I 

114TH CONGRESS 

2D SESSION H. R. 5344 

To clarify that pilot programs that honor and reward organ donation are 

not preempted by Federal criminal law and that offering and accepting 

such benefits in accordance with a pilot program are not criminal acts. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 26, 2016 

Mr. CARTWRIGHT (for himself, Mr. GRIJALVA, Mr. HONDA, Ms. EDDIE BERNICE JOHNSON of Texas, Mr. POLIS, Mr. RANGEL, Mr. YOUNG of Alaska, 

Mr. MARINO, and Mr. POSEY) introduced the following bill; which was 

referred to the Committee on Energy and Commerce 

A BILL 

To clarify that pilot programs that honor and reward organ 

donation are not preempted by Federal criminal law and 

that offering and accepting such benefits in accordance 

with a pilot program are not criminal acts. 

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 2016’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) As of January 2016, 121,000 people await 

2 an organ transplant, with 100,000 of those people 

3 waiting for a kidney, and average wait times are ap4 proaching five years for a kidney, with twice as 

5 many people being added to waiting lists as getting 

6 a transplant. 

7 (2) Living donor kidney transplants peaked in 

8 2006 and have declined since due to a scarcity of liv9 ing donors. 

10 (3) Of the roughly two million Americans who 

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

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

13 major organs healthy enough for transplanting. 

14 (4) On average, 22 people a day died while 

15 waiting for an organ, with the majority of those peo16 ple waiting on a kidney. 

17 (5) In 2013 nearly 3,000 people were perma18 nently removed from kidney waiting lists and 2,000 

19 from liver, heart, and lungs waiting lists because 

20 they became permanently too sick to receive a trans21 plant. 

22 (6) 90% of dialysis patients are not employed 

23 because dialysis requires multiple treatments per 

24 week which last several hours and leave patients 

25 drained, thus creating a huge financial burden on 


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1 the patients, their families, and the government 

2 which is not included in the cost estimates above. 

3 (7) A patient receiving a kidney transplant on 

4 average has an additional 10–15 years of life at a 

5 much more enjoyable and productive level as com6 pared with remaining on dialysis, while receiving a 

7 kidney from a living donor providing 4–8 years of 

8 additional life as compared to receiving a kidney 

9 from a deceased donor. 

10 (8) As medical advances extend people’s lives as 

11 they wait for an organ transplant, waiting lists will 

12 get longer and the costs for individuals and the Fed13 eral Government will increase significantly. 

14 (9) Roughly seven percent of the Medicare 

15 budget goes to the End Stage Renal Disease Pro16 gram, with dialysis costing Medicare over $87,000 

17 per patient per year, as Federal law dictates that 

18 Medicare will cover dialysis for everyone who has 

19 made minimal Social Security tax payments. 

20 (10) A kidney transplant pays for itself in less 

21 than two years, with each transplant saving an aver22 age of over $745,000 in medical costs over a 10-year 

23 period, 75 percent of which is savings to the tax24 payers. 


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1 (11) Experts project that if the supply of trans2 plant kidneys could be increased to meet the de3 mand, taxpayers would save more than 

4 $5,500,000,000 per year in medical costs. 

5 (12) The World Health Organization estimates 

6 that 10 percent of all transplants take place on the 

7 international black market, the last choice for des8 perate patients facing an alternative of death, how9 ever recipients often face infected kidneys and have 

10 poor health outcomes and donors are often victim11 ized. 

12 (13) Present policy on domestic donation, which 

13 is not evidence based and has never been subject to 

14 studies or pilots to determine effectiveness in in15 creasing the availability of donated organs and the 

16 effectiveness of safeguards that prevent coercion or 

17 exploitation, precludes all but altruistic donation, 

18 prohibiting any form of incentive or benefit for do19 nors. 

20 (14) Experts are arriving at a consensus that 

21 trials are necessary to find new methods of pro22 moting additional organ donation which will save 

23 lives and reduce organ trafficking. 


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1 SEC. 3. CLARIFICATION OF CERTAIN PROVISIONS OF THE 

2 NATIONAL ORGAN TRANSPLANT ACT. 

3 (a) RELATION TO OTHER LAWS.— 

4 (1) GOVERNMENTS ENCOURAGING ORGAN DO5 NATION.—Section 301 of the National Organ Trans6 plant Act (42 U.S.C. 274e) shall not— 

7 (A) apply to actions taken by the Govern8 ment of the United States or any State, terri9 tory, tribe, or local government of the United 

10 States to carry out a covered pilot program; or 

11 (B) prohibit acceptance of any noncash 

12 benefits provided by the pilot program under 

13 subparagraph (A). 

14 (2) NO PROHIBITION ON OTHER BENEFITS PRO15 GRAMS.—Nothing in this section shall be construed 

16 to prohibit actions, other than actions described in 

17 this section, taken by any State, territory, tribe, or 

18 unit of local government in the United States to pro19 vide benefits for organ donation, including pursuant 

20 to section 301 of the National Organ Transplant Act 

21 (42 U.S.C. 274e). 

22 (3) CLARIFICATION OF MEANING OF BEN23 EFIT.—For purposes of the National Organ Trans24 plant Act, valuable consideration does not include 

25 the following: 


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1 (A) Reimbursement for travel, lodging, 

2 food during travel, and other expenses related 

3 to donation. 

4 (B) Provision of or reimbursement for de5 pendent care needs related to donation. 

6 (C) Reimbursement for lost wages related 

7 to donation. 

8 (D) Medical expenses related to donation 

9 and all related follow up care including prevent10 ative follow up care and medication. 

11 (E) Paperwork or legal costs related to do12 nation. 

13 (F) Any insurance policy against the risk 

14 of death or disability as a result of donating an 

15 organ or the longer-term health effects of hav16 ing donated an organ. 

17 (b) DEFINITION.—In this section: 

18 (1) The term ‘‘organ’’ means the human kid19 ney, liver, heart, lung, pancreas, bone marrow ob20 tained by aspirate, cornea, eye, bone and other mus21 culoskeletal tissue, skin, and heart valves and other 

22 cardio and vascular tissue. 

23 (2) The term ‘‘covered pilot program’’ means a 

24 pilot program approved by the Secretary of Health 

25 and Human Services, subject to an ethical review 


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1 board process, with a term of not more than 5 fiscal 

2 years, for the purpose of measuring the effect of re3 moving disincentives or providing a noncash benefit 

4 that may increase the organ pool. Distributions of 

5 organs from deceased donors under the pilot pro6 gram shall be conducted only through the Organ 

7 Procurement and Transplantation Network at a 

8 transplant center approved by the United Network 

9 for Organ Sharing or any other entity designated by 

10 the Secretary of Health and Human Services. 

Æ 


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