CMS on Thursday began to issue warning letters to about 35 transplant programs that have failed to meet agency standards, "giving them one last opportunity to prove their quality before taking enforcement action," which could include the loss of federal funding, the Los Angeles Times reports (Ornstein, Los Angeles Times, 8/4). The Times in June reported that an investigation found 20% of the 236 federally funded heart, liver and lung transplant programs do not meet minimum CMS standards for the number of procedures performed and survival rates. Nine lung transplant programs and 36 heart transplant programs did not meet CMS standards, and those programs accounted for 71 more deaths 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 takes such action in few cases. In March, CMS sent letters to all of the transplant programs that requested information about staffing and performance (Kaiser Daily Health Policy Report, 6/30). CMS has reviewed the information and has sent the letters to ask the 35 unidentified transplant programs to confirm the data and "let us know of any other information we ought to know about," Barry Straube, chief medical officer at the agency, said. He added, "We want to make sure that there's due process here. We'll be taking action soon." In addition, Straube said that CMS will release revised agency standards for transplant programs this year, rather than in 2007 as previously expected (Los Angeles Times, 8/4).

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