U.S. Sen. Todd Young (R-IN) and a bipartisan contingent of his U.S. Senate Finance Committee colleagues continue to seek accountability in the U.S. organ procurement and transplant system.
The four senators, who included committee chairman U.S. Sen. Ron Wyden (D-OR), sent Sept. 5 letters to eight organ procurement organization (OPO) executives asking them details about “potential serious and compromising conflicts of interest among OPOs and their leadership’s financial and business relationships.”
Sen. Young and his colleagues are attempting to crack down on potential financial conflicts of interest and abuse of taxpayer money by the OPO executives, as well as current and former board members of the Association of Organ Procurement Organization (AOPO), according to his staff.
“Investigative reporting has uncovered that some OPO executives may have financial interests in for-profit companies conducting business with OPTN members,” wrote Sen. Young and his colleagues in the identical letters. “OPOs and their executives have engaged in a complex web of financial relationships with tissue processors, researchers, testing laboratories, and logistics providers, which have the potential for creating conflicts of interest. Some OPOs have also engaged in criminal activity.”
The eight letters were sent to: Wayne Dunlap, an AOPO board member and executive director of New Mexico Donor Services in Albuquerque, N.M.; Marty Sellers, AOPO medical advisor and organ recovery surgeon at Tennessee Donor Services in Nashville; Rick Hasz, an AOPO board member and president and CEO of the Gift of Life Donor Program in Philadelphia; Jeffrey Orlowski, a past AOPO president and current president and CEO of the LifeShare Network in Oklahoma City, Okla.; Jennifer Prinz, an AOPO board member and president and CEO of the Denver-based Donor Alliance; Colleen McCarthy, AOPO president and vice president of the Organ and Tissue Donation in Milwaukee, Wis.; Jan Finn, a past AOPO president and CEO of the Midwest Transplant Network in Westwood, Kan.; and Barry Massa, AOPO’s immediate past president and executive director of Cincinnati’s LifeCenter Organ Donor Network.
The committee members also pointed out that they heard testimony in July and received credible allegations that senior members of the current Organ Procurement and Transplantation Network (OPTN) contractor, the United Network for Organ Sharing’s patient protection and policymaking committees may harbor undisclosed for-profit interests and may be leveraging their UNOS leadership positions to self-enrich at the expense of patient care, according to their letters.
“These alleged conflicting financial and business relationships pose serious risks to those in need of a lifesaving organ transplant,” Sen. Young and his colleagues wrote.
“We are also troubled by the lack of transparency in the current system, which allows OPO executives to potentially maintain personal financial interests in entities doing business with OPOs or other members of the OPTN, especially those financial interests which may affect patient care,” they wrote. “We are also concerned about financial relationships and conflicts of interest from OPOs with outside entities, as well as volume-based incentives that may distort OPO priorities regarding the delivery of organ procurement.”
For these reasons, the committee members requested that each letter recipient answer several questions regarding each OPO’s financial and business relationships.
For instance, Sen. Young and his colleagues requested that each describe all personal financial interests or business relationships he or she and/or other board members or executives of each OPO had from 2015 to the present, and to provide records.
Additionally, the senators sent a Sept. 5 letter to Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure after an Aug. 9 audit report from the U.S. Department of Health and Human Services’ Office of Inspector General found that OPOs misspent taxpayer dollars by using Medicare to reimburse inappropriate expenditures.
Specifically, the audit report titled “Medicare Paid Independent Organ Procurement Organizations Over Half a Million Dollars for Professional and Public Education Overhead Costs That Did Not Meet Medicare Requirements,” found that an estimated $664,295 of taxpayer money was misspent on unallowable professional and public education overhead costs, including for entertainment, meals, lobbying, and gifts, according to the report.
“As the Senate Committee on Finance continues its investigation into the nation’s organ procurement system, we are concerned that these abuses and misuse of taxpayer dollars may result from CMS’s failure to properly oversee OPO finances,” Sen. Young and his colleagues wrote. “This ongoing lack of oversight has enabled OPOs to circumvent Medicare reimbursement requirements, resulting in misspent taxpayer dollars, including on sports tickets and other executive perks disguised as ‘education and awareness.’ Clearly these expenditures do not meaningfully contribute to organ recovery and they raise additional questions about the legitimacy of OPO spending.”
The senators urged CMS to implement reforms to address problems with the current reimbursement system for organ procurement and requested that CMS provide written answers to several questions by Sept. 19, as well as a briefing “no later than one week following receipt of your answers.”