I 
117TH CONGRESS 
1ST SESSION H. R. 1592 
To combat forced organ harvesting and trafficking in persons for purposes 
of the removal of organs, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 3, 2021 
Mr. SMITH of New Jersey (for himself, Mr. SUOZZI, and Mrs. HARTZLER) in-
troduced the following bill; which was referred to the Committee on For-
eign Affairs, and in addition to the Committees on Energy and Com-
merce, and the Judiciary, for a period to be subsequently determined by 
the Speaker, in each case for consideration of such provisions as fall with-
in the jurisdiction of the committee concerned 
A BILL 
To combat forced organ harvesting and trafficking in persons 
for purposes of the removal of organs, and for other 
purposes. 
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 ‘‘Stop Forced Organ 
Harvesting Act of 2021’’. 
SEC. 2. STATEMENT OF POLICY. 
It shall be the policy of the United States— 
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(1) to combat international trafficking in per-
sons for purposes of the removal of organs; 
(2) to promote the establishment of voluntary 
organ donation systems with effective enforcement 
mechanisms in bilateral diplomatic meetings and in 
international health forums; and 
(3) to promote the dignity and security of 
human life in accordance with the Universal Dec-
laration of Human Rights, adopted on December 10, 
1948. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) 
APPROPRIATE
COMMITTEES
OF
CON-
GRESS.—The term ‘‘appropriate committees of Con-
gress’’ means— 
(A) the Committee on Foreign Relations of 
the Senate; and 
(B) the Committee on Foreign Affairs of 
the House of Representatives. 
(2) FORCED
ORGAN
HARVESTING.—The term 
‘‘forced organ harvesting’’ means the removal of one 
or more organs from a person by means of coercion, 
abduction, deception, fraud, or abuse of power or a 
position of vulnerability. 
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(3) ORGAN.—The term ‘‘organ’’ has the mean-
ing given the term ‘‘human organ’’ in section 
301(c)(1) of the National Organ Transplant Act (42 
U.S.C. 274e(c)(1)). 
(4) TRAFFICKING IN PERSONS FOR PURPOSES 
OF
THE
REMOVAL
OF
ORGANS.—The term ‘‘traf-
ficking in persons for purposes of the removal of or-
gans’’ means the recruitment, transportation, trans-
fer, harboring, or receipt of a person for the purpose 
of removing one or more of such person’s organs, by 
means of— 
(A) coercion; 
(B) abduction; 
(C) deception; 
(D) fraud; 
(E) abuse of power or a position of vulner-
ability; or 
(F) transfer of payments or benefits to 
achieve the consent of a person having control 
over a person described in the matter preceding 
subparagraph (A). 
SEC. 4. AUTHORITY TO DENY OR REVOKE PASSPORTS. 
Section 4076 of the Revised Statutes (22 U.S.C. 212) 
is amended— 
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(1) by inserting ‘‘(a)’’ before ‘‘No passport’’; 
and 
(2) by adding at the end the following: 
‘‘(b)(1) The Secretary of State may refuse to issue 
a passport to any individual who has been convicted of 
an offense under section 301 of the National Organ 
Transplant Act (42 U.S.C. 274e) if such individual, in the 
commission of such an offense, used a passport or crossed 
an international border. 
‘‘(2) The Secretary of State may revoke a passport 
previously issued to any individual described in paragraph 
(1).’’. 
SEC. 5. REPORTS ON FORCED ORGAN HARVESTING AND 
TRAFFICKING IN PERSONS FOR PURPOSES 
OF THE REMOVAL OF ORGANS IN FOREIGN 
COUNTRIES. 
(a) INCLUSION OF INFORMATION IN ANNUAL COUN-
TRY REPORTS ON HUMAN RIGHTS PRACTICES.—The For-
eign Assistance Act of 1961 (22 U.S.C. 2151 et seq.) is 
amended— 
(1) in section 116 (22 U.S.C. 2151n), by add-
ing at the end the following: 
‘‘(h) FORCED
ORGAN
HARVESTING
AND
TRAF-
FICKING IN PERSONS FOR PURPOSES OF THE REMOVAL 
OF ORGANS.— 
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‘‘(1) IN
GENERAL.—The report required by 
subsection (d) shall include an assessment of forced 
organ harvesting and trafficking in persons for pur-
poses of the removal of organs in each foreign coun-
try. 
‘‘(2) DEFINITIONS.—In this subsection: 
‘‘(A) FORCED ORGAN HARVESTING.—The 
term ‘forced organ harvesting’ means the re-
moval of one or more organs from a person by 
means of coercion, abduction, deception, fraud, 
or abuse of power or a position of vulnerability. 
