October 9, 2025
Mr. Markey (for himself and Mr. Blumenthal) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions
To protect the independent judgment of health care professionals acting in the scope of their practice in overriding AI/CDSS outputs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
Section 1. Short title
This Act may be cited as the Right to Override Act
.
Sec. 2. Table of contents
The table of contents for this Act is as follows:
Sec. 3. Definitions
In this Act:
(1) Adverse employment action
The term adverse employment action, with respect to a health care professional, includes—
(A)
the termination, suspension, or demotion of the health care professional from a job;
(B)
any disciplinary action or retaliatory investigation against the health care professional;
(C)
the imposition of a work schedule that is more burdensome to the health care professional;
(D)
the failure of the health care professional to receive, or any adverse adjustment in the ability of the health care professional to receive, a promotion;
(E)
the denial of the health care professional in receiving or being eligible to receive—
(i)
compensation, including the denial of an increase in compensation; or
(ii)
any other job-related benefit or opportunity, including for telework, training, or travel;
(F)
revocation of admitting privileges;
(G)
a reassignment of a duty or the assignment of a duty inappropriate for the job, skill set, or experience of the health care professional;
(H)
a change in the ability to practice at a location for which the health care professional would otherwise be able;
(I)
an adverse evaluation or performance review;
(J)
any other modification to the terms, conditions, or privileges of employment or work of the health care professional that, from the perspective of a reasonable person, puts the health care professional in a materially adverse position when compared to the position of the professional prior to the modification; and
(K)
any other action or inaction that results in the health care professional being in a materially adverse position when compared to the position of the professional prior to the action or inaction.
(2) Artificial intelligence clinical decision support system; AI/CDSS
The term artificial intelligence clinical decision support system or AI/CDSS means technology that—
(A)
supports decision-making based on algorithms, or models, based in clinical practice guidelines or that derive relationships from training data, including such algorithms or models that are developed using unsupervised learning models; and
(B)
produces an output that results in a prediction, classification, recommendation, evaluation, or analysis.
(3) AI/CDSS output
The term AI/CDSS output means any recommendation, decision, or other output of AI/CDSS.
(4) Commerce; industry or activity affecting commerce
The terms commerce and industry or activity affecting commerce have the meanings given such terms in section 101 of the Family and Medical Leave Act of 1993 (29 U.S.C. 2611).
(5) Covered entity
The term covered entity—
(A)
means any individual or entity that—
(i)
employs, or otherwise engages in the performance of work for remuneration, a health care professional; and
(ii)
is engaged in commerce (including government), or an industry or activity affecting commerce (including government); and
(B)
includes such an individual or entity that is—
(i)
a health care facility in any setting, such as a nurse's office in a school setting; or
(ii)
a health plan or an administrator of a health plan.
(6) Engaged in the performance of work for remuneration
The term engaged in the performance of work for remuneration, with respect to an individual performing work for a covered entity, includes the individual having admitting privileges for the covered entity without regard to whether such individual is employed by such entity.
(7) Health care professional
The term health care professional—
(A)
means an individual—
(i)
licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or
(ii)
required to be so licensed, registered, or certified but that is exempted by other statute or regulation; and
(B)
includes—
(i)
an individual described in subparagraph (A) without regard to whether the individual works at a health care facility, including a home health aide or a home care provider; and
(ii)
an individual who is employed by, or otherwise engaged in the performance of work for remuneration for, a health plan to make prior authorization determinations or other determinations regarding coverage under a health plan.
(8) Health care services
The term health care services means any services that relate to—
(A)
the diagnosis, prevention, or treatment of any human disease or impairment;
(B)
the assessment or care of the health of human beings; or
(C)
making prior authorization determinations or other determinations regarding coverage under a health plan.
(9) Health plan
The term health plan has the meaning given the term in section 3000 of the Public Health Service Act (42 U.S.C. 300jj).
(10) Override
The term override, with respect to an AI/CDSS output, means making a decision contrary to such output.
(11) Override data
The term override data—
(A)
means any data related to adherence to or deviation from AI/CDSS outputs; and
(B)
includes—
(i)
any such data that is metadata or audit data; or
(ii)
any such data related to a particular health care professional or group of health care professionals, or related to a particular AI/CDSS.
