There’s a twist on an old saying that goes “No good deed goes unpunished.” Unfortunately, many living organ donors are finding this to be the policy after their supreme sacrifice.

The Austin American-Statesman takes a look several cases where hospitals ignore a federal law stating that a living organ donor should not pay medical bills related to their donation and post-operation care.

The story starts with Philip Knisely. In 2008, Knisely donated one of his kidneys to a co-worker and father of three, Jose Vara. In weeks leading up to the surgery, Knisely was assured that, per federal law, he and his insurance company wouldn’t be billed. Those costs would go to the recipient’s insurance company or Medicare. Instead:

Knisely, a 53-year-old tax analyst for the state comptroller’s office, has received numerous notices that his insurance company was billed thousands of dollars by the hospital, doctors and other medical providers for treatment of post-surgery complications such as pancreatitis, an inflammation of the pancreas. Knisely said he also has been billed directly several times and has been contacted by a collection agency because he wouldn’t pay.

“I’ve been appalled about how this has been handled,” he said.

The American-Statesman outlines several other cases with similar outcomes. In some cases, a living organ donor has even been dropped by their insurance or denied care on the grounds that their donation constituted a “pre-existing condition.”

One woman in Texas who donated a part of her liver to her sister had to provide her insurance information to get pain medication. She later received a bill that should have gone to someone else. In many cases, the newspaper says, organ donors are paying out-of-pocket for bills they should not have received in the first place.

The advice of one of the organ donors: Take a notepad with you. This is good advice for anyone seeking medical help. Ask questions. Get treatment and billing information up front and in writing. Read your medical bills closely.

Serious medical debt can affect anyone, but there are laws in place to protect organ donors. Don’t get stuck with someone else’s bill.