Cspan is your unfiltered view of government. Funded by these Television Companies and more including comcast. Are you thinking this is just a Community Center . Know it is way more than that. Comcast is part of 1000 committee centers to create wifi enabled so students from low income families can get the tools they need to be ready for anything. Comcast supportspan as a Public Service along withhese other television providers. Giving you a front row seat to democracy. Next transplant recipients and organ procurement professionals testify on the effectiveness off the organ transplanthe system. This Senate Finance subcommittee on healthcare hearing is about an hour and 45 minutes. [background noises] good morning. The subcommittee on health of the Senate Finance committee will come to order. Hour i first want to thank senator wyden and senator crapo for their help in allowing us to move forward with his hearing today. In regards to transplants. I also want to acknowledge senator young not only for his taking on the responsibilities for this hearing but also his leadership on this issue. We thank senator daines for his cooperation and allowing the subcommittee todays hearing lastly i want to thank senator grassley who has been the real champion on this issue for many, many years. He will be t joining us is that the Judiciary Committee right now. He will be joining us shortly. At that time he will be recognized for his Opening Statements. In the unites states the need for organs is far greater than those available. There are about 104,000 adults and children on the National Transplant waitlist. Every 10 minutes another person is added to it. In 2020 Senate Committee on finance and investigation into the system andst document significant failures. Today we discuss the path forward to a better system. My constituents in maryland have access to two excellent transplant centers in our states appeared maryland also is a tier one Organ Procurement Organization that is taking innovative action to some of the most underserved areas like Baltimore City to encourage Organ Donation. This op o has been among the top 10 performers nationwide. Access to transplant in maryland is far from perfect. Despite the highperformance transplant ecosystem, due to the major underlying issues with the current transplant network, 148 people died while transplant waiting list in maryland last year. That is unacceptable. Other states are not so lucky. Marylanders and people across the nation deserve better. Naturally 17 people die each daywaiting for an organh transp. Op os are ranked tier one, 22, 23 depending on performance levels tier three being the lowest. I going to the center for medicare and Medicaid Services in 2023 Performance Review 24 op os or 42 have been classified tier three. Senator wyden, grassley, young youngand i believe in the Senate Finance committees investigation into the organ transplant system for over three years. Each new line of inquiry has exposed more and more failures. Which are often borne by the sickest patients in the nation. Specifically our committee has uncovered transportation and testing failures that up at patients lives at risk. Outdated Information Technology undermining the network a lack of oversight by the current Organ Procurement Transplantation Network op tm contractors. The United Network of organco sharing, and misuse of medicare funds. These disparities impact people throughout the country including those who are low income, the uninsured, members of racial ethnic minorities, people with disabilities and rural populations. Even more concerning u. S. Digital services found you knows is incapable of modernizing the opt and it infrastructure. The stakes of neglecting the needs of the Underserved Community could not be higher. During the last administration cms put out an op oh final rule which will establish a tearing system that triggers decertification competition reassignment. Has taken critical steps to modernize opt and statutory changes are necessary to ensure able to work better equipped organizations to ensure opt and is operating in efficient and safe manner. When lives are at stake congress cannot accept logistics report administration as excuses. Last week we held a roundtable senior officials from the Center Medicare and Medicaid Services was productive conversation we discussed efforts to modernize transplant system increase transparency and accountability. Currently we have a system that works well for some. Some of our witnesses will discuss today. Weed is insufficient. An individualen lives of their bill to two a for travel to get care should not determine access to lifesaving organs. Today we have the opportunity to or from patients and professionals who are working on key reforms are committee will l continue to address the Biggest Challenges facing our nation including the transport system. We demand better. But that limit recognize senator young. Thank you chairman for your leadership on this issue. See senator wyden here who has shown exemplary leadership as it relates as well. One of the real champions we indicated will be joining us a bit later as i understand. Everyday 17 people die while on organ transplant waiting list. Another 13th or removed we are too sick to receive a transplant. The total is more than 100,000 americans on the organ transplant waiting list today. Including nearly 1200 in my home state of indiana. These are not just statistics. These are lives. Organ donation is a personal issue for me. My friend from