CMS to cease funding two California heart transplant programs for failure to meet minimum standards

Transplant News,  Dec, 2006  

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The federal agency overseeing the nation's transplant centers announced on Nov. 28 that it will cease funding two heart programs because of their failure to meet minimum performance standards. A third program agreed to pull its program out of the Medicare program, according to the Los Angeles Times.

The US Centers for Medicare and Medicaid Services (CMS) sent letters to the heart transplant programs at Wake Forest University Baptist Medical Center in Winston-Salem, NC, and Montefiore Medical Center in New York City notifying them they will be losing their funding. They have 30 days to challenge the CMS action.

With the same fate looming, the third heart program located at St. Louis University Hospital in St. Louis, MO agreed to withdraw from the Medicare program, the Times reported in its Nov. 29th edition.

The CMS action was undoubtedly meant as a warning to US transplant centers that the government intends to begin taking actions if they fail to meet minimum annual performance standards.

Barry Straube, MD, CMS's chief medical officer, told the Times the agency's action could force poorly performing programs to improve or drop out of Medicare. "It might be possible that people were not taking this seriously enough and thinking that we would not take this action," he said.

Reviews of other poorly performing transplant programs have already begun.

The Medicare minimum standard for heart transplants performed annually is 12. Montefiore and St. Louis University performed no heart transplants in 2005, and Wake Forest performed only two and has a one-year patient survival rate of 43%, far under the federal government requirement of 73%, the Times reported.

Mark Wright, a Wake Forest Baptist spokesman, said transplant officials will meet this week to decide how to address the situation. "We have invested a tremendous amount of resources in our heart transplant program. We feel it is a viable program," Wright told the Times.

Montifiore also said it plans to continue its heart program and St. Louis University said it will remain open without its Medicare patients.

The aggressive CMS action would appear to be the result of a Times report last June that revealed a fifth of the nation's 236 federally funded heart, liver and lung transplant centers had subpar patient survival or performed too few operations to ensure competency.

In August, CMS sent letters to 35 underperforming centers, which allowed them another chance to improve before actions are taken to shut them down.

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