(P) submit to the Secretary, on an annual basis, a report on the clinical and scientific status of the organ transplantations, and

(Q) meet such other criteria regarding compliance with this part as the Secretary may establish.

[(2) Grants under section 371(a)(2) may be made for two years. No such grant may exceed $500,000 for any year and no organ procurement organization may receive more than $800,000 for initial operation or expansion.]

(3) Grants or contracts under section [371(a)(3)] 371(a)(2) may be made for not more than 3 years.

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REPORT

[SEC. 376. [274d] Not later than February 10 of 1991 and of each second year thereafter, the Secretary shall publish, and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Labor and Human Resources of the Senate. A report on the scientific and clinical status of organ transplantation. The Secretary shall consult with the Director of the National Institutes of Health and the Commissioner of the Food and Drug Administration in the preparation of the report.]

SEC. 377 [174f] STUDY BY GENERAL ACCOUNTING OFFICE.

[(a) IN GENERAL.-The Comptroller General of the United States shall conduct a study for the purpose of determining

[(1) the extent to which the procurement and allocation of organs have been equitable, efficient, and effective;

[(2) the problems encountered in the procurement and allocation; and

[(3) the effect of State required-request laws.

[(b) REPORT.-Not later than January 7, 1992, the Comptroller General of the United States shall complete the study required in subsection (a) and submit to the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources of the Senate, a report describing the findings made as a result of the study.]

SEC. 377. STUDY BY GENERAL ACCOUNTING OFFICE.

(a) STUDY.

(1) IN GENERAL.-The Comptroller General of the United States shall conduct a study for the purpose of determining and making recommendations concerning

(A) the composition of the boards of direction of organ procurement organizations and of the Organ Procurement

and Transplantation Network on the date of enactment of this section, and the effect of the Organ Transplant Program Reauthorization Act of 1993 on the composition and functioning of such boards;

(B)(i) the number and percentage of cadaveric organ transplants for foreign nationals and nonresident aliens categorized by organ procurement organization and by transplant center and information on any reciprocal agreements between organ procurement organizations and foreign countries or territories;

(ii) the number and percent of the organizations referred to in clause (i) above the organ procurement transplant network guidelines of 10 percent; and

(iii) any information on the current rate of organ donation by individuals other than United States citizens or legal residents;

(C) organ donation rates and the impact of various organ allocation systems on organ procurements rates; and

(D) the equitable allocation of organs nationwide, including an analysis of the relative probability of receiving an organ for patients with similar characteristics for each category of transplanted organ by organ procurement organization and recommendations for developing a regional allocation system in order to ensure that—

(i) patients in one region have an equivalent probability of receiving an organ as do patients with similar characteristics in another region; and

(ii) patients within a region have an equivalent probability of receiving an organ as do other patients with similar characteristics in that region.

(2) EQUITABLE ALLOCATION.-In carrying out paragraph (1) with respect to subparagraph (D), the Comptroller General shall

(A) recommend regions for allocating organs to encompass as large a geographic area as is practical, taking into account medical appropriateness, and the geographic proximity of patients with comparable priority for receiving an

organ;

(B) take into account the impact on organ donation and procurement rates; and

(C) consult with experts in the area of organ allocation and organ donations and consider their recommendations regarding the establishment of regions in the country for the purpose of allocating organs.

(b) REPORT.-Not later than 2 years after the date of enactment of the Organ Transplant Program Reauthorization Act of 1993, the Comptroller General of the United States shall complete the study required under subsection (a) and prepare and submit to the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources of the Senate, a report describing the findings made as a result of the study.

SEC. 378. AUTHORIZATION OF APPROPRIATIONS.

For the purpose of carrying out this part, there are authorized to be appropriated $8,000,000 for fiscal year [1991, and such sums

as may be necessary for each of the fiscal years 1992 and 1993.] 1994, and such sums as may be necessary for each of the fiscal years 1995 and 1996.

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