Senate confirms NIH director and FDA commissioner, advances Dr. Oz for CMS administrator

The Senate on Tuesday confirmed Martin Makary as FDA commissioner and Jay Bhattacharya as NIH director. Makary was confirmed in a 56-44 vote, with three Democratic senators — Sen. Maggie Hassan (D-N.H.), Sen. Jeanne Shaheen (D-N.H.), and Sen. Dick Durbin (D-Ill.) — voting alongside Republicans to confirm him. Bhattacharya was confirmed in a 53-47 vote along party lines.

During his confirmation hearing, Makary, a pancreatic cancer surgeon and health policy researcher at Johns Hopkins University, suggested he shared Republican concerns regarding expanded access to the abortion pill mifepristone, which the Biden administration made available without an in-person medical appointment.

Makary also expressed support for vaccines while also suggesting FDA needs to review the role of vaccine experts whom the agency turns to for advice.

Meanwhile, Bhattacharya, a health economist and professor of medicine at Stanford University, also expressed support for vaccines during his confirmation hearing but added that scientists should conduct more research on the relationship between autism and vaccines.

In addition, the Senate Finance Committee on Tuesday voted 14-13 along party lines to advance the nomination of Mehmet Oz, a cardiothoracic surgeon and TV host, as CMS administrator.

Senate Finance Committee Chair Sen. Mike Crapo (R-Idaho) said that Oz's background "makes him uniquely qualified to manage the intricacies of CMS," adding that Oz "discussed his vision to ensure CMS provides Americans with access to superb care, especially for our most vulnerable patients."

Sen. Ron Wyden (D-Ore.), the ranking member on the committee, said that during his confirmation hearing, Oz "was given the chance to assure the American people that he would not be a rubber stamp for Republican plans to gut Medicaid and hike Affordable Care Act premiums. At every turn, he failed the test." (Mueller, New York Times, 3/25; Frieden, MedPage Today, 3/26;  Lawrence, STAT, 3/25; Frieden, MedPage Today, 3/25; Weixel, The Hill, 3/25)

Trump nominates Susan Monarez for CDC director

President Donald Trump on Monday nominated Susan Monarez, the current acting director of CDC, to serve as director of the agency permanently.

"Americans have lost confidence in the CDC due to political bias and disastrous mismanagement," Trump wrote on Truth Social, adding that Monarez would work with HHS Secretary Robert F. Kennedy Jr. to address the chronic disease epidemic and restore CDC's accountability.

"As an incredible mother and dedicated public servant, Dr. Monarez understands the importance of protecting our children, our communities, and our future," Trump wrote.

Monarez has served as acting director of CDC since January and previously worked at the Advanced Research Projects Agency for Health. Monarez holds a doctorate in microbiology and immunology and had postdoctoral training in microbiology and immunology at Stanford University. If confirmed by the Senate, Monarez would be the first nonphysician to lead CDC in over 50 years.

Earlier this month, President Trump withdrew his nomination of Dave Weldon for CDC director after the White House determined Weldon didn't have enough support to win confirmation from the Senate.

Georges Benjamin, executive director of the American Public Health Association, said that Monarez has "several solid attributes: strong respect for [science-based decision-making], has successfully worked in government, has managed programs in complex environments, and is an expert in infectious disease. If confirmed, I look forward to working with her." (Mandavilli/Stolberg, New York Times, 3/24; Kim, et. al., Associated Press, 3/24; Muoio, Fierce Healthcare, 3/24; Weixel, The Hill, 3/24)

However, veterinary scientists have said letting the virus run through poultry unchecked would be both inhumane and dangerous and could have significant economic consequences.

"That's a really terrible idea, for any one of a number of reasons," said Gail Hansen, a former state veterinarian for Kansas. If the bird flu virus was allowed to run through a flock of 5 million birds, "that's literally 5 million chances for that virus to replicate or to mutate," Hansen said.

Large numbers of infected birds are also likely to transmit large amounts of the virus, which puts farm workers and other animals at risk. "So now you're setting yourself up for bad things to happen," Hansen said. "It's a recipe for disaster." (Mandavilli, New York Times, 3/18)

Trump administration pauses hospice oversight program

CMS has put on hold a program aimed at increasing oversight of hospice care, which the hospice care industry said would penalize well-meaning operators without identifying underperforming ones.

In 2020, Congress passed a law requiring CMS to develop a program to increase oversight of underperforming hospices, including more reporting and monetary penalties for any wrongdoing. The law was passed in response to a pair of federal reports that found systemic issues were allowing poor-quality Medicare hospitals to slip through the cracks.

CMS finalized a methodology for the program in 2023 and released the first list of hospices it would target later that year. Leaders in the hospice industry supported the idea but had issues with the algorithm CMS planned to use.

"What was actually proposed by CMS … is a program that looked like it was penalizing rather than rehabilitating these providers," said Scott Levy, chief government affairs officer at the National Alliance for Care at Home, a trade group that represents hospice organizations.

"There were certain providers that we know that should be the target of a lot of activity at CMS that were falling completely [outside] of the special focus program," Levy added. (Goldman, Axios, 3/13)

RFK Jr. instructs anti-vaccine nonprofit to remove fake CDC page

HHS Secretary Robert F. Kennedy Jr. has instructed leaders of the Children's Health Defense, a nonprofit that Kennedy founded, to take down a web page that imitated the design of CDC's site but provided a case that vaccines cause autism.

The page had been published on a site that was registered to Children's Health Defense and was taken offline on Saturday.

"Secretary Kennedy has instructed the Office of the General Counsel to send a formal demand to Children's Health Defense requesting the removal of their website," HHS said in a statement, adding that HHS is "dedicated to restoring our agencies to their tradition of upholding gold-standard, evidence-based science."

It's unclear why Children's Health Defense published a page imitating CDC's. The organization did not respond to the New York Times’ request for comment and Kennedy has said he severed ties with the organization when he started his presidential campaign in 2023.

The page featured a headline that read "Vaccines and Autism" and had text laying out research that supported and debunked a link between vaccines and autism. The text included a citation to a study by Brian Hooker, chief scientific officer at Children's Health Defense, as well as other studies critical of vaccination.

"It's a mixture of things that are legitimately peer-reviewed and things that are bogus," said Bruce Gellin, who directed HHS' vaccine program in the Bush and Obama administrations. "The footnotes give you the impression that it's legitimate scientific work," he added. (Stolberg, et. al., New York Times, 3/22)