OPO accountability dossier

Life Alliance Organ Recovery Agency (University of Miami)

FLMPCMS Tier 3

OPTN Region 3 — South Florida (multiple counties)

CMS performance & status

CMS 2023 OPO Interim Annual Public Aggregated Performance Report, Table 5b: 2021 tier = Tier 3 (donation category 3E, transplant category 3E; 2019/2020/2021 = 3/3/3) — below median, decertification-eligible.

This OPO is graded Tier 3 (2023 Assessment (CY2021 data)) under the CMS Conditions for Coverage outcome measures. Tier 3 is below the median on a required measure — the band CMS deems out of compliance and eligible for decertification.

2023 OPO Interim Annual Public Aggregated Performance Report (CMS), Table 5b

Findings naming this OPO (14)

Testimony (1)

Senate Finance memo: complaint that an OPO recovered organs before the heart stopped and against family wishes; agency later decertified

Life Alliance Organ Recovery Agency (University of Miami)

The Senate Finance Committee's 2022 hearing staff memo documented a complaint that the Miami OPO recovered organs from a donor on November 28, 2018 before the donor's heart stopped and against the family's wishes, where the family had consented only to donation after circulatory death (DCD). HHS subsequently announced on September 18, 2025 that it would decertify the same agency, described as the first time HHS would decertify an operating OPO mid-cycle, after citing years of unsafe practices; the agency did not appeal.

U.S. Senate Finance Committee — UNOS Hearing Memo (Aug. 3, 2022); HHS.gov decertification announcement (Sept. 18, 2025): https://www.hhs.gov/press-room/hhs-decertifies-miami-organ-agency-reforms-transplant-system.html

Investigation (5)

First OPO decertification in U.S. program history: HHS moves to decertify Life Alliance / University of Miami

Life Alliance Organ Recovery Agency (University of Miami Health System)

On September 18, 2025, HHS announced it was moving to decertify the Life Alliance Organ Recovery Agency, a division of the University of Miami Health System, after an investigation cited years of unsafe practices, poor training, chronic underperformance, understaffing, and paperwork errors. HHS and the House Energy & Commerce Committee characterized this as the first time HHS has decertified an organ procurement organization in the program's history; the OPO had ranked in the lowest performance tier each year from 2019 through 2023.

House Energy & Commerce: HHS Announces Decertification of Florida OPO and Instates Further Safety Guidelines

HHS decertified an OPO for the first time in U.S. history

U.S. Department of Health and Human Services (HHS); Centers for Medicare & Medicaid Services (CMS); Life Alliance Organ Recovery Agency (University of Miami Health System)

On September 18, 2025, HHS announced it was decertifying the Life Alliance Organ Recovery Agency, a division of the University of Miami Health System serving roughly 7 million people across six South Florida counties, described as the first mid-cycle decertification of an organ procurement organization in HHS history. CMS cited years of unsafe practices, poor training, chronic underperformance, and understaffing. CMS later set an effective decertification/termination date of March 27, 2026 to allow an orderly transition, with Nevada Donor Network named as the successor provider for the donation service area.

HHS to Close University of Miami's Failing Organ Agency (HHS.gov press release)

HHS moved to decertify University of Miami's organ procurement agency

Life Alliance Organ Recovery Agency (University of Miami Health System) / CMS / HHS

In September 2025 (announced September 18), HHS/CMS issued an intent to decertify the Life Alliance Organ Recovery Agency, a hospital-based OPO division of the University of Miami Health System, citing years of unsafe practices, poor training, chronic underperformance, understaffing, and paperwork errors. The agency served roughly 7 million people across six South Florida counties; Nevada Donor Network was approved to assume responsibility for the service area.

HHS to Close University of Miami's Failing Organ Agency (HHS.gov)

University of Miami / Miami Transplant Institute paid $22M to settle DOJ False Claims Act allegations over medically unnecessary kidney-transplant lab tests

University of Miami (Miami Transplant Institute)

On May 10, 2021, DOJ announced the University of Miami agreed to pay $22 million to resolve three qui tam False Claims Act suits. The government alleged the university's electronic ordering system automatically prompted a set of laboratory tests at its own laboratory each time a patient was treated at the Miami Transplant Institute, several of which the government alleged were medically unnecessary, and that UM caused Jackson Memorial Hospital to submit inflated claims for pre-transplant laboratory testing in violation of related-party regulations. In a separate agreement, the United States reached a $1.1 million settlement with Jackson Memorial Hospital related to the conduct.

DOJ Office of Public Affairs: University of Miami to Pay $22 Million to Settle Claims Involving Medically Unnecessary Laboratory Tests and Fraudulent Billing Practices

Decertified Florida OPO subject of whistleblower allegations of retaliation against staff who reported understaffing and inadequate training

Life Alliance Organ Recovery Agency (University of Miami Health System)

CMS moved to decertify Life Alliance Organ Recovery Agency, a division of the University of Miami Health System, in September 2025 after an HHS/HRSA investigation documented understaffing, inadequate training, misdirected organs, and quality-oversight deficiencies; the agency did not appeal. Separately, an organ-reform oversight compilation reports an unproven allegation that a physician and a nurse said an OPO manager physically assaulted them after they raised staffing and training concerns, and that one was fired and the other's contract was not renewed after 17 years. The decertification facts are confirmed by HHS; the assault and termination claims are unproven allegations reported in an advocacy oversight compilation.

