The federal government has notified four more heart transplant programs, including one in California, that their federal funding may be pulled because they performed too few transplants in recent years to remain proficient.
Slated to lose their Medicare certification in 30 days are programs at Sutter Memorial Hospital in Sacramento, Hartford Hospital in Connecticut, Washington Hospital Center in Washington, D.C., and BryanLGH Medical Center East in Lincoln, Neb.
The relatively uncommon actions by the U.S. Centers for Medicare and Medicaid Services come after a Times investigation found that a fifth of the 236 federally funded heart, liver and lung transplant centers had subpar patient survival rates or performed too few operations to ensure competency. (Experts generally agree that the more a program performs specialized procedures, the sharper its performance.)
Since the newspaper's June report, the Medicare agency has been reviewing the performance of programs nationwide.
In November, the government said it would revoke funding for two other heart programs identified by The Times: those at Wake Forest University Baptist Medical Center in North Carolina and Montefiore Medical Center in New York. The heart program at St. Louis University Hospital, faced with a loss of funding, agreed to withdraw from Medicare.
Wake Forest and Montefiore were subsequently given extra time to make changes to meet Medicare standards.
Medicare's latest actions, made public Wednesday, show the "continued effort on behalf of the agency to make sure we're getting the best care we possibly can for Medicare beneficiaries," said Herb Kuhn, the agency's acting deputy administrator.
Articles in The Times over the last year have exposed excessive deaths at individual programs and lapses in oversight that have allowed subpar programs to continue operating. The articles have prompted investigations ordered by Sen. Charles E. Grassley (R-Iowa), now ranking minority member of the Senate Finance Committee.
In a statement Wednesday, Grassley said he is "heartened that the Medicare agency is taking action."
Some experts have suggested that there may be too many transplant centers in the U.S.
Each program notified this week performed fewer than 12 surgeries last year, the minimum set by the federal government, although all said they meet Medicare's survival thresholds.
