Senate GOP leaders join coalition disputing organ allocation policy change

Three Senate Republican leaders on Tuesday joined some of their peers to dispute a major rule change in U.S. policy for organ distribution gained a swath of powerful allies.

Senate Majority Leader Mitch McConnell (R-Ky), Senate Finance Committee Chair Chuck Grassley (R-Iowa) and Senate Appropriations Chair Richard Shelby (R-Ala.) joined 19 of their GOP colleagues to press HHS Secretary Alex Azar on the department's influence in ending the geography-based system for distributing organs for transplant. Sen. Roy Blunt (R-Mo.), chair of the Republican Policy Committee and the health appropriations subcommittee, co-led the letter after helping to spearhead an earlier probe.

The new policy, not yet in effect, gives the sickest patients the first priority for available organs.

The policy was voted on in early December by the board of the United Network for Organ Sharing, or UNOS, which is responsible for the organ allocation policy. The board includes transplant surgeons, transplant recipients and organ donors. UNOS is contracted to the Organ Procurement and Transplantation Network, or OPTN, the group tasked by HHS to oversee the distribution system.

The change has been in the works for years, stymied by gridlock caused by conflicting geographic interests. The longstanding geography-based policy meant that some regions, particularly the South and Midwest colloquially known as the "stroke belt" had a greater number of organs than northeastern states like New York or West Coast states like California — both of which have a high number of transplant candidates.

But top HHS officials put pressure on the UNOS board after transplant candidates from states including New York and California sued over the policy. The candidates faced long odds in obtaining organs because of where they lived. One of the plaintiffs, a Medicaid patient from New York, died before the UNOS board made its policy change.

The details of organ allocation policy have a significant impact on business operations of major transplant centers across the country, making it a linchpin issue for their legislative representatives.

Sens. Jerry Moran (R-Kan.) and Todd Young (R-Ind.) told Modern Healthcare that proposed legislation on the issue is in the works for introduction this Congress, although none has yet been introduced. Moran and Blunt started the coalition.

Three Democrats—Sens. Debbie Stabenow (D-Mich.), Gary Peters (D-Mich.) and Doug Jones (D-Ala.).—also signed the letter.