SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Organ Procurement
and Transplantation Network Amendments of 2000’’.
SEC. 2. FINDINGS.
(a) IN GENERAL.—The Congress finds as follows:
(1) It is in the public interest to maintain and
improve a system for promoting and supporting a
central network in the private sector to assist organ
procurement organizations and transplant centers in
the distribution of organs among transplant patients
and the provision of organ transplantation services,
and to assure quality and facilitate collaboration
among network members and individual medical
practitioners participating in network activities.
(2) The Organ Procurement and Transplan-
tation Network (‘‘Network’’), which was established
in the private sector pursuant to a contract awarded
by the Federal Government, should continue to be
operated by a nonprofit private entity pursuant to a
contract with the Federal Government.
(3) The Federal Government should continue to
provide Federal oversight of and financial assistance
for the services provided by the Network.
(4) The responsibility for developing, estab-
lishing, and maintaining medical criteria and stand-
ards for organ procurement and transplantation be-
longs in the private sector and is a function of the
Network.
(5) The Federal Government should assist the
efforts of the Network to serve patient and donor
families in procuring and distributing organs.
(6) The Federal Government should carry out
programs to educate the public with respect to organ
donation, including the need to provide for an ade-
quate rate of such donations.
(b) SENSE OF THE CONGRESS REGARDING FAMILY
DISCUSSIONS OF ORGAN DONATIONS.—The Congress rec-
ognizes the importance of families pledging to each other
to share their lives as organ and tissue donors and ac-
knowledges the importance of discussing organ and tissue
donation as a family.
(c) SENSE OF THE CONGRESS REGARDING LIVING
DONATIONS OF ORGANS.—The Congress—
(1) recognizes the generous contribution made
by each living individual who has donated an organ
to save a life; and
(2) acknowledges the advances in medical tech-
nology that have enabled organ transplantation with
organs donated by living individuals to become a via-
ble treatment option for an increasing number of pa-
tients.
SEC. 3. ORGAN PROCUREMENT AND TRANSPLANTATION
NETWORK.
(a) IN GENERAL.—Section 372 of the Public Health
Service Act (42 U.S.C. 274) is amended to read as follows:
‘‘ORGAN PROCUREMENT AND TRANSPLANTATION
NETWORK
‘‘SEC. 372. (a) IN GENERAL.—The Secretary shall
by contract provide for the continuing operation of an
Organ Procurement and Transplantation Network (in this
section referred to as the ‘Network’), which contract shall
be awarded to a nonprofit private entity that has expertise
and experience in organ procurement and transplantation.
The Network shall meet the following requirements:
‘‘(1) The Network shall be an independent,
nonprofit private entity that is a separate legal enti-
ty from the entity to which such contract is award-
ed.
‘‘(2) The Network shall in accordance with cri-
teria under subsection (b)(3) include as members
qualified organ procurement organizations (as de-
scribed in section 371(b)), transplant centers, and
other entities that have a demonstrated interest in
the fields of organ donation or transplantation.
(such members are in this section referred to as
‘Network participants’).
‘‘(3) The Network shall have a board of direc-
tors (in this section referred to as the ‘Board’). The
Board shall, after consultation with Network partici-
pants, establish the policies for carrying out the
functions described in this section for the Network.
‘‘(4) The Board shall be in accordance with the
following:
‘‘(A) The Board shall include representa-
tives of qualified organ procurement organiza-
tions, transplant centers, voluntary health asso-
ciations, and the general public, including a
reasonable proportion of the members of the
Board who are patients awaiting a transplant
or transplant recipients or individuals who have
donated an organ or family members of pa-
tients, recipients or donors.
‘‘(B) The Board shall establish member-
ship categories and qualifications with respect
to serving on the Board, and shall have exclu-
sive authority to admit individuals to member-
ship on the Board. Transplant surgeons and
transplant physicians shall comprise not less
than 50 percent of the membership of the
Board. The Board shall be limited to a total of
42 members.
‘‘(C) The Board shall have an executive
committee, and such other committees as the
Board determines to be appropriate.
‘‘(D) The chair of each such committee
shall be selected so as to ensure the continuity
of leadership for the Board.
‘‘(b) GENERAL FUNCTIONS.—The following applies
to the Network:
‘‘(1) The Network shall establish and operate a
national system to match organs and individuals
who need organ transplants, especially individuals
whose immune system makes it difficult for them to
receive organs.
