BILL NUMBER: S7151A

SPONSOR: BASKIN
 
TITLE OF BILL:

An act to amend the public health law, in relation to removing the
prohibition on patient participation in multiple transplant programs in
New York state

 
PURPOSE:

The purpose of this bill is to repeal New York's current prohibition on
multiple listing for organ transplantation candidate patients, allowing
patients to register at multiple transplant centers within the state.
This change would increase access to life-saving organs, align with
national standards, and reduce disparities in healthcare access for
transplant candidates statewide.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section one amends section 4363 of the public health law to repeal the
prohibition on multiple listing for organ transplantation candidate
              

patients, allowing patients to register at multiple transplant centers
within the state.

Section two provides for the effective date.

 
JUSTIFICATION:

Since 1990, New York has maintained a statutory prohibition preventing
organ transplant candidates from listing at multiple transplant programs
within New York State. Prohibition of this practice, known as "multi-
listing," disproportionately affects low-income patients on the organ
transplant waitlist and exacerbates racial and ethnic disparities in
transplant access. Unlike patients with private insurance - who can
circumvent the in-state restriction by listing at additional out-of-
state transplant centers Medicaid recipients and the underinsured face
significant financial barriers to doing so.  Under most circumstances,
Medicaid coverage does not permit enrollees to seek non-emergency care
outside New York State. This lack of portability, combined with the
prohibition on multi-listing, results in unequal access to lifesaving
transplant opportunities. Medicaid patients represent 27% of organ tran-
splant waitlist candidates but only 15% of recipients, whereas privately
insured patients constitute 35% of waitlist candidates yet account for
37% of transplants performed - Organ Procurement Transplantation Network
(OPTN) data as of February 2025.

New York's outdated ban also contradicts national standards established
by OPTN. Specifically, OPTN policies 3.2 (Notifying Patients of their
Options) and 3.4 (Multiple Transplant Program Registrations) explicitly
encourage multiple listings to improve patient outcomes, mandating tran-
splant centers inform patients about their rights to register at multi-
ple centers within the same Donation Service Area (DSA) or different
DSAs. By denying patients this right, New York's current system under-
mines patient autonomy and restricts individuals from making filly
informed healthcare decisions. Repealing New York State's ban on multi-
listing would significantly improve patient outcomes.  Multi-listing
substantially increases the likelihood of receiving a transplant. Kidney
candidates experience transplant rates 1.42 to 2.29 times higher, while
liver candidates see even more dramatic increases ranging from 1.82 to
7.41 times those of single listed candidates. Additionally, multi-listed
kidney candidates receive transplants faster, with median wait times
reduced from 6 years to 3.48 years. This reduction in wait times also
leads to lower mortality rates; multi-listed kidney candidates experi-
ence a 19% lower mortality rate while awaiting transplantation compared
to single-listed candidates. Moreover, multi-listed kidney recipients
have a 10% lower risk of graft failure, translating into improved long-
term health outcomes and quality of life.

After more than three decades, it is time for New York State policy to
reflect current national standards and evidence-based practices.
Repealing New York's outdated ban on multi-listing promotes fairness,
reduced disparities affecting vulnerable populations, and aligns state
policy with ethical principles advocated by OPTN guidelines. By elimi-
nating barriers to access and empowering patient choice, this legis-
lation ensures that access to critical care is a right available equit-
ably across all population - not a privilege reserved for those with
greater financial means.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

None.   
EFFECTIVE DATE:
Immediately.