[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2706 Referred in Senate (RFS)]
<DOC>
118th CONGRESS
2d Session
H. R. 2706
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 24, 2024
Received; read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
AN ACT
To prohibit discrimination on the basis of mental or physical
disability in cases of organ transplants.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Charlotte Woodward Organ Transplant
Discrimination Prevention Act''.
SEC. 2. DEFINITIONS.
In this Act:
(1) Auxiliary aids and services.--The term ``auxiliary aids
and services'' has the meaning given the term in section 4 of
the Americans with Disabilities Act of 1990 (42 U.S.C. 12103).
(2) Covered entity.--The term ``covered entity'' means any
licensed provider of health care services (including licensed
health care practitioners, hospitals, nursing facilities,
laboratories, intermediate care facilities, psychiatric
residential treatment facilities, institutions for individuals
with intellectual or developmental disabilities, and prison
health centers), and any transplant hospital (as defined in
section 121.2 of title 42, Code of Federal Regulations or a
successor regulation), that--
(A) is in interstate commerce; or
(B) provides health care services in a manner
that--
(i) substantially affects or has a
substantial relation to interstate commerce; or
(ii) includes use of an instrument
(including an instrument of transportation or
communication) of interstate commerce.
(3) Disability.--The term ``disability'' has the meaning
given the term in section 3 of the Americans with Disabilities
Act of 1990 (42 U.S.C. 12102).
(4) Human organ.--The term ``human organ'' has the meaning
given the term in section 301(c) of the National Organ
Transplant Act (42 U.S.C. 274e(c)).
(5) Organ transplant.--The term ``organ transplant'' means
the transplantation or transfusion of a donated human organ
into the body of another human for the purpose of treating a
medical condition.
(6) Qualified individual.--The term ``qualified
individual'' means an individual who, with or without a support
network, provision of auxiliary aids and services, or
reasonable modifications to policies or practices, meets
eligibility requirements for the receipt of a human organ.
(7) Reasonable modifications to policies or practices.--The
term ``reasonable modifications to policies or practices''
includes--
(A) communication with persons responsible for
supporting a qualified individual with postsurgical or
other care following an organ transplant or related
services, including support with medication;
(B) consideration, in determining whether a
qualified individual will be able to comply with health
requirements following an organ transplant or receipt
of related services, of support networks available to
the qualified individual, including family, friends,
and providers of home and community-based services,
including home and community-based services funded
through the Medicare or Medicaid program under title
XVIII or XIX, respectively, of the Social Security Act
(42 U.S.C. 1395 et seq., 1396 et seq.), another health
plan in which the qualified individual is enrolled, or
any program or source of funding available to the
qualified individual; and
(C) the use of supported decision-making, when
needed, by a qualified individual.
(8) Related services.--The term ``related services'' means
services related to an organ transplant that consist of--
(A) evaluation;
(B) counseling;
(C) treatment, including postoperative treatment,
and care;
(D) provision of information; and
(E) any other service recommended or required by a
physician.
(9) Supported decision-making.--The term ``supported
decision-making'' means the use of a support person to assist a
qualified individual in making health care decisions,
communicate information to the qualified individual, or
ascertain a qualified individual's wishes. Such term includes--
(A) the inclusion of the individual's attorney-in-
fact or health care proxy, or any person of the
individual's choice, in communications about the
individual's health care;
(B) permitting the individual to designate a person
of the individual's choice for the purposes of
supporting that individual in communicating, processing
information, or making health care decisions;
(C) providing auxiliary aids and services to
facilitate the individual's ability to communicate and
process health-related information, including providing
use of assistive communication technology;
(D) providing health information to persons
designated by the individual, consistent with the
regulations promulgated under section 264(c) of the
Health Insurance Portability and Accountability Act of
1996 (42 U.S.C. 1320d-2 note) and other applicable laws
and regulations governing disclosure of health
information;
(E) providing health information in a format that
is readily understandable by the individual; and
(F) working with a court-appointed guardian or
other person responsible for making health care
decisions on behalf of the individual, to ensure that
the individual is included in decisions involving the
health care of the individual and that health care
decisions are in accordance with the individual's own
expressed interests.
(10) Support network.--The term ``support network'' means,
with respect to a qualified individual, one or more people who
are--
(A) selected by the qualified individual or by the
qualified individual and the guardian of the qualified
individual, to provide assistance to the qualified
individual or guidance to that qualified individual in
understanding issues, making plans for the future, or
making complex decisions; and
(B) who may include the family members, friends,
unpaid supporters, members of the religious
congregation, and appropriate personnel at a community
center, of or serving the qualified individual.
