Wall Street Journal: Medicare’s Bad Call on Transplant Tests

Blood tests can save organs. Why are the feds denying coverage?

By: The Wall Street Journal Editorial Board

Government spending on healthcare often leads to rationed care owing to rising costs. Think of the waiting lists in Canada and new price controls on U.S. drugs. Another mistake is playing out in care for organ-transplant patients denied coverage for blood tests that detect problems.

In March, MolDX, a program run by Medicare contractor Palmetto GBA to make coverage decisions on molecular lab tests, changed its guidance for when certain blood tests can be used. The tests, which use molecular technology to catch signs of organ rejection, are often ordered for patients who had kidney, heart or lung transplants. Under the contractor’s new policy, the tests can no longer be used as part of routine monitoring care for most patients.

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