The Senate Finance Committee is more than three years into a bipartisan investigation into deadly failures of both the United Network for Organ Sharing (UNOS), which holds the national monopoly contract to manage the U.S. organ donation system (known as the Organ Procurement and Transplantation Network OPTN), as well as the local organ procurement organizations (OPOs) it is supposed to oversee. Timeline below. December 2019: Senators Grassley and Young ask the Office of the Inspector General to audit OPOs and UNOS for potential fraud. See Washington Post. February 2020: Senators Wyden, Grassley, Cardin, and Young launch a bipartisan investigation into UNOS. October 2020: Senate Finance Committee investigation continues with a letter to the Secretary of the U.S. Department of Health and Human Services (HHS). February 2021: Senators Wyden and Grassley issue UNOS a subpoena, citing “serious concerns related to UNOS’ role in overseeing our nation’s OPOs, which have been severely underperforming for decades… [and] the improper use of Medicare funds, conflicts of interest and gaps in oversight.” July 2021: Senators Wyden, Grassley, Cardin, and Young join a bicameral letter with bipartisan Members of the House Oversight Committee urging the Biden administration to accelerate the timeline for OPO accountability. April 2022: Senators Wyden, Grassley, Cardin, Young, and Moran write to HHS in support of more transparency for OPOs. August 2022: Senate Finance holds a bipartisan hearing and releases a bipartisan report, concluding “from the top down, the U.S. transplant system is not working, ​​putting Americans’ lives at risk.” See front-page Washington Post stories on UNOS tech failures and on UNOS/OPO patient safety failures, as well as hearing coverage. November 2022: Senator Booker and Rep Mondaire Jones lead a bicameral letter to HHS with other Members of the Congressional Black Caucus endorsing the Senate Finance Committee’s recommendations. November 2022: Senators Wyden, Grassley, Cardin, and Young write to the National Academies of Science, Engineering, and Medicine (NASEM), raising conflict of interest concerns related to the NASEM organ donation report. March 2023: Senators Wyden and Grassley write to UNOS about technology outages. March 2023: Senators Wyden, Grassley, Cardin, and Young send oversight letters to 10 OPOs regarding the practice of harvesting human pancreases to exploit a regulatory loophole. See Washington Post. July 2023: Senate Finance Committee holds bipartisan hearing into UNOS failures and whistleblower retaliation. July 2023: The Senate — led by the Senate Finance Committee — unanimously passes legislation to break up the OPTN monopoly contract, following unanimous passage of the same legislation by the House of Representatives. September 2023: Senators Wyden, Grassley, Cardin, and Young send oversight letters to 8 OPOs into “Potential Self-Dealing And Financial Conflicts Of Interest” as well as to the Centers for Medicare and Medicaid Services (CMS) regarding the need for regulatory reforms to OPO reimbursement structures. September 2023: Senators Wyden, Grassley, Cardin, Young, and Cassidy celebrate President Biden signing into law bipartisan legislation to break up the OPTN monopoly contract. See CBS.

October 2019: Rep Porter writes to HHS about abuses at the Los Angeles OPO. July 2020: Reps Porter and Bass urge HHS to finalize the OPO rule. August 2020: Bipartisan House Members including Rep Porter write to HHS urging finalization of the OPO rule. December 2020: The House Oversight Committee launches an investigation into 16 OPOs for “shocking mismanagement” and conflicts of interest, and into the Association of OPOs (AOPO) for misinformation. February 2021: Reps Porter, Krishnamoorthi, and Bass urge the Biden administration to finalize the OPO rule. May 2021: House Oversight holds a bipartisan hearing into OPO failures. See Washington Post. June 2021: House Oversight Committee “Expands Investigation into Fraud, Waste, and Abuse in Organ Transplant Industry” with a letter to the Nevada Donor Network July 2021: Chair Maloney, Ranking Member Comer, and Reps Krishnamoorthi, Porter, and Cloud join bicameral, bipartisan letter urging the Biden administration to accelerate the timeline for OPO accountability as “an urgent health equity issue.” August 2021: Rep Krishnamoorthi writes op-ed about OPO “greed and self-dealing.” February 2022: Reps Krishnamoorthi, Pressley, Bush, Bass, Porter, and Maloney write to CMS urging OPO accountability and transparency. September 2022: Reps Krishnamoorthi and Porter write to the National Academies of Sciences, Engineering, and Medicine “Regarding Potential Conflicts of Interest in Organ Transplant Industry Study”. See Washington Post and Kaiser Health News. November 2022: Reps Krishnamoorthi and Porter raise concerns about OPO data collection. See CBS Mornings with Gayle King. November 2022: Reps Pressley, Porter, and Khanna join bicameral colleagues in letter to HHS calling for the breakup of the UNOS monopoly and release of “OPO process data for evidence of effective and equitable performance, and to hold failing OPOs accountable before 2026, given that any delay costs lives and constitutes an urgent health care equity issue.”

