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Centers for Medicare and Medicaid Services
Government BodyFederal agency administering Medicare, Medicaid, and ACA marketplace plans. Sets reimbursement rates, drug pricing rules, and prior authorization policies that directly affect insurer and pharma profits.
insurancepharmaceuticals
Given
$0
Received
$0
Connections
7
Votes
0
Regulatory Capture Assessment
Regulatory capture occurs when a regulatory agency advances the interests of the industry it is meant to oversee. The indicators below track evidence of capture for this agency. According to the academic literature (Stigler 1971, Carpenter & Moss 2013), captured agencies exhibit declining enforcement, revolving door personnel pipelines, and rule-making that favors incumbents over public interest.
Industry connections
0
Enforcement actions
0
Revolving door
2
Relationships
| Type | Connected To | Details | Source |
|---|---|---|---|
| proposed_rule | Medicare Advantage Star Ratings Reform (CMS) | CMS proposed rule: Medicare Advantage Star Ratings Reform (CMS) | |
| issued_rule | Medicaid Unwinding / Redeterminations | CMS issued rule: Medicaid Unwinding / Redeterminations | |
| oversees (target) | Senate Finance Committee | Senate Finance Committee has jurisdiction over the Centers for Medicare and Medicaid Services | |
| oversees (target) | Senate HELP Committee | Senate HELP Committee has jurisdiction over CMS (healthcare programs) | |
| oversees (target) | House Ways and Means Committee | House Ways and Means Committee has jurisdiction over CMS (Medicare/Medicaid funding) | |
| Employed by (target) | Mehmet Oz | Nominated Administrator of CMS | Source |
| Employed by (target) | Robert F. Kennedy Jr. | Secretary of HHS, oversees CMS | Source |