Dr. Oz grilled by senators on bid to run Medicare and Medicaid agency
Television host and surgeon Mehmet Oz was grilled during Senate hearing on his bid to run agency that provides health coverage for 160 million people.
Television host and surgeon Dr. Mehmet Oz was grilled by senators Friday during a hearing on his bid to run an agency that oversees health coverage for more than 160 million Americans.
President Donald Trump said, “There may be no physician more qualified and capable than Dr. Oz to Make America Healthy Again,” when he first nominated Oz to serve as the Centers for Medicare and Medicaid Services administrator.
During Friday’s hearing, Oz vowed to empower patients to take charge of their health care and crack down on fraud, waste and abuse to safeguard federal health programs.
Oz, a familiar face to Americans from years as a daytime television host, also said he would protect vulnerable Americans while taking on chronic disease that leads to increasing federal health spending.
“I commit to doing whatever I can, working tirelessly, to ensure that CMS provides Americans with access to superb care, especially Americans who are our most vulnerable − our young, our disabled and our elderly,” Oz said.
But Senate Democrats pressed Oz on potential cuts to Medicaid health coverage for low-income Americans and Oz’s past television segments on alternative health remedies.
In his opening statement, Sen. Ron Wyden, D-Ore., questioned Oz’s record on paying Medicare and Social Security taxes and pitching “some of the most ludicrous wellness grifting that I’ve heard about to date.”
What is the agency Oz is nominated to run?
The Centers for Medicare & Medicaid Services, or CMS, operates under the U.S. Department of Health and Human Services, which is led by Robert F. Kennedy, Jr. The agency oversees Medicare, the federal health program for adults 65 and older and people with disabilities, and Medicaid, the federal-state health program for low income families.
CMS is among the world’s largest purchasers of health care with $1.5 trillion in spending during fiscal 2024, according to the agency’s annual financial report.
CMS and its contractors process more than one billion Medicare claims each year, monitor health care quality through inspections at hospitals and nursing homes and provide states with matching funds for Medicaid, the federal-state health program that covers low income families.
What would Oz do with Medicaid?
Last month, the House narrowly passed a budget resolution that could result in significant changes to Medicaid, the federal-state health insurance program for low-income and disabled residents that covers about 72 million people. Medicaid covers low-income pregnant women, 2 in 5 child births and nursing homes for some low-income seniors and others. Some low-income seniors are eligible for both Medicare and Medicaid.
When Sen. Maggie Hassan, D-N.H., pressed him about cuts to Medicaid and low-income children potentially losing coverage, Oz said he has not seen any House bill that seeks to cut Medicaid.
“I don’t want children losing health insurance,” Oz said.
Senators ask about private Medicare plans
Sen. Bill Cassidy, a Louisiana Republican, asked Oz about his thoughts on private Medicare plans’ use of prior authorization to deny or delay care. Oz agreed that these insurer approvals are “misused in some cases” and needs to be addressed.
Oz suggested a list of services with clear descriptions in which private Medicare plans could use preauthorization.
Cassidy also noted private Medicare Advantage plans get more federal funds per patient than government-run Medicare. He asked Oz how he would address this funding disparity.
Oz, who has touted private Medicare plans in the past, acknowledged more lucrative payments for these private plans is “upside down” and promised to crack down on practices such as upcoding to collect more lucrative payments from the taxpayer-funded program.
Oz’s vow to crack down on upcoding drew bipartisan support.
“Part is this is recognizing there’s a new sheriff in town,” Oz said. “We have to go after places and areas where we’re not managing the American peoples’ money well.”
What would Oz do with drug-pricing middlemen?
Oz also faced questions about the role of drug pricing middlemen called pharmacy benefit managers. When asked about the role of these pharmacy managers, Oz said he favors “complete and radical transparency” in how these managers operated.
He said such transparency would reveal the “spread pricing” of what these managers pay for these drugs compared to what they charge.
“The lack of transparency into what goes on when that pill leaves the pharmaceutical company and ends up in your home is where a lot of the money is made,” Oz said.
During his 2022 Senate bid, Oz disclosed shares in health companies
During his unsuccessful 2022 campaign for Senate in Pennsylvania, he filed a financial disclosure showing he once held up to $33.7 million in shares of companies that are regulated by the Centers for Medicare & Medicaid Services.
The TV talk show host owned between $280,000 and $600,000 in UnitedHealth Group and between $50,000 and $100,000 in CVS Health, which both provide health insurance plans under Medicare Advantage.
He also owned between $5.8 million and $26.7 million in Amazon and between $1.6 million and $6.3 million in Microsoft, two major technology providers for CMS, the agency he would run.
In a letter addressed to Oz, Sen. Elizabeth Warren, D-Mass., called on Oz to divest from his financial holdings related to industries regulated by the agency and commit to strong ethics safeguards, Reuters reported.
Oz has offered to divest much of that and resign his advisory posts.
(This story was updated to add new information.)
