HRSA living-donor reimbursement guidelines remove recipient-income eligibility test
Oct 4, 2026 edition · GC-2026-0166 · Published 2026-10-04 · Version 2 · Final
HRSA’s final living-donor reimbursement guidelines remove recipient household income as the eligibility determinant for applications reviewed from September 30. Donor priorities, financial-hardship review, other-source restrictions and the $6, 000 qualifying-expense ceiling remain material.
What happened
HRSA published final Living Organ Donation Reimbursement Program guidelines September 29 to implement the Honor Our Living Donors Act’s removal of recipient household income from donor reimbursement eligibility. They apply to applications reviewed on or after September 30, 2026. The final donor-centered priorities are income at or below 350 percent of HHS poverty guidelines, above 350 through 500 percent if resources permit, and above 500 through 750 percent through a financial-hardship waiver if resources permit. All categories open at the start of a budget period, with monitoring and advance notice if funding requires lower-priority categories to close.
Qualifying reimbursement remains limited to expenses not reasonably covered by the listed compensation, insurance or health-benefit sources, with a total federal ceiling of $6, 000 per potential donor evaluated or organ donated. The guidelines retain donor and recipient residence, lawful-presence and certification conditions, with recipient-related exceptions for nondirected donors. Eligible costs include specified travel and caregiving or lost-wage expenses, subject to the stated periods and evidence. Hardship above 500 percent requires case review and documented expenses through the transplant-center process. Removing recipient-income screening therefore does not mean unconditional reimbursement, payment for an organ or automatic acceptance of every expense.
Scope and timing
- Authority status
- Final
- Applicability
- Operationally relevant
- Audience
- Health systems, Provider networks
- Jurisdiction
- Federal
Why it matters
Transplant counselors should stop using the superseded recipient-income barrier while still explaining donor priority, funding and expense limits. A financial-hardship application requires its own evidence and determination, and nondirected donors have specific documentation treatment.
Recommended action
Update counseling and application materials for the September 30 review-date transition. Preserve donor-income priority and hardship evidence, other-source reimbursement checks and the $6, 000 cap. Use the actual final rules for expense periods and nondirected donors and track program funding notices.
Sources
- Modification of Living Organ Donation Reimbursement Program Eligibility Guidelines in Response To Honor Our Living Donors ActOfficial · Health and Human Services Department, Health Resources and Services Administration · 2026-09-29 · Source review 2026-10-05
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