A SERVICE
OF 
Medicare to Cover
Intestinal Transplants
WASHINGTON, D.C.: October 15, 2000 · by TNN Medical Reporter
Virginia Baskerville
- Medicare will now cover some intestinal transplants, the Health Care
Financing Administration has decided.
In a decision memorandum posted on
HCFA's website on October 4, HCFA stated: "Medicare will cover intestinal
transplantation for the purpose of restoring intestinal function in patients
with irreversible intestinal failure only when performed for patients who have
failed TPN [total parenteral nutrition] and only when performed in centers that
meet approval criteria. The criteria for approval of centers will be based on
an annual volume of 10 intestinal transplants per year with a 1-year actuarial
survival of 65%."
Until now, there has been no national Medicare
coverage policy on intestinal transplantation. Although individual Medicare
contractors could have individually decided to cover intestinal transplants,
HCFA said it knew of none that did so.
As of early October, only 439
total intestinal transplants had been performed in the United States. The
University of Pittsburgh Medical Center (UPMC) has performed 30% of all such
transplants worldwide and, in February 1999, it asked HCFA for Medicare
coverage of the transplants.
"While these procedures have been approved
by some third-party payers at our facility and at other transplant centers in
the United States…without Medicare's approval, it has been a real battle
with insurance companies for most patients," said Kareem Abu-Elmagd, MD, PhD,
director of intestinal transplantation at UPMC. "Without the financial burden
and associated hassles, patients can now concentrate on getting well with
transplantation."
For Your Information:
-
This site developed and maintained by
SLACK Incorporated
Questions or
comments? E-mail the Webmaster
Please be aware that medical advice, diagnoses and
physician references cannot be obtained from this site.