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Transplant programs get a delay in decertification

Instead of losing funds, two programs that didn't meet standards are telling regulators how they will improve.

January 13, 2007|Charles Ornstein and Tracy Weber | Times Staff Writers

Federal regulators have delayed pulling Medicare funding from two small heart transplant programs, stepping back from a move that they had said was meant to signal a crackdown on centers that didn't meet their standards.

The U.S. Centers for Medicare and Medicaid Services said Wake Forest University Baptist Medical Center in Winston-Salem, N.C., and Montefiore Medical Center in New York were submitting corrective plans, which the agency needed to review.

In November, Medicare officials said they would decertify -- and withdraw funding from -- the centers by the end of last year because both had failed to perform the minimum number of surgeries required by the government to ensure proficiency.

Both took opportunities to challenge the action.

Herb Kuhn, the Medicare agency's acting deputy administrator, said the agency was not retreating.

"There's a finite process here," he said. "We are moving in a thoughtful way -- but aggressive way -- to ensure we're dealing with the facilities that are not performing in a way that they should be."

Medicare's actions followed a June report in the Los Angeles Times that a fifth of the 236 federally funded heart, liver and lung transplant centers had subpar patient survival after one year or performed too few operations.

Wake Forest and Montefiore both were on the Times' list. Montefiore performed no heart transplants in 2005 and two through Oct. 31 last year. Wake Forest performed two in 2005 and two through October.

The federal standard is at least 12 per year.

"We are actively working with [Medicare] to present our plan of action to address the prior volume concerns of the program," Dr. Vinay Thohan, medical director of Wake Forest's congestive heart failure and heart transplant program, said in a statement.

Montefiore spokesman Mike Quane said his hospital had given a corrective plan to Medicare, but would not provide details while it remained under consideration.

"We do have an outstanding group of doctors and nurses we recruited for the transplant team, and we do expect to meet the standards," Quane said.

Another heart program, at St. Louis University Hospital, withdrew from Medicare in November after being threatened with a loss of funds.

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