The Texas Medical Association took a physician-led approach this session to legislation related to health information technology, namely ensuring that when it’s used, a human element is not left out.
TMA started this session pushing for a bill carried over from 2023 to delay delivery of sensitive patient test results, so it was only fitting Senate Bill 922 was medicine’s first triumph of 2025 – and one that originated with grassroots physician action.
Starting Sept. 1, SB 922 prevents certain sensitive test results – like a cancer diagnosis – from being electronically transmitted to patients immediately, allowing physicians to convey the information in an understandable and compassionate way. This was designed to give time for physician review or clarification. Dallas oncologist David Gerber, MD, testified two sessions in a row for such a solution after information-blocking provisions under the 21st Century Cures Act allowed patients to view possibly life-changing test results on their own before their physicians have time to deliver the news.
A similar measure cleared the 2023 Texas Legislature last session but fell victim to a last-minute veto.
Dr. Gerber has witnessed firsthand what the immediate release of test results means “in terms of patients’ emotional trauma.”
“I wonder, what is the total number of hours patients and their families spend anxious and uncertain, relying on internet searches, discussing things that actually have no clinical significance?” Dr. Gerber told Texas Medicine. “SB 922 is not a means to delay patients from receiving their information. It is a way to delay [that information] from further traumatizing patients.”
SB 922 is limited to two types of tests: a pathology or radiology report that has a reasonable likelihood of showing a finding of malignancy, or a test result that may reveal a genetic marker.
“I was incredibly proud to carry SB 922. This bill is simply about restoring compassion to modern medicine,” Rep. Caroline Fairly (R-Amarillo) told Texas Medicine. She championed the House counterpart to SB 922, which was authored by Sen. Kelly Hancock (R-North Richland Hills) and co-authored by Sen. Donna Campbell, MD (R-New Braunfels).
“While it’s important for patients to get timely access to test results, learning you have cancer through an email or portal notification – sometimes just hours before a major life event – is deeply unsettling,” Representative Fairly said.
Equally unsettling to medicine was the potential for health plans to leverage artificial intelligence (AI) to deny medically necessary care.
TMA successfully backed Senate Bill 815 by Sen. Charles Schwertner, MD (R-Georgetown), which prevents payers and their agents from using algorithms or AI in the utilization review process to “make, wholly or partly, an adverse determination.” In other words, a payer’s determination that care is not medically necessary, appropriate, or is experimental or investigational, must be made by an appropriately trained and qualified human reviewer. SB 815 also grants new authority to the Texas Department of Insurance to audit health plans’ use of algorithms or AI systems in utilization review.
Beyond a health plan’s use of algorithms and AI in utilization review, SB 815 made clean up edits to require notices of an adverse determination include a description of, and the source of, the screening criteria and review procedures used as guidelines in making the adverse determination.
“SB 815 is a necessary and timely measure that helps to protect patient access to appropriate care from being compromised by automated decision-making systems,” Dr. Silva testified in March.
TMA also engaged on House Bill 149 by Rep. Giovanni Capriglione (R-Southlake), which established consumer protections in relation to the use of AI across multiple sectors, including health care. On the latter, the bill requires providers of a health care service or treatment in which the patient “interacts with an artificial intelligence system” to use specified written disclosures to inform patients that they are interacting with an AI system “not later than the date of service or treatment,” or as soon as reasonably possible in an emergency.
The bill also creates the Texas Artificial Intelligence Council and the Artificial Intelligence Regulatory Sandbox Program, two new state oversight bodies tasked with advising the Texas government on AI-related policy and ensuring compliance with the new legal framework.
Dr. Silva says key provisions of both AI-related bills reflect TMA policy and guidance, which outline that the technology should be used as a support tool set with physicians at the lead.
“We want medical decisions to be made by a trained professional, not a computer,” the San Antonio radiologist told Texas Medicine.
Continue to read Texas Medicine Today for legislative updates and related TMA resources in development, and visit TMA's state advocacy webpage.
Editor's note: This story was updated to reflect some legislative developments post-publication in Texas Medicine.
Alisa Pierce
Reporter, Division of Communications and Marketing
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