OneLegacy Lawsuits: CMS Suit, Whistleblower Verdict, and Audits

OneLegacy, the largest organ procurement organization in the United States, is fighting on several legal fronts at once. It is a lead plaintiff in a federal lawsuit challenging the Centers for Medicare and Medicaid Services rules that could strip it of certification, and it has been the subject of a whistleblower verdict against Los Angeles County tied to its operations, an employment discrimination complaint, family allegations that it exceeded donation consent, and congressional investigations into its spending and performance. The OneLegacy lawsuits and related scrutiny span federal court, state court, and two committees of Congress.

The Federal Lawsuit OneLegacy Filed Against CMS

In August 2025, OneLegacy sued the U.S. Department of Health and Human Services and CMS in the Middle District of Florida, joined by LifeLink Foundation, Iowa Donor Network, LifeCenter Northwest, and LifeGift Organ Donation Center. The case, LifeLink Foundation, Inc. et al v. Kennedy et al (Case No. 8:25-cv-02042), names HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz as defendants.¹

The suit targets a 2020 CMS final rule that overhauled OPO evaluation. The old system let OPOs largely set their own benchmarks, and no organization had ever lost its federal contract in the roughly 35-year history of the program.² The new rule measures donation and transplantation rates against each OPO’s pool of potential donors and sorts organizations into three tiers. Tier 1 OPOs are automatically recertified, Tier 2 OPOs can face competition for their service areas, and Tier 3 OPOs can be decertified.³

The plaintiffs argue the rule violates the Administrative Procedure Act and the National Organ Transplant Act. They contend Congress required CMS to use multiple outcome measures and process performance measures, but the agency relies on just two “closely correlated” metrics that they say draw on unreliable state death-certificate data, ignore geographic and demographic differences, and depend partly on transplant surgeon decisions OPOs cannot control. The complaint calls the tiering approach a “Hunger Games” system that will destabilize the national organ donation network.¹

As of mid-2026 the case remains active. Both sides have filed summary judgment briefing and supplemental memoranda, with the most recent filings dated May 20, 2026.⁴ No injunction has been issued, and CMS has pressed forward: in January 2026 the agency issued a new proposed rule reaffirming performance-based tiering, and in March 2026 it began conducting recertification surveys under the updated methodology.⁵ CMS has estimated the first certification cycle could eliminate roughly 22 OPOs, about 40 percent of the national total.⁶

Why OneLegacy’s Own Performance Is at Stake

OneLegacy was initially flagged as a Tier 3, or failing, OPO under the 2020 measures. An analysis from the University of Pennsylvania covering 2012 through 2014 found the organization recovered organs from only 31 percent of its potential donors.⁷ Rep. Katie Porter called it “one of the worst performing OPOs in the country.”² OneLegacy has called that characterization “entirely inaccurate,” and by July 2023 said it had moved from Tier 3 to Tier 2.⁸

In December 2020 the House Committee on Oversight and Reform opened an inquiry into OneLegacy specifically, seeking records on executive and board compensation, potential conflicts of interest, anti-patient lobbying, and pandemic loan applications.⁷ At a May 2021 subcommittee hearing, Chairman Raja Krishnamoorthi said some OPOs had tried to “thwart” the investigation.⁹

The Senate Finance Committee began investigating 17 OPOs, including OneLegacy, in 2023. Senators Ron Wyden and Chuck Grassley released their bipartisan “Operation Transplant” report in June 2025. It identified a “pancreata loophole” in which OPOs recovered pancreata ostensibly for research to pad recertification numbers, an 850 percent increase in pancreata recovered for research between 2018 and 2022, without verifying the organs were actually used for islet cell transplantation research. The report also found OPOs had no uniform conflict-of-interest policies.¹⁰¹¹

Spending Audit and Lobbying Findings

A government audit found OneLegacy misspent more than $500,000 in taxpayer funds on items deemed “unallowable or poorly documented,” including football tickets, parade expenses, and lobbying costs.⁷ The HHS inspector general cited the organization for using Medicare funds to pay for luxury hotel rooms and Rose Bowl festivities.¹² OneLegacy has maintained that a federal hearing officer previously found its Rose Bowl float allocations “appropriate.”²