‘‘(2) The national system shall maintain one or
more lists of individuals who need organ transplants,
shall be operated in accordance with established
medical criteria, shall be operated through the use of
computers, and may function on a regionalized
basis.
‘‘(3) The Network shall establish criteria for
being a Network participant, shall establish medical
criteria for listing patients and for allocating organs,
and shall provide to members of the public an oppor-
tunity to comment with respect to such criteria.
‘‘(4) The Network shall maintain a twenty-four-
hour telephone and computer service to facilitate
matching organs with individuals included in the
list.
‘‘(5) The Network shall assist organ procure-
ment organizations in the distribution of organs.
The distribution of organs shall be based on medical
criteria established by the Network, and also shall be
based on equity and ethics without regard to eco-
nomic status of those awaiting organ transplants
and without political control or influence.
‘‘(6) The Network shall adopt and use stand-
ards of quality for the acquisition and transportation
of donated organs, including standards regarding
the transmission of infectious diseases.
‘‘(7) The Network shall prepare and distribute,
on a regionalized basis (and, to the extent prac-
ticable, among regions or on a national basis), sam-
ples of blood sera from individuals who are included
on the list and whose immune system makes it dif-
ficult for them to receive organs, in order to facili-
tate matching the compatibility of such individuals
with organ donors.
‘‘(8) The Network shall coordinate, as appro-
priate, the transportation of organs from organ pro-
curement organizations to transplant centers.
‘‘(9) The Network shall work actively to in-
crease the supply of donated organs.
‘‘(10) The Network shall recognize the dif-
ferences in health and in organ transplantation
issues between children and adults throughout the
system and adopt criteria, policies, and procedures
that address the unique health care needs of chil-
dren.
‘‘(c) SCIENTIFIC REGISTRY.—
‘‘(1) IN GENERAL.—The Network shall main-
tain a scientific registry of patients awaiting organ
transplantation, persons from whom organs are re-
moved for transplantation, and organ transplant re-
cipients for the ongoing evaluation of the scientific
and clinical status of organ transplantation.
‘‘(2) REPORTS.—The Network shall prepare for
inclusion in the report under section 375 an analysis
of scientifically and clinically valid information de-
rived from the scientific registry under paragraph
(1).
‘‘(d) INFORMATION AND DATA.—
‘‘(1) IN GENERAL.—The Network shall—
‘‘(i) The probability of receiving an
organ transplant.
‘‘(ii) The length of time that similarly
situated patients have waited historically to
receive a transplant.
‘‘(iii) Medical outcomes for similarly
situated patients, which information shall
be adjusted to reflect the medical risk fac-
tors for such patients.
‘‘(D) With respect to the patient involved,
the information shall include the information
described in subparagraph (C) as applied to the
service areas of specific qualified organ procure-
ment organizations (other than such areas in
which there is only one transplant center).
‘‘(E) Information under this paragraph
shall be updated not less frequently than once
a year.
‘‘(3) ANNUAL PUBLIC REPORT.—The Network
shall annually make available to the public a report
on the overall status of organ procurement and
transplantation.
‘‘(4) CONFIDENTIALITY.—Except for the re-
lease of information that is authorized under para-
graph (2) or (3) by the Network, neither the Net-
work nor the Secretary has authority to release the
following information (unless authorized in writing
by the patient or other entity with which the data
is concerned):
‘‘(A) Information that permits direct or in-
direct identification of any patient who is wait-
ing for a transplant, or who is an organ trans-
plant patient or recipient of an organ.
‘‘(B) Information that permits direct or in-
direct identification of any potential or actual
organ donors.
‘‘(C) Information that permits direct or in-
direct identification of participants in Network
deliberations or determinations related to prac-
titioner or institutional qualifications, due proc-
ess proceedings or peer review activities, except
for information announcing final decisions of
the Network.
This paragraph may not be construed as prohibiting
the disclosure of information within the Network, in-
cluding information disclosed in the course of inter-
active organ sharing operations within the Network.
‘‘(e) STUDIES.—
‘‘(1) IN GENERAL.—The Network shall carry
out studies and demonstration projects for the pur-
pose of improving procedures for organ procurement
and allocation, including but not limited to projects
to examine and attempt to increase transplantation
among populations with special needs or limited ac-
cess to transplantation, and among children.
