Centers for Medicare & Medicaid Services Administrator Mehmet Oz | Global Conference 2025

Appointment and Core Philosophy

• Mehmet Oz confirmed as new Administrator of the Centers for Medicare and Medicaid Services (CMS).
• Oz defines his approach to federal service through the lens of "empowerment," focusing on giving individuals agency over their health.
• He attributes the healthcare crisis to lifestyle-driven chronic illness, which he states drives 70% of US healthcare costs.

Strategic Objectives and Financial Goals

• CMS has set Objectives and Key Results (OKRs) prioritizing the activation of internal talent and the removal of bureaucratic barriers.
• The administration targets a potential $80 billion annual savings by correcting systemic incentives and eliminating waste.
• Oz cites a specific recent case where a firm was terminated for charging $200 million over five years for unusable code, highlighting a broader issue of managing 40,000 contractors with only 13 internal engineers.
• The "Make America Healthy Again" initiative aims to address chronic conditions, noting 40% of the population is obese and one-third has pre-diabetes.

Fraud, Waste, and Abuse Initiatives

• A dedicated "war room" has been established to intercept tens of millions of dollars in fraudulent payments before they leave the system.
• Oz flagged significant issues in hospice fraud, specifically instances where patients have five-year survival rates despite being classified for end-of-life care.
• Investigations have uncovered potential involvement of foreign nationals and possibly foreign governments in health insurance fraud schemes.

IT Infrastructure and Data Integration

• Oz proposes consolidating the current $16 billion annual expenditure for state Medicaid IT infrastructure into a unified federal platform to ensure interoperability.
• The strategy includes leveraging AI and "agentic AI" to provide real-time notifications to individuals regarding health metrics (e.g., missed prescriptions or physical activity).
• A key goal is enabling data portability between states to eliminate duplicate Medicaid payments for residents who cross state lines; current estimates suggest $1–$10 billion is lost annually due to such discrepancies.
• The administration intends to use executive orders on transparency and interoperability to facilitate this data flow.

Medicaid Incentive Structures and Federal-State Relations

• Oz highlighted a perverse financial incentive where states receive 90% federal matching funds for able-bodied Medicaid recipients but only ~65% for other populations (pregnant, elderly, disabled), inadvertently shifting resources away from the most vulnerable.
• The administration is engaging with governors to align incentives, allowing states flexibility ("write poetry") to address local needs while adhering to national goals.
• Oz explicitly stated opposition to using taxpayer dollars from states like Mississippi to fund illegal immigrants on Medicaid in states like California.
• Governors are described as supportive of federal assistance but "handcuffed" by current federal rules, as Medicaid costs have doubled over the last decade, crowding out other state spending like education.

Technology and Innovation

• CMS is "open for business" to private sector innovators, offering clear pathways, benchmarks, and predictability for companies developing breakthrough devices and therapeutics.
• The administration emphasizes the need for clinical trials that reflect the specific patient populations covered by government insurance.
• Oz argues that the current system is in a "critical condition" with "stable vital signs," warning that without immediate structural intervention, the system faces "disastrous collapse."

Human Capital and Workforce

• Oz expressed strong admiration for the "highly competent, skilled, mission-driven" individuals currently employed at CMS, stating they often feel restricted in their ability to innovate.
• Organizational changes focus on merging duplicate groups and aligning staff efforts with state-level needs to improve efficiency.
• Oz views individual health responsibility as a "patriotic duty," suggesting that personal health choices drive broader ecosystem improvements.