Warren & Democrats' Letter to Oz

December 10, 2024
Dr. Mehmet Oz
Administrator-Designate, Centers for
Medicare & Medicaid Services
Trump-Vance transition team
1100 S Ocean Blvd
Palm Beach, FL 33480
Dear Dr. Oz,
On November 19, 2024, President Trump announced his intention to nominate you to serve as
the Center for Medicare & Medicaid Services (CMS) Administrator.1 In the wake of that
nomination, we write regarding our concerns about your advocacy for the elimination of
Traditional Medicare and your deep financial ties to private health insurers.
The CMS Administrator oversees Medicare, Medicaid, and Affordable Care Act coverage,
setting the rules for and managing programs that provide health care coverage for 160 million
Americans.2 We have questions about your lack of qualifications for this job: although you were
a renowned heart surgeon, you have no management experience relevant to running these critical
health care programs. But we are equally concerned about your previous advocacy for Medicare
privatization. In June 2020, ahead of your campaign for U.S. Senate in Pennsylvania, you outlined your
vision for the Medicare program.3
Your plan advocated for covering every senior that is not on Medicaid “through the Medicare
Advantage program,”4 the private Medicare program run by for-profit insurers. This plan would
entirely eliminate Traditional Medicare – a program you have criticized as “highly
dysfunctional,”5 but which provides more accessible6 and less expensive care than private
insurers in Medicare Advantage.7 Indeed, private insurers that run the Medicare Advantage
program drastically overcharge for care: the non-partisan Medicare Payment Advisory
1
CNN, “Trump names Dr. Mehmet Oz to head Centers for Medicare and Medicaid Services,” Tami Luhby, Kate
Sullivan, and Alayna Treene, November 19, 2024, https://www.cnn.com/2024/11/19/politics/mehmet-oz-trump-
medicare-medicaid/index.html.
2
CMS.gov, “About Us,” https://www.cms.gov/about-cms.
3
Forbes, “Medicare Advantage For All Can Save Our Health-Care System,” Dr. Mehmet Oz and George Halvorson,
June 11, 2020, https://www.forbes.com/sites/steveforbes/2020/06/11/medicare-advantage-for-all-can-save-our-
health-care-system/.
4
Id.
5
Id.
6
Center for Medicare Advocacy, “Medicare Prior Authorization,” https://medicareadvocacy.org/prior-
authorization/.
7
Committee for a Responsible Federal Budget, “New Evidence Suggests Even Larger Medicare Advantage
Overpayments,” July 17, 2023, https://www.crfb.org/blogs/new-evidence-suggests-even-larger-medicare-advantage-
overpayments.
Committee (MedPAC) projects that these insurers will overcharge CMS $83 billion relative to
Traditional Medicare in 2024 alone.8 Over half of these overpayments are attributable to
“upcoding,”9 the strategy in which private insurers exaggerate the health conditions of their MA
enrollees on paper to secure higher payments from CMS – even if enrollees receive no treatment
for those conditions.10
In addition to overpayments, federal watchdogs have found that private insurers in Medicare
Advantage routinely delay and deny medically necessary care,11 impose burdensome utilization
management requirements on providers,12 and use deceptive marketing tactics to entice seniors to
join Medicare Advantage plans.13 However, your call to replace Traditional Medicare with
Medicare Advantage ignores these abuses.
Your advocacy for eliminating the Traditional Medicare program and replacing it with Medicare
Advantage also raises questions about your own financial conflicts of interest. In your financial
disclosures from your 2022 Senate run, you reported owning over $550,000 of stock in
UnitedHealth, the largest private insurer in Medicare Advantage and largest employer of
physicians in the nation.14 The company is currently under a sprawling antitrust investigation by
the Department of Justice – including for its role in aggressively upcoding Medicare Advantage
enrollees to secure higher payments from CMS – and has been sued on multiple occasions for
Medicare fraud.15 Under your plan, UnitedHealth’s revenue from Medicare Advantage would
roughly double to $274 billion annually.16
As CMS Administrator, you would be tasked with overseeing Medicare and ensuring that the
tens of millions of seniors that rely on the program receive the care they deserve, including
cracking down on abuses by private insurers in Medicare Advantage. The consequences of
failure on your part would be grave. Billions of federal health care dollars – and millions of lives
– are at stake.
8
Medicare Payment Advisory Commission, "Report to the Congress: Medicare Payment Policy,” June 2024, p. 373,
https://www.medpac.gov/wp-content/uploads/2024/03/Mar24_Ch12_MedPAC_Report_To_Congress_SEC-1.pdf.
9
Id. p. 375.
10
The Wall Street Journal, “Insurers Pocketed $50 Billion From Medicare for Diseases No Doctor Treated,”
Christopher Weaver et al., July 2024, https://www.wsj.com/health/healthcare/medicare-health-insurance-diagnosis-
payments-b4d99a5d.
11
HHS-OIG, “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns
About Beneficiary Access to Medically Necessary Care,” April 27, 2022, https://oig.hhs.gov/reports/all/2022/some-
medicare-advantage-organization-denials-of-prior-authorization-requests-raise-concerns-about-beneficiary-access-
to-medically-necessary-care/.
12
Letter from Senator Wyden to CMS Adminstrator Brooks-LaSure, October 29, 2024,
https://www.finance.senate.gov/imo/media/doc/102924_wyden_neal_pallone_letter_to_cms_about_ma.pdf.
13
Id.
14
The Lever, “Trump Picks Oz, Champion of Medicare Privatization,” November 19, 2024, Andrew Perez,
https://www.levernews.com/dr-oz-can-now-pull-off-his-medicare-privatization-scheme-2/.
15
Health Care Dive, “UnitedHealth under antitrust investigation by DOJ: reports,” February 28, 2024,
https://www.healthcaredive.com/news/unitedhealth-antitrust-investigation-doj-unitedhealthcare-optum/708727/;
HHS OIG, “United States Intervenes in Second False Claims Act Lawsuit Alleging that UnitedHealth Group Inc.
Mischarged the Medicare Advantage and Prescription Drug Programs, May 16, 2017,
https://oig.hhs.gov/fraud/enforcement/united-states-intervenes-in-second-false-claims-act-lawsuit-alleging-that-
unitedhealth-group-inc-mischarged-the-medicare-advantage-and-prescription-drug-programs/.
16
People’s Action, “UnitedHealth Will Be a Top Beneficiary of Trump’s Project 2025,” October 15, 2024,
https://peoplesaction.org/unitedhealth-will-be-a-top-beneficiary-of-trumps-project-2025/.
2
Given your financial ties to private insurers, combined with your view that the traditional
Medicare program is “highly dysfunctional” and your advocacy for eliminating it entirely, it is
not clear that you are qualified for this critical job.
Before your nomination comes to the Senate, Congress and the public deserve answers about
your views on Medicare and your financial conflicts of interest. We ask that you provide answers
to the following questions by December 24, 2024:
1) Do you still continue to view Traditional Medicare as a “highly dysfunctional” program?

