Hospitals enlisted to boost transplant supplies

By Sept. 1, you'll be required to report all deaths

Coming down the pike in late August is a new regulation that may complicate your life considerably: Health and Human Services Secretary Donna Shalala announced a new regulation in June that requires all hospitals to notify their regional organ procurement organization each time a patient dies to determine if the patient can donate lifesaving organs or tissues for transplant. The final regulation was published in the Federal Register (63 Fed Reg 33,856-33,875 [June 22, 1998]), and will take effect 60 days from the date of publication.

The regulation will become a condition for participation in the Medicare program, and as such affects 5,200 acute care hospitals. It is the latest step in the National Organ and Tissue Donation Initiative, launched by Vice President Al Gore several months ago.

About 4,000 Americans die each year waiting for an organ transplant. Last year, only 5,475 deaths resulted in donation.

"In the absence of the requirement we are making today, we have been missing thousands of opportunities for donation each year," Secretary Shalala said in a statement. "With better identification of potential donors, we can substantially reduce the number of deaths among those awaiting a transplant."

Under the rule, hospitals will refer 2.1 million hospital deaths annually to the nation's 63 organ procurement organizations or to third parties designated to handle the referrals. Hospitals also will work with the organizations to ensure that the family of every potential donor knows about its option to donate organs or tissues.

Organ procurement organizations in states that have passed similar laws have seen an increase of up to 40% in organ donation. Consent is requested even in cases where the individual has signed an organ donor card. The card provides an indication of the individual's wish, but consent by survivors is still needed.

To obtain a copy of the June 22, 1988, Federal Register, or any other recent issue, send your request to:

      New Orders

      Superintendent of Documents

      P.O. Box 371954

      Pittsburgh, PA 15250-7954

Specify the date of the issue you want and enclose a check or money order for $8 payable to the Superintendent of Documents, or enclose your Visa or MasterCard number and expiration date. Telephone: (202) 512-1800; fax: (202) 512-2250.

To see that document on the Internet, go to or to the Health Care Financing Administration Web site, The document is "42 CFR Part 482; [HCFA-3005-F]; RIN: 0938-AI95."