Today,
we will talk about the U.S. Organ Procurement and Transplantation Network and
the government contractor that oversees this program—the United Network for
Organ Sharing (UNOS).
In
1984, Congress passed the National Organ
Transplant Act, a bill cosponsored by the late Senator Orrin Hatch, a friend
and former chairman of this committee.
A
few years later, in 1998, the federal government contracted with UNOS to
oversee the transplantation network.
UNOS
performs three critical functions on behalf of the federal government:
policymaking, technology delivery and oversight of member compliance with its
policies and procedures.
However,
for more than a decade now, government watchdogs and the media have questioned
the adequacy of UNOS’s oversight.
That’s
because of multiple reports of fraud, waste and abuse, criminality, deadly
patient safety issues and failure to recover organs.
Some
have even observed that UNOS is 15 times more likely to lose, damage or
mishandle an organ in transit than a passenger airline loses luggage.
I’ve
written about all of these issues and more since at least 2005.
Sadly,
the federal government has only recently begun to take action.
As
a result, thousands of organs go to waste each year, resulting in lives lost
and billions of dollars wasted.
This
system is even worse for people of color and rural residents, who are less
likely to get on the waitlist and less likely to find a match.
At
least amongst themselves, UNOS’s senior leadership admits this fact.
One
official’s response to these concerns was to suggest rural Americans were dumb
and should just move somewhere else to obtain life-saving treatment.
That
attitude is totally unacceptable.
Now,
a bit about our investigation into UNOS.
In
February
2020, this committee sent a letter to UNOS, requesting information and data
on its oversight of the transplantation network.
We
found that there’s a huge variability in how well Organ Procurement
Organizations, known as OPOs, are serving their communities.
In
fact, according to the Centers for Medicare and Medicaid Services, as many as
22 of 57 OPOs are failing outcome and performance metrics.
This
variability has negative consequences for the transplantation network and
causes transplant hospitals to have fewer organs for patients on the waitlist.
We
also found that UNOS has a broken governance system that fails to hold its
members accountable for reoccurring patient safety issues.
As
I said in 2006, UNOS acts more like the “the fox guarding the chicken house,”
instead of a trustworthy and independent oversight body that holds its members
accountable.
As
such, transportation failures, ABO blood type testing, and allocation errors
are common occurrences at underperforming OPOs.
Mr.
Chairman, it’s about time we held this hearing.
Congress
has waited too long to fix this broken system.
We
must insist upon accountability moving forward.
