[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10282 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 10282
To amend the Public Health Service Act with respect to the Living Organ
Donation Reimbursement Program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
December 4, 2024
Ms. DelBene (for herself, Mr. Bucshon, Ms. Schrier, Mrs. Miller of West
Virginia, Mr. Nadler, and Ms. Kelly of Illinois) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, 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
_______________________________________________________________________
A BILL
To amend the Public Health Service Act with respect to the Living Organ
Donation Reimbursement Program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Expanding Support for Living Donors
Act of 2024''.
SEC. 2. NO CONSIDERATION OF INCOME OF ORGAN RECIPIENT.
Section 377 of the Public Health Service Act (42 U.S.C. 274f) is
amended--
(1) by redesignating subsections (c), (d), (e), and (f) as
subsections (d), (e), (i), and (j), respectively;
(2) by inserting after subsection (b) the following:
``(c) No Consideration of Income of Organ Recipient.--The recipient
of a grant under this section, in providing reimbursement to a donating
individual through such grant, shall not give any consideration to the
income of the organ recipient.''; and
(3) in subsection (i), as so redesignated--
(A) in paragraph (1), by striking ``subsection
(c)(1)'' and inserting ``subsection (d)(1)''; and
(B) in paragraph (2), by striking ``subsection
(c)(2)'' and inserting ``subsection (d)(2)''.
SEC. 3. REMOVAL OF EXPECTATION OF PAYMENTS BY ORGAN RECIPIENTS.
Section 377(e) of the Public Health Service Act (42 U.S.C.
274f(e)), as redesignated by section 2, is amended--
(1) in paragraph (1), by adding ``or'' at the end;
(2) in paragraph (2), by striking ``; or'' and inserting a
period; and
(3) by striking paragraph (3).
SEC. 4. ENSURING ELIGIBILITY OF DONATING INDIVIDUALS WHOSE HOUSEHOLD
INCOME IS AT OR BELOW 700 PERCENT OF THE POVERTY LINE.
Section 377 of the Public Health Service Act (42 U.S.C. 274f), as
amended by section 2, is further amended by inserting after subsection
(e) the following:
``(f) Eligibility of Donating Individuals Based on Household
Income.--
``(1) In general.--In providing reimbursement to donating
individuals using funds from grant awards under this section,
the recipient of the grant award shall not limit the
eligibility of a donating individual for such reimbursement
based on the individual's income if the individual's household
income is at or below 700 percent of the poverty line.
``(2) Definition.--In this section, the term `poverty line'
means the applicable poverty line as set forth in the most
recent poverty guidelines of the Department of Health and Human
Services published under the authority of section 673(2) of the
Community Services Block Grant Act.''.
SEC. 5. MAXIMUM AMOUNT OF REIMBURSEMENT.
Section 377 of the Public Health Service Act (42 U.S.C. 274f), as
amended by section 4, is further amended by inserting after subsection
(f) the following:
``(g) Reimbursement Amount.--
``(1) In general.--The amount of reimbursement of
qualifying expenses provided by a recipient of a grant award
under this section to each such donating individual shall be
the lesser of--
``(A) the total amount of the donating individual's
qualifying expenses; and
``(B) the maximum permissible amount described in
paragraph (2).
``(2) Maximum permissible amount.--
``(A) Rule.--Subject to subparagraph (B), the
maximum permissible amount described in this section
is--
``(i) for fiscal year 2026, $10,000; and
``(ii) for subsequent fiscal years, the
maximum permissible amount allowed under this
subsection for the preceding fiscal year
adjusted by the total percentage change
(rounded to the nearest hundredth) that
occurred in the Consumer Price Index for all
urban consumers (all items; United States city
average) for the preceding fiscal year.
``(B) Exception for recipients based on
insufficient funds.--The Secretary may, with respect to
reimbursement provided by a recipient of a grant award
under this section to donating individuals, lower the
maximum permissible amount under subparagraph (A) for a
fiscal year if the Secretary--
``(i) determines that such recipient has
insufficient funds to provide the full amount
that would otherwise apply under paragraph (1)
to all donating individuals; and
``(ii) at least 30 days before making such
determination effective, provides to the
Congress written notice of such determination,
including a justification.
