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Getting the latest healthcare news for you
Getting the latest healthcare news for you
A federal watchdog found Medicare shelled out an estimated $380 million over six years for organ acquisitions that never benefited its own enrollees — thanks to conflicting federal rules. Most of those organs went to non-Medicare transplants, while some weren't transplanted at all. The OIG is now urging CMS to fix its guidance to align with federal law.
A new report from the HHS Office of Inspector General (OIG) reveals that Medicare reimbursed transplant centers an estimated $380 million over a six-year period for organs that were never used in Medicare-covered transplants — a costly consequence of conflicting federal rules. The audit, covering 2017–2022, found that of 180 sampled organs reported as "Medicare usable," 43 went to non-Medicare transplants and 12 weren't transplanted at all, yet Medicare still footed the bill.
The root of the problem? CMS guidance instructs transplant centers to count any organ transferred to another center as Medicare-eligible, while the Social Security Act explicitly bars Medicare from paying for services provided to non-enrollees. That contradiction has quietly drained hundreds of millions from the program. On top of that, two transplant centers couldn't produce documentation for five organs they claimed were Medicare-eligible, resulting in an additional $154,210 in improper payments.
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Why it matters: This report adds to growing scrutiny of the U.S. organ transplant system, which has faced criticism over unsafe practices, geographic inequities, and governance gaps. Experts are calling for stronger federal coordination — not just policy patches — to restore accountability and public trust in a system that millions of patients depend on.
