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<bill bill-stage="Introduced-in-House" dms-id="H1B84431596A14F7587DD069137E4CA39" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>119 HR 4470 IH: Removing Burdens From Organ Donation Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2025-07-16</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 4470</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20250716">July 16, 2025</action-date><action-desc><sponsor name-id="V000134">Ms. Van Duyne</sponsor> (for herself, <cosponsor name-id="D000617">Ms. DelBene</cosponsor>, <cosponsor name-id="M001205">Mrs. Miller of West Virginia</cosponsor>, and <cosponsor name-id="C001059">Mr. Costa</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HWM00">Committee on Ways and Means</committee-name>, and in addition to the Committee on <committee-name committee-id="HIF00">Energy and Commerce</committee-name>, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To amend title XI of the Social Security Act to require hospitals participating in the Medicare and Medicaid programs to establish certain notification procedures with respect to organ procurement agencies.</official-title></form><legis-body id="HDF5EA17F0C834F92B6514992496BEA9D" style="OLC"> 
<section id="H84BF51648CD94A4D9A656717F552454F" section-type="section-one"><enum>1.</enum><header>Short title</header>
 <text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Removing Burdens From Organ Donation Act</short-title></quote>.</text></section> 
<section id="H9113D2AF5BBB443A87A24E0003962058"><enum>2.</enum><header>Notifying organ procurement agencies with respect to potential organ donors</header> 
<subsection id="H13FD1B2B7BA8476693A0E6E222522B67"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1138(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-8">42 U.S.C. 1320b–8(a)</external-xref>) is amended—</text> <paragraph id="H0FB337A8221144C39BFDE3DBE1B73BED"><enum>(1)</enum><text>in paragraph (1)(A)(iii)—</text> 
<subparagraph id="HBFCF62A68B1F4D44B8275219DFC08E37"><enum>(A)</enum><text>by adding <quote>and</quote> at the end;</text></subparagraph> <subparagraph id="H0FDC29DF3C3943E0B5DC340B9F490B77"><enum>(B)</enum><text>by striking <quote>that such</quote> and inserting</text> 
<quoted-block style="OLC" id="H9D4C136B2CA34F59B9FA3D12D840058F" display-inline="yes-display-inline"><text display-inline="yes-display-inline">that—</text> <subclause id="HC64E8B6DABE347B59669E05489AA4050"><enum>(I)</enum><text display-inline="yes-display-inline">such</text></subclause><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph> 
<subparagraph id="H570B80B3D30A40B2BFC255D260E4EDD7"><enum>(C)</enum><text>by adding at the end the following new subclause:</text> <quoted-block style="OLC" id="H6A5ECF49B5614F50AA68B754682FD20F" display-inline="no-display-inline"> <subclause id="HE0B51DA8DBD24118945087A86B2814BB"><enum>(II)</enum><text display-inline="yes-display-inline">subject to paragraph (4), beginning on the date that is 2 years after the date of the enactment of the Removing Burdens From Organ Donation Act, with respect to such a potential organ donor, such hospital’s designated organ procurement agency is issued an automated electronic notification and is provided electronic and remote access to the electronic health records of such potential organ donor when such electronic health records are updated to indicate that such potential organ donor is deceased or that the death of such potential organ donor is imminent, as determined in accordance with the protocol described in section 482.45(a)(1) of title 42, Code of Federal Regulations (or any successor regulation);</text></subclause><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph> 
<paragraph id="HD600AF43AFBC491799F4839F4DE75A49"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block style="OLC" id="H45032C30B12B464D9E436F50ECE2B070" display-inline="no-display-inline"> <paragraph id="H12C3D6006C26460082F0B89C164F2C26"><enum>(4)</enum><header>Exemptions from automated EHR access requirement</header> <subparagraph id="HC2ECCFEC8B714CD6A67471392F602B7A"><enum>(A)</enum><header>Exemptions</header> <clause id="H147F1C49F04748DDBB1596710F3EDA14"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may exempt a hospital or critical access hospital from the automated electronic notification and remote access requirement under paragraph (1)(A)(iii)(II) for a period of 3 years if the Secretary determines that meeting such requirement would result in a significant hardship, such as in the case of a hospital or critical access hospital located in a rural area without sufficient Internet access, or other exceptional circumstances demonstrated by the hospital.</text></clause> 
<clause id="H958BD7B087914B8BAC1C0E269246F6A3"><enum>(ii)</enum><header>Automatic exemption</header><text display-inline="yes-display-inline">The Secretary shall grant an exemption described in clause (i) to a hospital or critical access hospital for a period of 1 year if the Secretary determines that such hospital is affected by a cybersecurity attack (as defined in <internal-xref idref="H3B76DD0D610C4EBE913B2C0CF5AB2B1A" legis-path="(4)(C)">subparagraph (C)</internal-xref>), or is located in an area affected by a major disaster (as defined in section 5122(2) of title 42, United States Code) or any other natural or man-made disaster, and shall notify such hospital or critical access hospital of such exemption.</text></clause> <clause id="H501396F4BEDE4992A66EDE6911E23629"><enum>(iii)</enum><header>Extension</header><text display-inline="yes-display-inline">The Secretary may extend an exemption granted under clause (i) or (ii) if the hospital or critical access hospital demonstrates to the satisfaction of the Secretary that such an extension is necessary.</text></clause></subparagraph> 
