Texas Wellness Clinic Regulation in 2026: AI Disclosure, Physician Noncompetes, New CME and Proposed Ketamine Rules

Texas is the second-biggest market for med spas and wellness clinics, and most of the attention in 2025 and 2026 went to one law: HB 3749, known as Jenifer's Law, which regulates elective IV therapy. Our post on what it requires covers that. But the more important change for many clinics happened elsewhere, in laws about artificial intelligence, noncompetes and continuing education that apply regardless of which services you offer.

This post is a map of what changed in Texas between early 2025 and October 2026, based on bill texts and agency pages where we could read them and law-firm summaries where we could not. We have flagged which is which.

AI Disclosure Is Now a Compliance Item

• HB 149 (Texas Responsible AI Governance Act): signed June 22, 2025 and effective January 1, 2026. It requires health care providers to disclose to patients when AI is used in their care. The Attorney General has exclusive enforcement authority, and secondary sources report penalties of up to $200,000, which we could not confirm from the statute itself.
• SB 1188: effective September 1, 2025. Practitioners who use AI for diagnosis or treatment recommendations must disclose that use and review the AI's output. Provisions on where electronic health record data is stored begin January 1, 2026, per secondary sources.
• Who is affected: any clinic using AI scribes, intake or triage tools, chat assistants or AI-assisted marketing. If a tool touches patient care or patient communication, assume the rule may apply.

SB 1318: Physician Noncompetes

SB 1318, effective September 1, 2025, adds a new section of the Business and Commerce Code limiting noncompete covenants for physicians, with related provisions for dentists, nurses and physician assistants. It applies only to covenants entered into or renewed on or after the effective date. For physicians, the bill text as we read it caps the restriction at one year and a five-mile radius, caps any buyout at one year of salary and wages, and voids the covenant if the physician is discharged without good cause.

For clinics built on a physician-owned PC with a separate management company, this is a document-review item. Old employment agreements and any covenants in the medical director agreement should be checked, and renewals should be written to the new limits.

A New CME Hour on Nutrition and Metabolic Health

Under SB 25, as implemented by Texas Medical Board rule effective September 3, 2026, physicians renewing licenses on or after September 1, 2026 must complete one hour of continuing education on nutrition and metabolic health. Physicians must also complete two hours on forensic evidence collection under a separate law that applies to emergency room practice. Physician assistants have a parallel rule. Clinics running weight-loss programs under a medical director should make sure their physician knows about the new hour.

Proposed Rules for Ketamine IV Clinics

The Texas Medical Board published proposed rules in the Texas Register on July 10, 2026 that would regulate non-hospital clinics administering parenteral ketamine. As proposed, they would require a practice registration with a two-year term, a medical director who inspects each site every 90 days and oversees no more than three sites, set patient monitoring and ratio requirements, and require adverse event reports within 24 hours. We could not confirm the current status of the proposal, so check the Board's rule-changes page before relying on it. Wellness clinics offering ketamine infusions should watch it closely.

Federal Changes That Hit Texas Clinics

• GLP-1 compounding: FDA announced in February 2026 that it intends to restrict GLP-1 active ingredients in mass-marketed compounded drugs and will act against ads claiming a compounded drug is equivalent to the approved one. It sent about 30 warning letters to telehealth firms in March 2026, and a first FDA warning letter to a Texas med spa on drug handling has been reported. The Texas pharmacy board bars compounding that is essentially a copy of a commercially available drug, and we found no GLP-1-specific Texas pharmacy board action.
• Peptides: an FDA advisory committee voted in July 2026 to recommend adding BPC-157 and some other peptides to the 503A bulks list. That vote is advisory, FDA staff opposed it, and compounding is not authorized until FDA acts.
• Testosterone telehealth: DEA flexibilities for prescribing controlled substances by telemedicine run through December 31, 2026. If a permanent rule is not final by then, in-person requirements return on January 1, 2027. Plan for it now if you prescribe testosterone.

What Did Not Pass

Bills expanding APRN independence, bills requiring notice of healthcare transactions and ownership changes, and CPOM reform proposals did not become law in 2025, and we found no change to Texas's corporate practice of medicine doctrine. One bill that vendor blogs link to med spas, SB 378, was vetoed in June 2025 and dealt with barber and cosmetology practices, not med spas. Do not rely on claims that it changed anything for clinics. Many of the failed bills are likely to return when the Legislature meets in 2027.

What a Texas Clinic Should Do Now

• Inventory every AI tool that touches patient care or communication, and add the required disclosures.
• Review physician employment and medical director agreements against SB 1318 and rewrite old covenants at renewal.
• Tell your delegating physician about the new CME hour.
• If you offer ketamine IVs, track the proposed rules and plan for registration and medical director inspection duties.
• If you prescribe testosterone by telehealth, plan for the possibility that DEA flexibilities lapse on January 1, 2027.
• Review your delegation and standing orders against the Board's delegation rules and Jenifer's Law.

Where MedGrid Fits

Texas is a strict corporate practice of medicine state, so a clinic typically needs a physician-owned professional entity with a separate management company. MedGrid connects Texas clinics with a Texas-licensed physician, forms the entity structure, and helps write the delegation, protocols and standing orders the Board's rules call for. The management fee is flat and fair-market, and the agreements are separate documents. See our guides to Texas med spa laws and delegated authority, and finding a Texas medical director.

Frequently Asked Questions

• Do I have to disclose AI use to patients in Texas?: Under HB 149 and SB 1188, providers must disclose AI use in patient care, and practitioners using AI for diagnosis or treatment recommendations must review its output. Confirm exact wording with Texas counsel.
• Can a Texas clinic still use a noncompete for a physician?: Yes, within limits. For covenants entered or renewed on or after September 1, 2025, the term, radius and buyout are capped and the covenant is void if the physician is fired without good cause.
• Did Texas change its corporate practice of medicine rules?: We found no change. Texas remains a strict CPOM state, and bills on transaction notice and CPOM reform did not pass in 2025.
• Does Jenifer's Law cover Botox and fillers?: No. It covers elective IV therapy. See our dedicated post.
• What happens to testosterone telehealth prescribing next year?: It depends on whether DEA finalizes a permanent rule before the current flexibilities end on December 31, 2026.

This article is general educational information, not legal advice. It reflects bill texts, agency pages and law-firm summaries as of the publication date, and some items, including the ketamine proposal and AI penalty amounts, could not be confirmed against final primary text. Confirm your obligations with the Texas Medical Board and licensed Texas healthcare counsel.