Inside the Private Slack Channel Where Tech Giants Shape Medicare's Digital Health Future

A controversial digital workspace operated by the Centers for Medicare & Medicaid Services has become the focal point of a transparency debate after an investigation published Friday by KFF Health News revealed that technology and artificial intelligence companies have been directly lobbying federal health officials through a private Slack channel with minimal patient or physician representation.

The workspace, launched in August 2024 as part of CMS's Health Technology Ecosystem initiative, hosts approximately 1,700 members—predominantly industry representatives—with only a handful of patient advocates, doctors, and hospital representatives participating. The revelation has sparked concerns from legal experts who question whether the arrangement circumvents federal advisory committee laws designed to prevent regulatory capture.

Industry Access to Federal Officials

According to the KFF Health News investigation, which reviewed thousands of Slack messages, meeting transcripts, and video recordings, the workspace brings together major players including Oura Health, Palantir, and 8VC—a venture capital firm associated with Finn Kennedy, son of HHS Secretary Robert F. Kennedy Jr.—alongside numerous smaller health records-app companies. These firms have been discussing Medicare app promotion strategies and patient health records access directly with senior CMS officials including Morgan Taylor, senior policy adviser; Jacob Shiff, chief AI and technology officer at the CMS Innovation Center; and Amy Gleason, chief product officer for the Office of Health Technology and Products.

Joseph Daval, a former FDA lawyer and Harvard Medical School research specialist who reviewed the messages for KFF Health News, stated that the federal advisory committee law "was passed in part out of a concern about interest group capture." Legal experts consulted by KFF Health News suggested the workspace resembles a federal advisory committee that would normally require public transparency, though CMS maintains it represents voluntary technical collaboration.

The stakes became clearer when, according to the KFF Health News reporting, Shiff stated during a February call that he hoped the agency's work would become a "sales engine" for health apps, while Taylor said in an April meeting that if medicare.gov promotes an app, "it would be an app that I would trust and explore."

Industry Pushback Against Patient Protections

Within the Slack discussions documented by KFF Health News, industry representatives have advocated for reduced barriers to patient data access. Kristen Valdes, CEO of b.well health data company, wrote that "we need to stop protecting patients from themselves" regarding app access. Vendors pushed for easier app access to patient records through the national records exchange (TEFCA), arguing that vetted apps should stand "in the shoes" of the patient.

These conversations coincide with CMS's Medicare App Library—a webpage promoting two dozen commercial health apps to Medicare beneficiaries—whose selection criteria have not been fully publicly disclosed. The broader initiative, announced in July 2024, included pledges from over 60 companies to build a patient-centered health technology system.

The pattern extends beyond CMS. According to the KFF Health News investigation, a February FDA listening session on AI tools included at least 35 industry organizations but was not listed on the public calendar and remained closed to the public.

Medical Community Sounds Alarm

The physician community has expressed significant concerns about the rapid promotion of unvetted AI health tools. John Whyte, AMA chief executive, told KFF Health News that "some of these tools just aren't ready for primetime" and noted the lack of liability protection when tools fail. Six physician groups formally responded to Kennedy's comments suggesting AI can provide second opinions better informed than any doctor.

For Medicare beneficiaries, the controversy highlights a critical gap: government listing of health apps does not guarantee quality, security, or comprehensive safety vetting. Patients face increased responsibility for personal due diligence on privacy policies and data sharing practices as commercial health apps receive federal promotion through channels that traditionally signaled trustworthiness.

The investigation raises fundamental questions about the balance between accelerating health technology adoption and maintaining regulatory transparency—a tension that will likely shape digital health policy debates as AI tools become increasingly integrated into Medicare services.

Sources

1. Tech and AI Firms Lobbied Federal Health Officials in a CMS-Run Slack as Medicare Promotes Commercial Health Apps — Medical Daily