By: Scott Carroll, Kennedy Farr, and Jennifer Forward
Kennedy A. Farr
Jennifer Forward
Scott V. Carroll
Agentic artificial intelligence (“agentic AI”) refers to systems that can independently plan and execute multi-step tasks without continuous human direction. Today, these systems can analyze charts, labs, imaging, and medication lists, identify concerning trends, and even draft suggested care plans on their own.
This autonomy distinguishes agentic AI from traditional “generative AI,” such as ChatGPT, Microsoft Copilot, or Google Gemini. Generative AI cannot initiate tasks because it waits for human prompts and cannot interact with operational systems to schedule tasks. Once a conversation with a human ends, generative AI does not retain goals or continue working toward them. Agentic AI, by contrast, maintains objectives over time, continuously monitors new information, and adapts its actions to achieve its programmed goals.
While agentic AI promises potential relief from workforce shortages and could automate routine clinical tasks, it also comes with clinical, security, and ethical risks.
Clinically, agentic AI errors in diagnosis or treatment recommendations and orders could lead to patient harm. Agentic AI learns from human-provided data, and biased data can perpetuate health inequities. Further, since such systems by their nature operate autonomously, a single mistake can trigger a chain of incorrect actions that may harm a patient.
Security risks arise because agentic AI requires broad access to sensitive patient information. Weak security could expose data to breaches, and malicious actors could potentially hack an agentic system, allowing it to take harmful actions.
Accountability becomes unclear when an agentic AI system makes a mistake. Responsibility will likely fall on the clinician who used the tool, the facility that deployed it, and the developer who built it. Such a complicated and evolving legal and risk management landscape creates liability concerns. Indeed, MLMIC has issued several publications addressing risk management and the use of AI in clinical settings.
Practitioners should recognize that using agentic AI creates a professional obligation to understand the tools well enough to ensure satisfaction of the medical standard of care and to uphold the duty to do no harm. Errors made by agentic AI can breach these duties, especially when practitioners lack proper knowledge of how to use the system. Use of experimental or novel tools on patients also implicates concerns related to patient disclosure and consent and human subject safety considerations (and potential requirements for Institutional Review Board approvals). Finally, there is also the risk that increased reliance on automated systems could erode the human empathy central to patient care, as agentic AI cannot understand or express compassion.
Agentic AI is moving from pilots to clinical use, but guidance remains varying. Leading health coalitions, including the Coalition for Health AI and the Trustworthy and Responsible AI Network, have advanced methods to assess safety and performance. Additionally, there are some growing sets of guidelines to use when evaluating and validating this new technology. For example, on September 10, 2025, the Consumer Technology Association (CTA), North America’s largest technology trade association, released a new standard for validating AI tools that predict health outcomes. This fifth CTA AI standard offers a structured scheme for testing predictive algorithms in controlled and real-world settings. It emphasizes transparency about training data, encourages developers to ensure models can explain how they arrive at specific predictions, and calls for robust post deployment plans to monitor quality and recalibrate when performance drifts.
The sector has not united around one approach, leaving potential users to navigate a patchwork of frameworks. We expect over time that there will be a consolidated set of standards and guidelines for development and clinical use that developers, hospitals, systems, and clinicians can refer to when implementing AI and machine learning tools, including agentic AI.
Regarding regulation in New York State, there are not yet agentic-AI-specific rules for clinical care, but New York has established guidelines that will shape deployment in health settings. In 2023, the Governor issued an executive order establishing an AI policy and governance framework and directing ethical-use policies for state agencies, followed in 2024–2025 by guidance from the Office of Information Technology Services on responsible use of generative AI.
State medical boards retain their principal role of regulating the practice of medicine and have likewise begun articulating principals for the use of AI in medical practice, emphasizing that agentic systems cannot independently practice medicine, licensed clinicians remain ultimately responsible for diagnosis and treatment decisions assisted by AI, and development should be transparent, documented, and consistent with the standard of care, patient safety, and existing scope-of practice supervisions requirements. Indeed, over the last year, the New York State Board of Medicine has engaged in discussions with technical, legal, and regulatory representatives regarding this topic. However, no formal guidance or advisories have yet been issued by the Board. Additionally, professional specialty boards may develop their own specialty specific guidance for using agentic AI. Providers should closely monitor guidance from the Board of Medicine and their professional societies.
For hospitals and clinicians, professional standards operate alongside Department of Health requirements for the operation of hospitals and clinics, such as quality assurance, credentialing, and risk management, that apply when agentic AI influences diagnosis or treatment. Additionally, regulatory issues arise with agentic AI. Agentic AI systems may require FDA oversight, warranting premarket review and ongoing controls, because when, to a reasonable person, it provides medical treatment or clinical decision support that influences care, it could be considered a medical device warranting oversight. Users of AI and machine learning applications, including agentic AI, should understand the level of oversight by the FDA of their specific application and its current status.
