S.B. No. 1235 is a legislative bill designed to improve patient access to health records and enhance the exchange of health benefit plan information. It introduces new definitions and provisions in the Business & Commerce Code and Health and Safety Code, specifically defining "information blocking" and making it unlawful for individuals to intentionally violate federal laws related to this issue. The bill requires covered entities to comply with the Health Insurance Portability and Accountability Act and federal regulations on information blocking. It also grants patients or their authorized representatives the right to obtain copies of health records within specified timelines and allows for fees to be charged for these records, capped at $100 for certain low-income patients.

Furthermore, the bill establishes civil penalties for violations of health record access provisions, with penalties varying based on the severity of the violation. It mandates health benefit plan issuers to create application programming interfaces to facilitate access to health information. The bill also requires the commissioner to adopt rules that align with standards set by the Centers for Medicare and Medicaid Services (CMS) and includes a severability clause. The changes will apply only to violations occurring on or after the effective date of the Act, September 1, 2025, while newly added provisions in the Insurance Code will apply to health benefit plans starting January 1, 2026.

Statutes affected:
Introduced: Commerce Code 15.05, Health and Safety Code 181.001, Health and Safety Code 181.004, Health and Safety Code 181.102, Health and Safety Code 181.201, Health and Safety Code 241.154 (Commerce Code 15, Health and Safety Code 181, Health and Safety Code 241)