‘‘(2) CERTAIN TECHNOLOGIES.—The Network
may study the impact of possible transplantation of
animal organs (xenotransplantation) and other tech-
nologies to determine the impact upon, and prevent
negative effects on, the fair and effective use of
human allograft organs.
‘‘(f) QUALITY ASSURANCE; MONITORING OF NET-
WORK PARTICIPANTS.—The Network shall monitor the
operations of Network participants to the extent appro-
priate for determining whether the participants are main-
taining compliance with criteria under subsection (b)(3).
In monitoring a Network participant under the preceding
sentence, the Network shall inform the participant of any
findings indicating noncompliance by the participant.
‘‘(g) QUALITY ASSURANCE; PEER REVIEW PRO-
CEEDINGS.—
‘‘(1) IN GENERAL.—The Network shall develop
a peer review system for assuring that members of
the Network comply with criteria under subsection
(b)(3).
‘‘(2) NONCOMPLIANCE.—
‘‘(A) PAYMENT OF DAMAGES.—The Net-
work shall require that, as a condition of being
a Network participant, each such participant
agree that the Network may, through a peer re-
view proceeding under paragraph (1), require
the participant to pay damages for the failure
of the participant to comply with criteria under
subsection (b)(3). The Network shall establish
procedures to ensure that such proceedings are
conducted in an impartial manner, with ade-
quate opportunity for the Network participant
involved to receive a hearing. The Network shall
identify various types of violations of such cri-
teria and specify the maximum amount of dam-
ages that the Network may under this subpara-
graph require a Network participant to pay for
the type of violation involved.
‘‘(B) RESTRICTING
ACCESS
TO
ALLOCA-
TION SYSTEM.—If under subparagraph (A) it
has been determined that a Network participant
has engaged in substantial violations of criteria
under subsection (b)(3), the Network may re-
strict the extent to which such participant is
permitted to receive allocations of organs
through the Network.
‘‘(C) STATUS OF NETWORK PARTICIPANTS
WITH
RESPECT
TO
VIOLATIONS.—Subject to
paragraph (3), the Network may take actions to
make the public aware of the extent to which a
Network participant has been required to pay
damages under subparagraph (A) or has been
the subject of restrictions under subparagraph
(B).
‘‘(3) CONFIDENTIALITY.—With respect to a
peer review proceeding under paragraph (1), neither
the Network nor the Secretary has authority to re-
lease data or information to the public relating to
the proceedings without the written permission of all
the parties involved, except that if damages under
paragraph (2) are required to be paid, the require-
ment may be publicly announced after the conclusion
of the proceeding.
‘‘(h) ADMINISTRATIVE PROVISIONS.—
‘‘(1) LIMITATION ON AMOUNT OF CONTRACT.—
The amount provided under a contract under sub-
section (a) in any fiscal year may not exceed
$6,000,000 for the operation of the Network, includ-
ing the scientific registry under subsection (c). Such
limitation does not apply to amounts provided under
the contract for increasing organ donation and pro-
curement.
‘‘(2) RELATIONSHIP BETWEEN SECRETARY AND
NETWORK.—The 
administrative 
and 
procedural
functions described in this section for the Network
shall be carried out in accordance with the mutual
agreement of the Secretary and the Network. For
purposes of the preceding sentence, functions that
are scientific, clinical, or medical in nature are not
administrative or procedural functions and are with-
in the sole discretion of the Network. With respect
to the programs under titles XVIII and XIX of the
Social Security Act, this section may not be con-
strued as having any legal effect on such programs,
except to the extent that section 1138 of such Act,
or any other provision of such Act, provides other-
wise.
‘‘(3) NONFEDERAL ASSETS OF NETWORK.—
‘‘(A) IN GENERAL.—No assets in the pos-
session of the Network or revenues collected by
the Network, other than amounts appropriated
under section 378, shall be considered or be
treated as Federal property, Federal revenues,
or program funds pursuant to a Federal con-
tract, nor shall such assets, revenues, or non-
appropriated funds be subject to restriction or
control by the Secretary, nor shall any member
of the Network be required by the Secretary to
pay any fees to the Network, nor shall the Sec-
retary be authorized to collect or authorize col-
lection of service fees with respect to the Net-
work or the scientific registry under subsection
(c).
