The OPTN Fee Collection Authority Act authorizes the Secretary of Health and Human Services to collect registration fees from members of the Organ Procurement and Transplantation Network for each transplant candidate listed on the network’s waitlist. These fees would support the operation of OPTN and could be collected directly or via awards to eligible network participants, with funds treated as discretionary offsetting collections and retained until expended.
The bill also adds transparency requirements, requiring public posting of fee amounts and funded activities and quarterly updates. In addition, it establishes a nonbinding but structured oversight pathway: a GAO review within two years and a sunset on the authority after three years from enactment.
The bill also contains technical amendments to Section 372(b)(2) of the Public Health Service Act to advance interoperability and data reporting within the OPTN ecosystem.
At a Glance
What It Does
Authorizes the Secretary to collect registration fees from OPTN members for each transplant candidate placed on the network’s waitlist, with those fees funding OPTN operations and remaining available until expended. Collections can be made directly or via awards to OPTN entities.
Who It Affects
OPTN member organizations (hospitals, organ procurement organizations, transplant centers) that list transplant candidates and pay fees per listed candidate.
Why It Matters
Creates a dedicated funding stream for OPTN operations, increases financial transparency, and introduces oversight and sunset provisions to reassess the arrangement after three years.
More articles like this one.
A weekly email with all the latest developments on this topic.
What This Bill Actually Does
The bill would authorize federal collection of registration fees from members of the Organ Procurement and Transplantation Network for every transplant candidate they place on the waitlist. The fees would fund OPTN operations and would be treated as discretionary offsetting collections, available until expended.
The collected funds could be distributed to awardees described in the network’s baseline framework, and they must be credited to the appropriate HHS accounts. A new transparency requirement would require posting, on the OPTN website, the amount collected from each member and the activities those funds support, with quarterly updates.
The Comptroller General would review the program within two years and report recommendations to relevant committees. Finally, the authority to collect these fees would sunset three years after enactment.
The bill also makes targeted amendments to encourage interoperable health information technology and adds a data dashboard-related provision for network analytics, all while maintaining privacy safeguards under HIPAA rules.
The Five Things You Need to Know
The bill authorizes the Secretary to collect registration fees from OPTN members for each transplant candidate listed.
Fees are discretionary offsetting collections used to support OPTN operations.
Fees and funded activities must be posted on the OPTN website with quarterly updates.
GAO must review the program within two years and report findings and recommendations.
The authority to collect fees sunsets three years after enactment.
Section-by-Section Breakdown
Every bill we cover gets an analysis of its key sections.
General authority to collect registration fees
The Secretary may collect registration fees from any OPTN member for every transplant candidate the member lists on the network’s waitlist. Fees are designated to support the ongoing operation of OPTN and can be collected directly or via awards to eligible network participants. The collected funds are discretionary offsetting collections and remain available until expended, creating a dedicated funding stream for network activities.
Distribution of collected funds
Amounts collected under the registration-fee authority are to be credited to the currently applicable Department of Health and Human Services account as offsetting collections. They may be distributed among the OPTN awardees described in the network’s existing grant framework, to support operational needs and program activities as appropriations allow.
Transparency requirements
The Secretary must ensure transparency by posting, on the OPTN website, the per-member registration fee amount collected and a description of the activities those funds support. This information must be updated for each calendar quarter in which fees are collected, providing policymakers and stakeholders with a clear accounting of how funds are used.
GAO oversight
Not later than two years after enactment, the Comptroller General must conduct a review of activities conducted under this fee authority and submit a report with findings and recommendations to relevant Senate and House committees for consideration.
Sunset provision
The authority to collect registration fees under this subsection expires three years after enactment, mandating a reassessment of the funding approach and its impact on OPTN operations and stakeholder costs.
This bill is one of many.
Codify tracks hundreds of bills on Healthcare across all five countries.
Explore Healthcare in Codify Search →Who Benefits and Who Bears the Cost
Every bill creates winners and losers. Here's who stands to gain and who bears the cost.
Who Benefits
- Hospitals and transplant centers that participate in OPTN benefit from a clearer funding stream to support network operations and data infrastructure, potentially improving waitlist management and referral efficiency.
- Organ Procurement Organizations (OPOs) gain operational support for network activities and data sharing enhancements that optimize organ allocation and logistics.
- Transplant clinicians and coordinators rely on a well-funded OPTN for timely data, better coordination, and improved access to donor information.
- Public health researchers and policy makers gain access to more robust network data and reporting, supporting policy analysis and performance benchmarking.
- Patients on transplant waitlists stand to benefit from potentially faster, more coordinated organ matching and improved transparency around network funding.
Who Bears the Cost
- OPTN member hospitals and transplant centers that must fund per-candidate listing fees.
- Organ Procurement Organizations (OPOs) that participate in OPTN and incur per-listing charges.
- Small or rural facilities with tighter budgets that may face higher relative costs per listed candidate.
- Hospitals and centers that may consider cost-neutral adjustments or pass-throughs in charges to patients or payers as a result of the new fee structure.
- Facilities and networks with high listing volumes could experience greater annual fee exposure, potentially prompting financial planning changes.
Key Issues
The Core Tension
Funding OPTN operations vs. cost burden on OPTN members and potential effects on access to transplantation; the three-year sunset amplifies replacement risk if the funding mechanism proves essential but unreliable.
The bill creates a dedicated funding mechanism for OPTN operations, but that funding shifts costs to OPTN members who list candidates. The transparency requirements mitigate hidden charges, yet the real-world impact depends on how fees are set and whether awards under the network’s grant program adequately offset operational costs for smaller centers.
The sunset provision introduces funding uncertainty after three years, which could require political and statutory reauthorization or a redesign of the funding model. Additionally, linking fee revenue to specific network activities raises questions about accountability for fund allocation and the potential for unintended incentives in performance reporting.
Try it yourself.
Ask a question in plain English, or pick a topic below. Results in seconds.