(12) State
The term State has the meaning given the term in section 3000 of the Public Health Service Act.
Title I Policies for using and overriding AI/CDSS
Sec. 101. Policies with respect to using and overriding AI/CDSS
(a) In general
A covered entity that uses AI/CDSS shall—
(1)
adopt and adhere to a policy with respect to such usage—
(A)
that ensures that AI/CDSS outputs are not substituted for the independent judgment of a health care professional employed by, or otherwise engaged in the performance of work for remuneration for, the covered entity while such health care professional is acting in the scope of practice of such health care professional;
(B)
that allows such a health care professional to override an AI/CDSS output in a timely manner if, at the time of the override, in the judgment of the health care professional acting in the scope of practice of the health care professional, such an override is appropriate for the patient, or as necessary to comply with applicable law, including civil rights law;
(C)
that allows health care professionals and their representatives to provide feedback on AI/CDSS, including incorrect or biased outputs that require frequent override; and
(D)
that prohibits the sharing of override data on—
(i)
a specific health care professional; or
(ii)
a group of health care professionals when the identity of those professionals can be reasonably inferred;
(2)
inform health care professionals employed by, or otherwise engaged in the performance of work for remuneration for, the covered entity, and the representatives of such health care professionals, of the policy under paragraph (1), including the presence of AI/CDSS in the workplace and the ability of such health care professionals to override an AI/CDSS output;
(3)
provide training to such health care professionals on—
(A)
how to use AI/CDSS;
(B)
the circumstances where an AI/CDSS override is appropriate;
(C)
how to override an AI/CDSS output;
(D)
AI/CDSS development processes and any data or other inputs involved in such processes; and
(E)
any potential limitations for AI/CDSS, including any potential areas of bias in the AI/CDSS;
(4)
establish and maintain an AI/CDSS committee that shall—
(A)
convene upon the date that is later of—
(i)
the date of the adoption of AI/CDSS at the covered entity; or
(ii)
120 days after the date of enactment of this Act;
(B)
be comprised of at least as many non-managers as managers;
(C)
include membership of any labor organization, or other authorized representative, of health care professionals employed by, or otherwise engaged in the performance of work for remuneration for, the covered entity;
(D)
provide consultation to the covered entity in developing policies and practices related to the use of AI/CDSS, including policy required under subparagraphs (A) through (D) of paragraph (1); and
(E)
meet at least quarterly to—
(i)
review implementation of policies adopted by the covered entity with respect to AI/CDSS; and
(ii)
report to the covered entity on findings and suggestions for improvements; and
(5)
review—
(A)
all findings and suggestions from the AI/CDSS committee provided under paragraph (4)(E)(ii); and
(B)
any other feedback from health care professionals employed by, or otherwise engaged in the performance of work for remuneration for, the covered entity on the AI/CDSS technology and the policies of the entity with respect to such technology, including by reviewing any such feedback on patterns of issues with the AI/CDSS, such as incorrect or biased outputs that require frequent override.
(b) Data sharing exception
The prohibition under subsection (a)(1)(D) shall not apply—
(1)
in a case in which a covered entity is informing a patient or an authorized representative of a patient about a decision rendered in the administration of the care of such patient; or
(2)
in a case of a civil, criminal, or administrative action involving medical malpractice, negligence, or violation of any law.
(c) Oversight mechanism
Nothing in this Act shall prohibit a covered entity from reviewing the performance outcomes of AI/CDSS.
Sec. 102. Enforcement
(a) In general
Except as provided in subsection (c), the Secretary of Health and Human Services, acting through the Office for Civil Rights (referred to in this title as the Secretary
), shall receive, investigate, and attempt to resolve, including through imposing civil monetary penalties, complaints of violations of this title in the same manner as the Secretary receives, investigates, and attempts to resolve, including through imposing civil monetary penalties, complaints of violations of part C of title XI of the Social Security Act (42 U.S.C. 1320d et seq.).
