At a glance
During the US Department of Health and Human Services (HHS) Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP) annual meeting on February 11 – 12, 2026, policy makers emphasized Trump administration priorities, including:
- Support for artificial intelligence (AI) solutions and other innovative technology.
- Sustained government attention to information blocking, including cross-agency participation from the Federal Trade Commission (FTC), US Department of Justice (DOJ), and HHS Office of Inspector General (OIG).
- Support for interoperability solutions leveraging Fast Healthcare Interoperability Resources (FHIR®) standards and the Trusted Exchange Framework and Common Agreement (TEFCA).
IN DEPTH
Upcoming regulatory developments
- ASTP encouraged annual meeting attendees to submit comments on the Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) proposed rule. The comment period remains open until February 27, 2026. For more information about the HTI-5 proposed rule, see our client alert or visit McDermott Will & Schulte’s Information Blocking and Interoperability in Healthcare resources page.
- ASTP indicated HTI 6 is anticipated in summer 2026 and is expected to focus on facilitating interoperability with an emphasis on health applications. Tom Keane, assistant secretary for technology policy and national coordinator for health information technology, stated that stakeholders should include ideas for HTI 6 in their HTI 5 comments, even if those ideas may be viewed as “out of scope.”
- ASTP indicated that the Centers for Medicare & Medicaid Services (CMS) plans to launch a national provider directory in March 2026, combining current HHS directories into a single primary source. ASTP also indicated that the directory will be piloted with stakeholders for accuracy and that stakeholders may be able to review and test the information. The directory is expected to include new data fields, including whether providers participate in a CMS-aligned network.
- CMS seeks to modernize the US digital health ecosystem and is focused on providing Medicare beneficiaries with greater access to innovative technologies through its Health Tech Ecosystem initiative, a public-private collaboration between CMS and the healthcare industry. The initiative is organized by seven industry categories, including CMS-aligned networks, electronic health records (EHRs) and providers, payers, patient-facing apps, friends of the ecosystem, patients and/or caregivers, and states. Amy Gleason, acting administrator of US DOGE Service, noted that each category of the Health Tech Ecosystem is expected to announce its minimally viable product on July 4, 2026.
- Presenters indicated that the prescription drug prior authorization proposed rule is expected in March 2026 and is currently at the Office of Management and Budget.
Information blocking signals
- The annual meeting included a half-day information blocking bootcamp with speakers from the FTC Technology Enforcement Division, DOJ Antitrust Division, and the HHS OIG.
- ASTP indicated it is issuing notices of nonconformity to developers of certified health information technology (IT) under its health IT certification authorities.
- While OIG information blocking investigations are underway, ASTP and OIG regulators did not disclose timing for OIG enforcement actions.
- HHS, DOJ, and FTC presenters expressed concern about “dominant tech gatekeepers” using control over access to customers and their data to stifle up-and-coming competitors.
- Similarly, regulators expressed a policy goal of supporting the next generation of health IT innovators, particularly those “realizing the revolutionary potential of AI,” and not “big companies with large compliance teams,” said former HHS deputy secretary Jim O’Neill.
- Michael Lipinski of ASTP stated that the HTI 5 proposed rule’s changes to the “manner exception exhausted” condition of the infeasibility exception would better support “best-in-breed” solutions while not requiring bespoke interoperability elements.
- Lipinski also noted that, consistent with the HTI-5 proposed rule’s preamble guidance, ASTP proposes to remove the TEFCA manner exception because of feedback that the exception discourages TEFCA participation.
TEFCA: Growth, consent, and participation
- ASTP and HHS leadership repeatedly emphasized TEFCA’s growth in participation and exchange, and described TEFCA as a “trusted interoperability backbone.”
- HHS officials stressed the importance of participating in “two lanes,” i.e., both TEFCA and CMS-aligned networks.
- The Social Security Administration is expected to go live with TEFCA by early spring 2026.
- Presenters indicated that the Sequoia Project, the TEFCA recognized coordinating entity, is seeking feedback on its “Operationalizing Automated Consent” paper aimed at improving privacy and consent functionality across TEFCA. The paper is open for public comment.
Electronic prior authorization and real-time benefits
- Presenters highlighted the importance of real-time prescription benefit tools throughout the annual meeting.
- As noted, HHS will likely release the prescription drug prior authorization rule in March 2026. The rule is expected to promote automation that streamlines prior authorizations and reduces administrative burden for providers, with likely compliance implications for payers and technology vendors.
Data standards
- Presenters discussed expanding to USCDI v7 as a further increase to the dataset standard used for interoperability, while also noting stakeholder commentary about slow movement to USCDI v3.
- The discussion of v7 suggests that the administration may move aggressively to expand required data elements in response to complaints that earlier versions exclude data necessary for innovative technology solutions.
Practical next steps
- Directory readiness. Healthcare providers should consider whether their organizations should engage in provider directory testing and assign internal owners for directory data quality ahead of the March 2026 target. Accurate information on the directory could be particularly important as HHS explores changes to national provider identifier registration, which is currently done through the National Plan and Provider Enumeration System.
- Comment strategy. If submitting comments to the HTI 5 proposed rule, consider whether to include forward-looking concepts for the anticipated HTI 6 proposed rule, consistent with Assistant Secretary Keane’s suggestion.
- Information blocking risk mitigation. In light of the administration’s apparent commitment to information blocking enforcement and potential regulatory changes, certified EHR developers and other regulated actors should consider reassessing policies impacting access, exchange, and use of electronic health information; technical restrictions on access; and contracting/fee practices.
- TEFCA posture. TEFCA participants (or those evaluating participation) should consider whether their exchange roadmap aligns with the emphasized “two-lane” reality of TEFCA and CMS-aligned networks. Entities already participating in TEFCA should prepare for greater transparency, including with regard to the volume of exchange occurring across the network.
The McDermott difference
If you have questions about how ASTP’s regulations and policy priorities would affect your organization, or if you would like assistance preparing comments to submit to ASTP, please contact any of the authors of this client alert, your regular McDermott Will & Schulte lawyer, or your regular McDermott+ consultant.
