"Your voice of the transplant community"

Public Policy Statement

TRIO Public Policy Statement issued by Board (<-- click to read the statement issue 12/17/2010 on the Arizona cutback issue)

Legislative Initiative and TRIO Public Policy UPDATE Nov 2010....

TRIO has worked hard to forward the goal of extending Medicare coverage of immunosuppressive drugs for kidney transplant recipients beyond the current 36 months post transplant. It was hoped that this would be part of any health care reform legislation that was passed. It was not, however, part of the health care reform legislation that was passed.  Although this legislation was included in the health bill approved by the House of Representatives in November of 2009, the bill and this important legislation was not contained in the Senate bill in December nor in the final legislation signed by the President in March of 2010.  However, the original immunosuppressive bills (S. 565, H.R. 1458) remain active and I would ask you to please help by asking your Representatives and Senators to become cosponsors if they are not yet cosponsors. Please contact your Senators and Representative to urge them to cosponsor the Senate bill- S. 565 and The House Of Representatives bill- H.R. 1458, respectively.

Senate Amdt. 3102 to H.R. 3590- 2010 failed to be included in the bill signed by President Obama even though it was included in the original House bill.

Organ transplant recipients must take immunosuppressive medications for the life of the transplant to help prevent the body from rejecting the organ.  HR 1458 would extend immunosuppressive drug coverage for Medicare-eligible kidney transplant recipients for the life of the transplant.  They would not necessarily have access to other parts of Medicare, but this would ensure that they could retain Part B access to these expensive medications.  Currently, Medicare pays for most kidney transplants but covers medications for only 36 months post-transplant as part of the Medicare ESRD benefit.

Many kidney patients lose access to Immunosuppressive medications. In a study of 1,000 kidney transplant recipients, graft loss more than doubled when Medicare coverage for anti-rejection drugs ended.This is associated with a significant cost to Medicare and the taxpayers because patients who lose transplanted kidneys must return to dialysis or seek another transplant. Furthermore, once a transplanted kidney no longer works, the patient’s risk for death is nine times as large! 

In a survey by the United Network for Organ Sharing and the American Society of Transplantation, 70% of transplant centers report that patients have extreme or very serious problems paying for their medications, and 68% of kidney transplant deaths or graft failures are possibly the result of  lack of access to anti-rejection medications.

According to the most recent report from the United States Renal Data System, Medicare spends an average of $77,000 per year indefinitely dialyzing patients with kidney failure. However, it spends $106,000 the first year after transplant and an average of $17,000 per year thereafter, including the cost of Immunosuppressive medications. It thus makes financial sense for Medicare to remove the 36-month coverage limitation for  Immunosuppressive medications.

Sen. Richard J. Durbin (D-ill.) (along with other members of the U.S. Senate) supports extending coverage for Immunosuppressive medications for kidney transplant recipients. 

The two active bills are:

H.R.1458- Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act

S. 565- Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act 

Charlie W. Norwood Living Organ Donation Act

The United States Congress passed H.R. 710, the Charlie W. Norwood Living Organ Donation Act, which allows paired kidney donations. 

Latest Major Action: Became Public Law No: 110-144

The Senate companion bill was S.487

Title: Living Kidney Organ Donation Clarification Act


I included this law in our Legislative Initiatives Report for this reason:

 "Not later than 1 year after the date of enactment of this Act, and

annually thereafter, the Secretary of Health and Human Services shall

submit to the appropriate committees of Congress a report that details

the progress made towards understanding the long-term health effects of

living organ donation."


The Law:

To amend the National Organ Transplant Act to provide that criminal penalties do not apply to paired donations of human kidneys, and for other purposes.

Through paired kidney donation, two or more sets of living donors and candidates are matched to find biologically compatible donors. H.R. 710 clarifies that paired kidney donations do not violate the prohibition in the original 1984 National Organ Transplant Act against what they referred to as "valuable consideration.”

It is possible that paired kidney donations could increase the number of organ transplants by approximately 14% ( 2,000 each year.) Thank you Rep. Jay Inslee (D-WA) for sponsoring the legislation with the late Rep. Charlie Norwood (R-GA), and Sen. Carl Levin (D-MI) for introducing the companion bill in the Senate.

Congress renamed the final legislation in Norwood’s memory as the Charlie W. Norwood Living Organ Donation Act. 

The paired kidney donations legislation will save hundreds, even thousands, of lives.

- Mike Sosna
TRIO Public Policy Committee Chairman