Modification of Living Organ Donation Reimbursement Program Eligibility Guidelines in Response To Honor Our Living Donors Act

Giving a kidney or part of a liver to someone can cost the donor real money — gas, hotels, missed paychecks, child care. A federal program helps cover those costs, and as of September 30, 2026, more donors can qualify.

The Health Resources and Services Administration (HRSA) runs the Living Organ Donation Reimbursement Program. It pays eligible donors up to $6,000 per organ for qualifying non-medical costs such as travel, meals, lost wages, and child and elder care. Since 2007 the program has received more than 21,000 applications, approved nearly 89 percent of them, and helped make over 12,000 living donations possible.

What changed: a law called the Honor Our Living Donors (HOLD) Act, enacted in February 2026, says the organ recipient’s household income can no longer be used to decide whether the donor qualifies. HRSA took public comments in July and has now finalized new guidelines built around the donor’s own household income.

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At a glance — Priority 1: donor household income at or below 350% of the HHS Poverty Guidelines. Priority 2: above 350% up to 500%. Priority 3: above 500% up to 750%, through a financial hardship waiver. For a household of four in the 48 contiguous states, 500% works out to $165,000 and 750% to $247,500.

All three groups can apply from the start of each budget period. If money runs short, HRSA may close Priorities 2 and 3, with advance notice to transplant centers and the public. Hardship waivers are filed by a transplant social worker and can count costs like lost wages, travel, dependent care, out-of-pocket medical bills and even pet care. HRSA’s waiver decision cannot be appealed.

Questions go to Allison Hutchings, HRSA Division of Transplantation, at 240-290-2179. Reimbursement is not available for costs already covered by a state program, insurance, or a federal or state health benefits program.

Federal Register filing: https://www.federalregister.gov/documents/2026/09/29/2026-19911/modification-of-living-organ-donation-reimbursement-program-eligibility-guidelines-in-response-to

This is a Notice Nearby publisher-desk Federal brief — a short in-house summary of a public federal filing. It is not official agency minutes, not a newspaper story, and not Legal Publication. It does not satisfy a statutory notice requirement.