DHS Stops Medi-Cal Payments for Heart Transplants at Sutter Memorial Hospital
The Department of Health Services on Nov. 10 revoked certification for Sutter Memorial Hospital in Sacramento to perform heart transplants, making such procedures ineligible for Medi-Cal reimbursement at the hospital, the Los Angeles Times reports.
Sutter performed five heart transplants annually between 2002 and 2004, and three have been performed in 2005. The state requires a hospital to perform nine transplants annually to maintain certification, and Medicare requires 12 transplants annually to remain certified. According to the Times, it is "unclear" why federal official have not taken action against the program.
At least two insurers have stopped coverage of heart transplants at Sutter and are instead sending patients to Bay Area facilities, which are about 90 miles away.
Sutter officials said they will appeal the decision and try to keep the program open. Six patients currently are on the waiting list for heart transplants at Sutter.
Margaret Mette, assistant administrator of the hospital, said the loss of state certification will affect only one patient already on the list and one patient who was expecting to join the list (Zarembo/Ornstein, Los Angeles Times, 11/22).