The Office of the National Coordinator for Health IT is proposing to eliminate or weaken dozens of health IT certification criteria, but provider organizations are pushing back hard to preserve requirements around AI transparency and documentation—specifically "model cards" that force vendors to disclose how their AI systems work.

This matters because the certification framework determines what software vendors must prove before selling to healthcare systems. Removing transparency requirements could allow opaque AI tools into clinical workflows without providers knowing how they make decisions. Major provider groups including the American Hospital Association, Medical Group Management Association, and others argue that keeping AI "model card" requirements protects clinicians from liability and prevents vendors from offloading compliance burdens onto already-stretched clinical staff. The stakes are operational: if vendors aren't required to document AI behavior, hospitals and practices become responsible for understanding—and defending—systems they don't fully control. In litigation or licensing disputes, that's a material liability exposure.

Healthcare leaders should view this as a critical leverage point. The certification criteria directly affect what you can—and cannot—safely deploy in your EHR, diagnostics, or documentation workflows. Losing transparency mandates means vendors control the narrative on how their AI performs, not you. If your practice is evaluating AI-enabled tools (which increasingly covers everything from scheduling to coding to clinical decision support), push back on any vendor that refuses to provide documentation on model training data, validation performance, and known limitations. The ONC rule is still in comment phase—this isn't settled yet, and provider input is being weighted heavily. If you're a DSO, hospital system, or large practice, this is a moment to join industry advocacy or file comments directly. The alternative is implementing AI systems with limited transparency into their decision logic, which creates both clinical and compliance risk.

What to watch: The ONC's final rule decision, expected in the coming months, will likely reflect provider pressure—but don't assume transparency wins if vendor lobbying intensifies.