Newly-Released Emails Evidence Collusion and Bias in Rewriting of Nation’s Liver Allocation Policy
Dec 21 2021
WASHINGTON - Today, U.S. Senators Jerry Moran (Kan.) and Roy Blunt (Mo.) issued the following statement in response to the release of documents, including emails between the United Network for Organ Sharing (UNOS) and organ procurement organizations, regarding the national liver allocation policy. The emails released are in response to a November 17, 2021, United States Court of Appeals for the Eleventh Circuit ruling against UNOS, the Department of Health and Human Services’ contractor for organ procurement and transplantation. The Court found that UNOS “repeatedly failed to live up to its production obligations” to release documents in ongoing litigation and the Court acknowledged these documents show “personal opinions about the relative merits of living in different regions of the United States.”
“These newly-released emails are disgusting and absolutely unacceptable. They show clear collusion by UNOS and several organ procurement organizations prior to the liver allocation policy being announced, leaving no doubt that the liver allocation policy must be overturned,” the senators said. “From the time the changes to the national liver allocation policy were first announced three years ago, we raised the alarm about the major flaws in the policymaking process. UNOS overruled the expert Liver and Intestine Committee, excluded certain public comments in the deliberations, and arrived at an outcome that was radically different from the decision previously reached. What we learned today is that the process was not simply flawed, it was deliberately designed to deny patients in the South and Midwest their fair chance at a lifesaving liver transplant.
The emails show a pattern of collusion between UNOS, a New England-area organ procurement organization, and others prior to the changes in the liver allocation policy being announced. The changes favored certain states at the expense of states in the South and Midwest, which are predicted to see a substantial decrease in organ availability. The emails further include profane and disparaging comments about people living in the South, demonstrating a clear bias against these areas in the policymaking process.
The senators continued, “UNOS tried to use the legal system to cover their tracks. Thankfully they were unsuccessful and their callous arrogance has now been laid bare. We have repeatedly said the process and policy for determining liver allocations needs to be made fairly and transparently. Neither UNOS nor the Department of Health and Human Services have lived up to this standard. These emails perfectly illustrate our biggest fears and what we’ve known all along – that the process is totally biased and fundamentally flawed. We demand that the Department of Health and Human Services immediately reverse its implementation of the misguided liver allocation policy.”
Since the initial allocation decision was made in December 2018, Blunt and Moran have repeatedly pressed HHS to review the liver allocation policymaking process and HHS’ oversight of the program and its contractor, UNOS:
- January 2020: Blunt, Moran Urge HHS to Continue Delaying Changes to National Liver Distribution Policy
- August 2019: Blunt, Moran Press HHS Secretary Azar on Proposed Changes to Kidney, Pancreas Allocation Policies
- May 2019: Blunt, Moran Call for Delay in Liver Allocation Policy Pending GAO Study
- February 2019: Misguided Changes to National Liver Allocation Policy Will Hurt Kansas City-area Patients
- January 2019: Blunt, Grassley, 20 Senate Colleagues Demand Answers on Changes to National Liver Distribution Policy
- December 2018: Blunt, Moran Challenge Flawed Changes to National Liver Distribution Policy