National Coverage Analysis (NCA) Tracking Sheet

Liver Transplantation



Medicare covers “adult liver transplantation when performed on beneficiaries with end stage liver disease other than hepatitis B or malignancies ... when performed in a facility which is approved by HCFA as meeting institutional coverage criteria.” This policy has been in effect since July 15, 1996. The policy was written before the recent advances in hepatitis and cancer therapy. Medicare is now re-examining our coverage policy with respect both exclusions.

National Coverage Determinations

Benefit Category

Inpatient Hospital Services

Requestor Information

Requestor NameRequestor Letter
Internal HCFA Request N/A

Important Dates

Formal Request Accepted and Review Initiated
Expected NCA Completion Date
Public Comment Period
12/17/1999 - 01/17/2000
Decision Memo Released


Lead Analysts
Jackie Sheridan-Moore

Actions Taken


Review by OCSQ staff regarding information submitted on liver transplantation from numerous transplant centers.

April 23, 1999

Received letter from American Liver Foundation (ALF) dated April 22, 1999 submitting a monograph on “Hepatitis B: An Appropriate Indication for Liver Transplantation.”

June 29, 1999

HCFA Administrator advises Congressman Waxman that we have received the ALF Monograph and indicates our interest in reconsidering the national coverage decision.

August 25, 1999

Director, Office of Clinical Standards and Quality (OCSQ) briefs HCFA Deputy Administrator on several liver transplant issues including our interest in reconsidering the national coverage exclusion of hepatitis B and cancer.

November 18, 1999

Director, OCSQ met with CAG staff to discuss a new national coverage decision.

December 2, 1999