Hospitals square off on transplant rule

Some of Florida’s top hospitals are gearing up for a major legal battle over a new state proposal governing organ-transplant programs.

Nemours Children’s Hospital recently filed a motion to support a rule proposed by the Florida Agency for Health Care Administration (AHCA) in August, joining Memorial Healthcare System in Broward County and AdventHealth Orlando in backing the plan. Meanwhile, Tampa General Hospital, UF Health Shands Hospital in Gainesville, and Jackson Memorial Hospital in Miami have filed challenges, arguing the proposal lacks sufficient safeguards for patient care.

Administrative Law Judge Joshua Pratt has scheduled a three-day hearing beginning December 17 to consider the consolidated challenges.

The proposed rule aims to update standards for hospitals that wish to start or continue organ-transplant services. Supporters, including Nemours, Memorial Healthcare, and AdventHealth, said the rule was the product of extensive committee collaboration. “The committee met and participated in a good faith, healthy debate over the particulars to be included in the transplantation licensure rule,” attorneys for Nemours wrote.

Opponents, however, argue that the rule does not set minimum yearly procedure requirements needed to ensure surgical proficiency. Tampa General, UF Health Shands, and Jackson Memorial warn that allowing “low-volume, low-quality” programs could weaken established centers. “Decreasing the volume of organ transplant patients for existing programs could impact the programs’ viability and quality of care,” UF Health Shands and Jackson wrote in their joint petition.

Florida’s transplant program oversight has long been tied to the state’s now-repealed “certificate of need” process, which lawmakers eliminated in 2019 after years of debate. The Legislature directed AHCA to create new licensure standards to maintain care quality without limiting competition.

An earlier version of the transplant rule was withdrawn in 2021 after similar objections from major hospitals. The revised version was reintroduced on August 19 and has reignited the controversy.

Tampa General, Shands, and Jackson contend the new rule exceeds AHCA’s authority, calling it an “invalid exercise of delegated legislative authority.” In contrast, Nemours, Memorial Healthcare, and AdventHealth maintain that it properly follows legislative direction and strengthens patient access to transplant services.