Grassley, Wyden Sound the Alarm on Officials Bypassing Organ Donation List, “Skipping the Line” for Less Critical Patients

WASHINGTON– Senate Judiciary Committee Chairman Chuck Grassley (R-Iowa) and Senate Finance Committee Ranking Member Ron Wyden (D-Ore.) are demanding answers from Department of Health and Human Services (HHS) officials regarding a reported increase in organs allocated out of sequence, a practice known as “line skipping.” Grassley, a former chairman and senior member of the Senate Finance Committee, and Wyden, current ranking member, cite an alarmingNew York Timesreport revealing that “last year, officials bypassed patients on organ waiting lists in nearly 20 percent of transplants from deceased donors. Those organs often went to patients who were not as sick or had not been waiting as long.”
The letters were addressed to Centers for Medicare and Medicaid Services (CMS) Acting Administrator Stephanie Carlton and Health Resources and Services Administration (HRSA) Administrator Thomas J. Engels.
“As the federal agency responsible for overseeing the [Organ Procurement Organizations] and the transplant centers, [CMS and HRSA have] a considerable responsibility for ensuring that these organizations do not engage in behaviors that undermine the system of equitable distribution of lifesaving organs. However, theTimesfound that at least some OPOs and transplant centers bypassed patients to reduce their work burden, increase their profits, and manipulate their performance measures without any apparent rebuke from CMS’s former leadership,”the senators wrote.
The senators cite the astonishing example of LifeGift, a Texas-based OPO that skipped 15-year-old Marcus Edsall-Parr, who had been waiting for a transplant nearly his entire life, because Marcus’ case was difficult to match. LifeGift gave the kidney to an open offer at an Illinois hospital rather than transporting the life-saving organ from Illinois to Michigan for Marcus. Marcus’ doctors reportedly filed a complaint about the incident but have yet to receive a response.
“Marcus’s case is not an exception to the rule, but an example of an issue that has steadily increased in prevalence. Continued reports of unethical behavior within the organ donation system will undermine the willingness of Americans to give others the gift of life. Strengthening public trust in our nation’s organ donation system is a matter of life and death,”the senators continued.
Grassley and Wyden's letters toCMS Acting Administrator Stephanie Carltonand toHRSA Administrator Thomas J. Engelscan be found here.
Background:
For nearly two decades, Grassley has engaged in bipartisan oversight of the organ transplant system and the government offices tasked with ensuring patient safety. Grassley first launched an investigation into the organ donation system as Finance Committee chair in2005and continued his inquiries, while gaining bipartisan support, during his chairmanship in2020.
Congress passed theSecuring the U.S. OPTN Actas a result of Grassley and Wyden’s long-standing, bipartisan oversight. The bill, which wassigned into lawin 2023, resulted in the first competitive bidding process for Organ Procurement and Transplantation Network (OPTN) contracts in the program’s nearly half-a-century history and gave HRSA additional statutory authorities to improve management of this system.
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