Dana-Farber's Medicare funding at risk due to overreliance on Brigham and Women's

Dana-Farber Cancer Institute is at risk of losing its Medicare contract following a CMS survey that found deficiencies related to the Boston-based cancer hospital's oversight of its inpatient unit.

At the direction of CMS, the Massachusetts Department of Health surveyed Dana-Farber Cancer Institute Aug. 4. The survey revealed the hospital "was not in substantial compliance" with six Medicare rules, according to a letter CMS sent to Dana-Farber in August and recently obtained by Axios.

In a statement to Becker's Hospital Review, Dana-Farber said most of the issues CMS identified were related to the "oversight and administration of care" provided in its 30-bed inpatient unit. Although Dana-Farber and Boston-based Brigham and Women's Hospital are independent organizations, Dana-Farber's inpatient unit is housed in Brigham and Women's. According to CMS, Dana-Farber violated Medicare rules by relying on Brigham and Women's to handle a number of processes, including verifying staff credentials and managing patient complaints.

"Dana-Farber has been providing excellent, safe and effective inpatient cancer care in our current structure for 20 years," the hospital said in the statement to Becker's. Dana-Farber said CMS officials have been "been very complimentary about the actual care we provide, but want to ensure that Dana-Farber is more clearly responsible for all of the services provided to patients in our inpatient hospital."

Dana-Farber has until the end of June to correct the issues CMS identified. The hospital has already submitted a plan to fix the problems to CMS, which includes the following changes:

  • Independently verifying credentials of all physicians who may see a patient in Dana-Farber's inpatient unit
  • Entering into more detailed and explicit contracts with Brigham and Women's for services provided to Dana-Farber patients
  • Implementing specific policies and procedures covering all aspects of care in Dana-Farber's inpatient unit
  • Establishing an independent, Dana-Farber-specific patient complaint process
  • Using Dana-Farber-specific staff for some services in the inpatient unit

"We are committed to meeting all of CMS' current conditions of participation and fully expect to be able to keep caring for patients in the Medicare program," said Dana-Farber.

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