Texas SB 1188 (AI in Electronic Health Records 2025)

• Authority: Texas
• Parent authority: State governments
• Jurisdiction: United States
• Collections: U.S. state and local documents
• Most recent activity: Enacted
• Most recent activity date: 2025-06-20

Risk subdomain coverage

Good coverage — Comprehensive governance measures or mitigations with clear procedures relating to the risk subdomain are explicitly described.

• Compromise of privacy
• Overreliance and unsafe use

Minimal coverage — Brief mention but no specific mitigations, recommendations or governance measures relating to the risk subdomain are described.

• AI system security vulnerabilities
• False or misleading information
• Lack of capability or robustness
• Lack of transparency or interpretability

All other risk subdomains had no coverage in this document.

Risk Coverage Summary

The document addresses privacy and security risks (2.1, 2.2), AI-generated misinformation in healthcare (3.1), overreliance on AI systems (5.1), and lack of robustness and transparency (7.3, 7.4). Coverage is concentrated in healthcare-specific AI safety measures, with particular focus on human oversight, transparency requirements, and data protection.

Sector coverage

Good coverage — Comprehensive governance measures or mitigations with clear procedures relating to the sector are explicitly described.

• Health Care & Social Assistance

Minimal coverage — Brief mention but no specific mitigations, recommendations or governance measures relating to the sector are described.

• Information

All other sectors had no coverage in this document.

Sectors Summary

The document exclusively governs the Health Care and Social Assistance sector, with comprehensive requirements for electronic health records, AI use in diagnostic purposes, and data management practices. While it involves electronic health record systems (Information sector infrastructure), the regulatory focus is entirely on healthcare providers and practitioners.

Legislative Status

Hard Law

Legislative Status Summary

This is a binding Texas state statute with mandatory obligations, enforcement mechanisms including civil penalties up to $250,000, disciplinary actions, and designated enforcement authorities (attorney general, regulatory agencies).

Actors

Proposer

• Entity Types: AI_Governance_Actor
• Entities: Legislature of the State of Texas
• Summary: The document is a Texas Senate Bill enacted by the state legislature, as indicated by the header 'BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS'.

Target

• Entity Types: AI_Deployer
• Entities: Covered entities (health care practitioners, health facilities as defined in Section 181.001), excluding specific facility types like home and community support services agencies, nursing facilities, continuing care facilities, assisted living facilities, intermediate care facilities, day activity and health services facilities, and certain waiver program providers
• Summary: The law applies to 'covered entities' defined as health care practitioners and facilities that maintain electronic health records, who are deploying AI systems for diagnostic purposes in healthcare settings.

Enforcer

• Entity Types: AI_Governance_Actor
• Entities: Attorney General of Texas; Commission (Health and Human Services Commission); Texas Medical Board; Texas Department of Licensing and Regulation; Texas Department of Insurance; Appropriate regulatory agencies
• Summary: Multiple state agencies and the attorney general are explicitly designated with enforcement authority including investigation, disciplinary action, injunctive relief, and civil penalties.

Monitor

• Entity Types: AI_Governance_Actor
• Entities: Commission (Health and Human Services Commission); Texas Medical Board; Texas Department of Licensing and Regulation; Texas Department of Insurance; Appropriate regulatory agencies
• Summary: The commission and regulatory agencies are responsible for conducting investigations and ensuring compliance through monitoring mechanisms, with memorandum of understanding requirements for coordination.

AI Lifecycle Stages

Lifecycle stages covered by the documents, as defined in the OECD Framework for the Classification of AI Systems

• Collect and Process Data
• Verify and Validate
• Deploy
• Operate and Monitor

AI Lifecycle Summary

The document primarily addresses the Deploy and Operate and Monitor stages of AI lifecycle, with some coverage of data collection requirements. It regulates the deployment of AI for diagnostic purposes in healthcare settings and requires ongoing monitoring through practitioner review and compliance mechanisms.

Technical Scope

Terms relating to technical scope that are mentioned or implicitly referenced in the document

• AI Models
• AI Systems
• Predictive AI
• Task-specific AI

Technical Scope Summary

The document explicitly mentions AI systems used for diagnostic purposes and algorithms/decision assistance tools in electronic health records. It does not mention frontier AI, general purpose AI, foundation models, generative AI, compute thresholds, or open-source models. The focus is on task-specific diagnostic AI applications in healthcare.