Organ Donation Clarification Act of 2018
This bill specifies that certain payments and pilot programs relating to organ donation do not violate the National Organ Transplant Act, which prohibits the exchange of valuable consideration for human organs.
[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6448 Introduced in House (IH)]
<DOC>
115th CONGRESS
2d Session
H. R. 6448
To amend the National Organ Transplant Act to clarify the definition of
valuable consideration, to clarify that pilot programs that honor and
reward organ donation do not violate that Act, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 19, 2018
Mr. Cartwright (for himself, Mr. Lewis of Minnesota, Mr. Cohen, Mr.
Grijalva, Ms. Jenkins of Kansas, Ms. Eddie Bernice Johnson of Texas,
Mr. Khanna, Mr. Marino, Mr. Polis, Mr. Young of Alaska, Mr. Bishop of
Georgia, Mr. Fitzpatrick, Mr. Posey, Mr. Kelly of Pennsylvania, Mr.
McGovern, and Mr. Carson of Indiana) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the National Organ Transplant Act to clarify the definition of
valuable consideration, to clarify that pilot programs that honor and
reward organ donation do not violate that Act, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Organ Donation Clarification Act of
2018''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) As of June 2018, 115,000 people await an organ
transplant, with 95,000 of those people waiting for a kidney,
and average wait times are approaching five years for a kidney,
with twice as many people being added to waiting lists as
getting a transplant.
(2) Living donor kidney transplants peaked in 2004 and have
declined since due to a scarcity of living donors.
(3) Of the roughly two million Americans who die annually,
only 10,500 to 13,800, representing less than one percent of
all deaths each year, possess major organs healthy enough for
transplanting.
(4) On average, 20 people a day died while waiting for an
organ in 2017, with the majority of those people waiting for a
kidney.
(5) In 2017, 4,700 people were permanently removed from
kidney waiting lists and 1,800 from liver, heart, and lungs
waiting lists because they became permanently too sick to
receive a transplant.
(6) Ninety percent of dialysis patients are not employed
because dialysis requires multiple treatments per week which
last several hours and leave patients drained, thus creating a
huge financial burden on the patients, their families, and the
government which is not included in the cost estimates above,
and which can help lead to as few as ten percent of dialysis
patients being employed.
(7) A patient receiving a kidney transplant on average can
go 10-15 years living without dialysis while enjoying a much
higher quality of life.
(8) As medical advances extend people's lives on dialysis,
the number of patients on dialysis will increase significantly,
as will the costs for individuals and the Federal Government.
(9) Roughly seven percent of the Medicare budget goes to
the End Stage Renal Disease Program, with dialysis costing
Medicare over $87,000 per patient per year, as Federal law
dictates that Medicare will cover dialysis for everyone who has
made minimal Social Security tax payments.
(10) A kidney transplant pays for itself in less than two
years, with each transplant saving an average of over $700,000
in medical costs over a 10-year period, 85 percent of which is
savings to the taxpayers.
(11) Experts project that if the supply of transplant
kidneys could be increased to meet the demand, taxpayers would
save more than $12,000,000,000 per year in medical costs.
(12) The World Health Organization estimates that 10
percent of all transplants take place on the international
black market, the last choice for desperate patients facing an
alternative of death, however recipients often face infected
kidneys and have poor health outcomes and donors are often
victimized.
(13) Present policy on domestic donation, which is not
evidence based and has never been subject to studies or pilots
to determine effectiveness in increasing the availability of
donated organs and the effectiveness of safeguards that prevent
coercion or exploitation, precludes all but altruistic
donation, prohibiting any form of incentive or benefit for
donors.
(14) Experts are arriving at a consensus that trials are
necessary to find new methods of promoting additional organ
donation which will save lives and reduce organ trafficking.
SEC. 3. CLARIFICATION OF CERTAIN PROVISIONS OF THE NATIONAL ORGAN
TRANSPLANT ACT.
(a) Relation to Other Laws.--Section 301 of the National Organ
Transplant Act (42 U.S.C. 274e) is amended by adding at the end the
following:
``(d) Relation to Other Laws.--
``(1) Governments encouraging organ donation.--This section
shall not--
``(A) apply to actions taken by the Government of
the United States or any State, territory, tribe, or
local government of the United States to carry out a
covered pilot program; or
``(B) prohibit acceptance of any noncash benefits
provided by the pilot program under subparagraph (A).
``(2) No prohibition on other benefits programs.--Nothing
in this subsection shall be construed to prohibit actions,
other than actions described in this section, taken by any
State, territory, tribe, or unit of local government in the
United States to provide benefits for human organ donation.
``(3) Covered pilot program.--For purposes of this
subsection, the term `covered pilot program' means a pilot
program approved by the Secretary of Health and Human Services,
subject to an ethical review board process, with a term of not
more than 5 fiscal years, for the purpose of measuring the
effect of removing disincentives or providing a noncash benefit
that may increase the organ pool. Distributions of organs from
deceased donors under the pilot program shall be conducted only
through the Organ Procurement and Transplantation Network at a
transplant center approved by the United Network for Organ
Sharing or any other entity designated by the Secretary of
Health and Human Services.''.
(b) Valuable Consideration.--Section 301(c)(2) of the National
Organ Transplant Act (42 U.S.C. 274e(c)(2)) is amended to read as
follows:
``(2) The term `valuable consideration' does not include
the following:
``(A) Reasonable payments associated with the
removal, transportation, implantation, processing,
preservation, quality control, and storage of a human
organ.
``(B) Reimbursement for travel, lodging, food
during travel, and other logistical expenses related to
donation.
``(C) Provision of advanced payments or
reimbursement for dependent care needs for pre-
transplant appointments in addition to during the
period of donation and post-transplant follow up care
related to the donation for up to a 10-year period.
``(D) Reimbursement for lost wages related to
donation.
``(E) Medical expenses related to donation and all
related follow-up care including preventative follow-up
care and medication for up to a 10-year period.
``(F) Paperwork or legal costs related to donation.
``(G) Any term life insurance policy against the
risk of death or disability as a result of donating an
organ or the longer term health effects of having
donated an organ, that--
``(i) in the case of a life insurance
policy, provides for payments in amounts
greater than $2,000,000, adjusted annually for
inflation; and
``(ii) in the case of a disability
insurance policy, provides for payments beyond
the reasonable earnings expectations of the
donor.''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
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