The American Hospital Association (AHA) has responded to a September 2025 request for information (RFI) from the Office of Science and Technology Policy (OSTP) on regulatory reform on artificial intelligence (AI) to promote innovation and adoption.
The Trump administration is committed to ensuring the United States achieves global dominance in AI and issued the RFI to obtain feedback from businesses and the public on current federal regulations that are hampering AI adoption and innovation. AI has tremendous potential in healthcare, from analyzing and interpreting medical images, aiding clinicians with decision-making, streamlining operations, and easing the considerable administrative burden faced by providers. While AI tools have been adopted in healthcare, the AHA says hospitals and health systems have merely scratched the surface of the potential uses to support them and the patients they serve.
In order to accelerate innovation and adoption, the AHA believes regulations need to be eased. In its response, the AHA explained that around one-quarter of healthcare spending goes on administrative tasks, amounting to around $1 trillion annually. Feedback from member hospitals and health systems indicates that regulatory administrative burdens are contributing to the financial instability of many hospitals, around 40% of which are now operating with negative margins.
The AHA has already voiced opposition against further administrative burdens and costs related to the proposed update to the HIPAA Security Rule and has welcomed the Trump administration’s recognition that overly restrictive regulations lead to higher costs, hamper competition, and stifle innovation. AHA members have voiced their concern that excessive regulation of AI is likely to severely limit adoption and innovation. Given the potential for AI to improve efficiency and enhance the quality of care, a balance needs to be struck between regulation to ensure patient safety while incorporating sufficient flexibility to support innovation.
In the letter to the OSTP, Ashley Thompson, the AHA’s senior vice president of public policy analysis and development, explained that current administrative burdens have forced many hospitals to scale back patient services or close, and that excessive regulatory and administrative burdens have added unnecessary cost and reduced patient access to care. To ensure the full potential of AI in healthcare, the AHA makes four main recommendations for AI reform: leveraging existing policy frameworks to avoid redundancy; removing regulatory barriers; ensuring AI is used safely and effectively; and providing incentives and infrastructure investment to expand the use of AI in healthcare.
Current regulatory frameworks were developed around human clinicians and discrete medical device updates, which may create challenges if the same frameworks are applied to continuously updating AI tools; however, creating a new regulatory framework for AI could result in redundancy and inefficiency. The AHA recommends that any AI policies be synchronized with existing regulatory frameworks such as HIPAA, the HHS cybersecurity performance goals, FDA rules on premarket testing, and the CMS Medicare Advantage regulations.
The AHA recommends removing regulatory barriers that could stifle innovation, explaining that the current patchwork of state privacy laws and 42 Part 2 regulations has had a direct impact on the ability of hospitals to develop and deploy AI tools. The AHA has already responded to several problematic proposed HIPAA Security Rule update, and recommended voluntary consensus-based cybersecurity practices such as the HHS cybersecurity performance goals, rather than further regulation. The AHA suggests the Trump administration work with Congress to address HIPAA preemption, recommending the enactment of a full HIPAA preemption, as varying state laws are currently creating complications for its members. Further, the AHA supports the removal of all remaining requirements under the Part 2 regulations, which are hindering access to important health information and impacting the ability of SUD providers to leverage AI tools for care delivery.
Regarding patient safety, the AHA recommends that trained clinicians be kept in the decision loop for algorithms that may impact access to care or care delivery, for consistent privacy and security standards for third-party vendors, and to implement policies that include post-deployment standards for AI healthcare tools to ensure the ongoing integrity of those tools.
The AHA has also stressed that infrastructure needs to be improved to support the adoption of AI tools. For instance, hospitals in rural areas often lack reliable broadband and Wi-Fi access, which has proven to be a barrier to digital services and the adoption of AI tools. Incentives should be aligned to support AI adoption, as inadequate reimbursement has meant that many providers do not have the necessary resources to invest in the infrastructure to support the adoption of AI tools. The AHA also encourages cross-agency collaboration to develop training and potential grant funding opportunities to support patient educational efforts on digital health tools.
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