‘‘(B) GIFTS.—This section does not pro-
hibit the Network from accepting gifts of money
or services, including gifts to carry out activities
to provide for an increase in the rate of organ
donation.
‘‘(4) COMMUNITY ENDORSEMENT OF CONTRACT
RECIPIENT.—In the case of any contract under sub-
section (a) that is awarded after the date of the en-
actment of the Organ Procurement and Transplan-
tation Network Amendments of 2000, the Secretary
shall select an applicant to receive the contract from
among applicants that have the written endorsement
of a majority of the combined total number of trans-
plant centers and qualified organ procurement orga-
nizations that are Network participants (without re-
gard to whether such centers or organizations en-
dorse more than one applicant for the contract).
‘‘(5) CHANGE IN CONTRACT RECIPIENT.—With
respect to the expiration of the period during which
a contract under subsection (a) is in effect, if the
Secretary makes a determination to award the con-
tract to a different entity than the entity to which
the previous contract under such subsection was
awarded, the Secretary shall publish in the Federal
Register a notice that such change in the adminis-
tration of the Network will take place, and the
change may not take effect any sooner than the ex-
piration of the 6-month period beginning on the date
on which the notice is so published. Such a change
does not affect the membership status of any Net-
work participant, or the membership status of any
individual who serves on the Board (other than any
membership position that is predicated solely on
being a representative of the current contractor
under subsection (a)).
‘‘(i) ADDITIONAL PROCEDURES REGARDING OVER-
SIGHT AND PUBLIC ACCOUNTABILITY.—For purposes of
providing oversight of and public accountability for the op-
eration of the Network, the Secretary shall establish pro-
cedures for—
‘‘(1) conducting public hearings and receiving
from interested persons comments regarding criteria
of the Network and critical comments relating to the
manner in which the Network is carrying out its du-
ties under this section;
‘‘(2) providing such comments to the Network
and receiving responses from the Network; and
‘‘(3) the consideration by the Secretary of such
comments.
‘‘(j) EVALUATIONS BY GENERAL ACCOUNTING OF-
FICE.—
‘‘(1) IN GENERAL.—The Comptroller General of
the United States shall periodically conduct evalua-
tions of the Network, including the structure and
function of the Network and the relationship be-
tween the Secretary and the nonprofit private entity
that under subsection (a) operates the Network. The
first such evaluation shall be completed not later
than 1 year after the date of the enactment of the
Organ Procurement and Transplantation Network
Amendments of 2000, and such an evaluation shall
be completed not later than every second year there-
after.
‘‘(2) INPUT FROM FIELD.—In conducting eval-
uations under paragraph (1), the Comptroller Gen-
eral shall consult with organizations that represent
transplant surgeons, transplant physicians, trans-
plant centers, and qualified organ procurement orga-
nizations, and with other experts in the field of
organ transplantation, including experts who are not
members of the Board of the Network or of the ex-
ecutive structure of the contractor under subsection
(a) .
‘‘(3) PROCEDURES
OF
NETWORK.—The Net-
work shall establish procedures for coordinating with
the Comptroller General for purposes of evaluations
under paragraph (1).
‘‘(4) REPORTS TO CONGRESS.—
‘‘(A) 
COMPTROLLER
GENERAL.—The
Comptroller General shall prepare reports de-
scribing the findings of evaluations under para-
graph (1) and shall submit such reports to the
Committee on Commerce of the House of Rep-
resentatives and the Committee on Health,
Education, Labor, and Pensions of the Senate.
The Comptroller General shall provide a copy of
each such report to the Network.
‘‘(B) NETWORK.—Not later than 180 days
after the date on which a report is submitted
under subparagraph (A), the Network shall
submit to each of the committees specified in
such subparagraph a report describing any ac-
tions the Network has taken in response to the
report under subparagraph (A).’’.
(b) RULE
OF CONSTRUCTION.—The amendments
made by this Act may not be construed as affecting the
duration of the contract under section 372 of the Public
Health Service Act that was in effect on the day before
the date of the enactment of this Act.
SEC. 4. ADDITIONAL AMENDMENTS.
