Binding law — in force
Tell patients when AI documents their visit (Rhode Island AI by Healthcare Providers Notification Act)
Since 2026-06-22, every healthcare provider licensed by the Rhode Island director of health and every healthcare facility that employs artificial intelligence to document in-person or telehealth visits must notify patients that AI is used for that purpose (R.I. Gen. Laws 23-108-3, enacted by P.L. 2026, ch. 199 and ch. 372). Detect ambient-scribe and note-drafting code that sends visit audio or transcripts to an AI model with no patient notice on the path.
Trust and provenance not reviewed by a lawyer · audit-grade · source verified 4 Oct 2026 · release 2026.10.05
- Lane
- Binding law — in force In force: applies since 22 Jun 2026
- Official source
- R.I. Gen. Laws 23-108-3 · captured 4 Oct 2026 · anchor hash (SHA-256)
d749cdce15b9…· 6 more anchors in the data release - Verification
- Quoted text found word for word in the captured official document (4 Oct 2026). Source last verified 4 Oct 2026: checked against the captured official document.
- Data release
- Data release 2026.10.05, data as of 4 Oct 2026, schema 0.3.10.
- Legal review
- Not reviewed by a lawyer. TwinEthos derived this rule from the official text it cites: treat it as research to check against that text; it is not legal advice. No TwinEthos rule has been legally reviewed yet. Open questions for counsel on this rule: 1.
- Audit standard
- Audit-grade: meets all 10 checks of the TwinEthos audit standard that apply to it. The audit standard is TwinEthos's own quality bar for provenance, dates, applicability, detectors, fixtures, remediation and licences; it is not a legal review.
- Detectors
1 detector (data flow), experimental: written from the rule's text and not yet measured for precision on real code, so treat a hit as a lead to verify.
Known limits:
- Notice given at check-in, in the EHR's patient portal or on paper outside the integrating code
- Scribe tools configured in a vendor console
Who it applies to
- Duty falls on: individual professional, organization
- Sectors: healthcare
- Rhode Island-licensed healthcare providers (physicians, physician assistants, dentists, nurses, nursing assistants and other professionals licensed by the director of health) and healthcare facilities (23-17-2(9)) that employ AI to document in-person or telehealth visits, and the ambient-scribe and note tools they deploy. In force since 2026-06-22. When and how the notice is given (each visit, at intake, in writing) is not specified and is for counsel.
- Whether it applies depends on facts outside the code; a person has to decide.
The guard to add
Send the person an AI-use notice on the decision path, before or when an AI system makes or substantially factors a consequential decision about them, and record its delivery.
A notice step in the decision workflow itself (application intake, underwriting, eligibility, applicant or employee scoring, diagnostic support) that runs before the model call, e.g. send_admt_notice(consumer) ahead of underwrite(), or a notice block rendered on the intake page the person submits from. The notice says that AI is used in the decision, for what, and how to get more information or ask for review, and its delivery is stored with the decision (notice id, channel, timestamp). The template lives in the repo so its content is reviewable; a privacy-policy paragraph alone is not on the decision path.
Where it goes: 1 application source code, 9 AI output handling, 14 user-facing text.
What this provision adds:
- Notify the patient that AI documents the visit, for in-person and telehealth visits alike, and keep a record that the notice was given.
Example (FastAPI + OpenAI SDK), before:
@app.post('/applications')
def apply(app_in: Application):
resp = client.chat.completions.create(model=MODEL, messages=underwriting_prompt(app_in))
return {'decision': underwrite(resp.choices[0].message.content)}After:
@app.post('/applications')
def apply(app_in: Application):
notice = send_admt_notice(app_in.applicant_id, template='ai_decision_notice_v2')
resp = client.chat.completions.create(model=MODEL, messages=underwriting_prompt(app_in))
decision = underwrite(resp.choices[0].message.content)
db.decisions.insert(app_in.id, decision, notice_id=notice.id)
return {'decision': decision, 'ai_notice': notice.text}Control: Consequential AI decision without consumer notice. The same guard addresses 9 items with binding law in 8 jurisdictions. Engineering guidance, not legal advice.
Standards that recommend the same control
- Financial AI decisions should offer enquiry, appeal, and review channels to affected people (MAS FEAT) (MAS FEAT Principles · MAS FEAT Principles — Accountability (External), Principles 10-11)
Rule id ri-hb7538.ai-visit-documentation-patient-notice · review status: primary source derived