Editor's Note
Federal officials’ public rebuke of the Coalition for Health AI (CHAI) highlights mounting tensions over who should shape guardrails for artificial intelligence (AI) in healthcare, Modern Healthcare October 10 reports. As hospitals accelerate AI adoption, industry leaders, regulators, and developers are clashing over how to ensure the technology’s safety and fairness.
The dispute intensified after Health and Human Services (HHS) Secretary Robert F. Kennedy Jr accused CHAI on social media of trying to “build a regulatory cartel.” Days earlier, Deputy HHS Secretary Jim O’Neill and Food and Drug Administration Commissioner Marty Makary, MD, MPH, blasted CHAI in The Washington Examiner, calling it an “unethical syndicate” driven by big tech interests that could “stifle health tech startups” and harm patients.
CHAI CEO Brian Anderson, MD, pushed back, saying the 4-year-old coalition is not a regulator but a convener of stakeholders—from hospitals to patient advocates—working to develop best practices. He emphasized that disagreements are frequent but that members are committed to responsible AI deployment.
The conflict reflects broader unease as the federal government maintains a light regulatory touch and states move ahead with their own AI laws. This patchwork of rules has created urgency for industrywide frameworks. Nonprofits like URAC have stepped in, launching an AI accreditation program in September to offer neutral oversight. URAC CEO Shawn Griffin, MD, noted that hospitals and vendors with financial stakes in AI face inherent conflicts of interest that complicate self-policing.
Despite rising adoption, most health systems remain early in their AI governance journeys. An August survey by the Healthcare Financial Management Association found only 18% have mature governance structures and comprehensive AI strategies. Hartford Healthcare’s Barry Stein, MD, said cross-sector coalitions are critical to identifying safe, responsible implementation practices that reflect the needs of clinicians and patients alike.
CHAI, which includes major players such as Google, Microsoft, and OpenAI, has lost some members—Amazon exited this summer—but has gained momentum among startups seeking practical guidance. Rad AI’s chief growth officer said CHAI’s standardized “model cards” help startups navigate disparate hospital evaluation processes, making it easier to bring AI innovations to market.
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