Mehmet Oz has been confirmed as the new director of the Centers for Medicare and Medicaid Services (CMS).
The Senate voted to confirm the cardiac surgeon and former daytime television host on April 3 in a party-line vote of 53–45.
He will lead the agency responsible for providing health coverage to more than 160 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act (ACA) health insurance marketplace.
Oz has previously vowed to reform the healthcare system, in line with Robert F. Kennedy Jr.’s Make America Healthy Again agenda.
“Dr. Oz will work closely with Robert F. Kennedy Jr. to take on the illness industrial complex, and all the horrible chronic diseases left in its wake,” then-President-elect Trump said in a statement in November, after he nominated Oz for the role.
Medicare, Medicaid’s future. Oz’s appointment comes as discussion ramps up about potential Medicaid cuts and the House’s proposed budget.
During a March 14 Senate confirmation hearing, Oz did not commit one way or the other when asked if he would agree to oppose cuts to Medicaid, the government health insurance program for people with low income or disabilities. He did say, however, he was in favor of work requirements for participants.
The House of Representatives plans to cut $880 billion from the budget of the department that oversees Medicare and Medicaid over the next 10 years. While the White House has said it doesn’t plan to make major cuts to Medicaid, the nonpartisan Congressional Budget Office said this budget can’t be met without significantly cutting Medicare or Medicaid coverage.
The New York Times reported last month that Oz had taken a stronger stance on Medicare, expressing interest in addressing bipartisan concerns about prior authorization and overpayment. (The Medicare Payment and Advisory Commission predicts the federal government will spend $84 billion more on Medicare Advantage plans in 2025 than if those plans were traditional fee-for-service Medicare.)
Oz also expressed concern about brokers switching patients from one plan to another in the ACA marketplace without their express permission. CMS said there was “a large number” of unauthorized plan switches in 2024. The agency and others have made moves to better regulate brokers, like making it easier for CMS to suspend them.
Navigate the healthcare industry
Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.
“Part of this is just recognizing there’s a new sheriff in town,” Oz said in his March 14 hearing. “We actually have to go after places and areas where we’re not managing the American people’s money well.”
His stances. Oz vowed to fix the US healthcare system by turning to technology like artificial intelligence (AI) to speed up Medicare Advantage’s prior authorization process.
“We have AI support tools, navigation systems that could pretty quickly adjudicate whether you should have to wait even a day to get the medication that will get you out of pain, or even a week for the procedure that you should be allowed to have,” Oz said during the hearing. “It will take the angst out of the system for the American people.”
He also said he would continue the drug price negotiation program launched by the Biden administration and that he supports “complete and radical transparency” around the actions of pharmacy benefit managers.
He’s in line with many Republicans on the issues of abortion and gender-affirming care for minors. Missouri Republican Senator Josh Hawley said this week that Oz had told him he is “unequivocally pro-life” and does not support gender-affirming drugs and surgeries for people under 19, the New York Times reported.
Currently, Medicare does not pay for abortion except in cases of rape, incest, or a life-threatening condition to the pregnant person.
While states decide whether Medicare and Medicaid will pay for gender-affirming care, President Trump has issued an executive order directing HHS to investigate ways to “end the chemical and surgical mutilation of children,” including actions like ending CMS participation for healthcare systems that perform gender-affirming care.
His conflicts. Oz has multiple potential conflicts of interests that critics worry could influence his decisions.
For one, last year, he and his son co-founded health benefits company ZorroRX, which aims to save hospitals money by helping patients sign up for the 340B pricing program, the Washington Post reported.
CMS directly influences how much money hospitals—and by extension, companies like ZorroRX—make from the federal system.
Oz is also an authorized broker for TZ Insurance Solutions, a for-profit company that sells Medicare Advantage plans, the New York Times reported.