Hospital System Challenges State On Neonatal Plan

Sep 26, 2018

A move by the Florida Department of Health to establish a new designation of high-level neonatal intensive care services is being challenged in state administrative court. 

Adventist Health System has filed a petition in the state Division of Administrative Hearings seeking to toss proposed changes to three rules that, if adopted, effectively would allow only hospitals that have regional perinatal intensive care centers to operate level IV neonatal intensive care units.

Adventist, which operates as Florida Hospital, does not have a regional perinatal intensive care center --- known as a RPICC --- and therefore couldn’t operate a level IV neonatal intensive care unit under the proposed rule changes.

In its challenge, the hospital argued that many institutions in the state are not RPICC centers but have the capabilities to provide what would be designated as level IV neonatal intensive care services.

“As a result, sick children will have very limited access to these services who need this kind of care, which is in direct contradiction to the department’s responsibility to regulate health care in the state in a manner that promotes access to high quality health care and this proposed rule will have the opposite effect,” attorneys for Florida Hospital wrote in their petition.

Among other things, attorneys argue that the Florida Department of Health’s authority is limited to developing standards for the development and operation of RPICCs, which are specialized units in hospitals that are designed to provide a range of health services to women with high-risk pregnancies and infants.

The proposed rule changes address the regulation of neonatal intensive care units, Florida Hospital argues.

Those units are regulated by the state’s certificate of need program, which is administered by the Agency for Health Care Administration, not the health department.

“By not adhering to the certificate of need statutory and regulatory framework, the NICU level IV designation will only be available to only a select few institutions, which will likely result in managed care plans to selectively contract with only those facilities and this will come at the expense of limiting choice for Medicaid patients,” the petition said.