IIB 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 Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 2 HR 2706 RFS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Charlotte Woodward 2 Organ Transplant Discrimination Prevention Act’’. 3 SEC. 2. DEFINITIONS. 4 In this Act: 5 (1) AUXILIARY AIDS AND SERVICES.—The term 6 ‘‘auxiliary aids and services’’ has the meaning given 7 the term in section 4 of the Americans with Disabil- 8 ities Act of 1990 (42 U.S.C. 12103). 9 (2) COVERED ENTITY.—The term ‘‘covered en- 10 tity’’ means any licensed provider of health care 11 services (including licensed health care practitioners, 12 hospitals, nursing facilities, laboratories, inter- 13 mediate care facilities, psychiatric residential treat- 14 ment facilities, institutions for individuals with intel- 15 lectual or developmental disabilities, and prison 16 health centers), and any transplant hospital (as de- 17 fined in section 121.2 of title 42, Code of Federal 18 Regulations or a successor regulation), that— 19 (A) is in interstate commerce; or 20 (B) provides health care services in a man- 21 ner that— 22 (i) substantially affects or has a sub- 23 stantial relation to interstate commerce; or 24 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 3 HR 2706 RFS (ii) includes use of an instrument (in- 1 cluding an instrument of transportation or 2 communication) of interstate commerce. 3 (3) DISABILITY.—The term ‘‘disability’’ has the 4 meaning given the term in section 3 of the Ameri- 5 cans with Disabilities Act of 1990 (42 U.S.C. 6 12102). 7 (4) HUMAN ORGAN.—The term ‘‘human organ’’ 8 has the meaning given the term in section 301(c) of 9 the National Organ Transplant Act (42 U.S.C. 10 274e(c)). 11 (5) ORGAN TRANSPLANT.—The term ‘‘organ 12 transplant’’ means the transplantation or trans- 13 fusion of a donated human organ into the body of 14 another human for the purpose of treating a medical 15 condition. 16 (6) QUALIFIED INDIVIDUAL.—The term ‘‘quali- 17 fied individual’’ means an individual who, with or 18 without a support network, provision of auxiliary 19 aids and services, or reasonable modifications to 20 policies or practices, meets eligibility requirements 21 for the receipt of a human organ. 22 (7) REASONABLE MODIFICATIONS TO POLICIES 23 OR PRACTICES.—The term ‘‘reasonable modifications 24 to policies or practices’’ includes— 25 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 4 HR 2706 RFS (A) communication with persons respon- 1 sible for supporting a qualified individual with 2 postsurgical or other care following an organ 3 transplant or related services, including support 4 with medication; 5 (B) consideration, in determining whether 6 a qualified individual will be able to comply 7 with health requirements following an organ 8 transplant or receipt of related services, of sup- 9 port networks available to the qualified indi- 10 vidual, including family, friends, and providers 11 of home and community-based services, includ- 12 ing home and community-based services funded 13 through the Medicare or Medicaid program 14 under title XVIII or XIX, respectively, of the 15 Social Security Act (42 U.S.C. 1395 et seq., 16 1396 et seq.), another health plan in which the 17 qualified individual is enrolled, or any program 18 or source of funding available to the qualified 19 individual; and 20 (C) the use of supported decision-making, 21 when needed, by a qualified individual. 22 (8) RELATED SERVICES.—The term ‘‘related 23 services’’ means services related to an organ trans- 24 plant that consist of— 25 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 5 HR 2706 RFS (A) evaluation; 1 (B) counseling; 2 (C) treatment, including postoperative 3 treatment, and care; 4 (D) provision of information; and 5 (E) any other service recommended or re- 6 quired by a physician. 7 (9) SUPPORTED DECISION-MAKING.—The term 8 ‘‘supported decision-making’’ means the use of a 9 support person to assist a qualified individual in 10 making health care decisions, communicate informa- 11 tion to the qualified individual, or ascertain a quali- 12 fied individual’s wishes. Such term includes— 13 (A) the inclusion of the individual’s attor- 14 ney-in-fact or health care proxy, or any person 15 of the individual’s choice, in communications 16 about the individual’s health care; 17 (B) permitting the individual to designate 18 a person of the individual’s choice for the pur- 19 poses of supporting that individual in commu- 20 nicating, processing information, or making 21 health care decisions; 22 (C) providing auxiliary aids and services to 23 facilitate the individual’s ability to communicate 24 and process health-related information, includ- 25 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 6 HR 2706 RFS ing providing use of assistive communication 1 technology; 2 (D) providing health information to per- 3 sons designated by the individual, consistent 4 with the regulations promulgated under section 5 264(c) of the Health Insurance Portability and 6 Accountability Act of 1996 (42 U.S.C. 1320d– 7 2 note) and other applicable laws and regula- 8 tions governing disclosure of health informa- 9 tion; 10 (E) providing health information in a for- 11 mat that is readily understandable by the indi- 12 vidual; and 13 (F) working with a court-appointed guard- 14 ian or other person responsible for making 15 health care decisions on behalf of the individual, 16 to ensure that the individual is included in deci- 17 sions involving the health care of the individual 18 and that health care decisions are in accordance 19 with the individual’s own expressed interests. 20 (10) SUPPORT NETWORK.—The term ‘‘support 21 network’’ means, with respect to a qualified indi- 22 vidual, one or more people who are— 23 (A) selected by the qualified individual or 24 by the qualified individual and the guardian of 25 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 7 HR 2706 RFS the qualified individual, to provide assistance to 1 the qualified individual or guidance to that 2 qualified individual in understanding issues, 3 making plans for the future, or making complex 4 decisions; and 5 (B) who may include the family members, 6 friends, unpaid supporters, members of the reli- 7 gious congregation, and appropriate personnel 8 at a community center, of or serving the quali- 9 fied individual. 