Is CON challenge imminent in Hillsborough?

A decision by the Agency for Health Care Administration to award a new hospice program in Hillsborough County to a hospital-affiliated hospice program could draw a challenge from the longstanding existing provider, LifePath, if a Christmas Eve letter to the state is any indication.

Nine applications were submitted to provide new hospice services in Hillsborough County. The state last week announced the hospice program would be awarded to West Florida Health, which is a newly formed company sponsored by Florida Hospital in Orlando and Tampa General Hospital in Tampa.

Tallahassee attorney Seann M. Frazier, with the firm Parker, Hudson, Rainer & Dobbs, wrote a letter to the Agency for Health Care Administration on Dec. 24 on behalf of his client, LifePath, opposing the West Florida Health application as well as one submitted by BayCare Hospice of Hillsborough (sponsored by BayCare Hospital and SunCoast Hospice, a Saint Petersburg-based hospice.)

“LifePath does not oppose the introduction of a new hospice provider that will serve the entire Hillsborough County community, provide healthy competition, and expand the use of hospice services to those who would benefit from that care,” Frazier’s letter reads.

CON 10299 Suncoast BayCare Hospice of Hillsborough, LLC (Letter of Opposition)

The concern is that the hospital would stop referring patients to LifePath and refer them instead to the facility it owns. Thirty-six percent of LifePath’s Medicare residents were discharged from a hospital the same day they entered the hospice. Its $3.8 million operating margin could quickly turn into a $5.4 million operating deficit if the referrals from hospitals stopped coming.

“If either hospital applicant is approved, the impact on LifePath would be immediate and devastating,” Frazier’s letter reads. “Rather than a gradual ramping up of admissions upon the introduction of a new provider, a hospital-based hospice provider possesses the power to immediately shut down referrals to existing providers such as LifePath, and instead refer all of its hospital patients to its affiliated hospice provider.”

Frazier says that the CON (certificate of need) program is meant to promote a health competition and the approval of either hospital affiliated hospice would “create an anti-competitive health care silo” and that it would be unlikely the hospice wold “seek to serve patients discharged from competing hospital systems, or even from the community at large.”

LifePath treats hospice patients in their homes as well as in one of two freestanding centers, one in Temple Terrace and the other in Ruskin. LifePath is part of Chapter Health Systems Inc.

Agency for Health Care Administration spokeswoman Shelisha Coleman said affected providers have until March 16 to challenge the agency’s decision to award a CON. Challenges can be filed by entities that filed applications but weren’t chosen as well as by existing providers, such as LifePath.

AHCA Secretary Liz Dudek in December said she expected litigation to arise from the October 2014 batching cycle where the state announced the need for  3,100 new nursing home beds and hospice programs. “It’s just part of the process,” she said.

Christine Jordan Sexton

Tallahassee-based health care reporter who focuses on health care policy and the politics behind it. Medicaid, health insurance, workers’ compensation, and business and professional regulation are just a few of the things that keep me busy.



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