BY: TIM CARPENTER Kansas Reflector
TOPEKA — U.S. Sen. Jerry Moran accused a federal agency of attempting to thwart congressional intent through implementation of a reform law addressing bias, mismanagement and monopoly control of the national organ procurement and transplant network.
Moran, a Kansas Republican, began calling in 2018 for changes to the nonprofit United Network for Organ Sharing (UNOS) of Richmond, Virginia. For decades, UNOS has held the government contract to operate a network to match donor organs with patients on waiting lists. It manages retrieval and delivery as well as sets policy for prioritizing distribution of kidneys, livers and other organs in the United States.
President Joe Biden signed in September a law requiring the federal Health Resources and Services Administration (HRSA) to break the monopoly contract held by UNOS.
“We thought with passage of this legislation … that we were finally giving those waiting for a transplant something called hope,” Moran said in a speech on the U.S. Senate floor. “Our goals were good: To increase the competition for this contract, to eliminate that good-old-boy network.”
Moran said HRSA wasn’t adhering to congressional intent of the bipartisan law. He objected to the agency’s intention to restrict competition for new contracts to nonprofit organizations, such as UNOS, to the exclusion of for-profit businesses. HRSA announced a plan to issue initial transition contracts lasting up to five years, which raised concern change sought by Congress and patient groups could be slowed.
HRSA also showed willingness to allow UNOS’ board to retain oversight of the network rather pivot to an independent board, Moran said.
“This isn’t just some bureaucracy that’s doing something that doesn’t make sense to us,” Moran said. “This is an agency, a bureaucracy, a system that is damaging the capability of Kansans and Americans to get lifesaving treatment with the transplant of an organ.”
UNOS chief executive officer Maureen McBride said the organization would pursue revised organ transplant network contracts and welcomed competition from applicants, the Richmond Times-Dispatch said. UNOS’ management contract expired in September, but it was awarded a six-month extension.
UNOS was accused in congressional testimony or by critics of targeting whistleblowers, losing and damaging donated organs in transit, relying on an antiquated information technology system and directing organs from rural, high-donation states to urban, low-donor regions.
U.S. Sen. Charles Grassley, a Republican from Iowa, said there was no reason to limit competition in selection of contractors to manage the organ donation network. HRSA is part of the U.S. Department of Health and Human Services (HHS).
“The organ transplant business and network has been in shambles for decades, and people have needlessly died because of it,” Grassley said. “Patient advocacy organizations are rightfully concerned that HHS is caving to bad actors who’ve been running our nation’s organ donation system since 1986.”
Grassley said he sought to reform the “corrupt and broken” donation and transplant system since 2005. He asserted more than 200,000 Americans “needlessly died on the transplant waiting list,” with the toll disproportionately detrimental to people of color of those residing in rural areas.