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‘‘(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-
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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
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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
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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)
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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
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‘‘(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;’’.
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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—
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‘‘(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
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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-
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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.’’.
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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;
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‘‘(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-
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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-
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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.
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(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.
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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:
JEFF TRANDAHL,
Clerk.