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WASHINGTON, D.C. – America First Legal Foundation (AFL) has filed a lawsuit under the Freedom of Information Act (FOIA) against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), seeking to expose the behind-the-scenes influence and coordination with non-governmental organizations that shaped the Biden Administration’s race-based organ transplant policy agenda. This follows three other lawsuits AFL filed last week, seeking to reveal how race-based considerations were incorporated into organ transplant policy and oversight by the Biden Administration.
The lawsuit highlights HHS and CMS’s failure to produce records related to the development of the Increasing Organ Transplant Access (IOTA) Model in response to AFL’s records requests.
The IOTA Model, developed under the Biden Administration, is a six-year mandatory program that took effect on July 1, 2025. It rewards transplant hospitals with payments for increasing kidney transplant numbers, directly linking organ procurement to financial gain, and allows for race to be considered as a factor in the transplant process.
AFL submitted FOIA requests to HHS, CMS, and HRSA on August 18, 2025, seeking records on the outside influence that shaped the IOTA Model. AFL’s records requests sought to uncover the role of outside stakeholders in shaping this kidney transplant policy, including communications with organizations involved in organ procurement oversight and operations, as well as for-profit contractors.
Despite acknowledging AFL’s requests, HHS and CMS failed to issue required determinations, produced no responsive records, and provided no timeline for disclosure, leaving litigation as the only path to transparency.
“Biden officials embedded race into organ transplant policy and rebranded discrimination as ‘equity.’ This FOIA lawsuit seeks to expose the outside influence behind the IOTA Model, including the communications and meetings that shaped this program,” said Megan Redshaw, attorney for AFL. “The American people have a right to know who helped design that agenda, who pushed it, and what role outside stakeholders played in shaping policy that governs life-and-death decisions.”
These lawsuits are part of AFL’s broader campaign to dismantle the Biden Administration’s DEI infrastructure and restore Merit-Based Medicine to America’s healthcare system.
Read the full complaint here.
Learn more about the investigation here.
Learn more about AFL’s Merit-Based Medicine initiative here.
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