‘‘(B) ORGAN.—The term ‘organ’ has the 
meaning given the term ‘human organ’ in sec-
tion 301(c)(1) of the National Organ Trans-
plant Act (42 U.S.C. 274e(c)(1)). 
‘‘(C) TRAFFICKING IN PERSONS FOR PUR-
POSES
OF
THE
REMOVAL
OF
ORGANS.—The 
term ‘trafficking in persons for purposes of the 
removal of organs’ means the recruitment, 
transportation, transfer, harboring, or receipt of 
a person for the purpose of removing one or 
more of such person’s organs, by means of— 
‘‘(i) coercion; 
‘‘(ii) abduction; 
‘‘(iii) deception; 
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‘‘(iv) fraud; 
‘‘(v) abuse of power or a position of 
vulnerability; or 
‘‘(vi) transfer of payments or benefits 
to achieve the consent of a person having 
control over a person described in the mat-
ter preceding clause (i).’’; and 
(2) in section 502B (22 U.S.C. 2304)— 
(A) by redesignating the second subsection 
(i) (relating to child marriage status) as sub-
section (j); and 
(B) by adding at the end the following: 
‘‘(k) FORCED
ORGAN
HARVESTING
AND
TRAF-
FICKING IN PERSONS FOR PURPOSES OF THE REMOVAL 
OF ORGANS.— 
‘‘(1) IN
GENERAL.—The report required by 
subsection (b) shall include an assessment of forced 
organ harvesting and trafficking in persons for pur-
poses of the removal of organs in each foreign coun-
try. 
‘‘(2) DEFINITIONS.—In this subsection, the 
terms ‘forced organ harvesting’, ‘organ’, and ‘traf-
ficking in persons for purposes of the removal of or-
gans’ have the meanings given those terms in section 
116(h)(2).’’. 
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(b) ADDITIONAL REPORTS.— 
(1) IN GENERAL.—Not later than 30 days after 
the date on which each annual report required by 
sections 116 and 502B of the Foreign Assistance 
Act of 1961 (22 U.S.C. 2151n, 2304), as amended 
by subsection (a), is submitted, the Assistant Sec-
retary of State for Democracy, Human Rights, and 
Labor (in this subsection referred to as the ‘‘Assist-
ant Secretary’’), shall submit to the appropriate 
committees of Congress a report that includes the 
following: 
(A) With respect to each foreign country, 
an identification of any agencies, instrumental-
ities, or officials of the country that are respon-
sible for forced organ harvesting or trafficking 
in persons for purposes of the removal of or-
gans. 
(B) A tiered ranking described in para-
graph (2). 
(2) TIERED RANKING.—The tiered ranking de-
scribed in this paragraph is a tiered ranking of all 
foreign countries as follows: 
(A) TIER
COUNTRIES.—The Assistant 
Secretary shall designate a country as tier 1 if 
the country has low levels of forced organ har-
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vesting or trafficking in persons for purposes of 
the removal of organs and the government of 
such country is making significant efforts to 
combat those practices. 
(B) TIER
COUNTRIES.—The Assistant 
Secretary shall designate a country as tier 2 if 
the country has— 
(i) low or intermediate levels of forced 
organ harvesting or trafficking in persons 
for purposes of the removal of organs and 
the government of such country is not 
making significant efforts to combat those 
practices; or 
(ii) intermediate levels of forced organ 
harvesting or trafficking in persons for 
purposes of the removal of organs and the 
government of such country is making sig-
nificant efforts to combat those practices. 
(C) TIER
COUNTRIES.—The Assistant 
Secretary shall designate a country as tier 3 
if— 
(i) the country has high levels of 
forced organ harvesting or trafficking in 
persons for purposes of the removal of or-
gans; or 
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(ii) the government of such country is 
directly or indirectly supporting forced 
organ harvesting or trafficking in persons 
for purposes of the removal of organs. 
(3) FORM.—The report required by this sub-
section shall be submitted in unclassified form. 
(c) INTERIM REPORTS.—In addition to the annual re-
ports required by sections 116 and 502B of the Foreign 
Assistance Act of 1961 (22 U.S.C. 2151n, 2304), as 
amended by subsection (a), the Secretary of State may 
submit to the appropriate committees of Congress at any 
time one or more interim reports with respect to the status 
of forced organ harvesting and trafficking in persons for 
purposes of the removal of organs in foreign countries, in-
cluding information about countries whose governments 
have begun or ceased to make significant efforts to combat 
those practices since the date on which the most recent 
annual report was submitted under such sections. 
