The Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC) released the Health Data, Technology, and Interoperability: ASTP/ONC Deregulatory Actions to Unleash Prosperity (HTI-5) Proposed Rule on December 22, 2025.
The HTI-5 Proposed Rule includes deregulatory actions that update the ONC Health IT Certification Program to:
- reduce burden on health IT developers by streamlining ASTP/ONC’s voluntary Health IT Certification Program by removing redundant requirements;
- revise definitions to better promote electronic health information access, exchange, and use so that patients’ access to their data is not blocked; and
- advance a new foundation of AI-enabled interoperability solutions through modernized standards and certification.
In addition, the proposed rule enables ASTP/ONC to reset the Certification Program’s regulatory scope and establish a new foundation on which to build Fast Healthcare Interoperability Resources (FHIR®)-based API requirements in the future. Collectively, the proposals in the HTI-5 Proposed Rule directly align with President Trump’s goals as outlined in Executive Order (EO) 14192 (Unleashing Prosperity through Deregulation) and EO 14267 (Reducing Anti-Competitive Regulatory Barriers).
Public Comment
ASTP/ONC encourages the broader health IT community to carefully review the HTI-5 Proposed Rule in its entirety to understand the full suite of provisions being proposed. The proposed rule is on display at the Federal Register. It will publish in the Federal Register on December 29, 2025 and will be available for public comment for 60 days, closing on February 27, 2026 at 11:59 pm ET.
Resources
HTI-5 Proposed Rule Overview Fact Sheet
Read the fact sheet for an overview of key provisions in the proposed rule.
HTI-5 Proposed Rule Chart of Proposed Changes to Certification Criteria
Proposed removals and revisions of certification criteria in the HTI-5 Proposed Rule is available in a quick at-a-glance table.