Federal health officials have engaged in a year-long, behind-the-scenes campaign to promote artificial intelligence-powered health apps, granting tech companies significant influence in shaping the future of loosely regulated digital health. This initiative, branded the “Health Technology Ecosystem,” involves a private Slack chat room where industry leaders and government officials, including those from the Centers for Medicare & Medicaid Services (CMS) and the Food and Drug Administration (FDA), have discussed policy and product development.
The clandestine effort has facilitated direct communication between tech giants like Microsoft, Anthropic, OpenAI, Apple, and Google, and top Trump administration health officials. This collaboration aims to encourage Americans to use AI tools for managing their healthcare and medical records, with the government considering reimbursement for these services similar to how medical professionals are compensated. The lack of public disclosure and invitation for a select group to shape federal policy governing AI in healthcare has raised concerns among legal experts.
The process began in August 2025 with a private Slack workspace, where CMS senior policy adviser Morgan Taylor invited companies to share their understanding of AI development and monitoring. This workspace, which now has 1,700 members, includes representatives from major digital wellness and AI companies, as well as investment firms. Notably, patient advocates and doctors are sparsely represented.
CMS Administrator Mehmet Oz stated in September at a public launch that the initiative aims to let industry “play in the sandbox of government-supported healthcare.” This aligns with a plan to allow health apps to bill Medicare for AI services, such as tracking data from wearable devices. Health and Human Services Secretary Robert F. Kennedy Jr. has enthusiastically endorsed AI in healthcare, asserting its superiority to human doctors.
Industry Influence and Regulatory Concerns
The Medicare App Library, a new initiative, is being positioned as a lucrative pipeline for businesses to acquire new users. While the library currently features only two dozen commercial apps, it promotes AI-driven tools for managing conditions like obesity, cancer, and diabetes. Some apps, like Slothwise, launched this year and have received minimal reviews, yet are being promoted through the library.
The push for these apps to access sensitive patient data through the Trusted Exchange Framework and Common Agreement (TEFCA) network is a key focus. Tech vendors have lobbied for a “frictionless pathway” for verified users, allowing continuous access to medical records after initial consent. This approach has been championed by individuals like Ryan Howells of the CARIN Alliance and Kristen Valdes, CEO of b.well.
However, concerns about data privacy and security persist. Jason Kulatunga, founder of Fasten Health, cautioned about the risks of granting broad access to medical records, emphasizing the need for systems designed to counter malicious actors. Legal experts have noted that the Slack chat room’s structure resembles a federal advisory panel, which typically operates under public scrutiny and specific independence requirements.
“This is a great opportunity to support HHS’ goals and share your state-of-the-art understanding of safe Conversational AI development and monitoring to help FDA shape future guidance,” CMS senior policy adviser Morgan Taylor wrote in the Slack workspace.
CMS officials have declined to answer specific questions regarding the Slack workspace’s legality. Amy Gleason, chief product officer at CMS’ Office of Health Technology and Products, stated that the Health Technology Ecosystem is an “open, voluntary technical collaboration” aimed at making health information more accessible and useful.
During a February Zoom meeting, Jacob Shiff, CMS’ chief AI and technology officer, expressed hope that the agency’s work would act as a “sales engine” for health apps. He encouraged industry representatives to drive down costs to achieve profitability and scale. A recording of this meeting was made private shortly after KFF Health News inquired about comments made during the session.
The Medicare App Library’s webpage encourages older and disabled Americans to use AI-driven apps, with CMS officials suggesting these apps will be prioritized for new agency programs that reimburse companies for AI chatbot advice or wearable device tracking. Despite promises of prioritizing apps for reimbursement programs, CMS has not publicly detailed all criteria for app inclusion in the library.
The effort to increase the use of AI health apps is part of a broader initiative to make medical records more digitally accessible. Gleason has advocated for doctors to accept medical records directly from apps and has spoken about the administration’s success in enabling Americans to download apps and access their medical records without extensive regulation or rulemaking.
The AMA CEO John Whyte expressed caution, stating that some tools are not yet ready for widespread use due to insufficient data and unclear operational mechanisms. He also highlighted the lack of liability when these tools provide incorrect information.
The push for AI health app integration continues as federal officials promote easier access to medical records, while doctors voice concerns about patient data usage and the readiness of these nascent technologies. The role of private chat rooms in shaping health policy and the potential for industry capture remain subjects of scrutiny.