According to 2018 tax filings, CEO Tom Mone’s annual compensation exceeded $904,000. Board chair Bill Chertok received $100,000 a year, board vice chair Art Torres was paid $50,000, and other board members received $30,000 or more, all from Standard Acquisition Charges and CMS reimbursements. OneLegacy held roughly $85 million in cash reserves and $36 million in foundation assets as of 2018; its foundation nonetheless applied for a Paycheck Protection Program loan of between $150,000 and $350,000, which the organization later said was refused.¹²

Reporting by the Project on Government Oversight revealed that in November 2020, Mone emailed lobbyists and other OPO executives asking “Who knows Joe and/or Kamala… and how can we get to them BEFORE” patient advocates could influence incoming accountability rules. Mone also claimed to be “all over” the Xavier Becerra HHS nomination through board vice chair Torres. He later denied that Torres contacted the administration on OneLegacy’s behalf and said the organization was exercising its First Amendment rights.¹²

Tissue Harvesting Cases and the Los Angeles County Coroner

A multi-part Los Angeles Times investigation published in 2019 and 2020 documented how OneLegacy’s tissue procurement operations complicated death investigations by the LA County medical examiner-coroner.

Marietta Jinde died in 2016. OneLegacy removed bones and skin from her body before the coroner’s autopsy, which prevented the forensic pathologist from determining whether the bones were fractured, a finding relevant to a potential manslaughter investigation.¹³ In the case of Guillermo Valencia, who died in 2008 under unclear circumstances, coroners permitted tissue harvesting despite the cause of death being unresolved, and medical examiners could not later determine whether the death was a homicide or an accident.

The Times found OneLegacy operated inside seven Southern California county morgues with key card access, rented surgical space, and the ability to monitor government computer files for real-time notifications of deaths.¹⁴ In 2017, roughly 51 percent of OneLegacy’s tissue donors and 63 percent of its organ donors came from partnerships with government morgues. The investigation identified at least five instances in which procurement companies recovered body parts without initially reporting suspected unnatural deaths to the coroner, despite legal requirements to do so, and found that OneLegacy employees had contacted grieving families at death scenes, sometimes misrepresenting themselves as coroner’s office staff. Internal complaints from more than 20 coroner employees spanning 2002 to 2018 described frustrations with OneLegacy’s operations.¹⁵

Families have found it difficult to sue. California law provides broad protections for coroners and procurement companies from lawsuits except in cases of “extreme wrongdoing.” Mark Flath, whose son Jonn’s heart was harvested by OneLegacy in a way that prevented a complete autopsy, tried to sue both the coroner and OneLegacy, but his attorney withdrew after reviewing the legal protections and a judge dismissed the case.¹³ The Times reported more broadly that wrongful-death and medical malpractice suits in many jurisdictions have been “thwarted” by early tissue harvesting, because state laws shield the organizations from liability absent egregious conduct.

One connected relationship drew separate attention. Lakshmanan Sathyavagiswaran, who ran the LA County coroner’s office for 20 years before retiring in 2013, joined OneLegacy’s board less than two years later and was paid more than $2,000 a month. During his tenure he had implemented a “zero denial policy” designed to greenlight OneLegacy’s procurement requests. He resigned from the board in 2016 when the county asked him to temporarily direct the morgue again. Jonathan Jacobs of John Jay College’s Institute for Criminal Justice Ethics said public officials like medical examiners “should not be allowed to accept gifts or industry payments.” No formal ethics investigation was reported.¹⁶

The Bertone Whistleblower Verdict

In November 2018, Denise Bertone, a former lead pediatric death investigator at the LA County coroner’s office, filed a whistleblower lawsuit against the county. Bertone alleged retaliation after she raised concerns about the 2013 death of Cole Hartman, an eight-year-old disabled boy.

According to the suit, the boy had been found submerged in a top-loading washing machine by his stepmother and was hospitalized in a coma. OneLegacy obtained permission to harvest his organs. After he was removed from a ventilator he continued breathing, and the suit alleged a UCLA anesthesiologist administered a large dose of fentanyl as a “comfort measure,” which caused cardiac arrest, after which OneLegacy harvested his organs.¹⁷ Bertone told supervisors she believed the boy had died of a fentanyl overdose. The coroner’s office initially listed the cause of death as suffocation caused by submersion in water and, in December 2016, changed it to “consequences from a fentanyl overdose.”¹⁸ The LAPD launched an investigation into the death, according to a 2017 ABC7 report.¹⁹ Counsel for the anesthesiologist said her care was “medically appropriate” and that any suggestion she intended to hasten the child’s death was “factually wrong and patently offensive.”

