Technology companies and investors have been communicating directly with federal health officials through a CMS-run Slack workspace as the Trump administration advances efforts to expand AI-powered health applications and access to medical records, according to an Oct. 9 investigation by KFF Health News.
The investigation, based on thousands of Slack messages, meeting transcripts and video recordings reviewed by KFF, found that technology executives have participated in discussions with CMS officials about digital health applications, access to patient records and federal initiatives that could create new business opportunities for health technology companies.
CMS established the Slack workspace in August 2025, when Amy Gleason, now chief product officer for CMS’ Office of Health Technology and Products, welcomed participants and shared its code of conduct. The workspace has since grown to about 1,700 members. Participants include representatives from AI companies, digital health startups and investment firms. KFF reported that only a handful of patient advocates, physicians and hospital representatives were among its members.
In February, federal officials invited companies including Microsoft, Anthropic, OpenAI, Apple and Google to a listening session on conversational AI products for patients. The invitation was posted in the Slack workspace by CMS senior policy adviser Morgan Taylor. Representatives from at least 35 industry organizations attended the FDA meeting, which was not listed on the agency’s public calendar or in regulatory notices and was not open to the public, according to KFF.
The discussions have taken place alongside CMS’ Health Technology Ecosystem initiative, which aims to improve access to medical records and expand the use of digital health tools.
KFF found that CMS officials also discussed promoting commercial health applications through the Medicare App Library, which lists about two dozen apps for Medicare beneficiaries.
In a February Zoom call with industry representatives, Jacob Shiff, chief AI and technology officer at the CMS Innovation Center, said he wanted the agency to work as a “sales engine” for participating apps and suggested that companies with effective products would come out ahead. CMS restricted access to a recording of that call, which had been publicly viewable online, one day after KFF raised questions about it.
According to KFF, CMS officials also suggested during at least two meetings that apps listed in the Medicare App Library would be prioritized for a new federal initiative that reimburses companies for certain AI-enabled services, including chatbot advice and wearable device tracking.
Questions about patient data access also emerged in the discussions.
KFF reported that technology vendors advocated for applications to access patient medical records more easily through the Trusted Exchange Framework and Common Agreement, a national framework for exchanging electronic health information.
Some vendors pushed for a one-time consent model, under which an app could continue pulling a verified user’s records from the network without further approval or restrictions.
The proposals prompted concerns about privacy, security and the extent of access that third-party applications should have to sensitive patient information. Jason Kulatunga, founder of medical records management platform Fasten Health, warned other workspace members that any access system should assume some bad actors will try to exploit it, a risk that grows as more apps join. John Whyte, MD, CEO of the American Medical Association, questioned whether some of these tools are ready for patients, citing limited evidence on how they perform and handle patient data, along with unclear accountability when they make mistakes.
The investigation also raised questions about the transparency of federal officials’ interactions with technology companies.
Joseph Daval, a former FDA attorney who reviewed the Slack messages at KFF’s request, said the workspace shared some characteristics of a federal advisory committee. Such committees are subject to requirements intended to promote transparency and balanced representation.
However, the Slack workspace’s code of conduct states that the group is not an advisory committee and is intended for technical collaboration rather than providing federal officials with policy recommendations.
CMS declined to answer several questions from KFF about the workspace, including questions about its legality.
In a statement to KFF, Ms. Gleason described the Health Technology Ecosystem as a voluntary technical collaboration focused on making health information more accessible.
The agency said it remains committed to working with patients, providers, payers and technology companies to improve interoperability and access to digital health tools.