``(C) Special rules.--If the Secretary, with
respect to reimbursement provided by a recipient of a
grant award under this section to donating individuals,
makes a determination under subparagraph (B) to lower
the maximum permissible amount under subparagraph (A)
for a fiscal year--
``(i) such determination shall not affect
the amount of reimbursement for any approved
donating individual prior to the effective date
of such determination; and
``(ii) the maximum permissible amount under
subparagraph (A)(ii) for any subsequent year
shall be calculated without regard to such
lowered amount.''.
SEC. 6. ANNUAL REPORT.
Section 377 of the Public Health Service Act (42 U.S.C. 274f), as
amended by section 5, is amended by inserting after subsection (g) the
following:
``(h) Annual Report.--Not later than the end of fiscal year 2025
and annually thereafter, the Secretary--
``(1) shall submit to the Congress, and make publicly
available, a report on the impacts, ongoing activities,
challenges, and future needs of the program under this section;
``(2) shall include in each such report, for the year
covered by the report--
``(A) an overview of the program under this
section;
``(B) current and trended historical information
about the program under this section, including--
``(i) the total number of donating
individuals applying for reimbursement;
``(ii) the average and median reimbursement
amount provided to donating individuals;
``(iii) demographic information regarding--
``(I) donating individuals applying
for reimbursement; and
``(II) donating individuals
approved for reimbursement;
``(iv) the types of expenses for which
reimbursement was requested (including requests
for reimbursement of non-qualifying expenses);
``(v) the amount of funding provided to
donating individuals with respect to each such
type of expenses;
``(vi) the amount of funding provided to
donating individuals with respect to each organ
category;
``(vii) the total amount expended to carry
out this section, disaggregated by--
``(I) the amount expended by the
Secretary and the recipients of grants
under this section on administrative
expenses; and
``(II) the amount provided to
donating individuals as reimbursement;
``(C) the impacts of the program under this
section, including--
``(i) the number of completed donations for
which reimbursement was provided;
``(ii) the proportion of living donor
transplants in the United States in which the
donor received reimbursement through the
program under this section;
``(iii) an estimate of the savings to the
Medicare program under title XVIII of the
Social Security Act resulting from the program
under this section, both--
``(I) for the year covered by the
report; and
``(II) cumulatively since the
program's creation;
``(D) the types of donations made by donating
individuals receiving reimbursement, disaggregated
according to--
``(i) the type of organ donated; and
``(ii) whether the donations were directed,
non-directed, or a paired exchange;
``(E) a description of any efforts to expand or
improve the program under this section;
``(F) a description of the efforts of the Secretary
and recipients of grants under this section to increase
awareness of the program under this section;
``(G) a description of challenges experienced by
the program under this section, including--
``(i) the number and percentage of donating
individuals applying for reimbursement whose
qualifying expenses approached or exceeded the
maximum amount allowed under subsection (g);
and
``(ii) an estimate of the total funding
needed to fully reimburse, without regard to
the maximum amount allowed under subsection (g)
or donor income eligibility caps, all donating
individuals in the United States for all
qualifying expenses; and
``(H) areas of concern regarding, and identified
barriers to, the elimination of financial disincentives
to living organ donation; and
``(3) in addition to the matters listed in paragraph (2),
may include other such other matters as may be specified by the
Secretary.''.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS.
Subsection (j) of section 377 of the Public Health Service Act (42
U.S.C. 274f), as redesignated by section 2, is amended by striking ``is
authorized to be appropriated $5,000,000 for each of the fiscal years
2005 through 2009'' and inserting ``are authorized to be appropriated
such sums as may be necessary for fiscal years 2026 through 2035''.
SEC. 8. GAO STUDY.
Not later than 1 year after the date of enactment of this Act, the
Comptroller General of the United States shall--
(1) conduct a study on how the Medicare program under title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)
could, under existing statutory authorities, pay costs that
would otherwise be paid through the Living Organ Donation
Reimbursement Program under section 377 of the Public Health
Service Act (42 U.S.C. 274f); and
(2) submit to the Congress a report on the results of such
study, including recommendations for any changes needed to
achieve such purpose.
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