```

[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10282 Introduced in House (IH)]

<DOC>

118th CONGRESS
  2d Session
                               H. R. 10282

To amend the Public Health Service Act with respect to the Living Organ 
                    Donation Reimbursement Program.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            December 4, 2024

Ms. DelBene (for herself, Mr. Bucshon, Ms. Schrier, Mrs. Miller of West 
    Virginia, Mr. Nadler, and Ms. Kelly of Illinois) introduced the 
   following bill; which was referred to the Committee on Energy and 
  Commerce, and in addition to the Committee on Ways and Means, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL

 
To amend the Public Health Service Act with respect to the Living Organ 
                    Donation Reimbursement Program.

    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 ``Expanding Support for Living Donors 
Act of 2024''.

SEC. 2. NO CONSIDERATION OF INCOME OF ORGAN RECIPIENT.

    Section 377 of the Public Health Service Act (42 U.S.C. 274f) is 
amended--
            (1) by redesignating subsections (c), (d), (e), and (f) as 
        subsections (d), (e), (i), and (j), respectively;
            (2) by inserting after subsection (b) the following:
    ``(c) No Consideration of Income of Organ Recipient.--The recipient 
of a grant under this section, in providing reimbursement to a donating 
individual through such grant, shall not give any consideration to the 
income of the organ recipient.''; and
            (3) in subsection (i), as so redesignated--
                    (A) in paragraph (1), by striking ``subsection 
                (c)(1)'' and inserting ``subsection (d)(1)''; and
                    (B) in paragraph (2), by striking ``subsection 
                (c)(2)'' and inserting ``subsection (d)(2)''.

SEC. 3. REMOVAL OF EXPECTATION OF PAYMENTS BY ORGAN RECIPIENTS.

    Section 377(e) of the Public Health Service Act (42 U.S.C. 
274f(e)), as redesignated by section 2, is amended--
            (1) in paragraph (1), by adding ``or'' at the end;
            (2) in paragraph (2), by striking ``; or'' and inserting a 
        period; and
            (3) by striking paragraph (3).

SEC. 4. ENSURING ELIGIBILITY OF DONATING INDIVIDUALS WHOSE HOUSEHOLD 
              INCOME IS AT OR BELOW 700 PERCENT OF THE POVERTY LINE.

    Section 377 of the Public Health Service Act (42 U.S.C. 274f), as 
amended by section 2, is further amended by inserting after subsection 
(e) the following:
    ``(f) Eligibility of Donating Individuals Based on Household 
Income.--
            ``(1) In general.--In providing reimbursement to donating 
        individuals using funds from grant awards under this section, 
        the recipient of the grant award shall not limit the 
        eligibility of a donating individual for such reimbursement 
        based on the individual's income if the individual's household 
        income is at or below 700 percent of the poverty line.
            ``(2) Definition.--In this section, the term `poverty line' 
        means the applicable poverty line as set forth in the most 
        recent poverty guidelines of the Department of Health and Human 
        Services published under the authority of section 673(2) of the 
        Community Services Block Grant Act.''.

SEC. 5. MAXIMUM AMOUNT OF REIMBURSEMENT.

    Section 377 of the Public Health Service Act (42 U.S.C. 274f), as 
amended by section 4, is further amended by inserting after subsection 
(f) the following:
    ``(g) Reimbursement Amount.--
            ``(1) In general.--The amount of reimbursement of 
        qualifying expenses provided by a recipient of a grant award 
        under this section to each such donating individual shall be 
        the lesser of--
                    ``(A) the total amount of the donating individual's 
                qualifying expenses; and
                    ``(B) the maximum permissible amount described in 
                paragraph (2).
            ``(2) Maximum permissible amount.--
                    ``(A) Rule.--Subject to subparagraph (B), the 
                maximum permissible amount described in this section 
                is--
                            ``(i) for fiscal year 2026, $10,000; and
                            ``(ii) for subsequent fiscal years, the 
                        maximum permissible amount allowed under this 
                        subsection for the preceding fiscal year 
                        adjusted by the total percentage change 
                        (rounded to the nearest hundredth) that 
                        occurred in the Consumer Price Index for all 
                        urban consumers (all items; United States city 
                        average) for the preceding fiscal year.
                    ``(B) Exception for recipients based on 
                insufficient funds.--The Secretary may, with respect to 
                reimbursement provided by a recipient of a grant award 
                under this section to donating individuals, lower the 
                maximum permissible amount under subparagraph (A) for a 
                fiscal year if the Secretary--
                            ``(i) determines that such recipient has 
                        insufficient funds to provide the full amount 
                        that would otherwise apply under paragraph (1) 
                        to all donating individuals; and
                            ``(ii) at least 30 days before making such 
                        determination effective, provides to the 
                        Congress written notice of such determination, 
                        including a justification.
