AI Giants Got a Private Chat Room With the Government Officials Writing Their Healthcare Rules
October 10, 2026 — Washington, D.C.
A federal chat room run by the Centers for Medicare & Medicaid Services gave Microsoft, Google, OpenAI, Anthropic and Apple a direct, behind-the-scenes line to the officials shaping how AI apps get regulated — and reimbursed — in American healthcare. Almost nobody else got invited.
That’s the finding of a KFF Health News investigation published this week, built on thousands of Slack messages, meeting transcripts and video recordings from a workspace CMS calls the “Health Technology Ecosystem.”
What happened
The Slack workspace was launched in August 2025 by Amy Gleason — formerly the acting administrator of the Department of Government Efficiency — and has since grown to roughly 1,700 members. Its membership reads like an AI industry guest list: Microsoft, Anthropic, OpenAI, Apple, Google, Palantir, wellness company Oura and investment firm 8VC. Only a handful of members are patient advocates, doctors or hospital representatives, according to KFF’s review.
The workspace was more than a bulletin board. In February, federal health officials used it to invite companies to an FDA listening session on conversational AI products for patients — the kind of chatbots a hospital might point you to when you call about chest pain. Representatives from at least 35 industry organizations attended. The meeting never appeared on the FDA’s public calendar, and the public wasn’t invited. In a Slack message, CMS senior policy adviser Morgan Taylor told companies the session was a chance to share their “state-of-the-art understanding of safe Conversational AI development and monitoring to help FDA shape future guidance.”
The “sales engine” and the Medicare App Library
On a February Zoom call, Jacob Shiff, the chief AI and technology officer at CMS’s Innovation Center, told industry participants he hoped the agency’s work would function as a “sales engine” for health apps — promising a directory where “the people on this call who hopefully will have amazing solutions that work will be the winners.”
CMS officials have since pitched tech leaders on the newly launched Medicare App Library, which promotes about two dozen commercial apps to millions of Medicare beneficiaries. Days before the library’s public launch, officials told AI companies the page would be a powerful distribution channel — because patients trust products listed on a government website. CMS Administrator Mehmet Oz separately launched an initiative in September letting health apps bill Medicare for AI services such as wearable-device tracking.
Where it gets legally awkward
The workspace’s own code of conduct states the group is not an “advisory committee” and would not be used “to obtain advice or recommendations” for HHS officials. But legal experts told KFF the setup looks a lot like one — and federal advisory committees are legally required to operate in public. Joseph Daval, a former FDA lawyer now at Harvard Medical School, said the chat group’s consensus-building resembles committee behavior that would normally be subject to “membership requirements having to do with independence and fair balance.” CMS declined to answer KFF’s questions about the workspace’s legality; the FDA didn’t respond to requests for comment.
Meanwhile, vendors have used the channel to lobby for a “frictionless pathway” letting apps pull patients’ full medical records through the national TEFCA data network after a single consent — treating the app as if it stands “in the shoes of” the patient.
Why it matters
This is about who writes the rules for AI in your doctor’s office — and who profits. The same companies building the AI health apps get first access to the officials deciding what those apps must disclose, how they get vetted, and whether Medicare pays for them. Doctors’ groups are already raising the alarm: American Medical Association CEO John Whyte said many of these tools “aren’t ready for primetime,” with too little data on how they work or what happens when they get things wrong. HHS Secretary Robert F. Kennedy Jr. took the opposite view last week, endorsing AI in healthcare as “much better informed than any doctor in the country.” The rules are being written right now. The question is who gets to hold the pen.
Frequently asked questions
What is the CMS Health Technology Ecosystem?
A CMS-run Slack workspace launched in August 2025 by Amy Gleason to coordinate between federal health officials and tech companies on integrating AI into healthcare. It has grown to about 1,700 members.
Did anything illegal happen?
That isn’t established. CMS says the workspace is an “open, voluntary technical collaboration.” Legal experts say its consensus-building resembles a federal advisory committee, which would legally have to operate in public — something the chat room did not do.
What is the Medicare App Library?
A CMS webpage that promotes roughly two dozen commercial health apps to Medicare beneficiaries — seniors and people with disabilities — encouraging them to manage conditions like obesity and diabetes with AI-driven tools.
Why should patients care who lobbied?
Because the apps in question analyze your medical records and give health advice, and the officials deciding the vetting, consent and reimbursement rules heard overwhelmingly from the companies selling them.
Sources: KFF Health News, Startup Fortune