(b) Civil monetary penalties
The provisions of section 1128A of the Social Security Act (42 U.S.C. 1320a–7a) (other than subsections (a) and (b) and the second sentence of subsection (f)) shall apply to the imposition of a civil monetary penalty under this section in the same manner as such provisions apply to the imposition of a penalty under such section 1128A.
(c) Exception
No complaint of a violation of this title shall be referred to the Attorney General for investigation as a criminal violation.
Sec. 103. Regulations
(a) In general
The Secretary may prescribe such regulations as may be necessary to carry out this title.
(b) Consultation
In prescribing any regulations authorized under this section, the Secretary—
(1)
shall consult with the Secretary of Labor; and
(2)
may consult with—
(A)
other Federal agencies that have expertise in artificial intelligence or health care; and
(B)
other Federal agencies that have jurisdiction over labor and employment issues, including the Equal Employment Opportunity Commission, the Department of Justice, and the National Labor Relations Board.
Title II Adverse employment actions; whistleblower protections
Sec. 201. Prohibition on adverse employment actions
No covered entity shall take an adverse employment action against a health care professional employed by, or otherwise engaged in the performance of work for remuneration for, the covered entity because the health care professional overrides an AI/CDSS output in a manner consistent with the requirements under section 101.
Sec. 202. Whistleblower protections
No covered entity shall discriminate or retaliate (including through intimidation, threats, coercion, or harassment) against any individual employed by, or otherwise engaged in the performance of work for remuneration for, the covered entity—
(1)
because the individual exercises, or attempts to exercise, any right provided under this Act; or
(2)
because the individual (or another individual or representative acting at the request of the individual) has—
(A)
filed a written or oral complaint to the covered entity or a Federal, State, local, or Tribal government entity of a possible violation of this Act;
(B)
sought assistance or intervention with respect to an AI/CDSS-related concern from the covered entity, a Federal, State, local, or Tribal government, or any individual or entity representing workers;
(C)
instituted, caused to be instituted, or otherwise participated in any inquiry or proceeding under or related to this Act;
(D)
given, or is about to give, any information in connection with any inquiry or proceeding relating to any right provided under this Act;
(E)
testified, or is about to testify, in any inquiry or proceeding relating to any right provided under this Act; or
(F)
discussed a possible violation of this Act with a co-worker.
Sec. 203. Enforcement
(a) Enforcement by Department of Labor
(1) Investigation
(A) In general
To ensure compliance with this title, the Secretary of Labor (referred to in this title as the Secretary
)—
(i)
shall have—
(I)
the investigative authority provided under section 11(a) of the Fair Labor Standards Act of 1938 (29 U.S.C. 211(a)); and
(II)
the subpoena authority provided under section 9 of such Act (29 U.S.C. 209); and
(ii)
may require, by general or special orders, a covered entity to file with the Secretary, in such form as the Secretary may prescribe, annual or special reports or answers in writing to specific questions (including information and records) as the Secretary may require as to the organization, business, conduct, practices, management, and relation to other corporations, partnerships, and individuals, of the covered entity.
(B) Reports and answers
A covered entity shall file any reports and answers (including information and records) required under subparagraph (A)(ii) in such manner, including under oath or otherwise, and within such reasonable time period as the Secretary may require.
(C) Joint investigations
The Secretary may conduct investigations and make requests for information, as authorized under this Act, on a joint basis with another Federal agency, a State attorney general, or a State agency.
(D) Obligation to keep, preserve, and make available records
A covered entity shall make, keep, preserve, and make available to the Secretary records pertaining to compliance with this title in accordance with section 11(c) of the Fair Labor Standards Act of 1938 (29 U.S.C. 211(c)) and in accordance with any regulation or order issued by the Secretary.
(2) Enforcement
The Secretary shall receive, investigate, and attempt to resolve complaints of violations of this title in the same manner that the Secretary receives, investigates, and attempts to resolve complaints of violations of sections 6 and 7 of the Fair Labor Standards Act of 1938 (29 U.S.C. 206 and 207).
(3) Civil monetary penalties
Subject to subsection (c), the Secretary may impose a civil monetary penalty on any person that violates this title—
(A)
in an amount of not more than $76,987 per violation; or
(B)
for repeat violations, in an amount of not more than $769,870 per violation.
