Medicare Proposes New Rules to Boost Organ Transplants

Proposed changes aim to increase use of less-than-perfect organs and set higher safety standards for donor groups.

Jan. 28, 2026 at 6:07pm

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The Centers for Medicare and Medicaid Services (CMS) has proposed new rules for the nation's transplant system that aim to increase the use of medically complex or less-than-perfect organs and set additional safety standards for organ procurement organizations (OPOs). The proposal comes as organ donations from deceased donors dropped for the first time in over a decade in 2025, sparking concerns about public trust in the system.

Why it matters

With over 100,000 people on the U.S. transplant waitlist, the majority seeking kidneys, the proposed rules are part of an ongoing effort to improve the complex transplant system and increase the supply of available organs. The changes could help address the shortage of donated organs and save lives, but also raise questions about the safety and oversight of the organ procurement process.

The details

The proposed rule would strengthen CMS oversight of OPOs, the groups that retrieve organs from deceased donors. It would add new requirements for how OPOs track the retrieval and usage of 'medically complex' organs, typically those from older or sicker donors. The goal is to encourage the use of these less-than-perfect organs, which may be suitable for some recipients even if they wouldn't last a lifetime. The proposal also aims to clarify definitions of 'unsound medical practices' for organ handling and patient safety.

  • The proposed rule was announced on January 28, 2026.
  • CMS expects the rule to be finalized later in 2026.

The players

Centers for Medicare and Medicaid Services (CMS)

The federal agency that oversees the Medicare and Medicaid programs and is proposing the new transplant system rules.

Dr. Mehmet Oz

CMS Administrator who stated the proposed rule 'strengthens accountability, clarifies expectations and gives us stronger tools to remove underperforming organizations, protect patients and honor the incredible gift of life.'

Jeff Trageser

President of the Association of Organ Procurement Organizations, who expressed cautious optimism that the proposed changes could help encourage the use of medically complex donated organs.

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What they’re saying

“Every missed opportunity for organ donation is a life lost.”

— Dr. Mehmet Oz, CMS Administrator (wbal.com)

“If we're going to look at maximizing opportunities to get people off the transplant list we've got to be sure hospitals are supporting donation, helping us to manage those medically complex donors, and transplant centers have mechanisms in place where they can make use of those.”

— Jeff Trageser, President, Association of Organ Procurement Organizations (wbal.com)

What’s next

CMS expects to finalize the proposed rule later in 2026.

The takeaway

The proposed changes aim to address the organ shortage by increasing the use of medically complex donated organs, but also raise questions about oversight and public trust in the transplant system. Successful implementation will require coordination between OPOs, transplant centers, and hospitals to ensure these less-than-perfect organs can be safely and effectively utilized.