Dr. Oz faces Senate: What he said on Medicaid, Medicare Advantage, prior authorization, and more

Mehmet Oz, MD, faced questions about everything from Medicaid funding to the products on his TV talk show as he met before senators Friday.

Mehmet Oz, MD, faced tough questions before the Senate Finance Committee Friday. Oz has been nominated to lead the Centers for Medicare & Medicaid Services and the post requires Senate approval.

Oz, President Donald Trump’s nominee to lead the Centers for Medicare & Medicaid Services, made his case before the Senate Finance Committee Friday. The Senate must confirm Oz to lead the CMS, which touches the lives of 160 million Americans.

A cardiothoracic surgeon, Oz found fame through his frequent appearances on Oprah Winfrey’s talk show, and he later had his own talk show for more than a decade. During his introductory remarks, Oz may have become the first Cabinet nominee to tout his Emmy Awards in his bid for Senate confirmation. He also ran for the U.S. Senate in Pennsylvania, losing to U.S. Sen. John Fetterman, D-Pa.

There doesn’t appear to be much drama about Oz’s confirmation. The Senate narrowly voted to confirm Robert F. Kennedy Jr. to lead the U.S. Department of Health & Human Services, which oversees CMS. The Senate has confirmed virtually all of Trump’s nominees, although the White House withdrew Dave Weldon’s nomination to lead the CDC Thursday when it became clear he didn’t have the votes.

Sen. Bill Cassidy, a Louisiana Republican and a physician, said during the hearing that he expects Oz to be confirmed. Republicans hold the majority in the Senate.

Still, Oz faced tough questions on topics including potential cuts to Medicaid, the Medicare Advantage program, prior authorization, and his talk show.

Medicaid

Oz faced questions about whether he would oppose cuts to the Medicaid program, and he didn’t give Democratic senators assurance that he would fight against reductions.

Sen. Ron Wyden, an Oregon Democrat who is the ranking Democrat on the committee, asked Oz if he would fight against Medicaid cuts and insisted on a “yes” or “no” answer.

Wyden asked, “Will you agree to oppose cuts in the Medicaid program?”

In response, Oz said, “I cherish Medicaid, and I've worked within the Medicaid environment quite extensively.”

When Wyden pressed again for a “yes” or “no,” Oz said, “I want to make sure that the patients today and in the future, have resources to protect them if they get ill. The way you protect Medicaid is by making sure that it's viable at every level.” Wyden then asked the record to reflect that Oz wouldn’t answer yes or no.

Sen. Maggie Hassan, a Democrat from New Hampshire, pointed to a Congressional Budget Office analysis that a Republican spending plan could result in millions of people losing Medicaid coverage and asked Oz about it. Hassan asked Oz how many children losing health insurance would be acceptable.

“I don’t want children losing health insurance,” Oz said.

Hassan responded, “Well, then you're going to need to reject the Republican budget plan.”

Healthcare leaders have worried about the prospect of Medicaid cuts. While Trump has said he won’t cut Medicaid benefits, he and GOP lawmakers have said they want to weed out fraud in the program. House Republicans have also pushed a spending plan that would raise the possibility of reduced funding for Medicaid.

Medicare Advantage

Democratic and Republican senators asked Oz about Medicare Advantage programs, generating some interesting responses. Oz has spoken favorably about Medicare Advantage in the past, but he offered some concerns about the program.

In response to questions from Cassidy, Oz said, “We're actually, apparently paying more for Medicare Advantage than we're paying for regular Medicare. So it's upside down.”

Oz said that he would like to look at “the up-coding that's going on, that's happening systemically in many systems, in many programs, to make sure that people are being appropriately paid for taking care of sick patients, but not for patients who aren't ill.”

Oz also suggested that another way of reducing spending would be to allow Americans to obtain multi-year agreements with Medicare Advantage plans, as opposed to signing annual agreements.

“That would save some of the money that the brokers are taking out of the middle. Some brokers do a great job. Some don't,” Oz said.

More than 30 million Americans, representing more than half of all those on Medicare, are members of Medicare Advantage plans. Hospitals have been increasingly critical of Medicare Advantage plans, saying they are too often denying or delaying claims.

Prior authorization

This is another area of interest from both Democratic and Republican lawmakers. Oz was asked about what he would do to ease headaches with prior authorization, a process requiring physicians and hospitals to gain approval from insurance companies for treatments, procedures and medications.

Oz said it’s one of the most frequent complaints he hears from physicians and says there’s room to make the process better.

