Recent AI Policy Developments: What Echocardiographers Need to Know

The artificial intelligence (AI) landscape in healthcare is rapidly evolving, with significant policy developments that will impact echocardiography practice. ASE is a leader in establishing thoughtful AI policies to advocate for rigorous validation processes, while supporting innovation that enhances patient care. Meanwhile, the federal government has taken a markedly different approach with the recent release of America’s AI Action Plan, emphasizing rapid advancement while reducing regulatory barriers. Understanding these parallel developments is crucial for echocardiographers and sonographers navigating the changing AI landscape.

ASE’s Leadership in AI Policy

ASE has been at the forefront of responsible AI integration in cardiovascular imaging. The Society’s October 2023 AI Policy Statement established clear principles emphasizing FDA-authorized validation processes, transparent development with attention to patient diversity, and balanced liability frameworks that encourage adoption of these tools while protecting clinicians. ASE advocates for standardized terminology using the AMA’s Current Procedural Terminology (CPT) taxonomy (assistive, augmentative, and autonomous) and maintains that AI should enhance rather than replace clinical expertise.

Recognizing areas for continued improvement, ASE submitted comprehensive comments to the White House’s Request for Information (RFI) on the AI Action Plan in March 2025. These comments outlined four key recommendations: standardizing AI terminology, strengthening FDA validation processes with unbiased algorithms, ensuring appropriate payment structures that recognize clinician oversight, and addressing liability concerns through equitable risk distribution across the healthcare ecosystem.

America’s AI Action Plan

On July 30, 2025, the White House released “Winning the AI Race: America’s AI Action Plan,” outlining over 90 federal policy actions across three strategic pillars. Pillar I (Accelerate Innovation) removes regulatory barriers, establishes healthcare regulatory sandboxes for rapid AI testing, and promotes open-source development while ensuring AI systems are “free from ideological bias.” Pillar II (Build Infrastructure) streamlines permitting procedures/processes for data centers, modernizes the electrical grid, and trains the workforce for AI infrastructure roles. Pillar III (International Leadership) exports American AI technology globally while restricting adversary access through enhanced export controls.

Potential Impact of America’s AI Action Plan on Echocardiography Services

The Administration’s action plan could accelerate AI adoption in echocardiography through regulatory sandboxes[1] that allow rapid testing of diagnostic tools without lengthy approval processes. Within the plan, infrastructure investments in high-performance computing have the possibility to enable real-time analysis and predictive modeling applications. Finally, proposed workforce development initiatives may support echocardiographer and sonographer training for AI-enhanced workflows.

However, the emphasis on reducing regulatory oversight may impact the rigorous validation processes currently required for medical AI applications. The plan’s directive to remove diversity, equity, and inclusion requirements from AI development could affect whether cardiovascular imaging AI tools are adequately tested across different patient demographics.

Where Federal and ASE Policies Align and Differ

Key Alignments

Both the Administration and ASE recognize AI’s potential to improve workflow efficiency and patient outcomes while maintaining that AI should complement clinical expertise. The Administration’s plan of support for evaluation systems aligns with ASE’s emphasis on rigorous validation. Finally, ASE and the Administration agree on the acknowledgement of the need for appropriate payment structures and workforce preparation.

Major Differences

• Regulatory Approach: The Administration’s plan prioritizes removing “red tape” to accelerate innovation, while ASE emphasizes FDA authorization and comprehensive validation processes as essential for patient safety. ASE’s RFI comments specifically called for strengthening FDA-authorized validation processes, but the final plan moved in the opposite direction by reducing regulatory oversight.
• Dataset Considerations: ASE advocates for transparent development with distinct patient datasets to prevent algorithmic bias and ensure a high standard of care. The Administration’s plan specifically eliminates diversity, equity, and inclusion references from AI frameworks, directly opposing ASE’s recommendation for continuous monitoring to prevent unintended biases.
• Liability: ASE explicitly addresses balancing malpractice liability across the medical community to encourage AI adoption, as detailed in the Society’s Policy Statement and the RFI comments. Unfortunately, America’s AI Action Plan does not address medical liability concerns, despite ASE’s emphasis on this as a critical barrier to AI adoption.

Reimbursement: A Critical Gap in Federal Policy

The AI Action Plan notably lacks specific policies on healthcare reimbursement for AI services, which is a critical concern for echocardiography practices and new AI technology developers. While the plan references general economic benefits, it doesn’t address reimbursement through Healthcare Common Procedure Coding System (HCPCS) codes, CPT codes, Medicare/Medicaid coverage, or other payment mechanisms.

ASE has been proactive in this space, establishing structured guidelines for AI developers seeking reimbursement through the creation of new CPT codes, as outlined in the ASE AI Procedures for CPT Designation. The Society requires FDA engagement and clinical trials before consideration, differentiates between AI technology types for appropriate reimbursement pathways, and emphasizes the need for clinical decision-making to be at the center of all reimbursement policies. ASE’s systematic approach helps establish appropriate payment models that recognize clinical value while maintaining oversight.

Congressional Inaction Leads to State Governance

While the executive branch has taken action with the AI Action Plan, Congress has notably failed to provide comprehensive AI legislation, leaving states to fill the policy void. The recent defeat of a proposed 10-year federal moratorium on state AI laws—which was stripped from the budget reconciliation package, the One Big Beautiful Bill (H.R. 1) by a 99-1 Senate vote—highlights Congress’s inability to reach consensus on AI policy. This federal inaction has resulted in a patchwork of state regulations, with all 50 states introducing AI-related legislation in 2025 and over half enacting some form of AI laws. This means echocardiography practices may face varying regulatory requirements depending on their location, creating a patchwork of legislation and protocols, leading to increased challenges for consistent adoption/implementation.

What This Means for Your Practice

These policy developments present both opportunities and challenges for echocardiography practices. The Administration’s emphasis on rapid AI deployment and infrastructure investment could accelerate access to innovative diagnostic tools. Regulatory sandboxes may allow echo practices to experiment with cutting-edge AI applications more easily.

However, the tension between the federal proposed rapid momentum and ASE’s emphasis on rigorous validation means echocardiographers will need to carefully evaluate AI tools for clinical effectiveness and patient safety. ASE encourages members to stay engaged with the Society’s guidance on AI adoption, as ASE continues advocating for appropriate validation standards and reimbursement pathways.

[1] Regulatory sandboxes are controlled environments where companies can test innovative products, services, or business models without having to abide by all existing regulations.