Mararie / Flickr Creative Commons

The federal government is threatening to cut off Medicare funding at the renowned Dana-Farber Cancer Institute in Boston after finding the cancer hospital "was not in substantial compliance" with Medicare rules.

Most of the violations stem from Dana-Farber inappropriately relying on Brigham and Women's Hospital to handle many day-to-day functions, according to documents obtained by Axios. Dana-Farber has until June 30 to fix the problems cited by the Centers for Medicare and Medicaid Services, but that date already marks the third extension from the agency. The original deadline was November 21, 2016.

If CMS terminates its Medicare contact with Dana-Farber, the hospital would lose more than $243 million in annual Medicare funds — or about a quarter of its entire revenue.

What happened: Massachusetts officials originally surveyed Dana-Farber in August, and this process has mostly been under wraps since then. Dana-Farber has a unique structure, in that its 30-bed inpatient facility is housed within Brigham and Women's Hospital, which is located a block away. But the two not-for-profit organizations are separate, independent entities.

That's the root of the problems, according to the CMS report. Dana-Farber has relied on Brigham and Women's to handle patient complaints, inform patients about their rights, track care quality and medical errors, verify the credentials of medical staff, and provide full nursing services. Dana-Farber's "failure to provide the independent oversight...placed all potential patients at risk to receive poor quality of care," the report said.

Dana-Farber says it has submitted two "plans of correction." In a statement, it said that CMS has "been very complimentary about the actual care we provide, but nevertheless want to ensure that Dana-Farber is more clearly responsible for all of the services provided to patients in our inpatient hospital."

Why this matters: Medicare has a lot of rules and regulations, known as conditions of participation, but the federal government only threatens to pull funding if it finds egregious offenses. Academic hospitals and other renowned health care organizations like Dana-Farber hold high rankings and reputations, but they are just as capable of flouting Medicare rules, sometimes putting patient care at risk. Modern Healthcare, for example, detailed Medicare safety violations at the Cleveland Clinic in 2014.

Go deeper

Election clues county by county

Ipsos and the University of Virginia's Center for Politics are out with an interactive U.S. map that goes down to the county level to track changes in public sentiment that could decide the presidential election.

How it works: The 2020 Political Atlas tracks President Trump's approval ratings, interest around the coronavirus, what's dominating social media and other measures, with polling updated daily — enhancing UVA's "Crystal Ball."

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 3 a.m. ET: 31,605,656 — Total deaths: 970,934 Total recoveries: 21,747,491Map.
  2. U.S.: Total confirmed cases as of 3 a.m. ET: 6,897,432 — Total deaths: 200,814 — Total recoveries: 2,646,959 — Total tests: 96,612,436Map.
  3. Health: The U.S. reaches 200,000 coronavirus deaths — The CDC's crumbling reputation — America turns against coronavirus vaccine.
  4. Politics: Elected officials are failing us on much-needed stimulus.
  5. Business: Two-thirds of business leaders think pandemic will lead to permanent changes — Fed chair warns economy will feel the weight of expired stimulus.
  6. Sports: NFL fines maskless coaches.

Trump pushes to expand ban against anti-racism training to federal contractors

Trump speaking at Moon Township, Penns., on Sept. 22. Photo: Mandel Ngan/AFP via Getty Images

President Trump announced late Tuesday that the White House attempt to halt federal agencies' anti-racism training would be expanded to block federal contractors from "promoting radical ideologies that divide Americans by race or sex."

Why it matters: The executive order appears to give the government the ability to cancel contracts if anti-racist or diversity trainings focused on sexual identity or gender are organized. The memo applies to executive departments and agencies, the U.S. military, federal contractors and federal grant recipients.

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