New turn in HTI-5 rule as Epic keeps AI model cards

A 2023 US rule made vendors of health records software give hospitals model cards, which tell how AI tools were made and examined. The new federal rule HTI-5 removes it.

On 26 October, the US health department told of HTI-5, a rule that removes the model cards for AI tools in health records software. After 4 days, Epic, a large US health records vendor, told that it will keep tools for fairness and correct results. The US health department tells that the rule removes more than $1.5 billion in costs.

What changes

The rule of 2023 made vendors give 31 facts about each predictive AI tool. These include the intended use, fairness, external validation and performance. HTI-5 removes this and the risk management rule. It starts on 28 December.

The proof and the claims

The US office for health information technology wrote that it had no data that shows that the rules changed the results for patients. The law firm Reed Smith tells that a large majority of commenters were against the change. California Attorney General Rob Bonta tells that transparency is the base of accountability.

What is not known

Epic gave no information on tools, times or prices. Its promise does not apply to other vendors, and hospitals with small vendors can get less standard information. No part of the rule shows that an AI tool is dangerous.

Insight: A rule becomes a promise that a vendor can change

In October 2026, a US Department of Homeland Security policy let one officer waive AI rules. A check of 175 AI tools found that 105 changed their terms in 15 weeks. At this time, the US rule for AI disclosure in health software is removed, and Epic gives a promise. This reads as more control for vendors, because the vendor can change a promise. Customers must put the disclosure into the contract.