The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer.
A transplant program must be located within a hospital that has a Medicare provider agreement.
To voluntarily become a Medicare certified provider, you will need to complete the following steps and submit the documents electronically to LARA-BSCSupport@michigan.gov, unless otherwise noted in the instructions.
- Complete Provider Enrollment Application (CMS-855A) and submit to Medicare Administrative Contractor (MAC). The MAC will provide you a recommendation letter once the initial review is complete.
- The hospital in which the transplant program is located must also simultaneously submit a revised CMS-855A form to its Medicare Administrative Contractor (MAC) to indicate the addition of a service.
- The transplant program can apply for and be approved for both an adult and pediatric transplant program for the same organ type or they can apply to be approved separately. If approved separately, they will be surveyed separately.
- Membership in the Organ Procurement and Transplantation Network (OPTN) by the transplant hospital is required.
- An initial survey by the Bureau of Survey and Certification will be scheduled upon notification from the MAC that the revised CMS-855A has been approved.
- Currently, CMS has prioritized initial surveys as lower priority tier work. Following the guidance of the CMS Mission and Priority Document, there may be an extended period of time before the initial survey can be completed.
- Once all of the above documents have been received, your application will be deemed complete and the Bureau of Survey and Certification will review and forward the documents to the CMS Chicago location for final determination and issuance of the Medicare provider number.
- Please note, this process can take up to 30-60 days from the day of receipt by the CMS Chicago location.
Notification of Significant Changes to a Transplant Program
Transplant programs must notify the Bureau of Survey and Certification immediately (defined as within 7 business days of the change occurring) of significant changes related to the hospital’s transplant program that could affect its compliance with Medicare requirements (required under 42 CFR 482.74).
These changes include but are not limited to:
- Key staff members of the transplant team, such as a change in the individual the transplant program designated to the OPTN as program’s “primary transplant surgeon” or “primary transplant physician”.
- Termination of an agreement between the hospital in which the transplant program is located and an OPO for the recovery and receipt of organs as required by section 482.100 and
- Inactivation of the transplant program.
- Such notifications can be emailed to LARA-BSCSupport@michigan.gov
- A transplant program may request consideration of mitigating factors in the initial approval and re-approval of a transplant program that does not meet the Conditions of Participation (CoP) at 482.80 or 482.82. Mitigating factors will not be considered in situations of immediate jeopardy.
- The transplant program must state on the CMS-2567, which is submitted to the Bureau of Survey and Certification, that it will apply for mitigating factors on the facility’s plan of correction (POC) for non-compliance with data submission, clinical experience, or outcomes noncompliance.
- Upon receipt of a POC, that includes an intent to apply for mitigating factors by the provider, the Bureau of Survey and Certification will provide a copy of the POC to CMS mailbox; OSOG_TransplantTeam.cms.hhs.gov and the Bureau of Survey and Certification will refer the provider to 488.61(f) for the list of information that should be submitted for the mitigating factors application. Mitigating Factors Application Checklist
- All information necessary for consideration of mitigating factors must be received within 120 calendar days of receipt of the formal written notification of noncompliance at 482.80 or 482.82.