Perspective               

HCFA Revises Standards for Transplant Centers

As you may know, Medicare covers some organ transplant procedures. It can be difficult, however, to find a Medicare-approved specialized facility because of rigorous Medicare standards for transplant centers. A new change in federal standards has now made it easier for people with Medicare to find an approved transplant facility. HCFA, the federal agency that administers Medicare, announced on August 2 that it has cut down the time it takes for heart, liver, and lung transplant centers to gain Medicare approval. Under the revised federal standards, transplant facilities will be able to get Medicare approval after one year of experience.

Until now, centers were required to operate on non-Medicare patients for two years before they could be eligible for Medicare approval, even if the doctors had past transplant experience at other Medicare-approved hospitals.

The new decision is based on a study published in the Journal of the American Medical Association and the New England Journal of Medicine, which concluded that a large volume of transplant procedures is a better predictor of outcomes than the number of years of experience. HCFA's Office of Clinical Standards and Quality agreed with this statement, saying that transplant centers need regular, intense experiences to perfect their surgeries.

Transplantation centers must still meet other criteria for Medicare approval, including patient selection policies, patient management protocols, commitment of the center resources, and the minimum volume and survival rates. HCFA is currently working on new policies for the re-evaluation of transplant centers.

Medicare has many special rules that apply to transplant patients. For example, it sometimes pays for immunosuppressive drugs people need for at least 36 months following a transplant surgery. Call your local State Health Insurance Assistance Program, or SHIP, for more information. The number is listed in Medicare & You. You can also call 1-800-MEDICARE.

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