jeffersonville indiana died because his heart transplant never came. We served together in the mehsuds marine corps and i have gotten to know connies wife, jennifer, over the years. She has made it her mission to raise awareness about the transplant process and help others from facing a similar fate. Because the organ transplant system is so complex most people do not know how it works. Or if patients are being protected. After it was elected in the early 20 tens i explored ways to try and incentivize innovation in the space. I had a silly idea to try to get a price concept to coax people to innovate the bureaucrats told me it would go nowhere. I began working organ procurement of oversight reform in 2018. I told the Washington Post then we cannot continue to allow thousands of americans who die each yearch waiting for lifesavg organs that we know are available if only the system mwork being managed by competet individuals operating in the light of day. I was proud to help champion Performance MeasuresOrgan Procurement Organizations with the centers for medicare and Medicaid Services adopted and finalized in 2020. Enjoyed my colleagues german wyden, former chairman grassley and senator cardin launching an investigation that same year. I welcome the announcement earlier this year that her so it will break up the Organ Procurement Transplantation Network monopoly. I dont my colleagues to co lead securing the u. S. Organ Procurement Transplantation Network act. Bipartisan legislation that gives herself the tools to implement commonsense reforms to act impatient interest. There is still much work to be done. Our friends and neighbors are still dying every day. It does not have to be this way but functional Organ Donation system could facilitate tens of thousands more Organ Transplants every year. American deserve to know what the Organ Donation and their government to increase Organ Donation transplantation as well as to ensure Patient Safety. Hhs and Congress Must treat Organ Donation reform but the urgency it deserves. Lives are being lost we cannot stand by will some of our most vulnerable neighbors die on the organ waiting list. Waiting for a call that never comes. We need strict enforcement of the rule, form of the opt in and to ensure the entire Organ Donation transplant system operates in the best interest of patients. Weve taken initial steps but cannot stop there. Look forward to hearing from our witnesses. And learning from their a experiences and expertise of living and working within the Organ Donation transplant system on a daily basis. I wont stop working on this issue until we increase the availability of organs for patients inty need and eliminate the inefficiencies occurring in our Organ Donation system. Thank you. Of the think you senator young. Senate finance committee of the leadership of senator wyden has been the moving factor on the investigations uncovered so many mistakes in abuses we have in the Current System. Senator wyden has been our leader in captain on this issue. I just want to note one aspect of her service on the finance committee as we have always considered this committee where you see the nba allstars in the healthcare arena. And certainly chairman cardin has been continuingg that. I am sitting in the seat this morning that was occupied for many years but senator rockefeller who was a greatwa champion and would be with us all the w way in terms of cleang up these abuses my colleague just mentioned bernard also especially what to think her republican colleague senator grassley and senator young. This has been in the best tradition of the Senate Finance commission with all the allstars we have in healthcare policy working in a bipartisan way and i appreciate it. Im going to be very brief we have a terrific panel of witnesses am going to have to be in and out to start by updating members and the public about our work and particularly moving forward with the Health Resources and Services Administration to implement the modernization of op tm the organ procurement network. We are pleased with the bipartisan support that the bill has gotten it has been good to see, who knows is not opposing legislation i can report to my colleagues and people who are following this ive had a number ofproductive conversations with Sherman Sanders on this. I want everybody to understand because im not going to be able to be here for the whole discussion, this committee on a bipartisan basis is witnessed by my colleagues here, we are going to be pulling out all of the stops to get the senate to act on this issue as soon as possible. The reason we are is because both of my colleagues just mentioned it. Think senator young use the word urgency. Cannot summit up better than that other than maybe a capitol you because this is a matter of life and death are too many americans. There is not a moment to lose friends, with respect to getting this bill passed in the Health Resources agency is on track to begin the contract process this fall. We are going to be working here to complement their effort. Last week we hosted a meeting with officials from the centers for medicare and Medicaid Services to discuss the administrations efforts to modernize the network to connect more americans with lifesaving organs. In particular bring more accountability and competition to the contracting process. The three of us senator grassley and others who attended, we got the message loud and clear that the agencies want to show a new emphasis on accountability and coordination. That