IB 
Union Calendar No. 422 
118TH CONGRESS 
2D SESSION 
H. R. 2706 
[Report No. 118–507] 
To prohibit discrimination on the basis of mental or physical disability in 
cases of organ transplants. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 19, 2023 
Mrs. CAMMACK (for herself, Mrs. DINGELL, Mr. SESSIONS, Ms. WASSERMAN 
SCHULTZ, and Mr. ISSA) introduced the following bill; which was referred 
to the Committee on Energy and Commerce 
MAY 14, 2024 
Additional sponsors: Mrs. BICE, Mr. FITZPATRICK, Mr. GARBARINO, Ms. 
KUSTER, Mr. MOULTON, Ms. BLUNT ROCHESTER, Mr. DAVIS of North 
Carolina, Ms. NORTON, Ms. CRAIG, Mr. RUTHERFORD, Mr. TONKO, Ms. 
PEREZ, Mr. COHEN, Ms. SHERRILL, Mr. STAUBER, Mr. CROW, Mrs. 
MILLER-MEEKS, Mr. MEUSER, Mr. HARDER of California, Mr. STEUBE, 
Ms. TENNEY, Ms. SLOTKIN, Mr. BACON, Mr. DUNN of Florida, Mr. 
DESAULNIER, Ms. BARRAGA´N, Mrs. HINSON, Mr. MOOLENAAR, Mr. 
ARMSTRONG, Mr. GROTHMAN, Mr. TRONE, Ms. BUSH, Mr. GOTTHEIMER, 
Ms. JAYAPAL, Ms. WILD, Mr. AMO, Ms. MOORE of Wisconsin, Mr. 
ALLRED, and Mrs. MILLER of Illinois 
MAY 14, 2024 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on April 19, 2023] 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6652
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
A BILL 
To prohibit discrimination on the basis of mental or physical 
disability in cases of organ transplants. 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6652
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Charlotte Woodward 
Organ Transplant Discrimination Prevention Act’’. 
SEC. 2. DEFINITIONS. 
In this Act: 
(1) AUXILIARY AIDS AND SERVICES.—The term 
‘‘auxiliary aids and services’’ has the meaning given 
the term in section 4 of the Americans with Disabil-
ities Act of 1990 (42 U.S.C. 12103). 
(2) COVERED ENTITY.—The term ‘‘covered enti-
ty’’ means any licensed provider of health care serv-
ices (including licensed health care practitioners, hos-
pitals, nursing facilities, laboratories, intermediate 
care facilities, psychiatric residential treatment facili-
ties, institutions for individuals with intellectual or 
developmental disabilities, and prison health centers), 
and any transplant hospital (as defined in section 
121.2 of title 42, Code of Federal Regulations or a 
successor regulation), that— 
(A) is in interstate commerce; or 
(B) provides health care services in a man-
ner that— 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(i) substantially affects or has a sub-
stantial relation to interstate commerce; or 
(ii) includes use of an instrument (in-
cluding an instrument of transportation or 
communication) of interstate commerce. 
(3) DISABILITY.—The term ‘‘disability’’ has the 
meaning given the term in section 3 of the Americans 
with Disabilities Act of 1990 (42 U.S.C. 12102). 
(4) HUMAN ORGAN.—The term ‘‘human organ’’ 
has the meaning given the term in section 301(c) of 
the National Organ Transplant Act (42 U.S.C. 
274e(c)). 
(5) ORGAN
TRANSPLANT.—The term ‘‘organ 
transplant’’ means the transplantation or transfusion 
of a donated human organ into the body of another 
human for the purpose of treating a medical condi-
tion. 
(6) QUALIFIED INDIVIDUAL.—The term ‘‘quali-
fied individual’’ means an individual who, with or 
without a support network, provision of auxiliary 
aids and services, or reasonable modifications to poli-
cies or practices, meets eligibility requirements for the 
receipt of a human organ. 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(7) REASONABLE
MODIFICATIONS
TO
POLICIES 
OR PRACTICES.—The term ‘‘reasonable modifications 
to policies or practices’’ includes— 
(A) communication with persons responsible 
for supporting a qualified individual with post-
surgical or other care following an organ trans-
plant or related services, including support with 
medication; 
(B) consideration, in determining whether a 
qualified individual will be able to comply with 
health requirements following an organ trans-
plant or receipt of related services, of support 
networks available to the qualified individual, 
including family, friends, and providers of home 
and community-based services, including home 
and community-based services funded through 
the Medicare or Medicaid program under title 
XVIII or XIX, respectively, of the Social Secu-
rity Act (42 U.S.C. 1395 et seq., 1396 et seq.), 
another health plan in which the qualified indi-
vidual is enrolled, or any program or source of 
funding available to the qualified individual; 
and 
(C) the use of supported decision-making, 
when needed, by a qualified individual. 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(8) RELATED
SERVICES.—The term ‘‘related 
services’’ means services related to an organ trans-
plant that consist of— 
(A) evaluation; 
(B) counseling; 
(C) 
treatment, 
including 
postoperative 
treatment, and care; 
(D) provision of information; and 
(E) any other service recommended or re-
quired by a physician. 
