Charlotte Woodward Organ Transplant Discrimination Prevention Act

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1520 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 1520

     To prohibit discrimination on the basis of mental or physical
               disability in cases of organ transplants.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           February 24, 2025

   Mrs. Cammack (for herself, Mrs. Dingell, Mr. Issa, Ms. Wasserman
  Schultz, and Mr. Sessions) introduced the following bill; which was
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

     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, 1 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.
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