Senator Questions Oversight of Transplant Programs

Senate Finance Committee Chair Chuck Grassley (R-Iowa) on Thursday sent a letter to federal officials who oversee organ transplant programs asking why they have not taken action against programs that fail to meet federal standards, the Los Angeles Times reports (Ornstein, Los Angeles Times, 6/30). The Times on Thursday reported that 20% of federally funded transplant programs do not meet minimum CMS standards regarding the number of procedures a center must perform and the survival rate.

According to the Times, 48 of the 236 federally funded transplant programs examined continue to operate "despite sometimes glaring and repeated lapses." Those 48 transplant programs accounted for 71 more deaths within one year of transplants than expected under normal conditions, based on a government analysis of survival rates.

CMS has the authority to revoke the certification of transplant programs that fail to meet agency standards but "rarely does," the Times reports. CMS has revoked the certification of 11 transplant programs since 2000, but, in "nearly all of those cases, it moved only after the programs had voluntarily ceased operations," according to the Times.

However, after CMS received detailed questions from the Times, agency officials in March sent letters to all of the transplant programs that requested information about staffing and performance.

An anonymous CMS official said that the agency to date has identified 25 transplant programs "seriously out of compliance" (California Healthline, 6/29).

Grassley previously has asked the Government Accountability Office to investigate the organ procurement and transplant system and determine whether federal agencies are able to provide effective oversight.

Grassley in a letter to the heads of CMS and the Health Resources and Services Administration said, "I have been increasingly concerned about the oversight of the organ procurement and transplantation system." He added that problems uncovered last year at three California programs, which have since closed, "may be indicative of problems at facilities elsewhere." Grassley said he was "troubled" by this possibility.

CMS spokesperson Peter Ashkenaz said agency officials had not seen Grassley's letter, so they were unable to comment. Ashkenaz said CMS will work with Grassley to address his questions (Ornstein/Weber, Los Angeles Times, 6/30).

KPCC's "Patt Morrison" on Thursday included a discussion of federally funded transplant programs that do not meet minimum CMS standards. Guests on the program included Barry Straube, chief medical officer at CMS, and Rep. Xavier Becerra (D-Calif.) (Morrison, "Patt Morrison," KPCC, 6/29).

The complete segment is available online in RealPlayer.