AI and telemedicine are changing how providers deliver care in Texas. These tools improve patient access and efficiency, but they also bring new compliance requirements.
New requirements under Texas law
Texas now regulates how providers use AI and store health records. Providers must:
- Disclose to patients: Tell patients when AI helps with diagnosis or treatment.
- Review AI recommendations: Clinicians must personally review AI-generated notes and decisions.
- Prevent discrimination: AI cannot be used in a way that creates bias or unequal care.
- Store records in the U.S.: All electronic health records must stay in the U.S. or its territories.
- Comply with enforcement: The Texas attorney general can investigate, fine or suspend licenses for violations.
Senate Bill 1188 bans storing Texas health records outside the United States. If someone misuses records on purpose, they can face fines of up to $250,000. These rules apply not only to hospitals and clinics but also to insurance companies and any business that handles health data for Texas residents.
Telemedicine standards and patient care
Texas law sets strict rules for telemedicine. Only doctors and nurse practitioners can provide telemedicine services. Other licensed professionals may offer telehealth, which covers different types of remote care. Providers also must:
- Hold a valid Texas license.
- Give the same quality of care as in-person visits.
- Practice only within their licensed scope.
Providers must also respect patients’ choices. They should offer in-person visits when needed and cannot treat telemedicine as lower-quality care. If a patient’s condition requires a physical exam, the provider must arrange an in-person visit.
Common compliance pitfalls in Texas
It can be easy to assume that AI tools stay compliant on their own. However, healthcare providers may need to be cautious about:
- Unverifiable software: Signing with an AI vendor without ensuring they provide enough transparency for practitioners to perform legally required clinical review
- Shadow IT storage: Using free or unvetted AI apps, such as standard consumer chatbots, which often store data on global servers outside the U.S.
- Vague consent language: Using a general “technology consent” form that doesn’t specifically name AI
- Automatic signatures: Finalizing an AI-generated note without a documented review from a licensed practitioner or without ensuring it is up to standard
- Neglecting guardian rights: Failing to update their portal to give parents immediate access to a minor’s electronic records (except for services where the minor has a legal right to consent)
While AI vendors may provide assurances, providers share the responsibility for how that tool is used and where its data lives. They can avoid these pitfalls by thoroughly reviewing their software agreements and tracking how patient files move through their system.
Preparing for compliance
Healthcare providers should act now to stay compliant. Key steps include:
- Review and update policies: Make sure internal policies reflect the new rules.
- Disclose AI use: Clearly tell patients when AI plays a role in care.
- Secure records: Store all electronic health records in the U.S. or its territories.
- Train staff: Teach employees about AI and telemedicine requirements.
- Document compliance: Keep records of your compliance efforts and seek legal guidance when needed.
Texas rules on AI and telemedicine continue to change. Even small mistakes can lead to fines, license suspensions or enforcement actions.
2026 outlook for AI telemedicine
Some emerging trends that may become more prominent throughout the year include:
- Hybrid care audits: Regulators may look more closely at how providers conduct their telemedicine services. Remote patients must receive the same standard of care as those seen in person.
- Shifts in vendor liability: Many providers now require AI companies to offer “indemnity.” Software companies may need to agree to pay for any fines or legal costs if their technology fails to follow the law.
- Domestic cloud migration: The new storage rules are now in effect, leading many practices to reorganize their tools and software. Moving forward, healthcare providers will need to be careful in making sure that no patient records or mirrors are stored on foreign servers.
Healthcare providers are the final safeguard for patient safety. To stay legally compliant, they must review their internal policies and contracts with AI vendors.
Providers are recommended to consult an experienced healthcare attorney to review their compliance programs, assess risks and build a framework that meets Texas law.