U.S. President Joe Biden has signed into law a new bill that will increase the number of eligible competitors for organ donation contracts, potentially reducing waiting lists and providing patients with greater access to lifesaving transplants.

Under the Securing the U.S. Organ Procurement Transplantation Network Act, the Health Resources and Services Administration (HRSA) will award grants, contracts, and cooperative agreements for managing and supporting the Organ Procurement and Transplantation Network, creating a more competitive bidding process. The OPTN requires select awards to operate, and the Government Accountability Office must review its historical financial operations.

It also removes the appropriations cap on funding that can be awarded to contractors, according to CNN. The law comes on the heels of a report published earlier this year, revealing that the OPTN's current contract holder, United Network for Organ Sharing, which has been in charge since 1986, poorly managed the network, leading to a waiting list of more than 100,000 people, of which about 6,000 die annually, as well as contracted infections from diseased organs.

White House press secretary Karine Jean-Pierre said the legislation “will break up the current monopoly system harnessing competition to allow HHS to contract with the best entities to provide a more efficient system for the people it serves.”

In its three-year investigation, the Senate Finance Committee found failures in the OPTN led to 70 deaths and more than 1,100 complaints between 2010 and 2020, including testing for blood types and diseases, and errors in retrieval that rendered donations useless, including organs that were abandoned or not picked up at airports. About 249 transplant recipients developed diseases from donated organs between 2008 and 2015, with over 25% later dying.

In his 2024 budget proposal, Biden called for $36 million in increased funding for organ procurement and transplantation, bringing the total to $67 million, and requested that Congress update decades-old rules around appropriations and contracts for organ transplants. HRSA also said it would develop a new data-sharing dashboard on individual transplant centers, as well as organ retrieval, waitlists, transplants, and demographics to address the problems found in the Senate investigation.

The bill, which was passed in bipartisan votes by the Senate and the House in July, is expected to improve transparency and accountability for patients in need of a transplant.

In a statement, UNOS said it “supports a more competitive and open bidding process” and “looks forward to taking part” in it.

The HRSA plans to begin soliciting bids later this fall.

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