(a) IN GENERAL.—Part H of title III of the Public
Health Service Act (42 U.S.C. 273 et seq.) is amended—
(1) by striking section 373;
(2) in section 374—
(A) in subsection (b)(1), by inserting after
‘‘organization’’ the following: ‘‘and other orga-
nizations for the purpose of increasing the sup-
ply of transplantable organs’’;
(B) in subsection (c), by striking ‘‘or 373’’
each place such term appears; and
(C) in subsection (d), by amending para-
graph (2) to read as follows:
‘‘(2) The term ‘organ’, with respect to trans-
plantation into humans, means the human or other
animal kidney, liver, heart, lung, pancreas, and any
other organ (other than human corneas and eyes)
specified by the Secretary by regulation. For pur-
poses of section 372(c), such term includes bone
marrow.’’;
(3) in section 375—
(A) in paragraph (1), by striking ‘‘this
part’’ and inserting ‘‘this section’’; and
(B) in paragraph (4)—
(i) by redesignating clauses (i) and
(ii) as subparagraphs (A) and (B), respec-
tively; and
(ii) in subparagraph (B) (as so redes-
ignated), by striking ‘‘comparative costs
and patient outcomes’’ and inserting ‘‘com-
parative patient outcomes’’;
(4) in section 376—
(A) by striking ‘‘the Secretary’’ and insert-
ing ‘‘the Organ Procurement and Transplan-
tation Network under section 372’’; and
(B) by striking ‘‘Committee on Energy and
Commerce’’ and inserting ‘‘Committee on Com-
merce’’; and
(5) by striking section 377.
(b) REDESIGNATIONS.—Part H of title III of the
Public Health Service Act, as amended by subsection (a)
of this section, is amended by redesignating sections 374
through 376 as sections 373 through 375, respectively.
(c) PERFORMANCE STANDARDS.—Section 371(b)(1)
of the Public Health Service Act (42 U.S.C. 273(b)(1))
is amended—
(1) 
by 
redesignating 
subparagraphs 
(D)
through (G) as subparagraphs (E) through (H), re-
spectively;
(2) by moving subparagraph (F) (as so redesig-
nated) two ems to the left; and
(3) by inserting after subparagraph (C) the fol-
lowing:
‘‘(D) notwithstanding any other provision of
law, has met the other requirements of this sub-
section and has been certified or recertified by the
Secretary as meeting the performance standards to
be a qualified organ procurement organization
through a process which—
‘‘(i) granted certification or recertification
within the previous 4 years with such certifi-
cation in effect as of October 1, 1999, and re-
maining in effect through the earlier of—
‘‘(I) January 1, 2002; or
‘‘(II) the completion of recertification
under the requirements of clause (ii); or
‘‘(ii) is defined through regulations pro-
mulgated by the Secretary not later than Janu-
ary 1, 2002, which—
‘‘(I) require recertifications of quali-
fied organ procurement organizations not
more frequently than once every 4 years;
‘‘(II) rely on performance measures
that are based on empirical evidence of
organ donor potential and other related
factors in each service area of qualified
organ procurement organizations;
‘‘(III) provide for the filing and ap-
proval of a corrective action plan by a
qualified organ procurement organization
that fails to meet the performance stand-
ards and a grace period of not less than 3
years during which such organization can
implement the corrective action plan with-
out risk of decertification; and
‘‘(IV) provide for a qualified organ
procurement organization to appeal a de-
certification to the Secretary on sub-
stantive and procedural grounds;’’.
SEC. 5. PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES
INCURRED TOWARD LIVING ORGAN DONA-
TION.
Part H of title III of the Public Health Service Act,
as amended by section 4(b) of this Act, is amended by
inserting after section 375 the following section:
‘‘PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES
INCURRED TOWARD LIVING ORGAN DONATION
‘‘SEC. 376. (a) IN GENERAL.—The Secretary may
make awards of grants or contracts to States, transplant
centers, qualified organ procurement organizations under
section 371, or other public or private entities for the pur-
pose of—
‘‘(1) providing for the payment of travel and
subsistence expenses incurred by individuals toward
making living donations of their organs (in this sec-
tion referred as ‘donating individuals’); and
‘‘(2) in addition, providing for the payment of
such incidental nonmedical expenses that are so in-
curred as the Secretary determines by regulation to
be appropriate.