10 SEC. 3. PROHIBITION OF DISCRIMINATORY POLICY. 11 The board of directors described in section 12 372(b)(1)(B) of the Public Health Service Act (42 U.S.C. 13 274(b)(1)(B)) shall not issue policies, recommendations, 14 or other memoranda that would prohibit, or otherwise 15 hinder, a qualified individual’s access to an organ trans- 16 plant solely on the basis of that individual’s disability. 17 SEC. 4. PROHIBITION OF DISCRIMINATION. 18 (a) IN GENERAL.—Subject to subsection (b), a cov- 19 ered entity may not, solely on the basis of a qualified indi- 20 vidual’s disability— 21 (1) determine that the individual is ineligible to 22 receive an organ transplant or related services; 23 (2) deny the individual an organ transplant or 24 related services; 25 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 8 HR 2706 RFS (3) refuse to refer the individual to an organ 1 transplant center or other related specialist for the 2 purpose of receipt of an organ transplant or other 3 related services; or 4 (4) refuse to place the individual on an organ 5 transplant waiting list. 6 (b) EXCEPTION.— 7 (1) IN GENERAL.— 8 (A) MEDICALLY SIGNIFICANT DISABIL- 9 ITIES.—Notwithstanding subsection (a), a cov- 10 ered entity may take a qualified individual’s 11 disability into account when making a health 12 care treatment or coverage recommendation or 13 decision, solely to the extent that the disability 14 has been found by a physician, following an in- 15 dividualized evaluation of the potential recipi- 16 ent, to be medically significant to the receipt of 17 the organ transplant or related services, as the 18 case may be. 19 (B) CONSTRUCTION.—Subparagraph (A) 20 shall not be construed to require a referral or 21 recommendation for, or the performance of, a 22 medically inappropriate organ transplant or 23 medically inappropriate related services. 24 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 9 HR 2706 RFS (2) CLARIFICATION.—If a qualified individual 1 has the necessary support network to provide a rea- 2 sonable assurance that the qualified individual will 3 be able to comply with health requirements following 4 an organ transplant or receipt of related services, as 5 the case may be, the qualified individual’s inability 6 to independently comply with those requirements 7 may not be construed to be medically significant for 8 purposes of paragraph (1). 9 (c) REASONABLE MODIFICATIONS.—A covered entity 10 shall make reasonable modifications to policies or practices 11 (including procedures) of such entity if such modifications 12 are necessary to make an organ transplant or related serv- 13 ices available to qualified individuals with disabilities, un- 14 less the entity can demonstrate that making such modi- 15 fications would fundamentally alter the nature of such 16 policies or practices. 17 (d) CLARIFICATIONS.— 18 (1) NO DENIAL OF SERVICES BECAUSE OF AB- 19 SENCE OF AUXILIARY AIDS AND SERVICES.—For 20 purposes of this section, a covered entity shall take 21 such steps as may be necessary to ensure that a 22 qualified individual with a disability is not denied a 23 procedure associated with the receipt of an organ 24 transplant or related services, because of the absence 25 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 10 HR 2706 RFS of auxiliary aids and services, unless the covered en- 1 tity can demonstrate that taking such steps would 2 fundamentally alter the nature of the procedure 3 being offered or would result in an undue burden on 4 the entity. 5 (2) COMPLIANCE WITH OTHER LAW.—Nothing 6 in this section shall be construed— 7 (A) to prevent a covered entity from pro- 8 viding organ transplants or related services at 9 a level that is greater than the level that is re- 10 quired by this section; or 11 (B) to limit the rights of an individual with 12 a disability under, or to replace or limit the 13 scope of obligations imposed by, the Americans 14 with Disabilities Act of 1990 (42 U.S.C. 12101 15 et seq.) including the provisions added to such 16 Act by the ADA Amendments Act of 2008, sec- 17 tion 504 of the Rehabilitation Act of 1973 (29 18 U.S.C. 794), section 1557 of the Patient Pro- 19 tection and Affordable Care Act (42 U.S.C. 20 18116), or any other applicable law. 21 (e) ENFORCEMENT.— 22 (1) IN GENERAL.—Any individual who alleges 23 that a qualified individual was subject to a violation 24 of this section by a covered entity may bring a claim 25 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 11 HR 2706 RFS regarding the allegation to the Office for Civil 1 Rights of the Department of Health and Human 2 Services, for expedited resolution, as appropriate. 3 (2) RULE OF CONSTRUCTION.—Nothing in this 4 subsection is intended to limit or replace available 5 remedies under the Americans with Disabilities Act 6 of 1990 (42 U.S.C. 12101 et seq.) or any other ap- 7 plicable law. 8 SEC. 5. APPLICATION TO EACH PART OF PROCESS. 9 The provisions of this Act— 10 (1) that apply to an organ transplant, also 11 apply to the evaluation and listing of a qualified in- 12 dividual, and to the organ transplant and post- 13 organ-transplant treatment of such an individual; 14 and 15 (2) that apply to related services, also apply to 16 the process for receipt of related services by such an 17 individual. 18 SEC. 6. EFFECT ON OTHER LAWS. 19 Nothing in this Act shall be construed to supersede 20 any provision of any State or local law that provides great- 21 VerDate Sep 11 2014 03:03 Sep 25, 2024 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2706.RFS H2706 ssavage on LAPJG3WLY3PROD with BILLS 12 HR 2706 RFS er rights to qualified individuals with respect to organ 1 transplants than the rights established under this Act. 2 Passed the House of Representatives September 23, 2024. Attest: KEVIN F. MCCUMBER, Clerk. 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