Bonnen Health Record Bill Exempts Home Health And Long-Term Care

The text as introduced · 1,094 words

89R6209 EAS-F

By: Bonnen
H.B. No. 4503

A BILL TO BE ENTITLED

AN ACT

relating to electronic health record requirements.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subtitle I, Title 2, Health and Safety Code, is

amended by adding Chapter 183 to read as follows:

CHAPTER 183. ELECTRONIC HEALTH RECORDS

Sec. 183.001. DEFINITIONS. In this chapter:

(1) "Biological sex" means the biological trait that

determines whether a sexually reproducing organism produces male or

female gametes.

(2) "Female" means an individual whose reproductive

system is developed to produce ova.

(3) "Governmental entity" means this state, an agency

of the executive, legislative, or judicial branch of state

government, or a political subdivision of this state. The term

includes a local health department.

(4) "Health care practitioner" means an individual who

is licensed, certified, or otherwise authorized to provide health

care services in this state.

(5) "Male" means an individual whose reproductive

system is developed to produce sperm.

(6) "Medical facility" means:

(A) a facility licensed or registered by a state

agency to provide medical care and other health care services; or

(B) a health care facility in this state that

provides medical care and other health care services and that

receives reimbursement under the state Medicaid program or receives

any other state funding, including pass-through federal money

provided to a state agency for grant awards.

(7) "Sexual development disorder" means a congenital

condition associated with atypical development of internal or

external genital structures. The term includes a chromosomal,

gonadal, and anatomic abnormality.

Sec. 183.002. REQUIREMENTS FOR ELECTRONIC HEALTH RECORD

STORAGE. (a) Each medical facility, health care practitioner, and

governmental entity shall store all electronic health record

information of residents of this state only at a location in the

United States.

(b) Each medical facility, health care practitioner, and

governmental entity shall ensure electronic health record

information of residents of this state, other than open data, is

inaccessible to any person located outside of the United States.

Sec. 183.003. REQUIRED MEDICAL HISTORY INFORMATION IN

ELECTRONIC HEALTH RECORD. A medical facility, health care

practitioner, or governmental entity shall ensure each electronic

health record maintained for an individual includes the

individual's medical history and any communications between the

practitioner and a specialty health care practitioner related to

the individual's metabolic health and diet in the treatment of a

chronic disease or illness.

Sec. 183.004. INFORMATION RESTRICTIONS IN ELECTRONIC

HEALTH RECORD. A medical facility, health care practitioner, or

governmental entity may not collect or store any information

regarding an individual's credit score or voter registration status

in the individual's electronic health record.

Sec. 183.005. ARTIFICIAL INTELLIGENCE IN ELECTRONIC HEALTH

RECORD. A health care practitioner who uses artificial

intelligence for diagnostic or other purposes, including the use of

artificial intelligence for recommendations on a diagnosis or

course of treatment based on a patient's medical record, shall

review all information obtained through the artificial

intelligence process to ensure the accuracy of the information for

that patient before entering the information in the patient's

electronic health record.

Sec. 183.006. ACCESS TO ELECTRONIC HEALTH RECORD OF MINOR.

(a) In this section, "minor" means an individual under 18 years of

age who has not had the disabilities of minority removed for general

purposes.

(b) A medical facility, health care practitioner, or

governmental entity shall ensure each electronic health record

system the facility, practitioner, or entity uses to store

electronic health records of minors automatically allows a minor's

parent, guardian, or conservator to fully access the minor's

electronic health record unless access to all or a portion of the

record is restricted under state or federal law or by a court order.

Sec. 183.007. ELECTRONIC HEALTH RECORD REQUIREMENTS

REGARDING BIOLOGICAL SEX. (a) Notwithstanding any other law, the

commission, the Texas Medical Board, and the Texas Department of

Insurance shall jointly ensure that:

(1) each electronic health record prepared or

maintained by a medical facility, health care practitioner, or

governmental entity in this state includes a separate space for the

health care practitioner to document:

(A) an individual's biological sex as either male

or female based on the individual's observed biological sex

recorded by a health care practitioner at birth; and

(B) information on any sexual development

disorder of the individual, whether identified at birth or later in

the individual's life; and

(2) any algorithm or decision assistance tool included

in an electronic health record to assist a health care practitioner

in making medical treatment decisions is based on an individual's

biological sex as recorded in the space described by Subdivision

(1)(A).

(b) This section does not prohibit an electronic health

record from including spaces for recording other information

related to an individual's biological sex or gender identity.

Sec. 183.008. AMENDING CERTAIN BIOLOGICAL SEX INFORMATION

IN ELECTRONIC HEALTH RECORDS. (a) A medical facility, health care

practitioner, or governmental entity may amend on an electronic

health record an individual's biological sex as recorded in the

space described by Section 183.007(a)(1)(A) only if:

(1) the amendment is to correct a clerical error; or

(2) the individual is diagnosed with a sexual

development disorder and the amendment changes the individual's

listed biological sex to the opposite biological sex.

(b) If an individual's biological sex is amended under

Subsection (a)(2), the medical facility, health care practitioner,

or governmental entity shall include in the individual's electronic

health record information on the individual's sexual development

disorder in the space described by Section 183.007(a)(1)(B).

Sec. 183.009. DISCIPLINARY ACTION BY LICENSING AGENCY;

MEDICAID REIMBURSEMENT INELIGIBILITY. (a) The appropriate state

licensing agency may take disciplinary action against a medical

facility or health care practitioner that violates this chapter as

if the medical facility or health care practitioner violated an

applicable licensing law.

(b) The commission may not provide Medicaid reimbursement

to a medical facility or health care practitioner that violates

this chapter and shall disenroll the medical facility or health

care practitioner from participation as a Medicaid provider.

Sec. 183.010. RULES. The commission, the Texas Medical

Board, and the Texas Department of Insurance shall adopt rules as

necessary to implement this chapter.

SECTION 2. (a) Except as provided by Subsection (b) of this

section, Chapter 183, Health and Safety Code, as added by this Act,

applies only to an electronic health record prepared on or after the

effective date of this Act.

(b) Section 183.002, Health and Safety Code, as added by

this Act, applies to the storage of an electronic health record on

or after January 1, 2026, regardless of the date on which the

electronic health record was prepared.

SECTION 3. This Act takes effect September 1, 2025.