I 

116TH CONGRESS 

2D SESSION H. R. 7900 

To amend the National Organ Transplant Act to clarify the definition of 

valuable consideration, to clarify that pilot programs that honor and 

promote organ donation do not violate that Act, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 31, 2020 

Mr. CARTWRIGHT 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 promote organ donation 

do not violate that Act, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Organ Donation Clari5 fication Act of 2020’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


kjohnson on DSK79L0C42PROD with BILLS
2 

•HR 7900 IH

1 (1) As of June 2020, 111,000 people await an 

2 organ transplant, with 93,000 of those people wait3 ing for a kidney, and average wait times are ap4 proaching five years for a kidney, with nearly twice 

5 as many people being added to the waiting lists as 

6 getting a transplant. 

7 (2) Of the roughly two million Americans who 

8 die annually, only 10,500 to 13,800, representing 

9 less than one percent of all deaths each year, possess 

10 major organs healthy enough for transplanting. 

11 (3) On average, 22 people a day died while 

12 waiting for an organ in 2019, with the majority of 

13 those people waiting for a kidney. 

14 (4) In 2019, approximately 4,200 people were 

15 removed from kidney waiting lists and approximately 

16 1,700 from liver, heart, and lungs waiting lists be17 cause they became permanently too sick to receive a 

18 transplant. 

19 (5) Ninety percent of dialysis patients are not 

20 employed because dialysis requires multiple treat21 ments per week which last several hours and leave 

22 patients drained, thus creating a huge financial bur23 den on the patients, their families, and the govern24 ment; moreover, lost tax revenue from these individ25 uals is not included in the cost estimates above, and 


kjohnson on DSK79L0C42PROD with BILLS
3 

•HR 7900 IH

1 which can help lead to as few as 10 percent of dialy2 sis patients being employed. 

3 (6) A patient receiving a kidney transplant, and 

4 thus no longer needing dialysis, can enjoy a much 

5 higher quality of life for another 10–15 years on av6 erage. 

7 (7) As medical advances extend people’s lives on 

8 dialysis, the number of patients on dialysis will in9 crease significantly, as will the costs for individuals 

10 and the Federal Government. 

11 (8) Roughly seven percent of the Medicare 

12 budget goes to the End Stage Renal Disease Pro13 gram, with dialysis costing Medicare over $90,000 

14 per patient per year, as Federal law dictates that 

15 Medicare will cover dialysis for everyone who has 

16 made minimal Social Security tax payments. 

17 (9) A kidney transplant pays for itself in less 

18 than two years, with each transplant saving an aver19 age of over $700,000 in medical costs over a 10-year 

20 period, 85 percent of which is savings to the tax21 payers. 

22 (10) Experts project that if the supply of trans23 plant kidneys could be increased to meet the de24 mand, taxpayers would save more than 

25 $12,000,000,000 per year in medical costs. 


kjohnson on DSK79L0C42PROD with BILLS
4 

•HR 7900 IH

1 (11) The World Health Organization estimates 

2 that 10 percent of all transplants take place on the 

3 international black market, the last choice for des4 perate patients facing an alternative of death, how5 ever recipients often receive infected kidneys and 

6 suffer poor health outcomes and donors are often 

7 victimized. 

8 (12) Present policy on domestic donation has 

9 never been subject to studies or pilots to determine 

10 effectiveness in increasing the availability of donated 

11 organs and the effectiveness of safeguards that pre12 vent coercion or exploitation, precludes all but altru13 istic donation, prohibiting any form of incentive or 

14 benefit for donors. 

15 (13) In 2010, Israel implemented sweeping 

16 changes to its national organ donation program in17 cluding reducing financial burdens on donors, giving 

18 future transplantation priority to registered organ 

19 donors and their families, and promoting donation 

20 by reimbursing the donor’s medical costs, 40 days of 

21 lost wages, and five years of medical and life insur22 ance costs, and as a result saw organ donation ap23 proximately triple over a 10-year period. 

24 (14) Experts are arriving at a consensus that 

25 trials are necessary to find new methods of proVerDate Sep 11 2014 04:13 Aug 18, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7900.IH H7900

kjohnson on DSK79L0C42PROD with BILLS
5 

•HR 7900 IH

1 moting additional organ donation which will save 

2 lives and reduce organ trafficking. 