(9) SUPPORTED
DECISION-MAKING.—The term 
‘‘supported decision-making’’ means the use of a sup-
port person to assist a qualified individual in making 
health care decisions, communicate information to the 
qualified individual, or ascertain a qualified individ-
ual’s wishes. Such term includes— 
(A) the inclusion of the individual’s attor-
ney-in-fact or health care proxy, or any person 
of the individual’s choice, in communications 
about the individual’s health care; 
(B) permitting the individual to designate a 
person of the individual’s choice for the purposes 
of supporting that individual in communicating, 
processing information, or making health care 
decisions; 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(C) providing auxiliary aids and services to 
facilitate the individual’s ability to communicate 
and process health-related information, including 
providing use of assistive communication tech-
nology; 
(D) providing health information to persons 
designated by the individual, consistent with the 
regulations promulgated under section 264(c) of 
the Health Insurance Portability and Account-
ability Act of 1996 (42 U.S.C. 1320d–2 note) 
and other applicable laws and regulations gov-
erning disclosure of health information; 
(E) providing health information in a for-
mat that is readily understandable by the indi-
vidual; and 
(F) working with a court-appointed guard-
ian or other person responsible for making health 
care decisions on behalf of the individual, to en-
sure that the individual is included in decisions 
involving the health care of the individual and 
that health care decisions are in accordance with 
the individual’s own expressed interests. 
(10) SUPPORT
NETWORK.—The term ‘‘support 
network’’ means, with respect to a qualified indi-
vidual, one or more people who are— 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(A) selected by the qualified individual or 
by the qualified individual and the guardian of 
the qualified individual, to provide assistance to 
the qualified individual or guidance to that 
qualified individual in understanding issues, 
making plans for the future, or making complex 
decisions; and 
(B) who may include the family members, 
friends, unpaid supporters, members of the reli-
gious congregation, and appropriate personnel at 
a community center, of or serving the qualified 
individual. 
SEC. 3. PROHIBITION OF DISCRIMINATORY POLICY. 
The 
board 
of 
directors 
described 
in 
section 
372(b)(1)(B) of the Public Health Service Act (42 U.S.C. 
274(b)(1)(B)) shall not issue policies, recommendations, or 
other memoranda that would prohibit, or otherwise hinder, 
a qualified individual’s access to an organ transplant solely 
on the basis of that individual’s disability. 
SEC. 4. PROHIBITION OF DISCRIMINATION. 
(a) IN GENERAL.—Subject to subsection (b), a covered 
entity may not, solely on the basis of a qualified individ-
ual’s disability— 
(1) determine that the individual is ineligible to 
receive an organ transplant or related services; 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
(2) deny the individual an organ transplant or 
related services; 
(3) refuse to refer the individual to an organ 
transplant center or other related specialist for the 
purpose of receipt of an organ transplant or other re-
lated services; or 
(4) refuse to place the individual on an organ 
transplant waiting list. 
(b) EXCEPTION.— 
(1) IN GENERAL.— 
(A) 
MEDICALLY
SIGNIFICANT
DISABIL-
ITIES.—Notwithstanding subsection (a), a cov-
ered entity may take a qualified individual’s 
disability into account when making a health 
care treatment or coverage recommendation or 
decision, solely to the extent that the disability 
has been found by a physician, following an in-
dividualized evaluation of the potential recipi-
ent, to be medically significant to the receipt of 
the organ transplant or related services, as the 
case may be. 
(B) 
CONSTRUCTION.—Subparagraph 
(A) 
shall not be construed to require a referral or 
recommendation for, or the performance of, a 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
medically inappropriate organ transplant or 
medically inappropriate related services. 
(2) CLARIFICATION.—If a qualified individual 
has the necessary support network to provide a rea-
sonable assurance that the qualified individual will be 
able to comply with health requirements following an 
organ transplant or receipt of related services, as the 
case may be, the qualified individual’s inability to 
independently comply with those requirements may 
not be construed to be medically significant for pur-
poses of paragraph (1). 
(c) REASONABLE MODIFICATIONS.—A covered entity 
shall make reasonable modifications to policies or practices 
(including procedures) of such entity if such modifications 
are necessary to make an organ transplant or related serv-
ices available to qualified individuals with disabilities, un-
less the entity can demonstrate that making such modifica-
tions would fundamentally alter the nature of such policies 
or practices. 
(d) CLARIFICATIONS.— 
(1) NO DENIAL OF SERVICES BECAUSE OF AB-
SENCE OF AUXILIARY AIDS AND SERVICES.—For pur-
poses of this section, a covered entity shall take such 
steps as may be necessary to ensure that a qualified 
individual with a disability is not denied a procedure 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB
associated with the receipt of an organ transplant or 
related services, because of the absence of auxiliary 
aids and services, unless the covered entity can dem-
onstrate that taking such steps would fundamentally 
alter the nature of the procedure being offered or 
would result in an undue burden on the entity. 
(2) COMPLIANCE WITH OTHER LAW.—Nothing in 
this section shall be construed— 
(A) to prevent a covered entity from pro-
viding organ transplants or related services at a 
level that is greater than the level that is re-
quired by this section; or 
(B) to limit the rights of an individual with 
a disability under, or to replace or limit the 
scope of obligations imposed by, the Americans 
with Disabilities Act of 1990 (42 U.S.C. 12101 
et seq.) including the provisions added to such 
Act by the ADA Amendments Act of 2008, sec-
tion 504 of the Rehabilitation Act of 1973 (29 
U.S.C. 794), section 1557 of the Patient Protec-
tion and Affordable Care Act (42 U.S.C. 18116), 
or any other applicable law. 
(e) ENFORCEMENT.— 
(1) IN GENERAL.—Any individual who alleges 
that a qualified individual was subject to a violation 
VerDate Sep 11 2014 
01:33 May 15, 2024
Jkt 049200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6203
E:\BILLS\H2706.RH
H2706
kjohnson on DSK7ZCZBW3PROD with $$_JOB