(4) Administrative complaints
An individual adversely affected by an alleged violation of this title may—
(A)
file a complaint of a violation of this title with the Secretary; and
(B)
designate a representative of a labor organization, regardless of the relationship between the individual and the labor organization, to—
(i)
file the complaint on behalf of the individual; or
(ii)
represent the individual for purposes of engagement with the Secretary regarding such complaint, including being present at worker interviews and participating in workplace inspections, conferences, and settlement negotiations.
(5) Litigation
The Solicitor of Labor may appear for and represent the Secretary on any litigation brought under this subsection. If the Secretary determines that a covered entity has violated this title, the Secretary may file a civil action in any appropriate United States district court to obtain injunctive relief to enforce this title.
(6) Burdens of proof
All complaints under this subsection shall be governed by the legal burdens of proof set forth in section 42121(b) of title 49, United States Code.
(b) Private right of action
(1) In general
Notwithstanding any action by the Secretary under subsection (a), any individual adversely affected by an alleged violation of this title (or a representative on behalf of such individual) may commence a civil action against any covered entity that violates this title in any Federal court of competent jurisdiction.
(2) Relief
(A) In general
In a civil action brought under paragraph (1) in which the individual described in such paragraph prevails, the court may award the individual—
(i)
damages of—
(I)
an amount equal to the sum of any actual damages including back pay sustained by the individual; or
(II)
not more than treble damages;
(ii)
statutory damages described in subparagraph (B);
(iii)
injunctive relief;
(iv)
equitable relief;
(v)
reasonable attorney fees and litigation costs; and
(vi)
while the action is pending, temporary relief, including temporary reinstatement.
(B) Statutory damages
(i) In general
The court may, in accordance with clause (ii), award statutory damages under subparagraph (A)(ii) against a covered entity in the following amounts:
(I)
For each violation of section 201 (regarding adverse employment actions), the court may award damages of an amount (subject to subsection (c)) of not less than $5,000 and not more than $20,000.
(II)
For each violation of section 202 (regarding whistleblower protections), the court may award damages of an amount (subject to subsection (c)) of not less than $10,000 and not more than $100,000.
(ii) Considerations for statutory damages
In determining the amount of statutory damages assessed under this subparagraph against a covered entity, the court shall consider any relevant circumstances presented by the parties to the action, including—
(I)
the nature and seriousness of the violation;
(II)
the number of violations;
(III)
the persistence of the misconduct;
(IV)
the length of time over which the misconduct occurred;
(V)
the willfulness of the misconduct; and
(VI)
the assets, liabilities, and net worth of the covered entity.
(3) Remedies for State workers
(A) Waiver of sovereign immunity
A State’s receipt or use of Federal financial assistance for any program or activity of a State shall constitute a waiver of sovereign immunity, under the 11th Amendment to the Constitution of the United States or otherwise, to a suit under this subsection for the relief described in paragraph (2) authorized under this subsection brought by an individual employed under, or otherwise engaged in the performance of work for remuneration under, that program or activity.
(B) Official capacity
An official of a State may be sued in the official capacity of the official by any individual who has complied with the procedures under this paragraph, for injunctive relief that is authorized under this subsection. In such a suit the court may award to the prevailing party those costs authorized by section 722 of the Revised Statutes (42 U.S.C. 1988).
(C) Applicability
With respect to a particular program or activity, subparagraph (A) applies to conduct that occurs—
(i)
after the date of enactment of this Act; and
(ii)
on or after the day on which a State first receives or uses Federal financial assistance for that program or activity.
(4) Definition of program or activity
In this subsection, the term program or activity has the meaning given the term in section 606 of the Civil Rights Act of 1964 (42 U.S.C. 2000d–4a).
(c) Inflation adjustment
(1) In general
Subject to paragraphs (2) and (3), the Secretary, not later than September 1 of each calendar year, shall adjust the dollar amounts referred to in subsections (a)(3) and (b)(2)(B)(i) by the percent increase, if any, in the consumer price index for all urban consumers (United States city average), or a successor index, as determined by the Bureau of Labor Statistics, or a successor agency, for the most recent 12-month period for which data is available.