was very welcome. A couple of other point is hearing is going to give us a chance to clear up confusion about what the legislation sticks sets out tond do the rums and if you listen to the rumors, i am telling you they are trying to run an incumbent Protection Program to smear this bill and senator grassley and i in particular at this session asked questions with respect to power legislation and these socalled rumors the three of us are going to it to privatize the system. If you listen to these rumors of site congresspeople are trying to sell organs on the side. It was outrageous the kind of stuff that we were hearing. Here is what we were told the Health Resources agency quote no, the system is not being privatized. In fact it notes our bill for the first time mandate in independent board of directors to oversee opt separate from the contract holder. Second, i asked to explain the boundaries that are actually in place for a Nonprofit Organization birdhouses going to work if they get a contract as part of opt end. They said forprofit organizations would be held to strict federal standards for contractors let me quote again limits on profits and fees and comprehensive oversight both before and after the contract. Also made clear they intend section of the contract concerning support for the independent opt and board of directors to be awarded to a Nonprofit Organization. So, to allo of those people that are trying to spread these false and ugly rumors about what this bill does, shame on you were going to blow the whistle and make sure the American People know the facts. These callings will be here this morning i will be in and out. We are working in a bipartisan way. By the way special credit to senator grassley who with me is the cochair of the whistleblowers carcass. We know a little bit about people speaking out if there are abuses. That is not the case here. I will just wrap up by saying here is what is. We want to make sure our country has the best in class Organ Transplantation system in the world. We found critical failures looking in ag bipartisan way fm the current contract holders especially when it comes to matters such as information, technology and logistics. The bill was written from top to bottom to ensure competition for technical functions like those will help the opt in perform to the highest level possible. Thanks to my colleagues ive spoken to both of them in recent days. Everybody understands this is priority business the Senate Finance committee theres not going to be an ounce of partisanship here were going to stay at it to get this done because the American People deserve it and is long overdue. Senator grassley, before you came i do not want to make disability bouquet tossing contest i was talking about the fact you have been bulldog in this every step of thehe way. I was really grateful last week we have the session to go through the legislation that we could all be together we appreciate your words blowing the whistle on these outrageous rumors that have been spread by some people who dont really want change that somehow to privatize things. Thanks for all your good work you will see it in the record we are so appreciative of your leading this for so many years. I respond by saying i thank you. We are finishing some stuff i started a long time ago. You were there helping me with every letter. We are in it together for the public. Thank you,e mr. Chairman. Think he senator white and thank you for your commitment to keep this on track to get done. It is very, very bipartisan. Senator young and i have already commented about senator grassleys leadership on this issue. We are both been mentored by senator grassley in regards to then need for this committees oversight on programs that we enact. He has taught us well. Nator grar this leadership, you are recognized. Thank you, chairman. We are here to visit about the urgent need to reform the transplant system and the deadly cost to patients and generous donor families due to decades of inaction. Due to decades of inaction. In 2005 i served in the investigation of the deadly failures in the monopoly past with managing the u. S. Organ donation system. Since then more than 200,000 patients needlessly died on the organ waiting list. There is a reason that i call eunice the fox guarding the house. For nearly two decades eunice has concealed Serious Problems the nations order and became an organization with the op instead of working to uncover incorrect the corruption. The human tragedy is more horrific because many of these were preventable they were the result of corrupt unaccountable monopoly that operates like a cartel than a public servant. A bipartisan investigation started when i was chairman of the committee and i already referred to chairman widens efforts working with me we uncovered kidneys loss in airports and technology that goes down in the coverup of patient staff. In uncovered a history of misinformation and lobbying against accountability and transparency for the op owes it is supposed to oversee. Were also aware of ongoing threats to whistleblowers and Patient Advocates instead of amending its bylaws to protect the brave individuals eunice has continued his longstanding of intimidation and retaliation. This is unacceptable. Tens of thousands of organs go to waste every year exploiting generous donor families while organ procurement executives travel on luxury private jets to fivestar resorts. Investigative reporting has revealed anticompetitive behavior designed to block ne