,i #aafth ,,congress #b;d ,session ,h4 ,r4 #gijj ,,in ,,the ,,house ,,of ,,representatives ,july #ca1 #bjbj,mr4 ,cartwright introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend the ,national ,organ ,transplant ,act to clarify the definition of valuable consideration1 to clarify that pilot programs that honor and promote organ donation do not violate that ,act1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,organ ,donation ,clarification ,act of #bjbj4 #b4 ,findings ,congress finds the following3 7#a7 ,as of ,june #bjbj1 #aaa1jjj people await an organ transplant1 with #ic1jjj of those people waiting for a kidney1 and average wait times are approaching five years for a kidney1 with nearly twice as many people being added to the waiting lists as getting a transplant4 7#b7 ,of the roughly two million ,americans who die annually1 only #aj1ejj to #ac1hjj1 representing less than one percent of all deaths each year1 possess major organs healthy enough for transplanting4 7#c7 ,on average1 #bb people a day died while waiting for an organ in #bjai1 with the majority of those people waiting for a kidney4 7#d7 ,in #bjai1 approximately #d1bjj people were removed from kidney waiting lists and approximately #a1gjj from liver1 heart1 and lungs waiting lists because they became permanently too sick to receive a transplant4 7#e7 ,ninety percent of dialysis patients are not employed because dialysis requires multiple treatments per week which last several hours and leave patients drained1 thus creating a huge financial burden on the patients1 their families1 and the government2 moreover1 lost tax revenue from these individuals is not included in the cost estimates above1 and which can help lead to as few as #aj percent of dialysis patients being employed4 7#f7 ,a patient receiving a kidney transplant1 and thus no longer needing dialysis1 can enjoy a much higher quality of life for another #aj-ae years on average4 7#g7 ,as medical advances extend people's lives on dialysis1 the number of patients on dialysis will increase significantly1 as will the costs for individuals and the ,federal ,government4 7#h7 ,roughly seven percent of the ,medicare budget goes to the ,end ,stage ,renal ,disease ,program1 with dialysis costing ,medicare over #ij1jjj per patient per year1 as ,federal law dictates that ,medicare will cover dialysis for everyone who has made minimal ,social ,security tax payments4 7#i7 ,a kidney transplant pays for itself in less than two years1 with each transplant saving an average of over #gjj1jjj in medical costs over a #aj-year period1 #he percent of which is savings to the taxpayers4 7#aj7 ,experts project that if the supply of transplant kidneys could be increased to meet the demand1 taxpayers would save more than #ab1jjj1jjj1jjj per year in medical costs4 7#aa7 ,the ,world ,health ,organization estimates that #aj percent of all transplants take place on the international black market1 the last choice for desperate patients facing an alternative of death1 however recipients often receive infected kidneys and suffer poor health outcomes and donors are often victimized4 7#ab7 ,present policy on domestic donation has never been subject to studies or pilots to determine effectiveness in increasing the availability of donated organs and the effectiveness of safeguards that prevent coercion or exploitation1 precludes all but altruistic donation1 prohibiting any form of incentive or benefit for donors4 7#ac7 ,in #bjaj1 ,israel implemented sweeping changes to its national organ donation program including reducing financial burdens on donors1 giving future transplantation priority to registered organ donors and their families1 and promoting donation by reimbursing the donor's medical costs1 #dj days of lost wages1 and five years of medical and life insurance costs1 and as a result saw organ donation approximately triple over a #aj-year period4 7#ad7 ,experts are arriving at a consensus that trials are necessary to find new methods of promoting additional organ donation which will save lives and reduce organ trafficking4 #c4 ,clarification of certain provisions of the ,national ,organ ,transplant ,act 7a7 ,relation to other laws ,section #cja of the ,national ,organ ,transplant ,act 7#db ,u4,s4,c4 #bgd;e7 is amended by adding at the end the following3 7d7 ,relation to other laws 7#a7 ,governments encouraging organ donation ,this section shall not-- 7,a7 apply to actions taken by the ,government of the ,united ,states or any ,state1 territory1 tribe1 or local government of the ,united ,states to carry out a covered pilot program2 or 7,b7 prohibit acceptance of any noncash benefits provided by the pilot program under subparagraph 7,a74 7#b7 ,no prohibition on other benefits programs ,nothing in this subsection shall be construed to prohibit actions1 other than actions described in this section1 taken by any ,state1 territory1 tribe1 or unit of local government in the ,united ,states to provide benefits for human organ donation4 7#c7 ,covered pilot program ,for purposes of this subsection-- 7,a7 the term covered pilot program means a pilot program approved by the ,secretary of ,health and ,human ,services1 subject to an ethical review board process1 with a term of not more than #e fiscal years1 for the purpose of measuring the effect of removing disincentives or providing a noncash benefit that may increase the organ pool4 ,distributions of organs from deceased donors under the pilot program shall be conducted only through the ,organ ,procurement and ,transplantation ,network at a transplant center approved by the ,united ,network for ,organ ,sharing or any other entity designated by the ,secretary of ,health and ,human ,services2 and 7,b7 the term noncash benefit means any benefit or thing of value received by an organ donor that is impossible to sell1 trade1 or otherwise transfer to another individual4 4 7b7 ,valuable consideration ,section #cja7;c77#b7 of the ,national ,organ ,transplant ,act 7#db ,u4,s4,c4 #bgd;e7c77#b77 is amended to read as follows3 7#b7 ,the term valuable consideration does not include the following3 7,a7 ,reasonable payments associated with the removal1 transportation1 implantation1 processing1 preservation1 quality control1 and storage of a human organ4 7,b7 ,reimbursement for travel1 lodging1 food during travel1 and other logistical expenses related to donation4 7,c7 ,provision of advanced payments or reimbursement for dependent care needs for pre-transplant appointments in addition to during the period of donation and post-transplant follow-up care related to the donation for up to a #aj-year period4 7,d7 ,reimbursement for lost wages related to donation4 7,e7 ,medical expenses related to donation and all related follow-up care including preventative follow-up care and medication for up to a #aj-year period4 7,f7 ,paperwork or legal costs related to donation4 7,g7 ,any term life insurance policy against the risk of death or disability as a result of donating an organ or the longer-term health effects of having donated an organ1 that-- 7i7 in the case of a life insurance policy1 provides for payments in amounts less than #b1jjj1jjj1 adjusted annually for inflation2 and 7ii7 in the case of a disability insurance policy1 provides for payments equal to or less than the reasonable earnings expectations of the donor4 4