3 SEC. 3. CLARIFICATION OF CERTAIN PROVISIONS OF THE 

4 NATIONAL ORGAN TRANSPLANT ACT. 

5 (a) RELATION TO OTHER LAWS.—Section 301 of the 

6 National Organ Transplant Act (42 U.S.C. 274e) is 

7 amended by adding at the end the following: 

8 ‘‘(d) RELATION TO OTHER LAWS.— 

9 ‘‘(1) GOVERNMENTS ENCOURAGING ORGAN DO10 NATION.—This section shall not— 

11 ‘‘(A) apply to actions taken by the Govern12 ment of the United States or any State, terri13 tory, tribe, or local government of the United 

14 States to carry out a covered pilot program; or 

15 ‘‘(B) prohibit acceptance of any noncash 

16 benefits provided by the pilot program under 

17 subparagraph (A). 

18 ‘‘(2) NO PROHIBITION ON OTHER BENEFITS

19 PROGRAMS.—Nothing in this subsection shall be con20 strued to prohibit actions, other than actions de21 scribed in this section, taken by any State, territory, 

22 tribe, or unit of local government in the United 

23 States to provide benefits for human organ donation. 

24 ‘‘(3) COVERED PILOT PROGRAM.—For purposes 

25 of this subsection— 


kjohnson on DSK79L0C42PROD with BILLS
6 

•HR 7900 IH

1 ‘‘(A) the term ‘covered pilot program’ 

2 means a pilot program approved by the Sec3 retary of Health and Human Services, subject 

4 to an ethical review board process, with a term 

5 of not more than 5 fiscal years, for the purpose 

6 of measuring the effect of removing disincen7 tives or providing a noncash benefit that may 

8 increase the organ pool. Distributions of organs 

9 from deceased donors under the pilot program 

10 shall be conducted only through the Organ Pro11 curement and Transplantation Network at a 

12 transplant center approved by the United Net13 work for Organ Sharing or any other entity 

14 designated by the Secretary of Health and 

15 Human Services; and 

16 ‘‘(B) the term ‘noncash benefit’ means any 

17 benefit or thing of value received by an organ 

18 donor that is impossible to sell, trade, or other19 wise transfer to another individual.’’. 

20 (b) VALUABLE CONSIDERATION.—Section 301(c)(2) 

21 of the National Organ Transplant Act (42 U.S.C. 

22 274e(c)(2)) is amended to read as follows: 

23 ‘‘(2) The term ‘valuable consideration’ does not 

24 include the following: 


kjohnson on DSK79L0C42PROD with BILLS
7 

•HR 7900 IH

1 ‘‘(A) Reasonable payments associated with 

2 the removal, transportation, implantation, proc3 essing, preservation, quality control, and stor4 age of a human organ. 

5 ‘‘(B) Reimbursement for travel, lodging, 

6 food during travel, and other logistical expenses 

7 related to donation. 

8 ‘‘(C) Provision of advanced payments or 

9 reimbursement for dependent care needs for 

10 pre-transplant appointments in addition to dur11 ing the period of donation and post-transplant 

12 follow-up care related to the donation for up to 

13 a 10-year period. 

14 ‘‘(D) Reimbursement for lost wages related 

15 to donation. 

16 ‘‘(E) Medical expenses related to donation 

17 and all related follow-up care including prevent18 ative follow-up care and medication for up to a 

19 10-year period. 

20 ‘‘(F) Paperwork or legal costs related to 

21 donation. 

22 ‘‘(G) Any term life insurance policy against 

23 the risk of death or disability as a result of do24 nating an organ or the longer-term health ef25 fects of having donated an organ, that— 


kjohnson on DSK79L0C42PROD with BILLS
8 

•HR 7900 IH

1 ‘‘(i) in the case of a life insurance pol2 icy, provides for payments in amounts less 

3 than $2,000,000, adjusted annually for in4 flation; and 

5 ‘‘(ii) in the case of a disability insur6 ance policy, provides for payments equal to 

7 or less than the reasonable earnings expec8 tations of the donor.’’. 

Æ 


kjohnson on DSK79L0C42PROD with BILLS