Dive Brief:
- Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., sent letters to HHS officials last week demanding the CMS and the Health Resources and Services Administration look into the growing problem of “line skipping” in organ donation, after media reports suggested patients were being passed over in the organ donation process in favor of less sick recipients.
- Reports from The New York Times, cited by the senators, found line skipping occurred in nearly 20% of transplants from deceased donors last year. For comparison, patients received out of order organ donations in about 2% of such donations in 2016, the letter said.
- The senators have charged the CMS and HRSA, which oversee organ procurement organizations, with explaining their process for monitoring organ distribution, and asked officials to provide transparency into any complaints the agencies might have received about line skipping since 2019.
Dive Insight:
Citing the Times’ reporting, the senators said some organ procurement organizations of bypassing patients who have been waiting to receive organs at times for years in order to reduce their work burden, boost profits or elevate their performance measures.
The letters say this occurred “without any apparent rebuke from CMS’s former leadership.”
In what they call a “particularly egregious example,” a Texas-based organ procurement organization, LifeGift, allegedly skipped over a 15-year-old patient who had been waiting to receive a transplant for nearly his entire life rather than transport the necessary organ across state lines.
“Marcus’s case is not an exception to the rule, but an example of an issue that has steadily increased in prevalence,” the senators wrote. “Continued reports of unethical behavior within the organ donation system will undermine the willingness of Americans to give others the gift of life. Strengthening public trust in our nation’s organ donation system is a matter of life and death.”
Lawmakers have previously raised concerns about the organ donation process for long wait times, conflicts of interest, as well as organ procurement organizations using reporting loopholes to inflate their performance metrics.
One of the major problems contributing to some of these problems was a lack of competition for contracts for organ procurement, according to Grassley.
While the organ donation system is overseen by the Organ Procurement and Transplantation Network, only one entity has held the contract to manage OPTN until recently: the United Network for Organ Sharing. Senators alleged it was a monopoly and in 2023 Congress passed legislation to open up the organ donation process to competitive bidding. The law also gave HRSA additional oversight into the system.
Clarification: This story has been updated to clarify the management of the organ donation system.
