CMS Seeks Comments on Hospital Organ Procurement Waiver Request

The Centers for Medicare & Medicaid Services (CMS) has published a notice in the Federal Register regarding an application from Sparks Family Hospital Inc., operating as Northern Nevada Medical Center in Sparks, Nevada, requesting a waiver to contract with an organ procurement organization (OPO) other than its currently designated one. The hospital seeks to enter into an agreement with Nevada Donor Network, Inc. instead of its designated OPO, Donor Network West, which serves the San Ramon, California area. OPOs are nonprofit entities responsible for the procurement and transport of organs for transplant within defined geographic areas mandated by CMS. Under current regulations, hospitals participating in Medicare and Medicaid must work exclusively with their designated OPO. However, hospitals may request a waiver from CMS if they believe an alternative arrangement will increase organ donations and ensure equitable patient treatment within the affected geographic areas. In evaluating waiver requests, CMS considers factors including cost-effectiveness, quality improvement, and long-standing relationships between hospitals and OPOs. This waiver process is governed by provisions of the Social Security Act and accompanying regulations at 42 CFR 486.308. CMS has opened a public comment period until February 6, 2026, to gather input from OPOs and stakeholders before making a final determination on the waiver application. All comments will be publicly posted and considered alongside consultations with relevant agencies such as the Health Resources and Services Administration and the United Network for Organ Sharing. The notice does not impose additional information collection requirements under the Paperwork Reduction Act. The waiver, if granted, would impact organ procurement arrangements and could serve as a precedent for future similar requests, affecting regulatory compliance and hospital-OPO partnerships within the organ donation ecosystem.