CMS Notifies Four Transplant Programs Of Potential Funding Loss

Main Category: Transplants / Organ Donations
Also Included In: Cardiovascular / Cardiology;  Medicare / Medicaid / SCHIP
Article Date: 05 Feb 2007 - 22:00 PDT

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CMS has notified four additional heart transplant programs that they might lose Medicare funding because they failed to meet minimum agency standards for the number of procedures performed annually, the Los Angeles Times reports (Weber/Ornstein, Los Angeles Times, 2/1). In June 2006, the Times reported that an investigation found 20% of the 236 federally funded heart, liver and lung transplant programs do not meet minimum CMS standards for the number of procedures performed and survival rates. Nine lung transplant programs and 36 heart transplant programs did not meet CMS standards, and those programs accounted for 71 more deaths within one year than expected under normal conditions, based on a government analysis of survival rates. CMS has the authority to revoke the certification of transplant programs that fail to meet agency standards. In August 2006, CMS began to issue warning letters to about 35 transplant programs that have failed to meet agency standards and requested that the programs make improvements before action was taken. In November 2006, CMS notified the heart transplant programs at Wake Forest University Baptist Medical Center, which performed two transplants in 2005, and Montefiore Medical Center, which performed no transplants, that they might lose Medicare funding (Kaiser Daily Health Policy Report, 11/29/06). CMS later awarded the two heart transplant programs additional time to make improvements. The heart transplant program at St. Louis University Hospital, which also faced a potential loss of Medicare funding, agreed to withdraw from the program.

Recent Notifications
According to CMS, the heart transplant programs at Sutter Memorial Hospital, Hartford Hospital, Washington Hospital Center and BryanLGH Medical Center East will lose Medicare funding within 30 days unless they submit plans with explanations of their failure to meet agency standards and steps for short-term and long-term improvements. All four of the heart transplant programs have said that they would submit plans, which likely would prevent a loss of Medicare funding. Herb Kuhn, acting deputy administrator of CMS, said the recent notifications highlight the "continued effort on behalf of the agency to make sure we're getting the best care we possibly can for Medicare beneficiaries" (Weber/Ornstein, Los Angeles Times, 2/1).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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