Organ donors get cash back—no recipient income check needed!
Published Date: 9/29/2026
Notice
Summary
Starting now, living organ donors can get reimbursed without worrying about the recipient’s household income thanks to the new Honor Our Living Donors Act. This change makes it easier for more donors to get up to $6,000 back for travel, lost wages, and care costs. The updated rules kick in right away, helping donors across the country keep giving life without financial stress.
Analyzed Economic Effects
8 provisions identified: 5 benefits, 3 costs, 0 mixed.
Recipient Income No Longer Used
Starting with applications reviewed on or after September 30, 2026, an organ recipient's household income may not be considered when determining a living donor's eligibility for reimbursement under the Living Organ Donation Reimbursement Program (LODRP). HRSA implemented this change to conform with the Honor Our Living Donors Act enacted in February 2026.
Reimbursement Amounts and Rules Set
LODRP reimburses qualifying non-medical expenses up to $6,000 per organ donated. Qualifying items include travel, lodging, meals, lost wages, child/elder/disabled-adult care, out-of-pocket household medical expenses, pet care, and other non-discretionary household expenses. The program will pay for up to five trips (three for the donor, two for accompanying individuals), reimburse hotels up to 150% of the Federal per diem, and reimburse up to 4 weeks of lost wages plus up to 2 additional weeks for complication-related follow-up. Non-traditional or irregular income can be documented for lost-wage reimbursement.
Donor Income Priority Tiers Defined
LODRP uses donor household income (HHI) relative to the HHS Poverty Guidelines to set priority: Priority Category 1 is HHI at or below 350% of the Guidelines; Priority Category 2 is HHI >350% up to 500% (eligible if resources exist); Priority Category 3 is HHI >500% up to 750% (eligible via financial hardship waiver). All three categories are accepted at the start of each budget period but HRSA may close Categories 2 and/or 3 if funding is insufficient.
Financial Hardship Waiver Expanded
Donors with HHIs greater than 500% but no greater than 750% of the HHS Poverty Guidelines may apply for a financial hardship waiver. The waiver review considers documented expenses such as lost wages, travel/lodging/meals, child/elder/disabled-adult care, household out-of-pocket medical costs, pet care, and legally mandated payments (e.g., child support), and requires documentation showing these expenses reduce the donor's effective HHI to at or below 500% of the Guidelines.
Non-Directed Donors Can Apply Without Recipient
Non-directed (unspecified-recipient) living donors are expressly exempt from recipient-related eligibility criteria and documentation requirements and may apply for LODRP reimbursement without an identified recipient, provided they meet all other program criteria.
Tax Reporting for Unused-Expense Payments
If an intended donor proceeds in good faith toward donation but elects not to pursue donation (or donation is prevented by certain circumstances), the recipient of the cooperative agreement may reimburse qualifying expenses as if donation had occurred; in such cases the recipient of the cooperative agreement will file a form with the Internal Revenue Service reporting funds disbursed as income for expenses not incurred.
No Reimbursement If Other Coverage Exists
LODRP cannot provide reimbursement for qualifying expenses if the donor can receive reimbursement from other sources such as any State compensation program, an insurance policy, any Federal or State health benefits program, or an entity that provides health services on a prepaid basis.
Limits on Number of Donors Per Recipient
LODRP sets maximum numbers of donor candidates per recipient who may receive reimbursement at any given time: Kidney — one donor at a time, maximum of three donors total; Liver — one donor at a time, maximum of five donors total; Lung — two donors at a time, maximum of six donors total.
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