(2) Rounding
Any adjustment under paragraph (1) that is not a multiple of $10 shall be rounded to the nearest multiple of $10.
(3) Publication
The Secretary shall publish the adjusted amounts under paragraph (1) in the Federal Register, and on the official website of the Department of Labor, not later than October 1, of the applicable calendar year for the increase under such paragraph.
(4) Effective date
Each adjustment under paragraph (1) shall take effect on January 1 of the first calendar year beginning after the date of the increase under such paragraph.
(d) Arbitration and class action
Notwithstanding any other provision of law, no predispute arbitration agreement or predispute joint-action waiver shall be valid or enforceable with respect to any alleged violation of this title.
Sec. 204. Regulations
(a) In general
The Secretary may prescribe such regulations as may be necessary to carry out this title.
(b) Consultation
In prescribing any regulations authorized under this section, the Secretary—
(1)
shall consult with the Secretary of Health and Human Services; and
(2)
may consult with—
(A)
other Federal agencies that have expertise in artificial intelligence or health care; and
(B)
other Federal agencies that have jurisdiction over labor and employment issues, including the Equal Employment Opportunity Commission, the Department of Justice, and the National Labor Relations Board.
Title III General provisions
Sec. 301. Educational materials for covered entities and health care professionals
Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services, in consultation with the Secretary of Labor, shall develop and disseminate education materials for—
(1)
covered entities with respect to the compliance of such entities with the requirements under this Act; and
(2)
health care professionals to inform such professionals of their rights and protections under this Act.
Sec. 302. State enforcement
(a) In general
In any case in which a State attorney general or a State privacy regulator has reason to believe that an interest of the residents of a State has been or is adversely affected by any covered entity that violates any provision of this Act, the State attorney general or State privacy regulator, as parens patriae, may bring a civil action on behalf of the residents of the State in an appropriate State court or an appropriate district court of the United States to—
(1)
enjoin further violation of such provision by the covered entity;
(2)
compel compliance with such provision;
(3)
obtain damages, civil penalties, restitution, or other compensation on behalf of the residents of the State; or
(4)
obtain reasonable attorney’s fees and other litigation costs reasonably incurred.
(b) Rights of agency
Before initiating a civil action under subsection (a), the State attorney general or State privacy regulator, as the case may be, shall notify the Secretary in writing of such civil action. Upon receiving such notice, the Secretary may—
(1)
intervene in such action; and
(2)
upon intervening—
(A)
be heard on all matters arising in such civil action; and
(B)
file petitions for appeal of a decision in such action.
(c) Preemptive action by agency
In any case in which a civil action is instituted by or on behalf of the Secretary for a violation of this Act, a State attorney general or State privacy regulator may not, during the pendency of such action, institute a civil action against any defendant named in the complaint in the action instituted by or on behalf of the Secretary for a violation that is alleged in such complaint. In a case brought by the Secretary that affects the interests of a State, the State attorney general or State privacy regulator may intervene as of right pursuant to the Federal Rules of Civil Procedure.
(d) Preservation of State powers
Except as provided in subsection (c), no provision of this Act shall be construed as altering, limiting, or affecting the authority of a State attorney general or State privacy regulator to—
(1)
bring an action or other regulatory proceeding arising solely under the laws in effect in that State; or
(2)
exercise the powers conferred on the State attorney general or State privacy regulator by the laws of the State, including the ability to conduct investigations, administer oaths or affirmations, or compel the attendance of witnesses or the production of documentary or other evidence.
(e) Definition of Secretary
In this section, the term Secretary means—
(1)
with respect to a violation of title I, the Secretary of Health and Human Services; and
(2)
with respect to a violation of title II, the Secretary of Labor.
Sec. 303. Rule of construction
Nothing in this Act shall protect a health care professional from a medical malpractice or negligence claim for health care services provided through overriding an AI/CDSS output.
Sec. 304. Non-preemption
Nothing in this Act shall preempt a State law or collective bargaining agreement.