HHS to Close University of Miami's Failing Organ Agency (HHS.gov)

Money trail (1)

HHS moved to decertify University of Miami's OPO (Life Alliance Organ Recovery Agency), Sept 2025

Life Alliance Organ Recovery Agency / University of Miami Health System

On Sept. 18, 2025, HHS announced it was moving to decertify the Life Alliance Organ Recovery Agency, the OPO operated by the University of Miami Health System, after an investigation cited unsafe practices, inadequate training, chronic understaffing and underperformance. HHS described it as the first time it had moved to decertify an OPO mid-recertification-cycle; CMS subsequently announced a replacement provider of organ-procurement services for South Florida.

HHS — 'HHS to Close University of Miami's Failing Organ Agency'

Consent gap (3)

HHS issued an unprecedented mid-cycle decertification of an OPO over chronic safety failures

U.S. Department of Health and Human Services / CMS; Life Alliance Organ Recovery Agency (University of Miami Health System)

On September 18, 2025, HHS/CMS announced the decertification of the Life Alliance Organ Recovery Agency, a division of the University of Miami Health System serving South Florida, citing years of unsafe practices, chronic understaffing, poor training, and recordkeeping errors; HHS described the action as the first mid-cycle decertification of an organ procurement organization and announced a transition to a new provider.

CMS Announces New Provider of Organ Procurement Services in South Florida

HHS moved to decertify a South Florida OPO and announced DCD safety guidelines after a procurement investigation

U.S. Department of Health and Human Services; Centers for Medicare & Medicaid Services; Life Alliance Organ Recovery Agency (University of Miami Health System)

In September 2025 HHS announced the first-ever decertification of an organ procurement organization, identifying the South Florida OPO operated within the University of Miami Health System, following an investigation citing unsafe practices, understaffing, and missed recoveries, and announced further organ-procurement and DCD safety guidelines.

HHS Announces Decertification of Florida OPO and Instates Further Safety Guidelines (House E&C)

HHS/CMS moved to decertify an Organ Procurement Organization mid-cycle for the first time

Life Alliance Organ Recovery Agency (division of University of Miami Health System); HHS / Centers for Medicare & Medicaid Services (CMS)

In September 2025, HHS announced it was moving to decertify the Life Alliance Organ Recovery Agency, a division of the University of Miami Health System, after an investigation cited years of unsafe practices, poor training, chronic underperformance, understaffing, and paperwork errors. HHS described it as the first time it had decertified an OPO mid-cycle. CMS subsequently named the Nevada Donor Network to provide organ-procurement services in southern Florida.

HHS.gov, "HHS to Close University of Miami's Failing Organ Agency" (Sept. 2025)

Bedside (4)

HHS moved to decertify a university-affiliated OPO mid-cycle for the first time, citing chronic underperformance

Life Alliance Organ Recovery Agency (University of Miami Health System) / CMS

On September 18, 2025, HHS announced the decertification of the Life Alliance Organ Recovery Agency, a division of the University of Miami Health System, after documented noncompliance with federal OPO Conditions for Coverage including deficiencies in staffing, training, and quality oversight. HHS described it as the first time an OPO was decertified mid-cycle, with CMS overseeing continuity of services and identifying a successor provider for the service area.

HHS to Close University of Miami's Failing Organ Agency (HHS.gov, Sept. 18, 2025)

HHS decertified a South Florida OPO (Life Alliance Organ Recovery Agency, University of Miami) citing a record of deficiencies tied to patient harm

Life Alliance Organ Recovery Agency (University of Miami Health System) / U.S. Department of Health and Human Services

In 2025 HHS moved to decertify, and then decertified, Life Alliance Organ Recovery Agency, a division of the University of Miami Health System, marking what HHS described as the first mid-cycle decertification of an OPO. CMS and HHS cited years of noncompliance with the OPO Conditions for Coverage, including problems with staffing, training, and quality oversight, and documented deficiencies tied to patient harm. CMS subsequently named a replacement provider for South Florida.

HHS to Close University of Miami's Failing Organ Agency (HHS.gov press release)

HHS/CMS moved to decertify a Florida OPO after investigation found years of unsafe practices

U.S. Department of Health and Human Services / Centers for Medicare & Medicaid Services / Life Alliance Organ Recovery Agency (University of Miami Health System)

In September 2025, HHS/CMS announced the mid-cycle decertification of a Florida organ procurement organization, Life Alliance Organ Recovery Agency, a division of the University of Miami Health System, after an investigation cited chronic underperformance, understaffing, inadequate training, and documentation errors. HHS described it as the first mid-cycle decertification of an OPO, and CMS subsequently announced a replacement provider of organ procurement services for South Florida.

HHS to Close University of Miami's Failing Organ Agency (HHS.gov)

HHS/CMS moved to decertify a University of Miami OPO (Life Alliance Organ Recovery Agency) in the first mid-cycle OPO decertification

Life Alliance Organ Recovery Agency (University of Miami)

On September 18, 2025, HHS announced it was moving to decertify Life Alliance Organ Recovery Agency, a division of the University of Miami Health System, after a review cited years of documented noncompliance with the federal OPO Conditions for Coverage, including chronic understaffing, training and quality-oversight deficiencies. HHS described it as the first mid-cycle decertification of an OPO; CMS subsequently approved another OPO to assume organ-procurement services for the South Florida donation service area.

HHS to Close University of Miami's Failing Organ Agency (HHS.gov, Sept 2025)


Every item is institution-level public record, source-linked; no patient, donor, or family is named. A Tier or finding here repeats the government's own assessment of an organization holding a public monopoly. Back to OrganWatch.