Washington, D.C. -Today, Rep. Raja Krishnamoorthi, the Chairman of the Subcommittee on Economic and Consumer Policy, and Subcommittee Member Katie Porter sent letters to 11 Organ Procurement Organizations (OPOs) and a letter to the Association of Organ Procurement Organizations (AOPO) requesting documents about the performance, finances, operations, and potential conflicts of interest of OPOs. The Members expressed concern that OPOs, which have been granted the public trust to manage organ donations and secure organs for life-saving transplant procedures, are falling short of their important public responsibilities.
“One research analysis estimated there may be up to 28,000 available organs from deceased donors annually that are not ultimately transplanted into patients who need them, which equates to around 25,000 lives that are not saved even when organ donors are located," wrote the Members. “The burden of OPO failures is disproportionately borne by patients of color, making OPO reform an urgent health care equity issue."
Together, the 11 OPOs and their OPO affiliates would need to recover more than 2,300 additional organs every year to meet new standards promulgated by the Centers for Medicare and Medicaid Services (CMS).
Nationwide, there are 58 OPOs, each of which has a government-granted regional monopoly for identifying and coordinating the transfer of available organs from donors to transplant centers. OPOs recuperate costs by receiving reimbursements from CMS and per-organ fees from transplant centers, which are ultimately passed on to Medicare and other payors. The Members’ letter cites reports of poor performance at OPOs, including “reports of gross mismanagement, " “reports of serious lapses in quality control, " and “reports of financial impropriety."
In their letters to the individual OPOs, the Members highlight reports raising serious concerns, including poor performance under CMS’s new objective measures, exorbitant executive pay, death and injury caused by basic errors, criminal convictions for kickback schemes, improper payments from Medicare for a Rose Bowl float and festivities, and potential impropriety and conflicts arising out of lucrative side businesses, such as a private airline, dialysis centers, and tissue banks and processors.
“This litany of reports is an indictment against the industry and demonstrates the need for reform," declared the Members.
AOPO and the OPO industry have spent large sums to lobby against much-needed reforms. Despite the pushback, reform efforts have moved forward.
On Nov. 20, 2020, CMS finalized a rule to enforce new objective measures for donation and transplantation, update those benchmarks based on national OPO performance, allow for competition against OPOs with middling performance, and require more frequent recertification reviews.
The Subcommittee seeks from the OPOs a broad range of documents that will shed light on their internal workings and financing, including governing documents; financial statements; policies and practices on conflicts of interest, fee-setting, and business activities outside of organ donations; lobbying efforts against reforms; and reports of mishandled organs. These requests are directed to: DCI Donor Services, Indiana Donor Network, Kentucky Organ Donor Affiliates, Legacy of Hope, Life Alliance Organ Recovery Agency, LifeLink Foundation, LifeNet Health, LifeSource, New England Donor Services, OneLegacy, and We Are Sharing Hope South Carolina.
The Subcommittee requested all documents and information from AOPO and the 11 OPOs by Jan. 13, 2021.