The regulatory and industry guidance discussed in this article do not resolve the legal issues but provide early guidance to practitioners and the industry as agentic AI enters clinical practice. Physicians and medical groups considering any AI tool need to evaluate these tools as they would any new medical device or drug, ensuring they understand the technology, its intended use, and built-in safeguards, and take additional risk management steps that are appropriate based on the nature of the tool. If you have questions about the topics discussed in this article, please contact Lippes Mathias health law team members Scott V. Carroll (scarroll@lippes.com), Kennedy A. Farr (kfarr@lippes.com), or Jennifer Forward (jforward@lippes.com).
Auburn Community Hospital (ACH) is pleased to announce the appointment of Migdalia Bonilla-Martir, MD, FACOG, as Chief of Obstetrics and Gynecology.
“Those are the two main things we look at when we consider strategically where we’re going to grow,” he said. 
To provide local care for the anticipated new arrivals near the Micron site in the North and needs in the West, additional expansions have been planned or were already completed at the Liverpool/ Clay Carling Road location, including pediatric care this year, and Upstate’s eighth location for physical medicine and rehabilitation that was finalized last year. Upstate also provides more than a dozen services in the Camillus area to help meet patient needs.
I will not debate the politics behind the recent health care cuts, but I will share my concerns about their impacts.
From breast cancer surgery, hernia repairs and laparoscopic surgery, to endocrine surgery, ulcer care, bariatric surgery and more, the Crouse Medical Practice General Surgery team offers a wide array of surgical procedures to help patients return to health and continue enjoying their lives. The team of 12 physicians brings a vast depth of knowledge and experience that combine to create a supportive practice that consistently focuses on patient-centered care. This patient-focused philosophy is built upon collaboration with the team, including primary care providers, as Clinton Ingersol, MD, Hillary McMullin, MD, Benjamin Sadowitz, MD, FACS and Angelina Schwartz, MD each explained in their own words.
Similarly, for Dr. Schwartz, her approach to patient care is focused on open communication and reaching decisions together as a team.
Open lines of communication and support apply not only to patient care, but also to how the team works together to provide optimal healthcare for patients, as Dr. Schwartz emphasized.
Dr. Ingersol echoed these ideas, highlighting the streamlined communication process within the Crouse healthcare network specifically. “It’s great for patients when everyone is on the same page and communicating in a multidisciplinary fashion. Especially within the Crouse network, it’s so easy to communicate with our primary care colleagues. We can send direct messages to each other to coordinate patient care and ask questions. Our office staff does a great job of coordinating referrals from primary care offices, making sure that patients are seen according to urgency, and making sure things are followed up on and communicated properly,” he explained.
“Our senior partner, Dr. Schu, has been great to work with, has been a very willing mentor, and we frequently do cases together. There’s been a lot of exchange of ideas and techniques because I bring in certain expertise, knowledge and biases and he has this wealth of experience and way of doing things. Having all of that at our disposal to decide what is in the best interest of patients is really valuable,” Dr. Ingersol explained. “Any time I have a case that I anticipate being difficult or may run into something I wasn’t anticipating preoperatively, there’s always someone who’s more than willing to come in and take a look or join me if needed. That’s one of the advantages of a big group that has so much experience.”
“In thyroid care, one thing that we’re starting to look into is a new technology called RFA, or radiofrequency ablation,” Dr. Ingersol said. “We’re not in an active phase yet, but it’s something that’s in the near future across the country and becoming a popular modality of treating thyroid nodules.”
With an administration that invests in cutting edge technologies, and a team of forward-looking surgeons always interested in the latest up-and-coming treatments for patients, it seems the Crouse Medical Practice General Surgery team is well-prepared for the evolving needs of patients and will continue to thrive.
“The future is very bright for Crouse in terms of overall surgery, with many great surgeons and a lot of advanced technology. The administration has made it a priority to make sure we stay technologically ahead of the game, so that’s a big piece of it,” said Dr. Sadowitz. “Crouse has always had the right mindset of ‘patients come first’ from the top down. The hospital always aims to keep very talented people in the hospital doing cases, so that not only are the patients highly satisfied, but the surgeons are, too. It’s a unique mix you really don’t find in many places, and it’s a hard balance to maintain, but Crouse has always excelled at doing just that, and as long as we keep that focus, I think it will continue into the future.”
When I asked Andrea what guidance she gives clinicians whose patients are aging and asking questions about the future, she emphasized the importance of early planning. Her advice: choose the best housing option early so you can age in place.
Technology plays a major role in the healthcare sector’s ability to store and handle private patient data. This has improved the efficiency of healthcare delivery, but it has also increased the susceptibility of healthcare providers to cyberattacks. The healthcare industry has witnessed a rise in cyber threats, including ransomware attacks, phishing scams, and data breaches. As a result, medical professionals need to take precautions against online threats to both themselves and their patients. A comprehensive Cyber insurance policy is one way to accomplish this.
Almost two years ago, New York enacted PHL Article 45 A, which took effect on August 31, 2023. One of the intents behind this law was flagging large business consolidation in the healthcare field, potentially allowing New York’s Department of Health to regulate the increased transaction prices, reduced competition, or narrowed access to healthcare for residents of the state. Please see our previous article formore information on PHL 45-A here. Importantly, New York’s statute includes Managed Services Organizations (“MSOs”), even though they do not provide healthcare services themselves, as part of any healthcarerelated transaction subject to review.