On March 14, the U.S. Senate held a confirmation hearing on the nomination of Mehmet Oz, MD, for administrator of the Centers for Medicare & Medicaid Services (CMS). Dr. Oz is a cardiologist and former television show host and currently is vice-chair and professor of surgery at Columbia University and directs the Cardiovascular Institute and Complementary Medicine Program at New York Presbyterian Hospital.
Dr. Oz indicated that some of his priorities in the position, if confirmed, would be to reduce healthcare spending by improving poor health, increasing use of technology, incentivizing providers and stopping wasteful spending, fraud and abuse. The Senate Committee on Health, Education, Labor and Pensions (HELP) will soon schedule a vote on whether to advance his nomination to the full Senate.
Why This Matters to Rheumatologists
If confirmed, Dr. Oz would oversee Medicare, Medicaid, the Children’s Health Insurance Program and the Affordable Care Act health insurance marketplaces. His potential confirmation comes at a crucial time for rheumatologists for several reasons.
First, like all medical specialists, rheumatology professionals are experiencing declining reimbursements for treating Medicare beneficiaries. When coupled with an aging population that is getting sicker, this poses an unenviable paradox in which providers are being paid less to treat more Medicare beneficiaries. It is unclear at this time the extent to which the CMS will work with Congress under Dr. Oz’s leadership to ensure providers are paid adequately.
Second, while Dr. Oz pledged during the hearing to scrutinize Medicare Advantage plans, he has in the past called for expanding the program to cover everyone not on Medicaid. More than half of all Medicare beneficiaries are on Medicare Advantage plans, but these plans often employ deceptive marketing tactics. They are also plagued by burdensome requirements for referrals and prior authorization, higher out-of-pocket expenses and limited drug formularies. These issues have imposed unnecessary hardships on rheumatologists and their patients.
Third, Dr. Oz affirmed his intent to defend Medicare drug price negotiations in court. The Medicare Drug Price Negotiation Program has been an important pillar of the ACR’s advocacy portfolio since its inception. However, given the previous Trump administration’s preference for drug importation to drive down costs, the future of the program is unclear.
Ongoing Activity
These are just a few of the issues the ACR continues to track surrounding Dr. Oz’s nomination. The HELP committee will soon vote to advance Dr. Oz’s nomination to the Senate floor for confirmation. He is expected to be confirmed.