Press Release

May 17, 2023
Bipartisan Senators Introduce Legislation to Break Up Monopoly Contract for Organ Donation Network
Senate Bill Gives HRSA Clear Authority to Expand Competition for Organ Procurement and Transplantation Network Contract

WASHINGTON – U.S. Senators Ben Cardin (D-Md.), Ron Wyden (D-Ore.), Chuck Grassley (R-Iowa), Todd Young (R-Ind.) and Bill Cassidy (R-La.) today led the introduction of legislation to help break up the monopoly contract currently held by the United Network for Organ Sharing (UNOS) to manage the Organ Procurement and Transplantation Network (OPTN).

“The grave disparities in access to organ transplants are unconscionable,” said Senator Cardin. “Our bipartisan bill will move us toward a more transparent and equitable system that will save lives by improving timely access to needed transplant organs, particularly for patients in underserved communities.”

“Major changes are needed to modernize the organ procurement system on behalf of Americans on the waiting list for an organ transplant that will save their lives,” Senator Wyden said. “For too long UNOS has had a stranglehold on this contract, and as the Finance Committee’s investigation showed, that lack of accountability has had dire consequences. It’s high time to bring in some competition so there can be more accountability and know-how to improve results and save lives.” 

“UNOS’s monopoly over the U.S. organ donation system has been disastrous,” Senator Grassley said. “Decades of corruption and mismanagement have left vulnerable patients to die on the waiting list while unused organs from generous American donors go to waste. Building on the Senate Finance Committee’s investigation, I’m committed to working with my bipartisan colleagues to advance long-overdue competition in this life and death area of health care.”

“Our bipartisan legislation will help ensure accountability and transformation in the organ donation and transplant system,” said Senator Young. “The important reforms included in our bill will provide the flexibility necessary to conduct a thoughtful, full, and open competition process for the OPTN contract, which will improve the system and help save lives.”

“The management of the organ transplant system in the U.S. needs serious reform,” said Dr. Cassidy.  “Breaking up this monopoly will increase competition, save lives and improve the system. When it is referred to the HELP Committee, as ranking member and a physician who referred many patients for transplants, I look forward to advancing this legislation.”

The legislation would remove barriers in OPTN contracting and give the Health Resources and Services Administration (HRSA) statutory authority to improve management of the organ transplantation system in the U.S. The current OPTN contract is set to expire September 30, 2023, making the proposed changes urgent and timely for HRSA to make meaningful reforms. The legislation is a companion bill to H.R. 2544, which passed unanimously today at a House Energy and Commerce Committee markup.

Last year, the Finance Committee revealed consistent mismanagement and underperformance by UNOS that has held the contract since its inception decades ago. In March, HRSA launched an initiative to modernize the OPTN so it better serves patients and families.

Additional co-sponsors include Senators Elizabeth Warren (D-Mass.), Jerry Moran (R-Kan.), and Cory Booker (D-N.J.).

A two-page summary of the bill can be found here. A section by section can be found here. The full legislative text can be found here.