Bertone alleged that after raising her concerns she was denied her prior position when she returned from medical leave in early 2015, lost overtime pay and a take-home vehicle, was blocked from promotional opportunities, and was effectively forced into early retirement in 2017. In December 2021, a jury awarded her $8.4 million. LA Superior Court Judge Robert S. Draper denied the county’s motions for a full retrial and for judgment notwithstanding the verdict. Bertone accepted a reduced award of $3 million plus interest in July 2022 to avoid a partial retrial on damages.¹⁷ OneLegacy was not itself the defendant, but the case grew directly out of a OneLegacy procurement.

The LeGree Employment Discrimination Complaint

Former OneLegacy employee Melissa LeGree, who is African-American, filed an amended complaint alleging racial harassment and retaliation. LeGree accused OneLegacy’s then-chief financial officer, Cynthia Perley, of making racially demeaning comments about her appearance, telling her that “white women and Asian women can get away with more than you can because of the way you are built,” excluding her from social interactions and gift-giving that included white colleagues, and leading a workplace “new look” training that featured slides implying natural African-American hair was “unkempt.” LeGree alleged that after she reported the harassment to CEO Tom Mone in April 2017, she was demoted, reclassified from exempt to non-exempt, placed on indefinite administrative leave, and had her office removed. The complaint sought a jury trial.²⁰

The Carrico Consent Allegation

Dennis Carrico alleged OneLegacy exceeded the scope of his consent after the death of his 23-year-old son, Kristopher. Carrico said he authorized donation of ligaments, tendons, and the pericardium. When he received the autopsy report, he found OneLegacy had also recovered his son’s whole heart and upper and lower leg bones without his permission. In a letter, CEO Tom Mone acknowledged that the employee involved “did not fully explain that the whole heart must be recovered” and said the individual would receive additional training.²¹ No formal lawsuit by Carrico was identified in available reporting.

Where OneLegacy Stands Now

The stakes of the certification lawsuit are concrete. CMS began its 2026 recertification surveys in March of that year, using performance data from 2022 through 2026. The January 2026 proposed rule confirmed that OPOs assigned only to Tier 3 service areas face decertification, though organizations retain the right to appeal and cannot be decertified until all administrative appeals are exhausted.⁵ With the Florida case still awaiting a ruling on summary judgment, OneLegacy is seeking judicial relief before the certification cycle concludes, while continuing to answer for the operational, financial, and employment allegations that have accumulated around it over the past several years.

1
AOPO. LifeLink Foundation et al v. Kennedy et al, Complaint
2
POGO. Heartless: Organ Donation Contractors Lobby Against a Popular Health Care Initiative While Pocketing Pandemic Relief Loans
3
Federal Register. Medicare and Medicaid Programs: Organ Procurement Organizations Conditions for Coverage
4
PACER Monitor. LifeLink Foundation, Inc. et al v. Kennedy et al
5
CMS. QSO-26-06-OPO Interpretive Guidance
6
Bloomberg Law. HHS Sued by Organ Donor Nonprofits Over Cutthroat Competition
7
Costly Effects of the U.S. Organ Transplant System. Congressional Oversight of OPOs
8
OneLegacy Foundation. OneLegacy Foundation Report
9
U.S. Congress. Subcommittee on Economic and Consumer Policy Hearing Transcript
10
U.S. Senate Finance Committee. Wyden, Grassley Report Exposes How Organ Procurement Organizations Game the System
11
U.S. Senate Finance Committee. Operation Transplant Staff Report
12
POGO. America’s Transformative New Organ Donation Rule Goes Into Effect Over Objections From Monopolistic Contractors
13
Los Angeles Times. Body Parts Harvesting Hinders Coroner Autopsies
14
Los Angeles Times. How Body Brokers Took Over County Morgue
15
Los Angeles Times. Organ Procurement Coroner Report
16
Los Angeles Times. Former LA County Chief Medical Examiner-Coroner and OneLegacy
17
KIIS FM / iHeart. Former Coroner’s Investigator Who Won $8.4 Million Accepts Smaller Award
18
FOX LA. Former LA County Coroner’s Investigator Wins $8 Million in Retaliation Lawsuit
19
ABC7. Questions Arise Over Castaic Boy’s Death at LA Hospital
20
Helmer Friedman LLP. LeGree v. OneLegacy, First Amended Complaint
21
CBS News Los Angeles. Investigation: Tissue and Organ Donations Can Save a Life, but at What Cost