Texas TRAIGA: What Healthcare Practices Should Know

TRAIGA — Texas Responsible AI Governance Act (HB 149)

TRAIGA is a general-purpose AI governance statute with direct healthcare application. For practices, the core provisions are two: providers using AI in care or treatment must disclose it to patients, and the statute prohibits manipulative and discriminatory uses of AI systems.

Penalties are tiered, up to $200,000 per uncurable violation. Curable violations carry lower penalties and a cure period; uncurable ones do not. Enforcement belongs exclusively to the Texas Attorney General — TRAIGA creates no private lawsuit right, which distinguishes it from laws like Tennessee's SB 1580.

The companion law: Texas SB 1188

SB 1188 requires that AI used in a diagnostic capacity be disclosed, operates in the Texas Medical Board licensure context, and adds provisions on where health-records data may be located. Where both statutes apply to the same conduct, the combined exposure across the two laws can reach up to $450,000 per violation.

The practice of medicine occurs where the patient is physically located during the encounter — not where your office is. A Texas resident seen in person at your Florida office is governed by Florida law for that visit. But when that patient returns home and you conduct a telehealth follow-up while they are physically in Texas, TRAIGA applies to that encounter. Any practice conducting even occasional telehealth visits with patients located in Texas is operating inside TRAIGA's reach for those visits.

TRAIGA builds in recognition for documented governance: practices following the NIST AI Risk Management Framework receive statutory protection against TRAIGA penalties. That makes a documented, framework-aligned AI governance program not just good practice but a recognized statutory defense posture in Texas.

From a governance standpoint — not legal advice — practices touching Texas patients generally work through questions like these:

• Disclosure: Do patients receive clear notice when AI is used in their care, treatment, or diagnosis — and is that notice documented?
• Inventory: Do you know every AI tool in the workflow (scribes, coding, scheduling, chatbots, decision support), so nothing is undisclosed by omission?
• Framework alignment: Is your AI use mapped to the NIST AI Risk Management Framework — the posture TRAIGA itself recognizes?
• Telehealth mapping: Do you know which encounters involve patients physically located in Texas?

Our free 7-question risk assessment shows where a practice stands on exactly these dimensions.