[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1782 Reported in Senate (RS)]
<DOC>
Calendar No. 441
119th CONGRESS
2d Session
S. 1782
To prohibit discrimination on the basis of mental or physical
disability in cases of organ transplants.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 15, 2025
Mrs. Moody (for herself, Ms. Hassan, Mr. Scott of Florida, Ms. Smith,
Mr. Daines, Mr. Kaine, Mrs. Hyde-Smith, Mr. Whitehouse, Mrs. Blackburn,
Mr. Warner, Mr. Schmitt, Mr. Warnock, Mr. Coons, Mr. Justice, Mr.
Marshall, Mr. Kelly, Mr. Fetterman, Mr. Van Hollen, Mr. Reed, Mrs.
Gillibrand, Mr. Budd, and Mrs. Capito) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
June 22, 2026
Reported by Mr. Cassidy, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To prohibit discrimination on the basis of mental or physical
disability in cases of organ transplants.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE.</DELETED>
<DELETED> This Act may be cited as the ``Charlotte Woodward Organ
Transplant Discrimination Prevention Act''.</DELETED>
<DELETED>SEC. 2. DEFINITIONS.</DELETED>
<DELETED> In this Act:</DELETED>
<DELETED> (1) Auxiliary aids and services.--The term
``auxiliary aids and services'' has the meaning given the term
in section 4 of the Americans with Disabilities Act of 1990 (42
U.S.C. 12103).</DELETED>
<DELETED> (2) Covered entity.--The term ``covered entity''
means any licensed provider of health care services (including
licensed health care practitioners, hospitals, nursing
facilities, laboratories, intermediate care facilities,
psychiatric residential treatment facilities, institutions for
individuals with intellectual or developmental disabilities,
and prison health centers), and any transplant hospital (as
defined in section 121.2 of title 42, Code of Federal
Regulations or a successor regulation), that--</DELETED>
<DELETED> (A) is in interstate commerce;
or</DELETED>
<DELETED> (B) provides health care services in a
manner that--</DELETED>
<DELETED> (i) substantially affects or has a
substantial relation to interstate commerce;
or</DELETED>
<DELETED> (ii) includes use of an instrument
(including an instrument of transportation or
communication) of interstate
commerce.</DELETED>
<DELETED> (3) Disability.--The term ``disability'' has the
meaning given the term in section 3 of the Americans with
Disabilities Act of 1990 (42 U.S.C. 12102).</DELETED>
<DELETED> (4) Human organ.--The term ``human organ'' has the
meaning given the term in section 301(c) of the National Organ
Transplant Act (42 U.S.C. 274e(c)).</DELETED>
<DELETED> (5) Organ transplant.--The term ``organ
transplant'' means the transplantation or transfusion of a
donated human organ into the body of another human for the
purpose of treating a medical condition.</DELETED>
<DELETED> (6) Qualified individual.--The term ``qualified
individual'' means an individual who, with or without a support
network, provision of auxiliary aids and services, or
reasonable modifications to policies or practices, meets
eligibility requirements for the receipt of a human
organ.</DELETED>
<DELETED> (7) Reasonable modifications to policies or
practices.--The term ``reasonable modifications to policies or
practices'' includes--</DELETED>
<DELETED> (A) communication with persons responsible
for supporting a qualified individual with postsurgical
or other care following an organ transplant or related
services, including support with medication;</DELETED>
<DELETED> (B) consideration, in determining whether
a qualified individual will be able to comply with
health requirements following an organ transplant or
receipt of related services, of support networks
available to the qualified individual, including
family, friends, and providers of home and community-
based services, including home and community-based
services funded through the Medicare or Medicaid
program under title XVIII or XIX, respectively, of the
Social Security Act (42 U.S.C. 1395 et seq., 1396 et
seq.), another health plan in which the qualified
individual is enrolled, or any program or source of
funding available to the qualified individual;
and</DELETED>
<DELETED> (C) the use of supported decision-making,
when needed, by a qualified individual.</DELETED>
<DELETED> (8) Related services.--The term ``related
services'' means services related to an organ transplant that
consist of--</DELETED>
<DELETED> (A) evaluation;</DELETED>
<DELETED> (B) counseling;</DELETED>
<DELETED> (C) treatment, including postoperative
treatment, and care;</DELETED>
<DELETED> (D) provision of information;
and</DELETED>
<DELETED> (E) any other service recommended or
required by a physician.</DELETED>
<DELETED> (9) Supported decision-making.--The term
``supported decision-making'' means the use of a support person
to assist a qualified individual in making health care
decisions, communicate information to the qualified individual,
or ascertain a qualified individual's wishes. Such term
includes--</DELETED>
<DELETED> (A) the inclusion of the individual's
attorney-in-fact or health care proxy, or any person of
the individual's choice, in communications about the
individual's health care;</DELETED>
<DELETED> (B) permitting the individual to designate
a person of the individual's choice for the purposes of
supporting that individual in communicating, processing
information, or making health care decisions;</DELETED>
<DELETED> (C) providing auxiliary aids and services
to facilitate the individual's ability to communicate
