Opinion ID: 1701716
Heading Depth: 2
Heading Rank: 1

Heading: CON Criteria and Standards for the Offering of MRI Services

Text: ¶ 14. Blackwell testified, and Dawkins conceded, [14] that the policy of the MSDH is to give preference to those applicants proposing to enter into joint ventures utilizing mobile and/or shared equipment. [15] State Health Plan at XI-45. As to the service-specific need criterion for the offering of MRI services, the State Health Plan provides: [t]he entity desiring to offer MRI services must document that the equipment shall perform a minimum of 1,700 procedures per year. [16] . . . This criterion includes both fixed and mobile MRI equipment. Applicants for non-hospital based MRI facilities may submit affidavits from referring physicians in lieu of the estimation methodology required for hospital based facilities. MRI procedures projected in affidavits shall be based on actual MRI procedures referred during the year. It is recognized that a particular MRI unit may be utilized by more than one provider of MRI services; some of which may be located outside of Mississippi. In such cases all existing or proposed providers of MRI services must jointly meet the required service volume of 1,700 procedures annually. If the MRI unit in question is presently utilized by other providers of MRI services, the actual number of procedures performed by them during the most recent 12-month period may be used instead of the formula projections. State Health Plan at XI-47 (emphasis added). The hearing officer found that: [t]he number of scans performed by [Alliance] at Gilmore and [Mission] when combined exceed 1,700. As Smith pointed out, it is not uncommon to alter routes or lose contracts. While this issue does become a bit convoluted, the fact remains that Alliance has been and continues to serve these two facilities with mobile MRI service. . . . [T]he mobile route that includes [Gilmore], [Mission] and [DeSoto] will easily exceed the required 1,700 procedures per year. (Emphasis added). This conclusion was adopted by the State Health Officer. ¶ 15. DeSoto initially presented evidence that Alliance's 1.5 Tesla MRI unit would perform more than 1,700 procedures annually among Gilmore, Mission, and DeSoto, based on the procedures performed at Gilmore and Mission in the most recent twelve-month period in conjunction with projections for DeSoto. See State Health Plan at XI-47. Specifically, in 2004, 1,440 MRI procedures were performed at Gilmore and 562 MRI procedures were performed at Mission. Additionally, DeSoto presented physician affidavits, in compliance with the State Health Plan, accounting for 372 additional projected MRI referrals. [17] Furthermore, Falls, also accepted as an expert in healthcare planning and systems analysis, testified that DeSoto's application complied . . . with all of the required criteria and standards[.] He added that in his review of prior staff analyses, DeSoto's application was the only mobile MRI application recommended for denial by the staff since 2003. . . . [I]t was the only . . . application in which this particular method of applying the 1,700 and 2,500 numbers was applied. . . . Ed Witek, accepted as an expert in health planning and healthcare finance, conceded that DeSoto can show that the route of the magnet has 1,700 or more procedures per year and meet that definition. . . . Finally, Smith testified that [t]here's nothing I know about at this point that precludes the viability of the Gilmore-Mission-DeSoto route. [18] Alliance was still under contract with Gilmore and Mission at the time of the hearing, and Smith testified that the proposed schedule was feasible given the upgraded power of the 1.5 Tesla MRI unit. ¶ 16. Applying the presumption of validity to the MSDH's decision, Miss. Baptist Med. Ctr., 663 So.2d at 579, this Court concludes that substantial evidence, i.e., more than a scintilla or a suspicion[,] Natchez Cmty. Hosp., 743 So.2d at 977, is present in the record to support the finding that the number of procedures exceeded the requirements of the State Health Plan. Therefore, DeSoto complied with the CON Criteria and Standards for the Offering of MRI Services. See Dishmon, 797 So.2d at 892; State Health Plan at I-2, XI-47.