By Rossanna J. Madrigal, JD, MPH and Michael R. Alexander, Esq. Brown & Fortunato, P.C.
The 89th Texas Legislature passed two laws in its last session addressing the use of artificial intelligence (“AI”) in the health care space. Senate Bill 1188 took effect in September 2025 and House Bill 149 became effective at the first of this year. In this article, we summarize the main points of each of these laws and address some potential risks and opportunities with respect to use of AI in health care.
Senate Bill 1188
The new law permits a health care practitioner to use AI for diagnostic purposes, including using AI for diagnosis and treatment plan recommendations under certain circumstances. In order to use AI in this manner, the practitioner must be acting within the scope of their license or authorization to provide health care services in Texas and they must review all records created with AI with the same diligence as records created by another person that the practitioner signs off on. Of course, practitioners cannot use AI in any manner that is 
restricted or prohibited by any law. And, if a practitioner decides to use AI for diagnostic purposes, then they must disclose the use of the technology to their patients. The law does not specify a method or specific requirements for this disclosure.
House Bill 149
House Bill 149 is titled the Texas Responsible Artificial Intelligence Governance Act (TRIAGA). TRIAGA is intended to be a framework through which Texans may utilize AI in business. TRIAGA has broad applicability to anyone that: promotes, advertises, or conducts business in Texas; produces a product or service used by Texans; or develops or deploys AI in Texas. Additionally, TRIAGA establishes the Texas Artificial Intelligence Council, whose role is to “ensure [AI] systems in this state are ethical and developed in the public’s best interest” and “ensure [AI] systems in this state do not harm public safety or undermine individual freedoms.” This Council will, among other things, review current laws and recommend reforms to promote innovation in the development of AI system in Texas and make recommendations to state agencies on the use of AI systems to improve efficiency and effectiveness. The Council is comprised of members appointed by the governor, lieutenant governor, and speaker of the house of representatives. and they will serve staggered four-year terms.
The specific duties and prohibitions under TRIAGA appear to be split between “persons”—i.e., everyone—and governmental entities—departments, offices, and authorities of the state of Texas that exercise governmental functions under Texas law). For example, a governmental entity is prohibited from using AI systems to evaluate a person or group based on personal behavior or personal characteristics with the intent to categorize them in a way that may result in detrimental or unfavorable treatment of that person or group. “Persons” (presumably including governmental entities), on the other hand, are prohibited from developing or deploying an AI system in a manner that intentionally aims to encourage a person to commit self-harm, harm another person, or otherwise engage in criminal activity. Similarly, “persons” are prohibited from deploying or developing an AI system for the sole purpose of infringing, restricting, or impairing an individual’s rights under the Constitution.
Notably, there is a specific provision aimed at providers of health care services. This provision requires providers of health care services that utilize an AI system to interact with patients to disclose to the patient or their caregiver that they are or will be interacting with an AI system. Such disclosure must be clear and conspicuous, written in plain language, and not be written in such a way as to purposefully subvert or impair the individual’s autonomy, decision-making, or choice (e.g., using bait and switch tactics, hidden fees/recurring charges, or emotionally manipulative language to get the person to agree). The notice must be provided no later than the date that the services are rendered.
Opportunities and Conclusion
The passage of these two laws, along with the establishment of the Council under TRIAGA indicates that the Texas legislature intended for these laws around the use of AI to develop over time, with input from the Council and stakeholders. The breadth of the current laws and seeming limited restrictions on the use of AI presents opportunities for health care providers to utilize AI systems in creative ways. AI can be used in a myriad of ways from chart dictation to treatment planning to communications with patients.
However, providers should not overlook the established laws for patient protection or the rules and guidelines for responsible practice of medicine/nursing/pharmacy. HIPAA still applies with respect to the use and disclosure of protected health information, and compliant business associate agreements with vendors or valid HIPAA authorizations from patients should be obtained when appropriate. Providers should engage in a discerning review of AI tools to ensure HIPAA compliance and the safety and security of your patients’ data and offices’ systems as a whole. If your office is already utilizing AI for diagnostic purposes, do not forget to disclose that use to your patients in writing, and to keep a copy in your files for later reference.
We are already seeing tools marketed specifically to physicians and health care entities that utilize AI to review patients charts to assist with treatment compliance, suggestions for modification of treatment plans, or identifying high risk patients for later outreach and follow up. AI is a tool that can be used responsibly to enhance patient care and assist in the improvement of patient outcomes. Time will tell how significant AI will be to Texas health care providers in the coming years and how involved the state of Texas will be in creating laws and regulations around such use for AI. t