‘‘(b) ELIGIBILITY.—
‘‘(1) IN GENERAL.—Payments under subsection
(a) may be made for the qualifying expenses of a do-
nating individual only if—
‘‘(A) the State in which the donating indi-
vidual resides is a different State than the
State in which the intended recipient of the
organ resides; and
‘‘(B) the annual income of the intended re-
cipient of the organ does not exceed $35,000
(as adjusted for fiscal year 2001 and subse-
quent fiscal years to offset the effects of infla-
tion occurring after the beginning of fiscal year
2000).
‘‘(2) CERTAIN
CIRCUMSTANCES.—Subject to
paragraph (1), the Secretary may in carrying out
subsection (a) provide as follows:
‘‘(A) The Secretary may consider the term
‘donating individuals’ as including individuals
who in good faith incur qualifying expenses to-
ward the intended donation of an organ but
with respect to whom, for such reasons as the
Secretary determines to be appropriate, no do-
nation of the organ occurs.
‘‘(B) The Secretary may consider the term
‘qualifying expenses’ as including the expenses
of having one or more family members of do-
nating individuals accompany the donating indi-
viduals for purposes of subsection (a) (subject
to making payment for only such types of ex-
penses as are paid for donating individuals).
‘‘(c) LIMITATION ON AMOUNT OF PAYMENT.—
‘‘(1) IN GENERAL.—With respect to the geo-
graphic area to which a donating individual travels
for purposes of subsection (a), if such area is other
than the covered vicinity for the intended recipient
of the organ, the amount of qualifying expenses for
which payments under such subsection are made
may not exceed the amount of such expenses for
which payment would have been made if such area
had been the covered vicinity for the intended recipi-
ent, taking into account the costs of travel and re-
gional differences in the costs of living.
‘‘(2) COVERED VICINITY.—For purposes of this
section, the term ‘covered vicinity’, with respect to
an intended recipient of an organ from a donating
individual, means the vicinity of the nearest trans-
plant center to the residence of the intended recipi-
ent that regularly performs transplants of that type
of organ.
‘‘(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 payment has been made,
or can reasonably be expected to be made, with respect
to such expenses—
‘‘(1) under any State compensation program,
under an insurance policy, or under any Federal or
State health benefits program; or
‘‘(2) by an entity that provides health services
on a prepaid basis.
‘‘(e) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘covered vicinity’ has the mean-
ing given such term in subsection (c)(2).
‘‘(2) The term ‘donating individuals’ has the
meaning indicated for such term in subsection
(a)(1), subject to subsection (b)(2)(A).
‘‘(3) The term ‘qualifying expenses’ means the
expenses authorized for purposes of subsection (a),
subject to subsection (b)(2)(B).
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there is authorized
to be appropriated $5,000,000 for each of the fiscal years
2000 through 2005.’’.
SEC. 6. PUBLIC AWARENESS; STUDIES AND DEMONSTRA-
TIONS.
Part H of title III of the Public Health Service Act,
as amended by section 5 of this Act, is amended by insert-
ing after section 376 the following section:
‘‘PUBLIC AWARENESS; STUDIES AND DEMONSTRATIONS
‘‘SEC. 377. (a) PUBLIC AWARENESS.—The Secretary
shall (directly or through grants or contracts) carry out
a program to educate the public with respect to organ do-
nation, including the need to provide for an adequate rate
of such donations.
‘‘(b) STUDIES
AND DEMONSTRATIONS.—The Sec-
retary may make grants to public and nonprofit private
entities for the purpose of carrying out studies and dem-
onstration projects with respect to providing for an ade-
quate rate of organ donation.
‘‘(c) GRANTS TO STATES.—The Secretary may make
grants to States for the purpose of assisting States in car-
rying out organ donor awareness, public education and
outreach activities and programs designed to increase the
number of organ donors within the State, including living
donors. To be eligible, each State shall—
‘‘(1) submit an application to the Department
in the form prescribed;
‘‘(2) establish yearly benchmarks for improve-
ment in organ donation rates in the State;
‘‘(3) develop, enhance or expand a State donor
registry, which shall be available to hospitals, organ
procurement organizations, and other States upon a
search request; and
‘‘(4) report to the Secretary on an annual basis
a description and assessment of the State’s use of
these grant funds, accompanied by an assessment of
initiatives for potential replication in other States.
Funds may be used by the State or in partnership with
other public agencies or private sector institutions for edu-
cation and awareness efforts, information dissemination,
activities pertaining to the State organ donor registry, and
other innovative donation specific initiatives, including liv-
ing donation.
