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OPTN board recommends roughly 19% hike in registration fee to HRSA for FY26
Summary
The OPTN board voted to recommend a 19.28% increase to the patient registration fee (to about $1,035) for fiscal year 2026 to cover unbudgeted HRSA/secretarial directives and other costs; the recommendation now goes to HRSA and the Secretary for approval after a 29–1 vote.
The Organ Procurement and Transplantation Network (OPTN) board voted to recommend a roughly 19.28% increase in the per-patient registration fee for fiscal year 2026, moving the fee to about $1,035 and sending the recommendation to the Health Resources and Services Administration (HRSA) and the Secretary for final approval.
Alan, who led the financial presentation, said the prior board had approved a FY25 baseline of about $74.5 million that assumed a 5.5% fee rise. He told the board that additional expenses tied to secretarial and HRSA directives, litigation, cloud migration and other priorities were omitted from that baseline. "In order to achieve all of those things, the fee would have to increase to 1000 and $35, which is roughly a 19% increase," Alan said during the presentation.
Alan described the arithmetic used for the recommendation: adding about $8.9 million in omitted expenses to the prior budget produced an adjusted budget around $83.4 million; after subtracting a $6.5 million appropriation paid directly to a contractor, dividing the $76.9 million net by an estimate of roughly 74,000 registrations produced the proposed $1,035 registration fee.
Board members debated the magnitude and drivers of the increase. Supporters said the increase reflects inflation and new mandatory work, while at least one member warned of the impact on centers that pay the fee. The motion to adopt the 19.28% fee recommendation was moved and seconded and passed by a 29–1 vote with 0 abstentions. The recommendation is nonbinding; HRSA and the Secretary must review and approve any fee change.
The board noted that this registration fee is the OPTN’s primary source of income to fund its operations and that HRSA’s approval is required before the increase takes effect. The board also said it will continue to refine project cost estimates as projects advance toward implementation.
The board will notify HRSA of its recommendation; no implementation date was set by the board pending HRSA review.
