AOPO Recommends Further Analysis of Proposed CMS Reimbursement Changes

Ensuring the Impact on the Organ Donation and Transplantation System is Fully Understood

McLean, VA. (September 15, 2022) – The Association of Organ Procurement Organizations (AOPO) submitted comments to the Centers for Medicare & Medicaid Services (CMS) on proposed organ acquisition reimbursement changes included in the proposed 2023 Hospital Outpatient Prospective Payment System (OPPS) Rule. In the letter, AOPO emphasized its shared goal with CMS to continue to improve the organ donation and transplantation system and expand the overall number of organ transplants to save more lives. AOPO points out how some of the proposed changes to reimbursement policies for organ procurement organizations (OPOs) could cause logistical system-wide disruptions, reduce resources, and ultimately reverse recent progress by OPOs and other stakeholders to expand the number of deceased donor transplants for the 11 consecutive year. Specifically, AOPO made the following recommendations:

      • Continue allowing organs originally procured for transplant purposes, but later deemed unusable and subsequently donated to research, to qualify as allowable Medicare organ acquisition costs. This important clarification will allow potentially groundbreaking research to continue.
      • Prior to making any changes to reimbursement policies for non-renal organs or Medicare’s share of standard acquisition charges, implement a system that provides OPOs access to up-to-date, real-time payer data that is available at the point of organ placement to avoid potential delays and disruptions.
      • Reconsider a proposal to reconcile non-renal organs retroactively financially in the same way kidneys are currently. Due to the far less frequent and predictable nature of non-renal organs, applying this same reconciliation policy would force OPOs to increase financial reserves and take a more conservative approach to budget forecasting, undercutting their ability to continue investing in community outreach, innovations, and other important activities that have been pushing the boundaries of transplant and led to increased transplantation rates.

AOPO also requested an extension on the request for information elements of this rule to allow AOPO and its OPO members sufficient time to collect and analyze data and provide more detailed responses to quantitative questions. AOPO also noted that several of its members have made separate data requests to the United Network of Organ Sharing and many are still awaiting responses. AOPO also suggests that a multi-stakeholder workgroup would be the most effective way to engage in a meaningful discussion with CMS and advance some of these multifaceted proposals, which impact a multitude of stakeholders and elements of this complex system.

“These are some outstanding questions that speak to the complex nature of the proposals included in this rule,” says Barry Massa, AOPO President and Executive Director LifeCenter Organ Donor Network. “We believe it is vital for CMS to consider all the stakeholder comments, downstream impacts, and logistical considerations before proceeding with proposals with this degree of potentially significant implications.”

These topics will also be a focus of AOPO’s upcoming Advocacy Day where AOPO’s member OPOs will meet with their Congressional representatives and staff to educate them about challenges currently facing OPOs and the organ donation and transplantation system.

“This is an opportunity for our member OPOs to go to Capitol Hill and tell our Congressional representatives about the complex process of organ procurement and transplantation,” says Steve Miller, AOPO CEO. “Part of our mission is to educate policymakers on the important challenges facing OPOs and the transplant system more generally so that together, we can save more lives and achieve our goal of 50,000 annual organ transplants in 2026.”


The Association of Organ Procurement Organizations (AOPO) is the not-for-profit trade association leading the nation’s organ donation community to save and improve lives through organ, eye, and tissue donation. Founded in 1984, AOPO advances organ donation and transplantation by driving continual improvement of the donation process, collaborating with stakeholders, and sharing successful practices with their OPO members. The vision of AOPO is to pursue the day when every donation opportunity results in lives saved. For more information, please visit