| Chapter 374 |
| 2026 -- S 2197 SUBSTITUTE A AS AMENDED Enacted 06/22/2026 |
| A N A C T |
| RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABILITIES AND HOSPITALS -- OVERSIGHT OF ARTIFICIAL INTELLIGENCE TECHNOLOGY IN MENTAL HEALTH CARE ACT |
Introduced By: Senators Urso, Tikoian, Zurier, Burke, Gu, Paolino, DiPalma, and Famiglietti |
| Date Introduced: January 23, 2026 |
| It is enacted by the General Assembly as follows: |
| SECTION 1. Title 40.1 of the General Laws entitled "BEHAVIORAL HEALTHCARE, |
| DEVELOPMENTAL DISABILITIES AND HOSPITALS" is hereby amended by adding thereto |
| the following chapter: |
| CHAPTER 5.5 |
| OVERSIGHT OF ARTIFICIAL INTELLIGENCE TECHNOLOGY IN MENTAL HEALTH |
| CARE ACT |
| 40.1-5.5-1. Short title. |
| This chapter shall be known and may be cited as the "Oversight of Artificial Intelligence |
| Technology in Mental Health Care Act". |
| 40.1-5.5-2. Definitions. |
| For the purposes of this chapter: |
| (1) "Administrative support" means tasks performed to assist a licensed professional or |
| provider in the delivery of therapy or psychotherapy services that do not involve therapeutic |
| communication. "Administrative support" includes, but is not limited to, the following: |
| (i) Managing appointment scheduling and reminders; |
| (ii) Processing billing and insurance claims; and |
| (iii) Drafting general communications related to therapy logistics that do not include |
| therapeutic advice. |
| (2) "Artificial intelligence", "artificial intelligence technology", or "AI" means a machine- |
| based system that can, for a given set of human-defined objectives, make predictions, |
| recommendations, or decisions influencing real or virtual environments. |
| (3) "Consent" means an affirmative written agreement, including by electronic means, |
| which unambiguously communicates the individual's explicit, express, freely given, informed, |
| voluntary, and specific agreement, and which is revocable by the individual. "Consent" does not |
| include an agreement that is obtained by the following: |
| (i) The acceptance of a general or broad terms of use, agreement, or a similar document |
| that contains descriptions of artificial intelligence along with other unrelated information; |
| (ii) An individual hovering over, muting, pausing, or closing a given piece of digital |
| content; or |
| (iii) Using deceptive actions. |
| (4) "Licensed professional or provider" means an individual who holds a valid license, |
| credential, or certification issued by this state to provide therapy or psychotherapy services. |
| (5) "Peer support" means services provided by individuals with lived experience of mental |
| health conditions or recovery from substance use or gambling that are intended to offer |
| encouragement, understanding, and guidance without clinical intervention. |
| (6) "Permitted use of artificial intelligence" means the use of artificial intelligence tools or |
| systems by a licensed professional or provider to assist in providing administrative support or |
| supplementary support in therapy or psychotherapy services where the licensed professional or |
| provider maintains responsibility for clinical judgement and reasonable therapeutic oversight of the |
| patient's use of the system, but not for vendor-controlled system design, algorithms, or outputs. |
| (7) "Religious counseling" means counseling provided by clergy members, pastoral |
| counselors, or other religious leaders acting within the scope of their religious duties if the services |
| are explicitly faith-based and are not represented as clinical mental health services or therapy or |
| psychotherapy services. |
| (8) "Supplementary support" means tasks performed to assist a licensed professional or |
| provider in the delivery of therapy or psychotherapy services that do not involve therapeutic |
| communication and that are not administrative support. "Supplementary support" includes, but is |
| not limited to, the following: |
| (i) Preparing and maintaining client records, including therapy notes; |
| (ii) Analyzing data to track client progress or identify trends, subject to review by a |
| licensed, credentialed, or certified professional; and |
| (iii) Identifying and organizing external resources or referrals for client use. |
| (9) "Therapeutic communication" means any verbal, non-verbal, or written interaction |
| conducted in a clinical or professional setting that is intended to diagnose or treat an individual's |
| mental, emotional, or behavioral health concerns. "Therapeutic communication" includes, but is |
| not limited to: |
| (i) Direct interactions with clients for the purpose of understanding or reflecting their |
| thoughts, emotions, or experiences; |
| (ii) Providing guidance, therapeutic strategies, or interventions designed to achieve mental |
| health outcomes; |
| (iii) Offering emotional support, reassurance, or empathy in response to psychological or |
| emotional distress; |
| (iv) Collaborating with clients to develop or modify therapeutic goals or treatment plans; |
