CMS Administrator Mehmet Oz, MD, is charting an ambitious path to reshape federal healthcare policy in line with President Donald Trump’s “Make America Healthy Again” agenda. His vision comes as President Trump on July 4 signed The One Big Beautiful Bill Act, a sweeping package of reforms targeting Medicaid, Medicare, and the ACA marketplace.[Becker's Hospital Review]

From plans to close a Medicaid funding “loophole” to probing hospitals over gender care for minors and clamping down on states using federal Medicaid funds to treat undocumented migrants, here are 15 key actions CMS has taken since Dr. Oz was confirmed as administrator:

1. CMS plans to add prior authorization for some traditional fee-for-service Medicare services as part of its newly launched Wasteful and Inappropriate Service Reduction model.

The agency will partner with companies specializing in AI and machine learning to test ways to provide an improved and expedited prior authorization process for traditional Medicare services including epidural steroid injections for pain management, cervical fusion, arthroscopy for knee osteoarthritis, and skin and tissue substitutes. The news came one week after the wider insurance industry announced reforms that aim to reduce and streamline prior authorization processes across commercial, Medicare Advantage and managed Medicaid plans.

2. CMS is enacting a final rule that will shorten the open enrollment period on the ACA exchange and create stricter eligibility verifications for enrollees. The changes will lower individual premiums by about 5% on average, and save around $12 billion in 2026 by clamping down on improper enrollments, according to the agency, which estimates as many as 5 million people may have improperly enrolled in ACA plans “enabled by weakened verification process and expanded premium subsidies.”

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