June 2016: White House hosts Organ Summit. See “FACT SHEET: Obama Administration Announces Key Actions to Reduce the Organ Waiting List”. July 2019: President Trump signs Executive Order on Advancing American Kidney Health. See Washington Post. December 2019: HHS proposes new data-driven rule for OPO accountability. November 2020: HHS publishes final rule for OPO accountability. See Washington Post. April 2021: Biden administration re-finalizes OPO rule through midnight regulatory review. See Project on Government Oversight. July 2023: United States Digital Service Report “Lives Are At Stake”— detailing failures of UNOS — becomes public. See Washington Post. March 2023: Biden administration announces OPTN Modernization Initiative, including plan to break up OPTN monopoly. See Washington Post. September 2023: President Biden signs the bipartisan Securing the U.S. Organ Procurement and Transplantation Network Act into law. See CNN.

May 2017: “Last Week Tonight with John Oliver: Dialysis” December 2018: “Lives Lost, Organs Wasted”, Washington Post February 2019: “Despite low performance, organ collection group gets new federal contract”, Washington Post February 2019: “Behind the failure of the first U.S. uterine transplant”, Washington Post June 2019: “Whistleblower threatened with being cremated alive after exposing mortuary kickback scheme”, CBS News June 2019: “11000 Americans Will Die Waiting for Transplants This Year”, New York Times August 2019: “She Beat Cancer. Now She’s in Another Fight for Her Life”, New York Times editorial board October 2019: “How organ and tissue donation companies worked their way into the county morgue”, LA Times October 2019: “Where you die can affect your chance of being an organ donor”, Associated Press October 2019: “Organ Failure: An American Horror Story”, Full Frontal with Samantha Bee February 2020: “How Lifesaving Organs For Transplant Go Missing In Transit”, Kaiser Health News August 2020, “Many die waiting for organs. The Trump administration could help.”, Washington Post editorial board September 2020: “He died when he got the wrong lungs. It wasn’t the only organ error in SC that day.”, The Post and Courier October 2020: “Heartless: Organ Donation Contractors Lobby Against a Popular Health Care Initiative While Pocketing Pandemic Relief Loans”, Project on Government Oversight March 2021: “Trump’s Organ-Donation Policy Fix Would Save Lives”, Bloomberg editorial board April 2021: “America’s Transformative New Organ Donation Rule Goes into Effect Over Objections from Monopolistic Contractors” November 2021: “Organ failure: The gatekeeper of Minnesota's organ transplant system is underperforming. It may be costing lives”, Rochester Post Bulletin November 2021: “Organ donation recovery rates worse for people of color, data show”, Axios December 2021: “Lawsuit alleges bullying tactics by transplant executives in bid to revamp system” April 2022: “The organ procurement system is failing people of color like me. It’s time for reform”, STAT July 2022: “Thousands of lives depend on a transplant network in need of ‘vast restructuring’”, Washington Post August 2022: “70 deaths, many wasted organs are blamed on transplant system errors”, Washington Post November 2022: “Investigation finds failures in organ transplant system: 17 to 20 people a day die on the waitlist", CBS News January 2023, “Tonya Ingram Feared the Organ Donation System Would Kill Her. It Did.”, New York Times March 2023: “Dozens of Americans die daily waiting for an organ transplant. Why do we let this happen?”, USA Today March 2023: “U.S. Organ Transplant System, Troubled by Long Wait Times, Faces an Overhaul”, New York Times March 2023: “Break up the human organ monopoly”, Washington Post editorial board August 2023: “The organ transplant system needs fixing”, Boston Globe editorial board