| and |
| (v) Offering behavioral feedback intended to promote psychological growth or address |
| mental health conditions. |
| (10) "Therapy or psychotherapy services" means services provided to diagnose or treat an |
| individual's mental health or behavioral health. "Therapy or psychotherapy services" does not |
| include religious counseling or peer support. |
| 40.1-5.5-3. Artificial intelligence in mental health care: use restrictions and |
| permissions. |
| (a) No licensed professional or provider shall be permitted to use artificial intelligence, |
| designed to simulate emotional attachment, bonding, or dependency or artificial intelligence |
| companions for mental health or emotional support, to assist in supplementary support or |
| therapeutic communication in therapy or psychotherapy services where the client's therapeutic |
| session is recorded or transcribed unless the patient or the patient's parent, guardian or other legally |
| authorized representative is informed in writing of the following and provides consent as defined |
| in § 40.1-5.5-2: |
| (1) That artificial intelligence will be used; |
| (2) The specific purpose of the artificial intelligence tool or system that will be used; and |
| (3) The patient or the patient's parents, or other legally authorized representative, provides |
| consent to the use of artificial intelligence. |
| (b) An individual, corporation, or entity may not provide, advertise, or otherwise offer |
| therapy or psychotherapy services, including through the use of Internetinternet-based artificial |
| intelligence, to the public in this state unless the therapy or psychotherapy services are conducted |
| by an individual who is a licensed professional or provider. |
| (c) A licensed professional or provider may use artificial intelligence only to the extent that |
| such use meets the requirements of subsection (a) of this section. A licensed professional or |
| provider may not allow or otherwise use artificial intelligence to do any of the following: |
| (1) Make independent therapeutic decisions; |
| (2) Directly interact with clients in any form of therapeutic communication without an |
| established relationship when the licensed professional or provider agrees to undertake diagnosis |
| and treatment of the patient and the patient consents under this section, whether or not there has |
| been an in-person encounter between the licensed professional or provider and the patient. The |
| provider retains responsibility for clinical judgement and reasonable therapeutic oversight of the |
| patient's use of the system, but not for vendor-controlled system design, algorithms, or outputs; or |
| (3) Determine therapeutic recommendations or treatment plans. |
| (d) If a client discloses that they are using software that includes AI features on their own |
| initiative, the licensed professional or provider may discuss the client's use of the software and offer |
| guidance about the client's use of the software. The licensed professional is responsible for |
| maintaining confidentiality and monitoring the safety of the client, intervening when necessary to |
| protect the safety of the client, and to discuss limitations and risks using the software poses to the |
| patient. |
| 40.1-5.5-4. Confidentiality of records. |
| All records kept by a licensed professional or provider and all communications between an |
| individual seeking therapy or psychotherapy services and a licensed professional or provider shall |
| be confidential and shall not be disclosed except as provided pursuant to the provisions of § 40.1- |
| 5-26. |
| 40.1-5.5-5. Penalties. |
| (a) The penalties pursuant to § 5-37.3-9 shall apply to any violation of the confidentiality |
| provisions of this chapter. |
| (b) The executive office of health and human services shall have authority to investigate |
| any actual, alleged, or suspected violation of this chapter. |
| (c) This chapter shall not apply to the following: |
| (1) Religious counseling; |
| (2) Peer support; and |
| (3) Self-help materials and educational resources that are available to the public and do not |
| purport to offer therapy or psychotherapy services. |
| (4) Any artificial intelligence tool or system that has been reviewed and cleared for use by |
| the federal Food and Drug Administration, or another federal agency tasked with approving |
| artificial intelligence and artificial intelligence algorithms for use in health care. |
| (5) Research pursuant to the patient consent and/or de-identification requirements of 21 |
| C.F.R. Pt. 50 and/or 45 C.F.R. Pt. 46 approved by a healthcare facility’s institutional review board |
| pursuant to § 23-17-19.1. |
| 40.1-5.5-6. Rules and Regulations. |
| The executive office of health and human services is authorized to promulgate rules and |
| regulations to carry out the intent of this chapter. |
| SECTION 2. This act shall take effect upon passage. |
| ======== |
| LC004017/SUB A |
| ======== |