HOSPITAL AGREEMENTS WITH ORGAN PROCUREMENT ORGANIZATIONS.

SEC. 155. HOSPITAL AGREEMENTS WITH ORGAN PROCUREMENT ORGANIZATIONS. (a) Hospital Agreements.— (1) In general.— (A) Identification of organ donors.— Section U38(a)(l)(A)(iii) (42 U.S.C. 1320b–8(a)(l)(A)(iii)) is amended to read as follows: “(iii) require that such hospital’s designated organ procurement agency (as defined in paragraph (3)(B)) is notified of potential organ donors;”. (B) Agreements with designated organ procurement agencies.— Section 1138(a)(1) (42 U.S.C. 1320b–8(a)(1)) is amended— (i) by striking the period at the end of subparagraph (B) and inserting ”; and”; and (ii) by adding at the end the following new subparagraph: “(C) the hospital or rural primary care hospital has an agreement (as defined in paragraph (3)(A)) only with such hospital’s designated organ procurement agency.”. (C) Waiver of requirements related to agreements.— Section 1138(a) (42 U.S.C. 1320b–8(a)) is amended— (i) by redesignating paragraph (2) as paragraph (3); and (ii) by inserting after paragraph (1) the following new paragraph: “(2) (A) The Secretary shall grant a waiver of the requirements under subparagraphs (A)(iii) and (C) of paragraph (1) to a hospital or rural primary care hospital desiring to enter into an agreement with an organ procurement agency other than such hospital’s designated organ procurement agency if the Secretary determines that— “(i) the waiver is expected to increase organ donation; and “(ii) the waiver will assure equitable treatment of patients referred for transplants within the service area served by such hospital’s designated organ procurement agency and within the service area served by the organ procurement agency with which the hospital seeks to enter into an agreement under the waiver. “(B) In making a determination under subparagraph (A), the Secretary may consider factors that would include, but not be limited to— “(i) cost effectiveness; “(ii) improvements in quality; “(iii) whether there has been any change in a hospital’s designated organ procurement agency due to a change made on or after December 28, 1992, in the definitions for metropolitan statistical areas (as established by the Office of Management and Budget); and “(iv) the length and continuity of a hospital’s relationship with an organ procurement agency other than the hospital’s designated organ procurement agency; 108 STAT. 4439 except that nothing in this subparagraph shall be construed to permit the Secretary to grant a waiver that does not meet the requirements of subparagraph (A). “(C) Any hospital or rural primary care hospital seeking a waiver under subparagraph (A) shall submit an application to the Secretary containing such information as the Secretary determines appropriate. “(D) The Secretary shall— “(i) publish a public notice of any waiver application received from a hospital or rural primary care hospital under this paragraph within 30 days of receiving such application; and “(ii) prior to making a final determination on such application under subparagraph (A), offer interested parties the opportunity to submit written comments to the Secretary during the 60-day period beginning on the date such notice is published.”. (D) Definitions.—Section 1138(a)(3) (42 U.S.C. 1320b–8(a)(3)), as redesignated by subparagraph (C), is amended to read as follows: “(3) For purposes of this subsection— “(A) the term ‘agreement’ means an agreement described in section 371(b)(3)(A) of the Public Health Service Act; “(B) the term ‘designated organ procurement agency’ means, with respect to a hospital or rural primary care hospital, the organ procurement agency designated pursuant to subsection (b) for the service area in which such hospital is located; and “(C) the term ‘organ’ means a human kidney, liver, heart, lung, pancreas, and any other human organ or tissue specified by the Secretary for purposes of this subsection.”. (2) Existing agreements.— Any hospital or rural primary care hospital which has an agreement (as defined in section 1138(a)(3)(A) of the Social Security Act) with an organ procurement agency other than such hospital’s designated organ procurement agency (as defined in section 1138(a)(3)(B) of such Act) on the date of the enactment of this section shall, if such hospital desires to continue such agreement on and after the effective date of the amendments made by paragraph (1), submit an application to the Secretary for a waiver under section 1138(a)(2) of such Act not later than January 1, 1996, and such agreement may continue in effect pending the Secretary’s determination with respect to such application. (3) Effective date.— The amendments made by paragraph (1) shall apply to hospitals and rural primary care hospitals participating in the programs under titles XVIII and XIX of the Social Security Act beginning January 1, 1996. (b) Study on Hospital Agreements with Organ Procurement Agencies.— (1) In general.— The Office of Technology Assessment (referred to in this section as the “OTA”) shall, pursuant to the approval of the Technology Assessment Board of the OTA, conduct a study to determine the efficacy and fairness of requiring a hospital to enter into an agreement under section 371(b)(3)(A) of the Public Health Service Act with the organ procurement agency designated pursuant to section 1138(b) of the Social Security Act for the service area in which such108 STAT. 4440 hospital is located and the impact of such requirement on the efficacy and fairness of organ procurement and distribution. (2) Report.— Not later than 2 years after the date of the enactment of this Act, the OTA shall complete the study required under paragraph (1) and prepare and submit to the Committee on Finance and the Committee on Labor and Human Resources of the Senate and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives a report containing the findings of such study and the implications of such findings with respect to policies affecting organ procurement and distribution.