​
Long Overdue Improvements to the Accountability of the Organ Donation System are Timely, Fiscally
Responsible, Broadly Supported, and Critical to Saving Lives
​Reforming the organ donation system could lead to ​28,000​ additional lifesaving transplants and save $12B​ over 5 years to Medicare
​
-
The government monopoly contractors who run the organ donation system (Organ Procurement Organizations, OPOs) are massively underperforming according to December 2019 HHS ​proposed rule​, which found ​more than half​ of OPOs out of compliance with proposed objective standards. (See red onvmap.) ​Secretary Azar​: “​ We’re going to stop looking the other way while lives are lost and hold OPOs accountable.”
​
-
OPOs also have a documented history of ​fraud, waste and abuse​. Yet CMS has not pulled a contract in ​decades​ because the current regulation is ​unenforceable​. (See ​JAMA​.)
​
-
COVID-19​ has increased urgency for reform as patients with organ failure are particularly at risk
​​
​​
Popular issue with broad-based coalition
​
-
Politico​: Organ donation reform is “​arguably [President Trump’s] most popular public health effort, with bipartisan support for cracking down on the organ procurement organizations that are responsible for recovering organs.”
​
-
New York Times​ editorial board: ​“an astounding lack of accountability and oversight in the nation’s creaking, monopolistic organ transplant system is allowing hundreds of thousands of potential organ donations to fall through the cracks.”
​
-
Washington Post​ editorial board: ​“Much of this death and waiting is unnecessary, because the organs would be available if those responsible for collecting and transporting organs did a better job. It is past time the government demanded it of them.”
​
-
Andy Slavitt and Adam Brandon​: ​“Perhaps most upsetting is just how willing policymakers have been to tolerate [OPOs]. Despite gross underperformance, as well as this highly troubling financial impropriety, no OPO has lost a contract in decades.
​
-
Ben Jealous, former NAACP President​: ​“Astoundingly [OPOs] are also asking that the new standards not be implemented until 2026, during which time tens of thousands more patients — disproportionately people of color — would die."
​​
​​
Bipartisan Congressional support
​
-
Senate Finance Committee​, Senators Grassley, Wyden, Young, and Cardin initiated bipartisan oversight into OPOs and their oversight contractor, UNOS.
​
-
Reps. Katie Porter and Karen Bass​, Chair of the Congressional Black Caucus, urged HHS to move urgently to finalize the proposed rule.
​
-
House Appropriations Committee​: “​The Committee supports efforts to establish objective outcome measures for Organ Procurement Organizations (OPO) as well as efforts to decertify underperforming OPOs at the conclusion of the current contract cycles"
​​
​
​
To support patients, Congressional offices can urge HHS to finalize rule at the patient-centered standard from December 2019, holding OPOs accountable at the upcoming ​2022 recertification cycle​; and support ongoing Congressional oversight.