Senate Finance Committee Advances Dr. Oz’s Nomination for CMS Administrator

April 9, 2025

EGWP marketplace medicaid Medicare

On March 25, the Senate Finance Committee voted 14-13 along party lines to advance the nomination of Dr. Mehmet Oz as CMS Administrator. During the confirmation hearing, Chair Mike Crapo (R-ID) and other Republicans expressed strong support for Dr. Oz, citing his prior experience as a physician and health advocate. Democrats however scrutinized the nomination. Ranking Member Ron Wyden (D-OR) criticized Dr. Oz’s failure to provide concrete answers to questions about whether he would protect federal health programs. Wyden also questioned Oz’s past promotion of Medicare Advantage plans (MA), remarking that given this history, putting him in charge of the agency “would be like letting the fox guard the hen house.”

His nomination now goes to the full Senate. If confirmed, Dr. Oz would oversee the agency responsible for administering over $1.5 trillion in annual federal health care spending and implementing a wide range of policy initiatives impacting the Medicare, Medicaid, and Affordable Care Act marketplaces.

legislation

Virginia and Hawaii Introduce PDAB Legislation

The Virginia Senate introduced a bill to establish a Prescription Drug Affordability Board (PDAB) to review drugs with a wholesale acquisition cost (WAC) of $60,000 or more per year or a WAC increase of $3,000 or more in any 12-month period. For drugs deemed to cause an affordability challenge, the legislation authorizes the PDAB to […]
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February 12, 2026

EGWP marketplace medicaid Medicare

Solutions

AHIP Shares Update on Plan Progress to Simplify Prior Authorization

AHIP shared progress on the voluntary, multi-year commitments made by AHIP, BCBSA, and leading health plans (including Cigna Healthcare) to streamline and simplify prior authorization. Health plans serving nearly 270 million Americans are participating in this initiative. The 2026 commitments took effect on Jan. 1 and include: reducing the scope of claims subject to prior […]
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February 12, 2026

EGWP marketplace medicaid Medicare

legislation

DOL Issues Proposed Rule on Improving Transparency into PBM Fees

Pursuant to President Trump’s Executive Order “Lowering Drug Prices by Once Again Putting Americans First,” the Department of Labor’s (DOL’s) Employee Benefits Security Administration (EBSA) issued a proposed rule that would require providers of PBM services and affiliated entities of brokerage and consulting services to disclose direct and indirect compensation to their self-funded ERISA fiduciary […]
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February 12, 2026

EGWP marketplace medicaid Medicare

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