<subparagraph id="H6F43E06BEA494647AD9B31547E9BB5DE"><enum>(B)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 2 years after the date of the enactment of the Removing Burdens From Organ Donation Act, and not less frequently than annually thereafter, the Secretary shall submit to the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Finance and the Committee on Health, Education, Labor, and Pensions of the Senate, a report on the number of exemptions granted under <internal-xref idref="HC2ECCFEC8B714CD6A67471392F602B7A" legis-path="(4)(A)">subparagraph (A)</internal-xref> during the previous year and the reason for granting each such exemption.</text></subparagraph> <subparagraph id="H3B76DD0D610C4EBE913B2C0CF5AB2B1A"><enum>(C)</enum><header>Cybersecurity attack defined</header><text display-inline="yes-display-inline">For purposes of <internal-xref idref="HC2ECCFEC8B714CD6A67471392F602B7A" legis-path="(4)(A)">subparagraph (A)</internal-xref>, the term <term>cybersecurity attack</term> means, with respect to a hospital or a critical access hospital, any kind of malicious activity that—</text> 
<clause id="H5F5428CF65F14A418C67F099EF779B8A"><enum>(i)</enum><text>attempts to collect, modify, disrupt, deny, degrade, or destroy information system resources of the hospital, including the information itself;</text></clause> <clause id="H02C778A222DF4DA1962023A4DC75E516"><enum>(ii)</enum><text>affects the confidentiality, integrity or availability of data, information, or operational technology system resources of the hospital; or</text></clause> 
<clause id="H82A62D18FE0E4D5A9FEB554AD4DC64E4"><enum>(iii)</enum><text display-inline="yes-display-inline">poses any other threat to the information, information systems, technology, or technological capabilities of the hospital, as determined by the Secretary.</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H2D0A793A0D834167B8ED37E4397DB0E7"><enum>(b)</enum><header>Guidance on best practices</header> <paragraph id="HA46283B9890447D58E844E6AED096B87"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall issue guidance to hospitals, critical access hospitals, organ procurement agencies, and electronic health record companies regarding best practices for complying with the automated electronic notification and remote access requirement under subclause (II) of section 1138(a)(1)(A)(iii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-8">42 U.S.C. 1320b–8(a)(1)(A)(iii)</external-xref>), as added by subsection (a). Such guidance shall be based upon the experiences of entities that have previous experience with the implementation of similar automated electronic notifications and remote access, and shall provide insights on what worked well and what did not.</text></paragraph> 
<paragraph id="H3B048E800C7F450B83FCC794D91A7147"><enum>(2)</enum><header>Explanation of changes to donors and family members</header><text display-inline="yes-display-inline">Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall issue guidance to State health agencies (or such other State agency, department, or authority as the Governor of each State may determine appropriate) regarding best practices for explaining the automated electronic notification and remote access requirement under subclause (II) of section 1138(a)(1)(A)(iii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-8">42 U.S.C. 1320b–8(a)(1)(A)(iii)</external-xref>), as added by subsection (a), to organ donors, potential organ donors, and the family members of such donors and potential donors.</text></paragraph></subsection> <subsection id="HE4B06858363F40E0A188ACE5CC241B3B"><enum>(c)</enum><header>GAO report and study</header><text display-inline="yes-display-inline">The Comptroller General of the United States (in this subsection referred to as the <quote>Comptroller General</quote>) shall—</text> 
<paragraph id="H1C0A11E06EF34C28B76D6EA40ACC740C"><enum>(1)</enum><text>carry out a study on the implementation of the automated electronic notification and remote access requirement under subclause (II) of section 1138(a)(1)(A)(iii) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-8">42 U.S.C. 1320b–8(a)(1)(A)(iii)</external-xref>), as added by subsection (a), that takes into account—</text> <subparagraph id="H15E29F5CAEA64482A9ED7E9EEDE1D1F3" display-inline="no-display-inline"><enum>(A)</enum><text>the cost of implementing the automated electronic notification and remote access requirement described in such paragraph;</text></subparagraph> 
<subparagraph id="HBD7B9AA6EC22451794260E00638BF68C"><enum>(B)</enum><text>the impact of hospital location on the implementation of such requirement, including the impact of limited broadband access in rural areas, and improvements that could be made to facilitate such implementation; and</text></subparagraph> <subparagraph id="HDB0D069BC1D94409A0EA8C2555974CD2"><enum>(C)</enum><text display-inline="yes-display-inline">the reports submitted by the Secretary pursuant to paragraph (4)(B) of section 1138(a) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1320b-8">42 U.S.C. 1320b–8(a)</external-xref>), as added by subsection (a); and</text></subparagraph></paragraph> 
<paragraph id="H0A1D8E24E0904C6FA40EDA8F7147FEF4"><enum>(2)</enum><text display-inline="yes-display-inline">not later than 3 years after the date of the enactment of the Removing Burdens from Organ Donation Act, submit to Congress a report on the results of the study carried out under paragraph (1) that includes—</text> <subparagraph id="H4D030D56B1C4455681105FF4DEAB3EF9"><enum>(A)</enum><text display-inline="yes-display-inline">an analysis of data maintained by the Department of Health and Human Services related to the outcomes of organ transplants performed after the enactment of the Removing Burdens from Organ Donation Act;</text></subparagraph> 
<subparagraph id="H9909CD5CAAD94FEB82F773A62617C0B1"><enum>(B)</enum><text display-inline="yes-display-inline">a review of issues related to securing patient data and the roles of the Centers for Medicare &amp; Medicaid Services and the Health Resources and Services Administration with respect to those issues; and</text> </subparagraph> <subparagraph id="H636A369175214ED6BC2A36CD32AA65F4"><enum>(C)</enum><text>any recommendations for further action, as appropriate.</text></subparagraph> </paragraph></subsection></section> 
</legis-body></bill>

