SECTION 1. SHORT TITLE.
This Act may be cited as the “Trial of Financial Incentives (Fi) for Living Kidney Donors and Families of Deceased Donors Act.”.
SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.
(a) Developing Pilot Program for Financial Incentives.undefined
(1) Organ Procurement and Transplantation Network.undefinedSection 372(b) of the Public Health Service Act (42 U.S.C. § 274(b)) is amended in subsection (2) by adding at the end the following:
(P) No later than six months after the date of enactment of the Trial of Financial Incentives (Fi) for Living Kidney Donors and Families of Deceased Donors Act, develop and implement an experimental policy, consistent with 42 C.F.R. § 121.8(g), for providing financial incentives (hereafter, “Fi”) to living kidney donors and families of deceased donors of organs.
(Q) The Fi program created pursuant to subparagraph (P) shall not:
(i) Alter the standards and methods of organ distribution under subparagraph (D), except that living kidney donors shall receive the next available kidney upon failure of their remaining kidney, and organs shall be allocated first to those transplantable patients with the shortest life expectancy; Presently kidneys are allocated to the patients who have been on the waiting list the longest even though others on the waiting list may have a shorter life expectancy.
(ii) Alter the quality standards used pursuant to subparagraph (E) Maintains quality control and ensures the present protocols that screen and qualify living donors to donate a kidney will also be utilized for patients who receive Fi. ; or
(iii) Permit payments to the family of an adult deceased donor if the donor was not registered with “Donate Life America” to be an organ donor or did not otherwise state an intention to be an organ donor in a will or advanced directive. 1) Reinforces the existing efforts to promote organ donation and 2) insures that the wishes of a deceased donor to not be an organ donor are honored
(R) The Fi program created pursuant to subparagraph (P) shall:
(i) Prohibit Fi payments to non-U.S. Citizens; Prevents non-U.S. Citizens who reside in other countries from coming to the USA for Fi
(ii) Prohibit spouses who are parents to children under age 18 from having living donor kidney surgeries for Fi within 30 days of one another; When both parents who have children wish to donate, this section ensures one living-donor parent is with the children while the other living-donor parent is being transplanted and recovering (hospital stay post-kidney-transplant is usually 2-3 days). Both parents donating a kidney doubles the family's Fi to $100,000.
(iii) Prohibit any additional payment arrangements, other than those Fi payments made by Medicare pursuant to the Trial of Financial Incentives (Fi) for Living Kidney Donors and Families of Deceased Donors Act, from being made among living kidney donors and recipients, families of deceased donors and recipients, or any other person, for organs donated in exchange for Fi payments; and
(iv) Prohibit Fi payments to living kidney donors who did not undergo a waiting period of at least two weeks prior to donation.
(iv) ensures that persons desirous of being a living kidney donor for Fi have time to reconsider their decision.
(S) No later than one year after the date of enactment of the Trial of Financial Incentives (Fi) for Living Kidney Donors and Families of Deceased Donors Act, and every year thereafter, submit to the Secretary a report containing information including but not limited to the costs and patient outcomes associated with organs donated in exchange for Fi compared to previous costs and outcomes of patients receiving organs from uncompensated donors.
(T) For the purposes of this section, the terms “financial incentives” and Fi mean a tax-free monetary payment of $50,000.00 The purpose of Fi is not simply to increase organ donation but to eliminate the waiting list (~121,000) and provide a kidney for all patients on dialysis who would survive the surgery (~400,000). Of those 521,000 patients, 412,405 are in need of a kidney therefore living kidney donation would provide an organ for 79 percent of those in need. In order to attract hundreds of thousands of living kidney donors and make deceased donation more likely, a substantial remuneration is needed. (It should be noted that since the inception of USA organ donation there have never been more than 14,750 total donors [living and deceased] in any one year utilizing the present organ donor policies, and in 2012 a patient on the waiting list died every 48 minutes.)
This Fi of $50,000 not only provides that significant financial incentive to donate, it is extremely cost effective: The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) itemizes the cost of end-stage-renal disease (ESRD) at $42.5 billion in the most recent reported yearundefined2009. Prorating that to 2014 one may estimate the present cost of ESRD at approximately $50 billion dollars. Once all patients on dialysis are transplanted, the savings to Medicare and the US Treasury would be $50 billion annuallyundefinedforeverundefinedand when a new ESRD patient is nearing the need for dialysis the transplant center only need call in the next citizen who wishes to receive Fiundefineddialysis will not be required.
in the recipient’s elected form of tax credit, tax deduction, retirement plan contribution, direct deposit, direct-to-charitable donation, All of these options benefit middle income and upper income citizens. "Direct deposit" ensures citizens with little or no income can also have a substantial benefit from Fi payable by Medicare Medicare is the chosen payor because it is Medicare that will have the existing ~$50 billion annual ESRD expense eliminated to qualifying living kidney donors and families of adult deceased donors in exchange for the donation. Qualifying donations shall be determined under existing procedures, maintains quality control and ensures the present protocols that screen and qualify living donors to donate a kidney will also be utilized for patients who receive Fi and such procedures shall not discriminate on the basis of sex, race, religion, or sexual orientation ensures Fi is available if a prospective donor is gay, lesbian, bisexual, transsexual, transgender, etc.
(U) No living kidney donor shall be denied health or life insurance on the basis of having been a living kidney donor.
(b) Reporting.undefinedSection 376 of the Public Health Service Act (42 U.S.C. § 274d) is amended by inserting after “and clinical status of organ transplantation” the following: “, including information transmitted to the Secretary pursuant to 42 U.S.C. § 274(b)(2)(S).” S is part of this Act.
SEC. 3. AMENDMENTS TO THE NATIONAL ORGAN TRANSPLANT ACT.
(a) Removal of Prohibition.undefinedSection 301 of the National Organ Transplant Act (42 U.S.C. § 274e) is amended in section (a) by adding immediately after “The preceding sentence does not apply with respect to human organ paired donation” the following: “, nor with respect to financial incentives (Fi) provided to living kidney donors and families of deceased donors pursuant to the trial program created by the Organ Procurement and Transplantation Network in accordance with 42 U.S.C. § 274(b)(2)(P).” P is part of this Act.
(b) Supersedure.undefinedSection 301 of the National Organ Transplant Act (42 U.S.C. § 274e) is further amended by adding at the end the following:
(d) The provisions of this subchapter shall supersede any and all State laws insofar as they may now or hereafter relate to the donation of organs in exchange for financial incentives (Fi).