‘‘(d) ANNUAL REPORT
TO CONGRESS.—The Sec-
retary shall annually submit to the Congress a report on
the activities carried out under this section, including pro-
visions describing the extent to which the activities have
affected the rate of organ donation.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN
GENERAL.—For the purpose of car-
rying out this section, there are authorized to be ap-
propriated $15,000,000 for fiscal year 2000, and
such sums as may be necessary for each of the fiscal
years 2001 through 2005. Such authorization of ap-
propriations is in addition to any other authoriza-
tions of appropriations that is available for such
purpose.
‘‘(2) STUDIES AND DEMONSTRATIONS.—Of the
amounts appropriated under paragraph (1) for a fis-
cal year, the Secretary may not obligate more than
$2,000,000 for carrying out subsection (b).’’.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS.
Section 378 of the Public Health Service Act (42
U.S.C. 274g) is amended to read as follows:
‘‘AUTHORIZATION OF APPROPRIATIONS FOR ORGAN
PROCUREMENT AND TRANSPLANTATION NETWORK
‘‘SEC. 378. (a) OPERATION OF NETWORK.—For the
purpose of providing for the Organ Procurement and
Transplantation Network under section 372, including the
scientific registry, there are authorized to be appropriated
$6,000,000 for fiscal year 2000, and such sums as may
be necessary for each of the fiscal years 2001 through
2005.
‘‘(b) INCREASING ORGAN DONATION AND PROCURE-
MENT.—For the purpose of increasing organ donation and
procurement through the Organ Procurement and Trans-
plantation Network under section 372, there are author-
ized to be appropriated such sums as may be necessary
for each of the fiscal years 2000 through 2005. Such au-
thorization of appropriations is with respect to such pur-
pose in addition to the authorization of appropriations es-
tablished in subsection (a).’’.
SEC. 8. STUDY REGARDING IMMUNOSUPPRESSIVE DRUGS.
(a) IN
GENERAL.—The Secretary of Health and
Human Services (referred to in this section as the ‘‘Sec-
retary’’) shall provide for a study to determine the costs
of immunosuppressive drugs that are provided to children
pursuant to organ transplants and to determine the extent
to which health plans and health insurance cover such
costs. The Secretary may carry out the study directly or
through a grant to the Institute of Medicine (or other pub-
lic or nonprofit private entity).
(b) 
RECOMMENDATIONS
REGARDING
CERTAIN
ISSUES.—The Secretary shall ensure that, in addition to
making determinations under subsection (a), the study
under such subsection makes recommendations regarding
the following issues:
(1) The costs of immunosuppressive drugs that
are provided to children pursuant to organ trans-
plants and to determine the extent to which health
plans, health insurance and Government programs
cover such costs.
(2) The extent of denial of organs to be re-
leased for transplant by coroners and medical exam-
iners.
(3) The special growth and developmental
issues that children have pre- and post-organ trans-
plantation.
(4) Other issues that are particular to the spe-
cial health and transplantation needs of children.
(c) REPORT.—The Secretary shall ensure that, not
later than December 31, 2000, the study under subsection
(a) is completed and a report describing the findings of
the study is submitted to the Congress.
SEC. 9. NULLIFICATION OF FINAL RULE RELATING TO
ORGAN 
PROCUREMENT 
AND 
TRANSPLAN-
TATION NETWORK.
Notwithstanding any other provision of law, the final
rule relating to the Organ Procurement and Transplan-
tation Network, promulgated by the Secretary of Health
and Human Services and published in the Federal Reg-
ister on April 2, 1998 (63 Fed. Reg. 16296 et seq. adding
part 121 to title 42, Code of Federal Regulations) and
amended on October 20, 1999 (64 Fed. Reg. 56649 et
seq.), shall have no force or legal effect.
SEC. 10. EFFECTIVE DATE.
The amendments made by this Act take effect Octo-
ber 1, 1999, or upon the date of the enactment of this
Act, whichever occurs later.
Passed the House of Representatives April 4, 2000.
Attest:
Clerk.
106TH CONGRESS
2D SESSION
H. R. 2418
AN ACT
To amend the Public Health Service Act to revise
and extend programs relating to organ procure-
ment and transplantation.