Medicare proposes new transplant rules that might increase use of less-than-perfect organs

CMS proposed rules to strengthen oversight of organ procurement organizations and to encourage greater use of medically complex donated organs, after a recent drop in deceased donations and amid a long-running transplant system overhaul.

The Centers for Medicare and Medicaid Services proposed new rules for the nation’s transplant system on Wednesday. The plan would strengthen oversight of organ procurement organizations and encourage greater use of medically complex donated organs. More than 100,000 people are on the U.S. transplant list, most seeking a kidney, and donations from deceased donors fell last year for the first time in over a decade. The proposal continues an overhaul of the transplant system that began during the first Trump administration. Key points: - CMS would strengthen oversight of organ procurement organizations (OPOs), which retrieve organs from deceased donors. - The proposal urges maximizing use of "medically complex organs," often from older or sicker donors, and would add tracking requirements for retrieval and use. - New definitions of "unsound medical practices" for organ handling and patient safety are included in the rulemaking. - More than 100,000 people are waiting for transplants, and deceased donor donations declined last year, raising concerns about public confidence. - Some rare reports earlier about patients prepared for retrieval despite signs of life prompted safeguards and contributed to people removing themselves from donor lists. - CMS said the rule would clarify expectations and provide stronger tools to address underperforming organizations. Summary: If finalized later in the year, the proposal would add tracking and reporting requirements for OPOs, tighten safety definitions, and encourage greater use of medically complex organs. Officials say the change is intended to strengthen accountability and expand organ availability, while questions remain about how transplant centers and hospitals will respond and whether similar requirements will be applied to them.