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U.S. Department of Health and Human Services Recommendations 43-45

The Advisory Committee on Organ Transplantation (ACOT) met on November 2–3, 2006 in Bethesda, MD and unanimously agreed on the following three recommendations:

Recommendation 43: ACOT recommends to the Secretary that the Medicare program allow donation after cardiac death (DCD) direct organ acquisition expenses be reimbursable to the organ procurement organization (OPO) under the Federal program.

When the next of kin has made the decision to pursue organ DCD, the Centers for Medicare and Medicaid Services-designated is responsible for expenses related to donation. ACOT recommends to the Secretary that the Medicare program allow these direct organ acquisition expenses to be reimbursable to the OPO under the Federal program. It would thereby remove a financial barrier to donation. Reimbursement to the OPO would begin at the time donation consent is given and continue until the time organs are recovered, or the time a patient is returned to palliative care. At that time, responsibility for expenses would revert to the patient or the patient's insurance carrier.

Recommendation 44: ACOT recommends to the Secretary that he promote collaboration between the transplant community and the insurance industry to adopt standards of coverage for living organ donors specifically relating to future adverse events (e.g., hernia repair, biliary tract reconstruction) resulting from the donation.

Recommendation 45: ACOT recommends to the Secretary that he take action intended to provide Medicare eligibility for any living donor who loses insurability as a result of disability on the basis of previous organ donation.

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