108 STAT. 4438 PUBLIC LAW 103-432—OCT. 31, 1994 medicare beneficiaries, and for transmitting such information to the State in which such a beneficiary resides. SEC. 155. HOSPITAL AGREEMENTS WITH ORGAN PROCUREMENT ORGANIZATIONS. (a) HOSPITAL AGREEMENTS.— (1) IN GENERAL. — (A) IDENTIFICATION OF ORGAN DONORS.—Section 1138(a)(l)(A)(iii) (42 U.S.C. 1320b-8(a)(l)(A)(iii)) is amended to read as follows: "(iii) require that such hospital's designated organ procurement agency (as defined in paragraph (3)(B)) is notified of potential organ donors;". (B) AGREEMENTS WITH DESIGNATED ORGAN PROCURE- MENT AGENCIES. —Section 1138(a)(1) (42 U.S.C. 1320b- 8(a)(1)) is amended— (i) by striking the period at the end of subparagraph (B) and inserting "; and"; and (ii) by adding at the end the following new subparagraph: "(C) the hospital or rural primary care hospital has an agreement (as defined in paragraph (3)(A)) only with such hospital's designated organ procurement agency.". (C) WAIVER OF REQUIREMENTS RELATED TO AGREE- MENTS.—Section 1138(a) (42 U.S.C. 1320b-8(a)) is amended— (i) by redesignating paragraph (2) as paragraph (3); and (ii) by inserting after paragraph (1) the following new paragraph: "(2)(A) The Secretary shall grant a waiver of the requirements under subparagraphs (A)(iii) and (C) of paragraph (1) to a hospital or rural primary care hospital desiring to enter into an agreement with an organ procurement agency other than such hospital's designated organ procurement agency if the Secretary determines that— "(i) the waiver is expected to increase organ donation; and "(ii) the waiver will assure equitable treatment of patients referred for transplants within the service area served by such hospital's designated organ procurement agency and within the service area served by the organ procurement agency with which the hospital seeks to enter into an agreement under the waiver. "(B) In making a determination under subparagraph (A), the Secretary may consider factors that would include, but not be limited to— "(i) cost effectiveness; "(ii) improvements in quality; "(iii) whether there has been any change in a hospital's designated organ procurement agency due to a change made on or after December 28, 1992, in the definitions for metropolitan statistical areas (as established by the Office of Management and Budget); and "(iv) the length and continuity of a hospital's relationship with an organ procurement agency other than the hospital's designated organ procurement agency;
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