STAT News: Transplant patients saw new Medicare guidance puts their donated organs at risk

By: Elaine Chen

Margaret Gamble was supposed to receive a blood test in the mail in May. It’s a regularly scheduled test to check if her kidney — the second she’s received in a transplant — has been damaged in any way.

Her kidney needs to be constantly monitored since it’s vulnerable to infections or, critically, rejection by her immune system.

But Gamble’s test never came. Her doctor told her there’s been a billing issue with her Medicare insurance, and so now she’s waiting, not knowing how her kidney is doing and if she could be in danger of losing it.

Gamble, a 70-year-old resident of West Columbia, S.C., can’t undergo a biopsy of her kidney, which is the traditional way of monitoring transplants, since she’s on blood thinners and is at heightened risk of bleeding. And because she’s already had two kidney transplants, her body has developed antibodies that would make it difficult for her to get a third donated kidney.

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Representatives Eshoo and Burgess Send Letter to CMS on Non-Invasive Post-Transplant Testing Coverage

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New Survey Shows that 95% of Patients are Concerned that a New Medicare Billing Article Limits Coverage of Non-Invasive Post-Transplant Tests