Montana doesn’t have an organ transplant center. When a Montanan needs a new heart, lungs or kidney, the surgery happens out of state, and the organization that coordinates donated organs for the whole state is based in Washington.
That organization, LifeCenter Northwest, could lose its federal certification under performance rules proposed by the Trump administration, and Montana’s four members of Congress have joined a group of Western lawmakers asking the administration to reconsider, the Daily Montanan reported.
Sens. Steve Daines and Tim Sheehy and Reps. Troy Downing and Ryan Zinke, all Republicans, signed the letter along with 13 others. It asks the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services to rethink “automatic decertification based solely on the current outcome-only, single-year tiering methodology.”
LifeCenter Northwest is the only organ procurement organization serving Montana, Alaska, most of Washington and 11 counties in North Idaho. Its territory covers more than 800,000 square miles and about 10 million people, with roughly 200 hospitals and only five transplant centers, all of them in Washington.
How the rules work
Organ procurement organizations, or OPOs, are the federally designated groups that work with hospitals and donor families, recover organs and get them to transplant centers. CMS grades them on two measures: how many donors end up with at least one organ transplanted, and how many recovered organs are actually transplanted.
LifeCenter’s objection is to the second one. “OPOs do not decide whether an organ is transplanted,” the organization said in a statement to the Daily Montanan. “Those decisions are made by transplant doctors at transplant hospitals.” It argues that other CMS quality programs adjust for population health, distance and year-to-year improvement, and that this one doesn’t.
The stakes are wide. Washington Sen. Maria Cantwell has said about 75% of OPOs could be at risk of decertification if the changes are finalized. LifeCenter said CMS hasn’t issued the final amendments yet and they’re expected late this year.
CMS has framed the tighter oversight as a trust issue. After a 2025 investigation into an organ procurement organization in Kentucky, HHS pledged changes, and CMS Administrator Dr. Mehmet Oz has said the agency wants to win back public confidence in the system.
What it means for Montana patients
Montana has hundreds of people waiting for organs at any given time. In 2025, 73 Montanans received transplants and 211 Montanans donated organs, according to the Daily Montanan’s reporting. LifeCenter coordinated 1,318 transplants across its region last year, a record for the group and 200 more than the year before.
Because the transplants themselves happen in Seattle or elsewhere, the logistics are tight. Organs and patients often move by air within narrow clinical windows. Losing the single coordinating organization, or having it replaced mid-stream, is the scenario the delegation’s letter is trying to head off. It asks that LifeCenter get “a clear pathway to demonstrate sustained, measurable improvement” before any decertification.
Todd Ware of Bigfork is one of the people the system worked for. He received a double-lung transplant the day after Christmas in 2020, when he estimated he had about two weeks left. He told the Daily Montanan his lungs were at about 17% capacity. Since then he has gone back to skiing and flying gliders. “It’s miraculous that they can synchronize me getting from Montana to Seattle and the organs coming in,” he said.
The timing is uncertain. CMS runs its OPO recertification on a multi-year cycle, and the current one is underway now. Industry groups, including the Association of Organ Procurement Organizations, have pushed for changes to the metrics, while some patient advocates have backed tougher oversight after reports of missed donors and poor performance at some organizations around the country. Where the final rules land will decide whether Montana’s arrangement continues as it is.
Montanans who want to register as donors can do so at donatelifemt.org or when renewing a driver’s license.
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