U.S. Representative Matt Cartwright, D-Pa., introduced legislation on May 26 that aims to clarify the legality of providing reimbursement to living organ donors. The Organ Donor Clarification Act of 2016 clarifies that pilot programs that provide non-cash incentives and reimbursements for expenses to organ donors are not preempted by federal criminal law.

Currently, organ transplantation is governed by the National Organ Transplant Act (NOTA) of 1984, which prohibits buying or selling organs for “valuable consideration.”

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“Confusion about what constitutes valuable consideration has hampered donation by scaring people away from reimbursing living organ donors for things like medical expenses and lost wages,” said Cartwright.  “Both are legal under NOTA, but the law’s lack of clarity and its criminal penalties have created uncertainty and prevented reimbursements in many cases.

The Organ Donor Clarification Act would clarify that certain reimbursements are not valuable consideration but are reimbursements for expenses a donor incurs, including:

  • Reimbursement for travel, lodging, food during travel, and other expenses related to donation.
  • Provision of or reimbursement for dependent care needs related to donation.
  • Reimbursement for lost wages related to donation.
  • Medical expenses related to donation and all related follow up care including preventative follow up care and medication.
  • Paperwork or legal costs related to donation.
  • Any 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.

The bill would also allow government-run pilot programs to test the effect of providing non-cash incentives to promote organ donation.  These pilot programs would have to pass ethical board scrutiny, be approved by HHS, distribute organs through the current merit based system, and last no longer than five years.

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The legislation has been endorsed by the following organizations: Americans for Tax Reform, American Foundation for Donation and Transplantation, American Medical Association, Fair Allocations in Research Foundation, Transplant Recipients International Organization, WaitList Zero.

The National Kidney Foundation issued the following statement expressing concern over language in the bill:

“The National Kidney Foundation (NKF) strongly supports removing barriers to living organ donation, and believes that all expenses related to the donation should be covered so that neither the organ donor, nor the organ recipient, bears any financial costs.While we appreciate Representative Cartwright for his efforts to increase organ donation, NKF is opposed to two provisions in The Organ Donation Clarification Act of 2016:

1. The authorization of pilot programs that, under the language in the bill, could include financial incentives or benefits for organ donation. NKF opposes financial payments that are above and beyond the reimbursement of donation-related expenses.

2. The authorization of non-cash benefits, as the bill does not define what a “non-cash benefit” is thus leaving the interpretation too open and subject to abuse.  “