                    ``(C) Special rules.--If the Secretary, with 
                respect to reimbursement provided by a recipient of a 
                grant award under this section to donating individuals, 
                makes a determination under subparagraph (B) to lower 
                the maximum permissible amount under subparagraph (A) 
                for a fiscal year--
                            ``(i) such determination shall not affect 
                        the amount of reimbursement for any approved 
                        donating individual prior to the effective date 
                        of such determination; and
                            ``(ii) the maximum permissible amount under 
                        subparagraph (A)(ii) for any subsequent year 
                        shall be calculated without regard to such 
                        lowered amount.''.

SEC. 6. ANNUAL REPORT.

    Section 377 of the Public Health Service Act (42 U.S.C. 274f), as 
amended by section 5, is amended by inserting after subsection (g) the 
following:
    ``(h) Annual Report.--Not later than the end of fiscal year 2025 
and annually thereafter, the Secretary--
            ``(1) shall submit to the Congress, and make publicly 
        available, a report on the impacts, ongoing activities, 
        challenges, and future needs of the program under this section;
            ``(2) shall include in each such report, for the year 
        covered by the report--
                    ``(A) an overview of the program under this 
                section;
                    ``(B) current and trended historical information 
                about the program under this section, including--
                            ``(i) the total number of donating 
                        individuals applying for reimbursement;
                            ``(ii) the average and median reimbursement 
                        amount provided to donating individuals;
                            ``(iii) demographic information regarding--
                                    ``(I) donating individuals applying 
                                for reimbursement; and
                                    ``(II) donating individuals 
                                approved for reimbursement;
                            ``(iv) the types of expenses for which 
                        reimbursement was requested (including requests 
                        for reimbursement of non-qualifying expenses);
                            ``(v) the amount of funding provided to 
                        donating individuals with respect to each such 
                        type of expenses;
                            ``(vi) the amount of funding provided to 
                        donating individuals with respect to each organ 
                        category;
                            ``(vii) the total amount expended to carry 
                        out this section, disaggregated by--
                                    ``(I) the amount expended by the 
                                Secretary and the recipients of grants 
                                under this section on administrative 
                                expenses; and
                                    ``(II) the amount provided to 
                                donating individuals as reimbursement;
                    ``(C) the impacts of the program under this 
                section, including--
                            ``(i) the number of completed donations for 
                        which reimbursement was provided;
                            ``(ii) the proportion of living donor 
                        transplants in the United States in which the 
                        donor received reimbursement through the 
                        program under this section;
                            ``(iii) an estimate of the savings to the 
                        Medicare program under title XVIII of the 
                        Social Security Act resulting from the program 
                        under this section, both--
                                    ``(I) for the year covered by the 
                                report; and
                                    ``(II) cumulatively since the 
                                program's creation;
                    ``(D) the types of donations made by donating 
                individuals receiving reimbursement, disaggregated 
                according to--
                            ``(i) the type of organ donated; and
                            ``(ii) whether the donations were directed, 
                        non-directed, or a paired exchange;
                    ``(E) a description of any efforts to expand or 
                improve the program under this section;
                    ``(F) a description of the efforts of the Secretary 
                and recipients of grants under this section to increase 
                awareness of the program under this section;
                    ``(G) a description of challenges experienced by 
                the program under this section, including--
                            ``(i) the number and percentage of donating 
                        individuals applying for reimbursement whose 
                        qualifying expenses approached or exceeded the 
                        maximum amount allowed under subsection (g); 
                        and
                            ``(ii) an estimate of the total funding 
                        needed to fully reimburse, without regard to 
                        the maximum amount allowed under subsection (g) 
                        or donor income eligibility caps, all donating 
                        individuals in the United States for all 
                        qualifying expenses; and
                    ``(H) areas of concern regarding, and identified 
                barriers to, the elimination of financial disincentives 
                to living organ donation; and
            ``(3) in addition to the matters listed in paragraph (2), 
        may include other such other matters as may be specified by the 
        Secretary.''.

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

    Subsection (j) of section 377 of the Public Health Service Act (42 
U.S.C. 274f), as redesignated by section 2, is amended by striking ``is 
authorized to be appropriated $5,000,000 for each of the fiscal years 
2005 through 2009'' and inserting ``are authorized to be appropriated 
such sums as may be necessary for fiscal years 2026 through 2035''.

SEC. 8. GAO STUDY.

    Not later than 1 year after the date of enactment of this Act, the 
Comptroller General of the United States shall--
            (1) conduct a study on how the Medicare program under title 
        XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
        could, under existing statutory authorities, pay costs that 
        would otherwise be paid through the Living Organ Donation 
        Reimbursement Program under section 377 of the Public Health 
        Service Act (42 U.S.C. 274f); and
            (2) submit to the Congress a report on the results of such 
        study, including recommendations for any changes needed to 
        achieve such purpose.
                                 <all>
```