perate patients facing an alternative of death, how-
ever recipients often receive infected kidneys and 
suffer poor health outcomes and donors are often 
victimized. 
(12) Present policy on domestic donation has 
never been subject to studies or pilots to determine 
effectiveness in increasing the availability of donated 
organs and the effectiveness of safeguards that pre-
vent coercion or exploitation, precludes all but altru-
istic donation, prohibiting any form of incentive or 
benefit for donors. 
(13) In 2010, Israel implemented sweeping 
changes to its national organ donation program in-
cluding reducing financial burdens on donors, giving 
future transplantation priority to registered organ 
donors and their families, and promoting donation 
by reimbursing the donor’s medical costs, 40 days of 
lost wages, and five years of medical and life insur-
ance costs, and as a result saw organ donation ap-
proximately triple over a 10-year period. 
(14) Experts are arriving at a consensus that 
trials are necessary to find new methods of pro-
moting additional organ donation which will save 
lives and reduce organ trafficking. 
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SEC. 3. CLARIFICATION OF CERTAIN PROVISIONS OF THE 
NATIONAL ORGAN TRANSPLANT ACT. 
(a) VALUABLE CONSIDERATION.—Section 301(c)(2) 
of the National Organ Transplant Act (42 U.S.C. 
274e(c)(2)) is amended to read as follows: 
‘‘(2) The term ‘valuable consideration’ does not 
include the following: 
‘‘(A) Reasonable payments associated with 
the removal, transportation, implantation, proc-
essing, preservation, quality control, and stor-
age of a human organ. 
‘‘(B) Advanced payments or reimburse-
ment for travel, lodging, food during travel, and 
other logistical expenses related to donation. 
‘‘(C) Advanced payments or reimburse-
ment for dependent care expenses related to do-
nation before, during, or after the donation, but 
not later than the date that is 10 years after 
the date of the donation. 
‘‘(D) Advanced payments or reimburse-
ment for lost wages related to donation. 
‘‘(E) Medical expenses related to donation 
and all related follow-up care including prevent-
ative follow-up care and medication for up to a 
10-year period. 
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‘‘(F) Paperwork or legal costs related to 
donation. 
‘‘(G) Any term life insurance policy against 
the risk of death or disability as a result of do-
nating an organ or the longer-term health ef-
fects of having donated an organ, that— 
‘‘(i) in the case of a life insurance pol-
icy, provides for payments in amounts less 
than $2,000,000, adjusted annually for in-
flation; and 
‘‘(ii) in the case of a disability insur-
ance policy, provides for payments equal to 
or less than the reasonable earnings expec-
tations of the donor.’’. 
(b) COVERED PILOT PROGRAM.—Section 301 of the 
National Organ Transplant Act (42 U.S.C. 274e) is 
amended by adding at the end the following: 
‘‘(d) COVERED
PILOT
PROGRAM
ENCOURAGING 
ORGAN DONATION.— 
‘‘(1) APPROVAL.—The Secretary may approve 
covered pilot programs for purposes of applying the 
exception in paragraph (2). 
‘‘(2) EXCEPTION TO PROHIBITION.—Subsection 
(a) does not prohibit— 
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‘‘(A) acquisition, receipt, or transfer of any 
noncash benefit provided pursuant to a covered 
pilot program; or 
‘‘(B) other actions taken to carry out a 
covered pilot program. 
‘‘(3) DEFINITIONS.—In this subsection: 
‘‘(A) The term ‘covered pilot program’ 
means a pilot program that— 
‘‘(i) is conducted by the Federal Gov-
ernment or any State, territory, Tribe, or 
local government; 
‘‘(ii) is approved by the Secretary 
under paragraph (1); 
‘‘(iii) is subject to an ethical review 
board process; 
‘‘(iv) has a term of not more than 5 
fiscal years; 
‘‘(v) is for the purpose of providing, 
or allowing the provision of, noncash bene-
fits for organ donation and organ donors, 
and measuring the effects of providing 
such noncash benefits; 
‘‘(vi) measures the effects of providing 
such noncash benefits; and 
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‘‘(vii) allows for the determination of 
the recipient of an organ donated pursuant 
to the covered pilot program— 
‘‘(I) in the case of organs from 
deceased donors, only by the Organ 
Procurement 
and 
Transplantation 
Network; and 
‘‘(II) in the case of nondirected 
organs from living donors, only by a 
transplant center that is a member of, 
and abides by the rules and require-
ments of, the Organ Procurement and 
Transplantation Network established 
pursuant to section 372 of the Public 
Health Service Act. 
‘‘(B) The term ‘noncash benefit’ means 
any benefit or thing of value received by an 
organ donor that is impossible to sell, trade, or 
otherwise transfer to another individual. 
‘‘(4) REPORT TO CONGRESS.—Not later than 
three years after the Secretary first approves a cov-
ered pilot program, and every three years thereafter 
until there is no longer a covered pilot program in 
operation, the Secretary shall submit a report to the 
Congress on— 
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‘‘(A) the impact of covered pilot programs 
on the organ pool; 
‘‘(B) the demographics of the donors par-
ticipating in covered pilot programs; 
‘‘(C) the demographics of the recipients of 
organs donated by participants in covered pilot 
programs; 
‘‘(D) 
the 
effectiveness, 
fairness, 
and 
equitableness of the distribution of nondirected 
living donor organs that are donated by partici-
pants in covered pilot programs; and 
‘‘(E) recommendations to Congress on— 
‘‘(i) improving covered pilot programs; 
and 
‘‘(ii) expanding the use of noncash 
benefits to incentivize organ donation.’’. 
(c) RELATIONSHIP TO PAYMENTS BY RECIPIENT OF 
ORGAN.—Subsection (d) of section 377 of the Public 
Health Service Act (42 U.S.C. 274f(d)) is amended to 
read as follows: 
‘‘(d) RELATIONSHIP TO PAYMENTS UNDER OTHER 
PROGRAMS.—An award may be made under subsection (a) 
only if the applicant involved agrees that the award will 
not be expended to pay the qualifying expenses of a donat-
ing individual to the extent that— 
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‘‘(1) payment has been made, or can reasonably 
be expected to be made, with respect to such ex-
penses— 
‘‘(A) under any State compensation pro-
gram, under an insurance policy, or under any 
Federal or State health benefits program; or 
‘‘(B) by an entity that provides health 
services on a prepaid basis; or 
‘‘(2) the recipient of the organ has made pay-
ment, or had agreed to make payment, with respect 
to such expenses.’’. 
Æ 
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