HHS Begins Decertification of Organ Procurement Group Over Safety Failures
TL/DR –
The Network for Hope, the federally-designated organ procurement organization serving Kentucky, Indiana, Ohio, and West Virginia, is under the process of being decertified by the Department of Health and Human Services (HHS) due to continuous patient safety failures. This follows the Health Resources and Services Administration’s review of 351 cases from 2021 to 2024 and a separate CMS review that discovered ongoing issues with donor evaluations, adverse-event reviews, and administration in Network for Hope. Although the organ procurement group plans to appeal the decision, federal regulations state that the service area cannot be opened to competitors until the administrative appeal process concludes, and Network for Hope will not be immediately replaced by another Organ Procurement Organization.
HHS Begins Decertification of Network for Hope
The U.S. Department of Health and Human Services (HHS) has initiated the process of decertifying Network for Hope, an organ procurement organization serving Kentucky, Indiana, Ohio, and West Virginia, due to ongoing patient safety issues.
The Health Resources and Services Administration (HRSA) examined 351 cases from 2021 to 2024 where organ donation authorization did not lead to donation. In May, a separate CMS review discovered continuous issues with donor evaluations and administrative procedures.
Network for Hope plans to appeal the decision, as stated to AP News, but has not provided further comment on its appeal, current operations, or contingency planning.
Implications of Decertification
The decertification marks an increase in federal oversight of the organ donation system and is the second recent challenge of CMS’s ability to remove a failing Organ Procurement Organization without disrupting regional organ donation and transplant operations.
The move follows CMS’s persistent efforts to enhance performance standards for OPOs, and implement more donation and transplant benchmarks.
Following a 2021 case involving the predecessor of Network for Hope, Kentucky Organ Donor Affiliates, HHS expanded its investigation into Network for Hope in 2025. At least 28 patients may not have been deceased when the organ procurement process commenced.
HRSA and CMS independently decided that the organization’s improvement was insufficient. CMS’s May review disclosed that earlier concerns continued to affect donor evaluations and the organization’s administration.
Appeal and Transition Process
If Network for Hope appeals, it will not be immediately replaced by another OPO. Federal regulations allot an OPO 15 business days to request a reconsideration post receiving a decertification notice. The administrative appeal process must conclude before its service area can be opened to competitors.
CMS declined to speculate on the appeal’s outcome or whether Network for Hope would appeal, but pointed out that federal law provides due process rights to affected organ procurement organizations and establishes a transition period to ensure continuous organ donation and transplantation services.
The University of Kentucky HealthCare, which operates a donor-care unit with Network for Hope, stated that it doesn’t expect a disruption in services as a result of the decertification.
Despite the decertification, some believe it was a necessary measure. Jennifer Erickson, senior fellow at the Federation of American Scientists, stated that Network for Hope’s inability to operate poses a persistent, deadly risk to 7 million people across Kentucky, Ohio, Indiana, and West Virginia.
The Trump administration recently completed a similar process in South Florida by decertifying the University of Miami’s Life Alliance Organ Recovery Agency and replacing it with the Nevada Donor Network.
Industry and Public Reaction
The Association of Organ Procurement Organizations supports corrective action when an OPO fails to meet federal standards. It urged HHS to publicly explain its decision and how it will preserve continuity for donor families, transplant programs, and patients.
Despite an ongoing struggle to maintain public trust in organ donation, over 100,000 people are currently awaiting transplants, and the United States performed more than 49,000 organ transplants in 2025 despite a decrease in deceased donation.
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