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Approval Of Hospice Programs Draws Numerous Challenges

Creative Commons
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Thirty-four petitions have been filed in administrative court by companies that are challenging AHCA's decisions to deny applications for hospice services or to approve those of competitors.

Legal wrangling has begun over Florida's decision late last month to approve hospice programs in seven counties across the state.

Thirty-four petitions have been filed in state administrative court by companies that either are challenging the Agency for Health Care Administration’s decisions to deny their applications for hospice services or to approve their competitors’ applications, according to a notice published Wednesday in the Florida Administrative Register.

Some companies also filed petitions in support of the state’s decisions to deny their competitors certificate of need applications for new hospice programs.

“In 17 years I’ve never seen anything like it,” said Paul A. Ledford, president and chief executive officer of the Florida Hospice & Palliative Care Association.

The state’s approval of Catholic Hospice Inc.’s certificate of need applications in Broward and Miami-Dade counties are the only decisions not drawing legal challenges, which Ledford said isn’t surprising. Catholic Hospice Inc. already is a hospice provider in those counties and received approval from the state for additional beds at existing facilities.

The challenges come after the state last month gave approval to eight hospice certificate of need applications.

Certificate of need, often referred to as CON, is a controversial regulatory process that supporters argue helps prevent unnecessary and costly expansions of services.

Critics, however, say the CON process is unnecessary regulation that encourages monopolies. Critics also argue that the CON process drives litigation among competing health care providers, which leads to increases in health care costs.

Ledford noted that sometimes challenges are filed by companies as a way to ensure they have a “seat at the table,” if the state attempts to negotiate a settlement in an effort to avoid an administrative hearing and potential court challenge.

The Republican-dominated Legislature in 2019 eliminated the CON process for hospitals but left it intact for hospice programs, nursing home beds and facilities that treat people with intellectual and developmental disabilities.