“This issue of pre-authorization is a pox on the system,” Oz said. “We spend 12% of the healthcare budget on administrative costs. Pre-authorization is misused in some settings.”

Insurers have said prior authorization is a necessary tool to control costs and avoid unnecessary expenses, and Oz said, “There needs to be a mechanism to confirm that procedures are worthwhile.”

Oz said that there are about 15,000 procedures that could require prior authorization, and he noted that different insurance companies have different requirements for procedures that need pre-approval. He said he’d like to see the number of procedures requiring prior authorization narrowed down to about 1,000.

Responding to questions from Cassidy about prior authorization, Oz said, “We're spending money, wasting money, trying to do a process that should be automated.”

Oz said he’d like to see more automation on a much smaller number of procedures requiring pre-approval. He said the authorization process should be similar to a consumer using a credit card and finding out almost immediately if the transaction can be done.

More hospitals and insurers are utilizing AI-powered technology in handling prior authorization requests. Healthcare leaders have said AI could help reduce headaches in the process, but hospital leaders say insurers are using AI tools to deny or at least delay reimbursements.

His talk show

Some of the most pointed questions concerned Oz’s long-running talk show, which he ended when he decided to run for the Senate in 2022.

Hassan asked about some of the weight loss supplements that he touted on his show, including green coffee extract. She asked if Oz would confirm that it’s not a miraculous drug for weight loss.

“I never said that that medication was a miracle weight loss drug,” Oz said. When Hassan pressed if it was fraudulently marketed and that it’s not a miraculous weight loss drug, Oz said, “Yes.”

Oz said he wasn’t paid to promote supplements on his show. “I take great pride in the research we did at the time to identify which of these worked and which ones didn't,” he said.

Hassan indicated she wasn’t satisfied with Oz’s responses. “It seems to me, you are still unwilling to take accountability for your promotion of unproven snake oil remedies to millions of your viewers, and that's really concerning,” she said.

Scientists criticized Oz for pushing remedies for weight loss on his show. In a 2014 study, researchers said they found “believable evidence” for only a third of the recommendations on “The Dr. Oz Show.”

Hospital payments

Sen. Sheldon Whitehouse, a Democrat from Rhode Island, implored Oz to look at the differences in reimbursements for hospitals in different states.

Pointing to his state, Whitehouse said hospitals in Rhode Island receive substantially less than hospitals in neighboring Massachusetts.

“As a doctor, I think you pretty well understand that if you've got two hospital facilities that are less than an hour apart from each other and that are in the same regional healthcare market, and one is paid 26% less than the other, you have created a massive and harmful distortion,” Whitehouse said.

Oz said he understood the problem and pledged to try to address the situation if he’s confirmed. Whitehouse said he hoped that would happen. The senator provided one of the more humorous moments in the hearing when he said, “I'm going to be on you like a ferret to get this fixed.”

Oz also said he’d discussed the situation with Sen. Bernie Sanders of Vermont, which receives even smaller reimbursements.

“I think there are opportunities to revisit that,” Sanders said.

Other takeaways

In his opening statement, Oz said that he wants to “empower beneficiaries with better tools and more transparency.” He also cited Trump’s executive order on price transparency.

He also said that he wants to incentivize doctors and providers to provide better care with technology. He touted the potential of AI to help clinicians. “Artificial intelligence can liberate doctors and nurses from paperwork so they can focus more on the patient,” Oz said.

Oz also pledged to use more high-tech tools to reduce waste and extend the life of the Medicare trust fund.

He also talked about the importance of tackling obesity and encouraging Americans to eat better and get more exercise.

Sen. Mike Crapo, R-Idaho, the chairman of the Senate Finance Committee, opened the hearing with praise for Oz.

“Your background and experiences bring a fresh perspective to the role of CMS administrator,” Crapo said. “As an accomplished physician, you have first-hand experience, not only with the bureaucratic nature of federal government payment programs, but also the impact of chronic disease.”

Wyden also asked if Oz plans to protect patient privacy in light of Elon Musk’s Department of Government Efficiency examining CMS in the midst of its review of federal programs.

Oz said he hasn’t talked with Kennedy or anyone in the Trump administration about DOGE’s work. He said he expects to learn more if he wins Senate approval.

“So I intend to spend my first precious few weeks in the agency, if confirmed, speaking to the staff, raising morale, getting people excited, and addressing what's going on with DOGE,” Oz said. “I will know a lot more if I'm confirmed.”