2) Do you still continue to support policies that would eliminate Traditional Medicare?
a. If so, how will you address concerns from seniors that will be forced out of the
problem?
b. If not, will you commit to opposing any and all efforts to privatize or cut
Medicare if you are confirmed as CMS Administrator?
3) How do you reconcile your support for turning Medicare over to private insurers with
findings from federal watchdogs and whistleblowers indicating that these private
companies overcharge taxpayers and unlawfully deny care?
4) Will you commit to fully divesting of any and all financial holdings related to the
insurance industry if you are confirmed as Administrator?
5) If confirmed as Administrator, will you commit to recusing from any decisions that may
impact insurers in which you currently have a financial interest?
Thank you for your attention to this matter. We will have additional questions as your
nomination moves forward in the Finance Committee.
Sincerely,
Elizabeth Warren Ron Wyden

United States Senator United States Senator
Lloyd Doggett Jeffrey A. Merkley

Member of Congress United States Senator
3
Richard J. Durbin Richard Blumenthal
United States Senator United States Senator
Benjamin L. Cardin
United States Senator

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December 10, 2024

Dear Dr. Oz,

1) Do you still continue to view Traditional Medicare as a “highly dysfunctional” program?

Elizabeth Warren Ron Wyden

Lloyd Doggett Jeffrey A. Merkley

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