Philo D. Hall, Member of the Firm in the firm’s Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was quoted in Axios, in “A Medicare Minefield Awaits Oz,” by Maya Goldman. (Read the full version – subscription required.)
Following is an excerpt:
Mehmet Oz, President-elect Trump's pick to lead the Centers for Medicare and Medicaid Services, is about to land in the middle of brewing tensions among Republicans over how the Medicare Advantage program works.
Why it matters: Privately run Medicare Advantage plans now enroll more than half of America's seniors, costing the federal government an estimated $83 billion more per year than the traditional Medicare program would for the same enrollees.
- A burgeoning anti-big-business wing of the GOP is coinciding with growing concern among fiscal hawks about the program's significant cost and its reported overuse of prior authorization that adds hurdles to seniors' access to care.
- Their differences in opinions and priorities withRepublicans who traditionally support privatized health insurance could complicate the Trump administration's vision of what's next for Medicare Advantage.
The big picture: Oz and the Trump administration are decidedly pro-Medicare Advantage and will likely continue to encourage seniors' enrollment in the program, said Philo Hall, a health care lawyer at Epstein Becker Green who worked at Health and Human Services during the George W. Bush administration.
- But they may do so in ways that insurance companies don't favor, such as by continuing to scrutinize how plans are paid for enrollees' illnesses, he said.
