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    • Mehmet Oz was put in charge of CMS, an agency responsible for Medicare
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    Mehmet Oz was put in charge of CMS, an agency responsible for Medicare

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    As television personality Dr. President Donald Trump’s nominee Mehmet Oz is confirmed as director of the Centers for Medicare & Medicaid Services, he would oversee two major federal health insurance programs that cover about two in five Americans and have a major influence on the nation’s health care system. country.

    In addition to providing direct health insurance to older adults and low-income families, CMS also oversees the Affordable Care Act and federal payments to hospitals and physicians.

    CMS administers Medicare, the federal health care program for U.S. residents age 65 and older and some younger people with qualifying medical conditions. Nearly 68 million people are covered by traditional government-run Medicare or Medicare Advantage plans, offered by private health insurers but subject to CMS oversight.

    CMS also oversees Medicaid, the federal health program for low-income families that covers 72 million people. As of July, an additional 7 million children were enrolled in the Children’s Health Insurance Program.

    The federal agency also oversees Affordable Care Act health insurance for millions of Americans. As such, the agency regulates ACA plans sold through Healthcare.gov or state-based insurance exchanges.

    In total, CMS employs more than 6,000 employees and operates a half-dozen centers responsible for everything from clinical quality standards to innovation. CMS falls under the umbrella of the U.S. Department of Health and Human Services, which also oversees the Centers for Disease Control and Prevention and the Food and Drug Administration. Trump has Robert F. Kennedy Jr. nominated to lead HHS.

    Because it oversees payments to doctors and hospitals that use Medicare and Medicaid, the agency’s reimbursement schedules often provide the template that private health insurance companies use to negotiate reimbursement rates with health care providers.

    Under President Joe Biden’s 2022 climate and health legislation, known as the Inflation Reduction Act, Medicare was given the authority to negotiate prices with pharmaceutical companies for a limited number of drugs.

    Earlier this year, Medicare announced negotiated rebates with pharmaceutical companies on 10 drugs prescribed to treat blood clots, cancer, heart disease and diabetes. The price discounts will not take effect until 2026. A further 30 drugs will be selected over the next two years at negotiated prices to be rolled out in 2027 and 2028.

    Nearly all U.S. hospitals accept Medicare and, as part of such participation, are subject to on-site inspections called surveys. These surveys verify that hospitals are meeting standards set by the agency.

    If confirmed by the Senate, Oz would succeed Chiquita Brooks-LaSure, who held a senior position within CMS when the Affordable Care Act was launched under President Barack Obama. She worked in the private sector during Trump’s first term and returned to serve as a CMS administrator during the Biden administration.

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