119-hr1520

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1520 Referred in Senate

    (RFS) ]

<DOC>
119th CONGRESS
 1st Session
 H. R. 1520

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 June 24, 2025

 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, 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 great-

er rights to qualified individuals with respect to organ transplants 
than the rights established under this Act.

 Passed the House of Representatives June 23, 2025.

 Attest:

 KEVIN F. MCCUMBER,

 Clerk.