Thursday, October 8, 2015

Heart transplant test firm gets shock on reimbursement plan

CNBC | Dan Mangan

This transplant test is facing a death sentence unless a rejection is on the horizon.

Its manufacturer warns that it will have to stop selling its commonly used blood test for detecting imminent organ rejection in heart transplant patients if a proposed 77 percent drop in the current Medicare reimbursement rate for the test is approved.

CareDx said that Medicare reimbursements for its AlloMap test would plunge from $2,821 per use now to what the company estimates would be just $644 per use under a proposed fee schedule released late last month by federal regulators.

That proposal is troubling transplant doctors and their patients, who get monitoring tests several times per year to see if they are on the verge of potentially fatal organ rejection.

The worry is that if AlloMap ceases being available, patients will instead be forced to rely on biopsies of transplanted hearts to monitor rejection, a process that is invasive, stressful and time-consuming. Such biopsies would actually cost Medicare significantly more than the rate being proposed for AlloMap, according to the company and transplant surgeons. Continue reading VIDEO


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