By: Christopher Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, MA.
A Health Care Provider Defense and Compliance Firm

This week, over 60 health and tech companies signed a high-profile health tech pledge at the White House. Major players like Apple, Amazon, Google, Microsoft, Epic, CVS Health, and UnitedHealth Group publicly committed to modernizing healthcare interoperability and data sharing.

CMS is billing this as a voluntary framework to move the industry forward by early 2026. They’re promising digital tools like QR-coded medical histories, better use of Fast Healthcare Interoperability Resources (FHIR) APIs, and new patient-facing AI tools. We’ve seen promises like this before, in 2016, 2018, and again now. Interoperability still isn’t solved. And many health systems still require a separate MyChart login for every hospital you’ve ever visited.

Let’s unpack a few real-world questions:

1. What happens when stakeholders don’t adopt FHIR fast enough?

   FHIR is central to this pledge. CMS wants aligned networks, especially EHR vendors and health data exchanges, to adopt FHIR by July 4, 2026. That means real investment in APIs, infrastructure, and staff.

   But FHIR isn’t plug-and-play. If even a few major players drag their feet, the whole pledge sputters. Providers relying on these vendors will be the ones stuck in limbo.

2. What if they don’t really want to do the hard stuff?

   The pledge language sounds great on paper. But CMS is asking EHR vendors to allow providers to use “any application or delegated technology” to access network data. That clashes with the business models of many legacy health IT companies. We should expect resistance disguised as “privacy concerns.” Don’t confuse press release unity with operational alignment.

3. Where’s the incentive for providers?

   So far, the pledge is all carrot for tech vendors and all responsibility for providers. CMS has not (yet) offered incentives for practices or health systems to participate. Want meaningful buy-in? CMS should tie it to reimbursement. Faster payments or reduced audit risk for CMS aligned behavior would get real traction from the provider community. Without it, this pledge risks being just another white paper with signatures.

4. Where are the health systems?

   Only a handful of big-name health systems such as Intermountain, Cleveland Clinic, Providence signed on. That’s very concerning. These pledges mean little without the large hospital systems that hold most of the data and dictate the pace of change.

5. Where is the patient voice in all this?

   If the goal is to improve patient access and control, then patients or their representatives should be at the table. Privacy groups, chronic illness organizations, and consumer advocates are notably absent.

   Providers should pay attention. If you’re being pitched tech solutions claiming CMS alignment, ask hard questions about actual FHIR readiness, patient access tools, and liability exposure. There may be opportunities here but ONLY if CMS follows through with regulatory teeth or financial incentives. If you have any questions or comments about the subject of this blog, please contact Parrella Health Law at 857.328.0382 or Chris directly at cparrella@parrellahealthlaw.com.