Relating to electronic health record requirements; authorizing a civil penalty.

Contracts

• Vendor Certification: You must immediately amend Master Service Agreements (MSAs) with EHR vendors and cloud providers (e.g., AWS, Azure) to mandate data sovereignty. The contract must guarantee that data is never stored, processed, or backed up on servers outside the United States.
• Indemnification: Update vendor contracts to include indemnification for civil penalties resulting from the vendor's failure to provide compliant data fields or domestic storage.
• Subcontractors: Require vendors to certify that their downstream subcontractors also comply with the US-only residency requirement.

Hiring/Training

• Clinical Staff: Providers must be trained to document "Human in the Loop" review. They cannot simply sign off on an AI diagnostic recommendation; they must affirmatively document their independent review.
• Intake Staff: Train front-desk personnel to stop collecting credit scores or voter registration status. If these fields exist in current workflows, they must be disabled.
• AI Disclosure: Staff must be trained to present and secure signatures on AI usage disclosure forms at the point of care.

Reporting & Record-Keeping

• Mandatory Data Fields: Your EHR must be reconfigured to capture "Biological Sex" (defined strictly as Male/Female based on gamete production) and a separate field for "Sexual Development Disorder."
• Parental Access: IT teams must disable automatic "adolescent privacy" filters in patient portals. Parents must have "complete, unrestricted, and immediate" access to minor records unless a court order exists.
• Metabolic Health: Configure the EHR to allow specific recording of diet and metabolic health communications for chronic disease management.

Fees & Costs

• Civil Penalties: The law introduces a tiered penalty structure: up to $5,000 for negligent violations, $25,000 for knowing violations, and $250,000 for violations involving financial gain.
• IT Remediation: Expect significant one-time costs for EHR reconfiguration and potential data migration fees to move storage to US-based servers.