(d) CONSIDERATION OF SIGNIFICANT EFFORTS.—In 
determining whether the government of a country is mak-
ing significant efforts to combat forced organ harvesting 
and trafficking in persons for purposes of the removal of 
organs under subsections (b) and (c), the Secretary of 
State shall consider— 
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(1) the extent to which the country is a country 
of origin, transit, or destination for forced organ 
harvesting and trafficking in persons for purposes of 
the removal of organs; 
(2) the extent of efforts by the government to 
combat forced organ harvesting and trafficking in 
persons for purposes of the removal of organs, and, 
particularly, the extent to which officials or employ-
ees of the government have participated in, facili-
tated, or condoned, or are otherwise complicit in, 
those practices; and 
(3) the measures that would be reasonable for 
the government to combat forced organ harvesting 
and trafficking in persons for purposes of the re-
moval of organs, considering the resources and capa-
bilities of the government. 
SEC. 6. REPORT ON UNITED STATES MEDICAL AND EDU-
CATIONAL INSTITUTIONS AT WHICH ORGAN 
TRANSPLANT SURGEONS FROM TIER 3 COUN-
TRIES ARE TRAINED. 
(a) IN GENERAL.—Not later than 180 days after the 
date on which each annual report required by sections 116 
and 502B of the Foreign Assistance Act of 1961 (22 
U.S.C. 2151n, 2304), as amended by section 5(a), is sub-
mitted, the Secretary of State, in consultation with the 
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Secretary of Health and Human Services, shall submit to 
Congress a report on medical and educational institutions 
and other entities in the United States at which organ 
transplant surgeons are trained. 
(b) ELEMENTS.— 
(1) IN
GENERAL.—Each report required by 
subsection (a) shall include an identification of each 
medical or educational institution or other entity in 
the United States at which one or more organ trans-
plant surgeons described in paragraph (2) are 
trained as of the date on which the report is sub-
mitted. 
(2) 
ORGAN
TRANSPLANT
SURGEON
DE-
SCRIBED.—An organ transplant surgeon described 
in this paragraph is an organ transplant surgeon 
who— 
(A) as of the date on which the report re-
quired by subsection (a) is submitted, is em-
ployed by or affiliated with an agency or instru-
mentality identified in the most recent addi-
tional report required by section 5(b) as being 
responsible for forced organ harvesting or traf-
ficking in persons for purposes of the removal 
of organs; and 
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(B) is a citizen or national of a country 
designated as a tier 3 country in the most re-
cent additional report required by section 5(b). 
SEC. 7. PROHIBITION ON THE EXPORT OF ORGAN TRANS-
PLANT SURGERY DEVICES TO CERTAIN ENTI-
TIES. 
Section 801 of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 381) is amended by adding at the end the 
following: 
‘‘(v) PROHIBITION ON EXPORT OF ORGAN TRANS-
PLANT SURGERY DEVICES TO CERTAIN ENTITIES.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
provision of this Act, a device that is intended for 
use in organ transplant surgery may not be exported 
to any entity that is identified in the most recent ad-
ditional report required by section 5(b) of the Stop 
Forced Organ Harvesting Act of 2021 as being re-
sponsible for forced organ harvesting or trafficking 
in persons for purposes of the removal of organs. 
‘‘(2) COORDINATION WITH THE SECRETARY OF 
COMMERCE.—The Secretary shall coordinate with 
the Secretary of Commerce to ensure compliance 
with paragraph (1).’’. 
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SEC. 8. IMPOSITION OF SANCTIONS WITH RESPECT TO 
FORCED 
ORGAN 
HARVESTING 
OR 
TRAF-
FICKING IN PERSONS FOR PURPOSES OF THE 
REMOVAL OF ORGANS FACILITATED BY TIER 
3 COUNTRIES. 
(a) LIST REQUIRED.—Not later than 180 days after 
the date on which each annual report required by sections 
116 and 502B of the Foreign Assistance Act of 1961 (22 
U.S.C. 2151n, 2304), as amended by section 5(a), is sub-
mitted, the President shall submit to Congress a list of 
each person that the President determines— 
(1) funds, supports, sponsors, or otherwise fa-
cilitates forced organ harvesting or trafficking in 
persons for purposes of the removal of organs; and 
(2) is— 
(A) an individual who is a citizen or na-
tional of a country designated as a tier 3 coun-
try in the most recent additional report re-
quired by section 5(b); or 
(B) an entity organized under the laws of 
such a country or otherwise subject to the juris-
diction of the government of such a country. 
(b) IMPOSITION OF SANCTIONS.—The President shall 
impose the following sanctions with respect to a person 
on the list required by subsection (a): 
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