and process health-related information, including
providing use of assistive communication
technology;</DELETED>
<DELETED> (D) providing health information to
persons designated by the individual, consistent with
the regulations promulgated under section 264(c) of the
Health Insurance Portability and Accountability Act of
1996 (42 U.S.C. 1320d-2 note) and other applicable laws
and regulations governing disclosure of health
information;</DELETED>
<DELETED> (E) providing health information in a
format that is readily understandable by the
individual; and</DELETED>
<DELETED> (F) working with a court-appointed
guardian or other person responsible for making health
care decisions on behalf of the individual, to ensure
that the individual is included in decisions involving
the health care of the individual and that health care
decisions are in accordance with the individual's own
expressed interests.</DELETED>
<DELETED> (10) Support network.--The term ``support
network'' means, with respect to a qualified individual, 1 or
more people who are--</DELETED>
<DELETED> (A) selected by the qualified individual
or by the qualified individual and the guardian of the
qualified individual, to provide assistance to the
qualified individual or guidance to that qualified
individual in understanding issues, making plans for
the future, or making complex decisions; and</DELETED>
<DELETED> (B) who may include the family members,
friends, unpaid supporters, members of the religious
congregation, and appropriate personnel at a community
center, of or serving the qualified
individual.</DELETED>
<DELETED>SEC. 3. PROHIBITION OF DISCRIMINATORY POLICY.</DELETED>
<DELETED> The board of directors described in section 372(b)(1)(B)
of the Public Health Service Act (42 U.S.C. 274(b)(1)(B)) shall not
issue policies, recommendations, or other memoranda that would
prohibit, or otherwise hinder, a qualified individual's access to an
organ transplant solely on the basis of that individual's
disability.</DELETED>
<DELETED>SEC. 4. PROHIBITION OF DISCRIMINATION.</DELETED>
<DELETED> (a) In General.--Subject to subsection (b), a covered
entity may not, solely on the basis of a qualified individual's
disability--</DELETED>
<DELETED> (1) determine that the individual is ineligible to
receive an organ transplant or related services;</DELETED>
<DELETED> (2) deny the individual an organ transplant or
related services;</DELETED>
<DELETED> (3) refuse to refer the individual to an organ
transplant center or other related specialist for the purpose
of receipt of an organ transplant or other related services;
or</DELETED>
<DELETED> (4) refuse to place the individual on an organ
transplant waiting list.</DELETED>
<DELETED> (b) Exception.--</DELETED>
<DELETED> (1) In general.--</DELETED>
<DELETED> (A) Medically significant disabilities.--
Notwithstanding subsection (a), a covered entity may
take a qualified individual's disability into account
when making a health care treatment or coverage
recommendation or decision, solely to the extent that
the disability has been found by a physician, following
an individualized evaluation of the potential
recipient, to be medically significant to the receipt
of the organ transplant or related services, as the
case may be.</DELETED>
<DELETED> (B) Construction.--Subparagraph (A) shall
not be construed to require a referral or
recommendation for, or the performance of, a medically
inappropriate organ transplant or medically
inappropriate related services.</DELETED>
<DELETED> (2) Clarification.--If a qualified individual has
the necessary support network to provide a reasonable assurance
that the qualified individual will be able to comply with
health requirements following an organ transplant or receipt of
related services, as the case may be, the qualified
individual's inability to independently comply with those
requirements may not be construed to be medically significant
for purposes of paragraph (1).</DELETED>
<DELETED> (c) Reasonable Modifications.--A covered entity shall make
reasonable modifications to policies or practices (including
procedures) of such entity if such modifications are necessary to make
an organ transplant or related services available to qualified
individuals with disabilities, unless the entity can demonstrate that
making such modifications would fundamentally alter the nature of such
policies or practices.</DELETED>
<DELETED> (d) Clarifications.--</DELETED>
<DELETED> (1) No denial of services because of absence of
auxiliary aids and services.--For purposes of this section, a
covered entity shall take such steps as may be necessary to
ensure that a qualified individual with a disability is not
denied a procedure associated with the receipt of an organ
transplant or related services, because of the absence of
auxiliary aids and services, unless the covered entity can
demonstrate that taking such steps would fundamentally alter
the nature of the procedure being offered or would result in an
undue burden on the entity.</DELETED>
<DELETED> (2) Compliance with other law.--Nothing in this
section shall be construed--</DELETED>
<DELETED> (A) to prevent a covered entity from
providing organ transplants or related services at a
level that is greater than the level that is required
by this section; or</DELETED>
<DELETED> (B) to limit the rights of an individual
with a disability under, or to replace or limit the
scope of obligations imposed by, the Americans with
Disabilities Act of 1990 (42 U.S.C. 12101 et seq.)
