 OMNIBUS BUDGET RECONCILIATION ACT (OBRA) (P.L. 99-509), passed in 1986. This Act directs hospitals, as a condition of eligibility to participate in the Medicare and Medicaid reimbursement program, to develop and implement policies that would identify potential donors and inform families about donation. The goal of the legislation was to increase the awareness of hospital personnel regarding their responsibilities concerning the legal rights of each individual to donate any part of or his/her whole body, or to decline such donation. The purpose of the "required request" legislation is to ensure that each person has the opportunity to exercise the legal right to donate. The law requires that hospital personnel offer the option of donation. Thus, the responsibility of raising the issue of donation is placed with the healthcare professional and not with the grieving family. The required request policies do not mandate that the families of potential donors consent to donation, only that they be offered the opportunity to consider the option of organ and tissue donation. The hospitals must also attempt to determine whether the donor had authorized the donation before his or her death by signing an organ donor card. As a result of this legislation, all hospitals have instituted policies requiring that each patient, on admission, be asked whether or not they wish to be an organ donor. Required request mandates also influence a hospital's ability to receive Medicare and Medicaid as a funding source. The Joint Commission on Accreditation of Healthcare Organizations also requires hospitals to have policies regarding the identification and referral of potential donors. Included in all of these provisions, is a requirement to demonstrate sensitivity to the patient and to potential donor families. Important note: There are new federal regulations governing hospital conditions of participation regarding organ, tissue, and eye donation. They enhance points made in OBRA. (See Hospital Conditions of Participation in Medicare and Medicaid Programs for revisions and details). |
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