The National Organ Transplant Act (“NOTA”) was enacted in 1984. This legislation provided for the creation of regional organ procurement organizations to coordinate the procurement of organs, and a national organ procurement and transplant network. Currently, the Federal government contracts with the United Network for Organ Sharing (“UNOS”) to provide the national organ procurement and transplant network. Additionally, NOTA prohibits the purchase and interstate sale of organs (effectively eliminating any sale of organs for transplantation). The intent of the ban on the sale of organs for transplant was to ensure that the organ donation process would remain altruistic rather than commercial.

Federal law now requires, as an amendment to the Social Security Act (OBRA 1985), that hospitals participating in Medicare or Medicaid have established written protocols for the identification of potential organ donors that:

1. assure that families of potential organ donors are made aware of the option of organ or tissue donation and their option to decline,
   
2. encourage discretion and sensitivity with respect to the circumstances, views, and beliefs of such families, and
   
3. require that such hospital’s designated organ procurement agency is notified of potential organ donors.
   

Thus, required request is now mandated under Federal law.