Texas has enacted a groundbreaking new law – Texas Senate Bill No. 922 (“S.B. 922”) that changes the way certain sensitive medical test results are shared with patients.  The law, which took effect on September 1, 2025, requires a 72-hour delay on the electronic release of test results related to positive or suspected malignancy and genetic diseases.  The purpose of this delay is to give patients’ ordering/treating physicians time to provide context and support before patients receive potentially life-changing news.

S.B. 922 is a direct response to Federal information blocking rule, which generally requires the timely release of finalized test results through electronic health record (“EHR”) systems and patient portals. Texas now joins Kentucky and California in permitting such delays, while Pennsylvania instead mandates direct patient notification of significant imaging abnormalities, as discussed in our Reed Smith Viewpoint article.

Key Provisions of the Texas Law

S.B. 922 amends Section 159.006(d) of the Texas Occupations Code and adds Section 159.0062 to require a delay before certain “sensitive test results” may be disclosed to patients or their representatives by electronic means.  The key provisions include:

• “Sensitive Test Result”:  The statute narrowly defines “sensitive test results” as (i) pathology or radiology reports with a reasonable likelihood of showing a finding of malignancy, or (ii) test results that may reveal a genetic marker.  Note that because the law relates to findings or potential findings of “malignancy” and genetic markers, the sensitive test results subject to required report embargos appear restricted to only cancer-related radiology/pathology reports, as well as genetic disease tests.  Consequentially, it appears that all other tests – for example, tests for severe non-cancerous liver disease or kidney disease, or endocarditis — remain subject to the federal requirement for timely electronic release.
• 72-Hour Delay: Sensitive test results may not be disclosed by electronic means until the third calendar day after the results are finalized. This delay is intended to give ordering/treating physicians time to review results and, where appropriate, communicate directly with patients before portal release.
• Scope of “Electronic Means”: The delay applies to any secure online patient portal, health software application, or other internet-based tool through which patients have consented to receive their medical records.
• Liability Shield: The statute expressly provides that failure to comply with the 72-hour delay cannot result in civil, criminal, administrative, or professional disciplinary action under Texas law.

During the enactment process, the Texas house committee clarified that the S.B. 922 addresses the issue of sensitive test results only.  “A person who administers or controls the electronic health record of a patient is responsible for implementing that prohibition.” Importantly, this bill in no way prevents a testing facility from sharing sensitive test results immediately with the patient over the phone, through video conference, or in person, as is the consistent practice of outpatient imaging centers which perform screening mammography procedures for example.

Federal Law Requirements

The 21st Century Cures Act (“Cures Act”), enacted in 2016, is a landmark federal law designed to accelerate medical innovation, enhance patient access to health information, and promote interoperability among health IT systems.  A central tenet of the Cures Act is empowering patients with timely, electronic access to their health data, thereby supporting informed decision-making and improved care coordination.

On May 1, 2020, the Office of the National Coordinator for Health Information Technology (“ONC”) finalized a rule implementing the Cures Act’s information blocking provisions through regulations at 45 CFR Part 171. The rule includes the following provisions:

• Definition of Information Blocking:  Information blocking is defined as a practice by a healthcare provider, health IT developer, health information exchange, or health information network that is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information (“EHI”), “except as required by law or covered by an exception”.
• Purpose: The rule is intended to ensure that patients and authorized parties have prompt, unfettered access to EHI, and to prevent practices that unreasonably restrict the flow of health information.
• Exceptions: The rule includes nine exceptions under 45 CFR Part 171 Subparts B, C, and D that recognize certain reasonable and necessary activities do not constitute information blocking.

Interaction Between the Texas Law and Federal Law

S.B. 922’s 72-hour hold directly intersects with the Federal information blocking rule, which generally requires the timely release of finalized test results to patients via electronic means.  However, the Federal rule explicitly recognizes that state laws may impose additional requirements or restrictions on the release of electronic health information by excluding from the definition any practices “required by law.”

In the preamble to the Federal rule, the ONC specified that practices “required by law” do not constitute information blocking. This means that legal requirements—including “[Federal and State] statutes, regulations, court orders, binding administrative decisions or settlements, . . . and tribal laws, as applicable” —are exempt from the definition of information blocking.  Thus, complying with a state law like S.B. 922 that delays sensitive test results is not considered information blocking under the Cures Act.

Compliance and Enforcement

S.B. 922 clearly states that failing to comply with the 72-hour delay cannot lead to civil, criminal, administrative, or professional disciplinary actions under Texas law.  However, after this three-day period, the Federal information blocking rule comes into effect again.  Health care providers and others must ensure that no further unreasonable delays occur unless another exception applies, especially in light of the recent increased enforcement efforts by the U.S. Department of Health and Human Services (HHS) regarding health data blocking.

Time will tell as to how such mandated embargos on getting report results will be received by patients and their providers. For example, women who have become accustomed to receiving timely notices of their screening mammography findings, may demand faster reporting. The consequence may be the burden of direct non-electronic reporting to patients anxious to receive timely mammographic findings.

Compliance with the embargo is also complicated since screening mammography patients can self-refer. The FDA mandates that mammography facilities that accept patients who do not have a healthcare provider will need to maintain a system for referring such patients to a healthcare provider when clinically indicated, which shall include when such patients’ mammogram assessment is either probably benign, suspicious, or highly suggestive of malignancy. We noted these FDA requirements in a Reed Smith Viewpoint article in 2023.

Conclusion

S.B. No. 922, by introducing a narrowly tailored exception to the general rule of timely electronic release of test results, attempts to strike a balance between the need for patient access and the importance of less timely but physician-mediated communication for sensitive findings. Time will tell how successful the mandated embargo of results reporting to patients by testing centers proves to be.

The new law is consistent with Federal information blocking rule, which expressly permit practices “required by law.” Health care providers and other stakeholders should review and update their policies and EHR configurations, among others, to ensure compliance with both Texas and federal requirements and remain alert to ongoing federal enforcement efforts in this area.

Reed Smith will continue to follow developments concerning electronic health information release regulations. If you have any questions about this client alert, seek guidance specific to your business, please do not hesitate to contact the authors or your health care attorneys at Reed Smith.