TX SB1188

Electronic health records must be physically stored within the United States or U.S. territories, including records held by third-party cloud computing services, with this storage requirement taking effect January 1, 2026

Health care providers may use artificial intelligence for diagnostic purposes and treatment recommendations, but must disclose AI use to patients and review all AI-generated records according to Texas Medical Board standards

Electronic health records must include a separate field documenting an individual's biological sex (male or female) as observed at birth, and any medical decision-assistance algorithms must incorporate this biological sex data

Biological sex designations in health records may only be amended to correct clerical errors or when an individual is diagnosed with a sexual development disorder

Parents, managing conservators, or guardians must be granted immediate, complete access to a minor's (age 17 or younger) electronic health records unless restricted by law or court order

Covered entities are prohibited from collecting, storing, or sharing credit scores or voter registration status in electronic health records

Civil penalties range from $5,000 per negligent violation to $250,000 for knowingly using protected health information for financial gain, and regulatory agencies may suspend or revoke licenses after three or more violations