including the provisions added to such Act by the ADA
Amendments Act of 2008 (Public Law 110-325), section
504 of the Rehabilitation Act of 1973 (29 U.S.C. 794),
section 1557 of the Patient Protection and Affordable
Care Act (42 U.S.C. 18116), or any other applicable
law.</DELETED>
<DELETED> (e) Enforcement.--</DELETED>
<DELETED> (1) In general.--Any individual who alleges that a
qualified individual was subject to a violation of this section
by a covered entity may bring a claim regarding the allegation
to the Office for Civil Rights of the Department of Health and
Human Services, for expedited resolution, as
appropriate.</DELETED>
<DELETED> (2) Rule of construction.--Nothing in this
subsection is intended to limit or replace available remedies
under the Americans with Disabilities Act of 1990 (42 U.S.C.
12101 et seq.) or any other applicable law.</DELETED>
<DELETED>SEC. 5. APPLICATION TO EACH PART OF PROCESS.</DELETED>
<DELETED> The provisions of this Act--</DELETED>
<DELETED> (1) that apply to an organ transplant, also apply
to the evaluation and listing of a qualified individual, and to
the organ transplant and post-organ-transplant treatment of
such an individual; and</DELETED>
<DELETED> (2) that apply to related services, also apply to
the process for receipt of related services by such an
individual.</DELETED>
<DELETED>SEC. 6. EFFECT ON OTHER LAWS.</DELETED>
<DELETED> Nothing in this Act shall be construed to supersede any
provision of any State or local law that provides greater rights to
qualified individuals with respect to organ transplants than the rights
established under this Act.</DELETED>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Charlotte Woodward Organ Transplant
Discrimination Prevention Act''.
SEC. 2. DEFINITIONS.
In this Act:
(1) Auxiliary aids and services.--The term ``auxiliary aids
and services'' has the meaning given the term in section 4 of
the Americans with Disabilities Act of 1990 (42 U.S.C. 12103).
(2) Covered entity.--The term ``covered entity'' means
any--
(A) entity operating a program or activity,
involving an organ transplant or related services,
receiving Federal financial assistance; or
(B) public entity covered by title II of the
Americans with Disabilities Act of 1990 (42 U.S.C.
12131 et seq.) that carries out activities relating to
such a transplant or services.
(3) Disability.--The term ``disability'' has the meaning
given the term in section 3 of the Americans with Disabilities
Act of 1990 (42 U.S.C. 12102).
(4) Organ.--The term ``organ'' has the meaning given the
term ``human organ'' in section 301(c) of the National Organ
Transplant Act (42 U.S.C. 274e(c)).
(5) Qualified individual with a disability.--The term
``qualified individual with a disability'' means such
individual within the meaning of the term as used in title II
of the Americans with Disabilities Act of 1990 (42 U.S.C. 12131
et seq.), section 504 of the Rehabilitation Act of 1973 (29
U.S.C. 794), and any other applicable Federal law, including
their implementing regulations.
(6) Reasonable modifications.--The term ``reasonable
modifications'' means such modifications within the meaning of
the term as used in or for the Americans with Disabilities Act
of 1990 (42 U.S.C. 12101 et seq.), section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. 794), and any other
applicable Federal law, including their implementing
regulations.
(7) Related services.--The term ``related services'' means
services, including the process by which an individual receives
such services, related to an organ transplant that consist of--
(A) evaluation and listing on the transplant
waiting lists;
(B) counseling;
(C) treatment, including postoperative treatment,
and care;
(D) provision of information; and
(E) any other service recommended or required by a
physician.
SEC. 3. PROHIBITION OF DISCRIMINATORY POLICY.
Section 372(b)(2)(B) of the Public Health Service Act (42 U.S.C.
274(b)(2)(B)) is amended to read as follows:
``(B) establish membership criteria and medical
criteria for allocating organs, which shall not include
medical criteria that would discriminate on the basis
of disability in access to an organ transplant, and
provide to members of the public an opportunity to
comment with respect to such membership and medical
criteria;''.
SEC. 4. PROHIBITION OF DISCRIMINATION.
(a) In General.--Consistent with section 504 of the Rehabilitation
Act of 1973 (29 U.S.C. 794), the Americans with Disabilities Act of
1990 (42 U.S.C. 12101 et seq.), and any other applicable Federal law,
including their implementing regulations, and, subject to subsection
(b), a covered entity shall not, on the basis of the disability of a
qualified individual with a disability--
(1) determine that the individual is ineligible to receive
an organ transplant or related services;
(2) deny the individual an organ transplant or related
services;
(3) refuse to refer the individual to an organ transplant
center or other related specialist for the purpose of receipt
of an organ transplant or other related services;
(4) refuse to place the individual on the transplant
waiting lists; or
(5) otherwise discriminate based on disability with respect
to the provision of an organ transplant or related services.
