New Rule Lets More Organ Donors Get Paid Back
Published Date: 7/1/2026
Notice
Summary
The Living Organ Donation Reimbursement Program is changing the rules to help more organ donors get money back for their donation costs. Now, the recipient’s income won’t matter—only the donor’s household income and financial need will count. These changes, inspired by the new Honor Our Living Donors Act, kick in soon, and HRSA wants your thoughts by July 31, 2026!
Analyzed Economic Effects
10 provisions identified: 7 benefits, 2 costs, 1 mixed.
Per-Donor Federal Reimbursement Cap of $6,000
The total federal reimbursement for all qualifying non-medical expenses for a potential donor or organ donated shall not exceed $6,000 per donor evaluated and/or organ donated.
What Expenses and Limits Are Covered
LODRP will reimburse qualifying expenses including travel, lodging, meals, lost wages, child/elder care, and out-of-pocket medical costs; donors may get up to five trips (three for donor, two for accompanying persons), lost-wage reimbursement for up to 4 weeks plus 2 additional weeks for complications, and hotel costs up to 150 percent of the federal per diem rate.
Recipient Income Removed from Eligibility
HRSA will stop using the transplant recipient's household income to decide whether a living organ donor can get reimbursement. Eligibility will instead be based only on the donor's household income and financial need, consistent with the HOLD Act signed February 3, 2026.
Two Donor Income Priority Tiers
LODRP will prioritize donors with household incomes at or below 350 percent of the HHS Poverty Guidelines as Priority Category 1. If resources allow, donors with household incomes between 351 and 500 percent of the HHS Poverty Guidelines will be eligible as Priority Category 2; HRSA estimates this framework would cover about 60 percent of current applicants.
Child and Elder Care Reimbursement Rules
LODRP will reimburse child-care and elder-care expenses if the donor has caretaker responsibilities for a minor child and/or an elder; transplant centers are encouraged to use consistent definitions and may consider 'elder' to mean age 60 and older.
Financial Hardship Waiver Capped at 750% HHS Poverty
LODRP will allow donors with household incomes between 501 and 750 percent of the HHS Poverty Guidelines to apply for a financial hardship waiver, reviewed case-by-case; waiver requests must show expenses that reduce HHI to at or below 500 percent and HRSA makes the final, nonappealable decision. HRSA estimates about 92 percent of current applicants have incomes at or below 750 percent.
No Recipient Income Documentation Required
Donor applicants will no longer be required to provide written documentation of the transplant recipient's household income; HRSA will instead ask donor applicants one multiple-choice question about the recipient's HHI (with an 'I do not know' option) for monitoring purposes.
Annual Report to Congress by December 31, 2027
By December 31, 2027, HRSA must submit an annual report to Congress estimating the number of donors not fully reimbursed in the previous fiscal year and the funding needed to fully reimburse all qualifying expenses.
Maximum Prospective Donors Per Recipient Set
LODRP sets limits on the number of prospective donors per recipient: kidney donors—one at a time, up to three total; liver donors—one at a time, up to five total; lung donors—two at a time, up to six total.
Citizenship and Residence Eligibility Rules
To receive LODRP reimbursement, the donor and recipient must be U.S. citizens or lawfully present in the United States and have primary residences in the United States or its territories; travel must originate from the donor's primary residence.
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