The Centers for Medicare and Medicaid Services (CMS) has granted certification approval to Methodist Specialty and Transplant Hospital of San Antonio for liver transplants to people with Medicare.
Mark B. McClellan, M.D., Ph.D., administrator of CMS, said that Methodist Specialty and Transplant Hospital has met a series of facility and patient selection criteria.
In its first year, Methodist’s experience with liver transplants saw 25 procedures performed with a 92.45 percent survival rate.
“Our comprehensive review showed that this Methodist hospital’s experience and survival rates provide the potential for a safe and effective transplant program,” he said. “I know how important a liver transplant program can be for the people of Central Texas , and liver transplants performed by this facility for people with Medicare will now be covered by Medicare.”
With this certification, coverage for liver transplants will be effective July 29, 2005.
CMS covers kidney, heart and liver transplants programs and helps to pay for heart and liver transplants only when performed in facilities meeting special quality standards. To date, 93 hospitals and medical centers, including Methodist Specialty and Transplant Hospital , have been approved by Medicare to perform liver transplants on Medicare beneficiaries.
Medicare-approved medical centers must meet extensive criteria set out by CMS and be reviewed by a board comprised of distinguished transplant surgeons. A facility must have Medicare-approval status before it can receive payment from CMS for liver transplantation services for Medicare beneficiaries.
In April 2005, Health and Human Services Secretary Mike Leavitt highlightedNational Donate Life Month to educate and increase awareness among Americans on the importance of organ donation.
Secretary Leavitt said the country is reaching record levels of organ donors and organ transplants, but the need for more organ donors remains great. Currently nearly 90,000 Americans are in need of an organ transplant and every 16 minutes, another person joins the waiting list. Thousands more are in need of a tissue transplant.
The criteria used by CMS for selection of liver transplant centers are intended to ensure that approval is given only to facilities with the necessary experience and expertise to perform this complex surgery successfully.
The criteria require facilities to have an established liver transplantation program with documented experience. For example, a facility would have had to perform 12 or more transplants in the year preceding its application for CMS certification, with an average one-year survival rate of 77 percent and a two-year rate of 60 percent.
The criteria also require facilities to have a patient selection process. These processes are generally based on a critical medical need for a transplant and a maximum likelihood of survival.
CMS's patient selection guidelines include a requirement that patient evaluations must indicate a very poor prognosis. For example, there must be less than 25 percent likelihood of survival for six months without the transplant, and all other approved medical and surgical therapies must have been tried or considered.
A list of the current approved liver transplant centers, including year of Medicare's approval, alphabetical by state, is available at http://www.cms.hhs.gov/providers/transplant/livrlist.asp.