Florida Hospitals Divided Over New Organ Transplant Program Rules
Originally published on November 6, 2025
Several Florida hospitals are engaged in a legal dispute over proposed changes to how the state approves organ transplant programs. The Florida Agency for Health Care Administration (AHCA) issued a new proposed rule in August that has created a clear divide among the state’s healthcare providers.
Tampa General Hospital, UF Health Shands Hospital in Gainesville and Jackson Memorial Hospital in Miami have filed challenges to the rule. On the opposing side, Nemours Children’s Hospital, Memorial Healthcare System and AdventHealth Orlando have intervened to support the proposed rule.
Legal Challenge Centers on Quality of Care Standards
The hospitals challenging the rule argue it does not include adequate safeguards for quality of care. According to their filings, the proposed rule does not require minimum numbers of transplant procedures each year to ensure proficiency.
UF Health Shands and Jackson Memorial filed a joint petition stating that the growth of low-volume programs could endanger existing programs by drawing patients away. They note there are only a limited number of organ transplant cases in Florida, and decreasing patient volumes for existing programs could affect their viability and quality of care.
These hospitals currently provide procedures such as heart, liver, lung and kidney transplants. Administrative Law Judge Joshua Pratt has scheduled a three-day hearing starting December 17 to consider the consolidated challenges.
Supporters Defend Rule Development Process
Nemours, Memorial Healthcare and AdventHealth contend the proposal emerged from a committee that worked on the issue. In their motions to intervene, they state the committee participated in good faith debate over details to include in the transplantation licensure rule, with all parties given opportunities to participate.
Memorial Healthcare and AdventHealth noted in their motions that they have transplant programs. Each supporting hospital stated the proposed rule is a “valid exercise of delegated legislative authority.”
This dispute continues years of debate about approving transplant programs in Florida.
Regulatory Background and Legislative Intent
Florida’s approach to transplant program approval has been changing since 2018, when the Legislature directed AHCA to develop licensure standards for organ transplant programs separate from the certificate of need process. In 2019, the Legislature repealed the certificate of need process altogether.
Florida long used the certificate of need process to determine whether hospitals should offer transplant procedures. While supporters said this helped ensure quality of care and control costs, opponents argued it created barriers in the healthcare system and limited competition.
An initial proposed rule drew opposition and was withdrawn in 2021. The new proposal was filed in August 2025.
Understanding the Legal Arguments
The challenges filed last month raised arguments under administrative law, including that the proposed rule is an “invalid exercise of delegated legislative authority.” Part of that argument questions whether the proposed rule carries out requirements of the 2018 law to include quality-of-care standards.
The moves to create new standards came after disputes about approval of transplant programs and a broader push by lawmakers to eliminate certificate of need processes.
The outcome of this hearing may affect how Florida approves and regulates specialty healthcare services moving forward. Healthcare organizations throughout the state may need to adjust their strategic planning based on the final rule determination.
Stay Informed About Healthcare Regulatory Changes
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