Days after it was passed by the House, the Senate cleared legislation Thursday evening that aims to overhaul the organ transplant system in the United States.

The bill now goes to President Joe Biden’s desk for his signature.

The bill would give the Department of Health and Human Services the authority to expand competition for contracts related to the operation of the Organ Procurement and Transplantation Network, which matches donor organs with patients waiting for transplants.

The legislation comes as the Biden administration moves to open up the contracting process that has allowed one company to manage the system for nearly 40 years, despite claims of mismanagement that has allowed patients to die on waiting lists.

“The management of the U.S. organ transplant system needs serious reform,” said Sen. Bill Cassidy, R-La., a co-sponsor of the Senate companion version of the bill and the ranking member of the Senate Health, Education, Labor and Pensions Committee. “Breaking up this monopoly will increase competition, save lives and improve the system. Glad to see our legislation pass Congress and look forward to it becoming law.”

The House bill, sponsored by Rep. Larry Bucshon, R-Ind., passed the House Tuesday under suspension of the rules, an expedited procedure that limits debate and amendments and requires a two-thirds majority for passage. The Senate cleared the bill Thursday by unanimous consent, just a week after the Senate Finance Committee held a hearing on the issue, in which Committee Chair Ron Wyden, D-Ore., urged quick passage of the bill. Wyden is the lead sponsor of the Senate companion bill.

The United Network for Organ Sharing, or UNOS, a nonprofit, private organization, has held the Organ Procurement and Transplantation Network contract since 1984 but has faced scrutiny over its oversight of underperforming organ procurement organizations.

The 1984 law that created the network has been interpreted over the years as preventing HHS from soliciting multiple bids from public and private organizations that may be able to better manage and operate the contract.

The legislation would broaden eligibility for the contracts, including by allowing for-profit organizations to submit bids.

A Senate Finance Committee investigation released last year found that hundreds of people have developed diseases from transplanted organs, and 70 people died between 2008 and 2015 from those illnesses.

The committee argued that such mistakes were allowed to happen because of UNOS’s lack of oversight of organ procurement organizations

A record-high 21.3 percent of procured kidneys were not transplanted in 2020, according to the Scientific Registry of Transplant Recipients. 

More than 100,000 Americans are currently waiting for an organ — mainly kidneys — and an estimated 17 people die each day on the waiting list.

The Biden administration said it is on pace to start the new contracting process this fall.

“With congressional passage of our legislation, the Biden Administration will have the tools it has asked for to implement a comprehensive modernization of the [Organ Procurement and Transplantation Network] contracting process,” Wyden said.