Government and Health Care

Spectrum’s lung program earns CMS certification

The approval will allow patients with Medicaid and Medicare to be covered.

May 2, 2014
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New recognition for an organ transplant program through Spectrum Health will grant more patient access to the procedure.

Spectrum announced last week it has earned formal certification from the Centers for Medicare and Medicaid Services for its lung transplant program.

Dr. Reda Girgis, medical director of the lung transplant program at Spectrum, said those associated with the procedure are happy to have passed the milestone and look forward to continuing to grow.

“It’s a direct reflection of the commitment to excellence shared by everyone in our program,” said Girgis in a written statement. “This will allow us to further expand and continue to serve the residents of West Michigan by offering this life-saving procedure to patients with a variety of advanced lung diseases.”

In order to receive recognition by CMS for Medicare to participate in the lung transplant program, CMS contractors evaluated the program last winter during an onsite visit.

The review was requested after Spectrum Health had completed the minimum annual requirement of 10 lung transplants. The onsite audit included procedure and policy assessment, personnel interviews and evaluation of patient care and outcomes in comparison with the national average.

According to the press release, CMS approval is often required by commercial insurance providers prior to agreeing to cover a transplant procedure. As a result of earning the recognition for the program, Spectrum is now eligible to receive reimbursement for procedures with patients who have Medicare and Medicaid health insurance plans.

According to Girgis, the approval will allow more patients to have access to the important medical procedure since there were limitations based on insurance plans prior to the certification.

“I think it is a big step toward establishing any organ transplant program — really, it is a requirement,” said Girgis. “It is something that we are proud of and, of course, the next step is to build on it.”

The lung transplant program has conducted 16 procedures since February 2013 at the Fred and Lena Meijer Heart Center in Grand Rapids, according to Bruce Rossman, media relations consultant at Spectrum.

The health care system has locations throughout West Michigan and employs more than 1,000 physicians and advanced practice providers in its network.

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