SEC. 3. PROHIBITION OF DISCRIMINATORY POLICY.
The board of directors described in section 372(b)(1)(B) of the
Public Health Service Act (42 U.S.C. 274(b)(1)(B)) shall not issue
policies, recommendations, or other memoranda that would prohibit, or
otherwise hinder, a qualified individual's access to an organ
transplant solely on the basis of that individual's disability.
SEC. 4. PROHIBITION OF DISCRIMINATION.
(a) In General.--Subject to subsection (b), a covered entity may
not, solely on the basis of a qualified individual's disability--
(1) determine that the individual is ineligible to receive
an organ transplant or related services;
(2) deny the individual an organ transplant or related
services;
(3) refuse to refer the individual to an organ transplant
center or other related specialist for the purpose of receipt
of an organ transplant or other related services; or
(4) refuse to place the individual on an organ transplant
waiting list.
(b) Exception.--
(1) In general.--
(A) Medically significant disabilities.--
Notwithstanding subsection (a), a covered entity may
take a qualified individual's disability into account
when making a health care treatment or coverage
recommendation or decision, solely to the extent that
the disability has been found by a physician, following
an individualized evaluation of the potential
recipient, to be medically significant to the receipt
of the organ transplant or related services, as the
case may be.
(B) Construction.--Subparagraph (A) shall not be
construed to require a referral or recommendation for,
or the performance of, a medically inappropriate organ
transplant or medically inappropriate related services.
(2) Clarification.--If a qualified individual has the
necessary support network to provide a reasonable assurance
that the qualified individual will be able to comply with
health requirements following an organ transplant or receipt of
related services, as the case may be, the qualified
individual's inability to independently comply with those
requirements may not be construed to be medically significant
for purposes of paragraph (1).
(c) Reasonable Modifications.--A covered entity shall make
reasonable modifications to policies or practices (including
procedures) of such entity if such modifications are necessary to make
an organ transplant or related services available to qualified
individuals with disabilities, unless the entity can demonstrate that
making such modifications would fundamentally alter the nature of such
policies or practices.
(d) Clarifications.--
(1) No denial of services because of absence of auxiliary
aids and services.--For purposes of this section, a covered
entity shall take such steps as may be necessary to ensure that
a qualified individual with a disability is not denied a
procedure associated with the receipt of an organ transplant or
related services, because of the absence of auxiliary aids and
services, unless the covered entity can demonstrate that taking
such steps would fundamentally alter the nature of the
procedure being offered or would result in an undue burden on
the entity.
(2) Compliance with other law.--Nothing in this section
shall be construed--
(A) to prevent a covered entity from providing
organ transplants or related services at a level that
is greater than the level that is required by this
section; or
(B) to limit the rights of an individual with a
disability under, or to replace or limit the scope of
obligations imposed by, the Americans with Disabilities
Act of 1990 (42 U.S.C. 12101 et seq.) including the
provisions added to such Act by the ADA Amendments Act
of 2008, section 504 of the Rehabilitation Act of 1973
(29 U.S.C. 794), section 1557 of the Patient Protection
and Affordable Care Act (42 U.S.C. 18116), or any other
applicable law.
(e) Enforcement.--
(1) In general.--Any individual who alleges that a
qualified individual was subject to a violation of this section
by a covered entity may bring a claim regarding the allegation
to the Office for Civil Rights of the Department of Health and
Human Services, for expedited resolution, as appropriate.
(2) Rule of construction.--Nothing in this subsection is
intended to limit or replace available remedies under the
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et
seq.) or any other applicable law.
SEC. 5. APPLICATION TO EACH PART OF PROCESS.
The provisions of this Act--
(1) that apply to an organ transplant, also apply to the
evaluation and listing of a qualified individual, and to the
organ transplant and post-organ-transplant treatment of such an
individual; and
(2) that apply to related services, also apply to the
process for receipt of related services by such an individual.
SEC. 6. EFFECT ON OTHER LAWS.
Nothing in this Act shall be construed to supersede any provision
of any State or local law that provides greater rights to qualified
individuals with respect to organ transplants than the rights
established under this Act.
Passed the House of Representatives September 23, 2024.
Attest:
KEVIN F. MCCUMBER,
Clerk.