to understand the pricing structure on the invoice that physicians are receiving. Appriss has indicated the following options for physicians:

Cost for the basic service – integrated access to the PMP through the physician’s electronic health record– is $50 per prescriber per year. This is access to controlled substance prescription data only.
Cost for the optional NarxCare graphic interface and Appriss analytics is an additional $250 per prescriber per year.
Always available at no cost is manual web access to the PMP through the Texas Board of Pharmacy via PMP Aware.

Physician groups may check with Appriss to see if they are eligible for reduced pricing per prescriber.

At TMA’s urging, Appriss is working on additional communications to physicians that more clearly explain the options and associated fees.

If you choose not to renew with Appriss, access to the PMP will no longer be accessible through your EHR within your workflow. It will still be available for free when you log in to the state’s system, PMP Aware, to check a patient’s prescribing history as required by law before prescribing opioids, benzodiazepines, barbiturates, and carisoprodol.

Questions about prescribing and the PMP program may be directed to TMA’s Health Information Technology Department by calling (800) 880-5720 or by email. Also check out TMA’s PMP resource page.

Deadline to Comply with Information-Blocking Rule

Starting April 5, all practices must comply with so-called information-blocking rules that are part of the federal 21st Century Cures Act, which is designed to facilitate widespread access and sharing of health information among patients and physicians. Follow this link to view the TMA article.

21st Century Cures Act: Interoperability and Information Blocking Webinar: Free for TMA members and their clinical staff, this webinar will help you develop plans to prepare your practice to implement the information-blocking rule. The webinar has been accredited for 1.25 AMA PRA Category 1 Credits™

Tag: Electronic Health Record (EHR)