(b) Exception.--
(1) Professional judgment in treatment.--Notwithstanding
subsection (a), following an individualized assessment by a
covered entity, the covered entity may take the disability of a
qualified individual with a disability into account in carrying
out a program or activity consistent with section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. 794), the Americans with
Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), and any
other applicable Federal law, including their implementing
regulations, including section 84.56 of title 45, Code of
Federal Regulations, as in effect on the date of enactment of
this Act.
(2) Clarification.--If a qualified individual with a
disability would be able to comply with the health requirements
following an organ transplant or provision of related services
if given the necessary reasonable modifications to policies,
practices, or procedures, or appropriate auxiliary aids and
services, the individual's inability to independently comply
with those requirements may not be taken into account for
purposes of paragraph (1).
(c) Clarifications.--
(1) Reasonable modifications.--
(A) In general.--Consistent with section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. 794), the
Americans with Disabilities Act of 1990 (42 U.S.C.
12101 et seq.), and any other applicable Federal law,
and their implementing regulations, a covered entity
shall make reasonable modifications to policies,
practices, or procedures when such modifications are
necessary to avoid discrimination on the basis of
disability as described in subsection (a) except as
provided in subsection (b), unless the entity can
demonstrate that making such modifications would
fundamentally alter the nature of the program or
activity involved.
(B) Inclusion.--For the purposes of subsection
(b)(2) and subparagraph (A), the reasonable
modifications may include the use of supported
decision-making, when needed, by a qualified individual
with a disability.
(2) Auxiliary aids and services.--Consistent with section
504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), the
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et
seq.), and any other applicable Federal law, and their
implementing regulations, a covered entity shall take such
steps as may be necessary to ensure that no qualified
individual with a disability is excluded, denied services,
segregated, or otherwise discriminated against, based on
disability, from or for a procedure associated with the receipt
of an organ transplant or related services because of the
absence of appropriate auxiliary aids and services, unless the
covered entity can demonstrate that taking such steps would
fundamentally alter the nature of the program or activity
involved or would result in an undue burden.
(3) Privacy and security of health information.--Nothing in
this subsection shall be construed to modify or alter the
requirements for privacy or security of individually
identifiable health information under the privacy, security,
and breach notification rules under parts 160 and 164 of title
45, Code of Federal Regulations (or a successor regulation) or
for the confidentiality of substance use disorder patient
records under part 2 of title 42, Code of Federal Regulations
(or a successor regulation).
(d) Enforcement.--When a complaint regarding an allegation of
discrimination on the basis of disability with respect to the provision
of an organ transplant or related services is brought to the Office for
Civil Rights of the Department of Health and Human Services, such
Office shall consider the complaint, consistent with the Office's
practices and procedures, for expedited complaint resolution or early
complaint resolution, as appropriate and as appropriate, may require a
remedy, consistent with the enforcement remedies for a violation of
section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), the
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), and
any other applicable Federal law, including their implementing
regulations.
(e) Report to Congress.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, and annually thereafter, the Secretary
shall prepare and submit to the committees specified in
paragraph (2) a report that contains--
(A) a description of the activities carried out
under this section, which shall, at a minimum,
contain--
(i) information concerning the number of
complaints received related to discrimination
as described in subsection (a);
(ii) a description of the process by which
the Office for Civil Rights of the Department
of Health and Human Services carried out the
expedited complaint resolution or early
complaint resolution, where appropriate;
(iii) the results of such complaints; and
(iv) information stating the resources
necessary for such Office to carry out such
activities; and
(B) recommendations by the Secretary to improve
enforcement of this Act.
(2) Submission.--The Secretary shall submit the report to
the Committee on Energy and Commerce of the House of
Representatives, and to the Committee on Health, Education,
Labor, and Pensions of the Senate.
SEC. 5. RULE OF CONSTRUCTION.
Nothing in this Act shall be construed to invalidate or limit the
rights, remedies, and procedures, including legal standards, available
to an individual aggrieved under--
(1) the Americans with Disabilities Act of 1990 (42 U.S.C.
12101 et seq.);
(2) section 504 of the Rehabilitation Act of 1973 (29
U.S.C. 794); or
(3) any other applicable Federal or State law that provides
additional protections against discrimination on the basis of
disability with respect to organ transplants or related
services.
Calendar No. 441
119th CONGRESS
2d Session
S. 1782
_______________________________________________________________________
A BILL
To prohibit discrimination on the basis of mental or physical
disability in cases of organ transplants.
_______________________________________________________________________
June 22, 2026
Reported with an amendment