CMS proposes using more imperfect organs from older donors to cut waitlist deaths, boost donations, and improve oversight.

The Centers for Medicare and Medicaid Services has proposed new rules to expand the use of less-than-perfect organs—especially from older or sicker donors—to reduce waitlist deaths. The plan strengthens oversight of organ procurement organizations (OPOs), requires better tracking of complex organs, and introduces new safety standards to address past incidents. CMS aims to improve accountability, allow removal of underperforming OPOs, and boost donation rates amid a recent decline. The changes are expected to be finalized later in 2026.