NICU Verification Program History

The AAP is a nonprofit professional organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists and is considered the professional home for over 4,500 neonatologists dedicated to the health, safety, and well-being of all infants. The AAP Committee on Fetus and Newborn (COFN), formed in 1937, has been devoted to improving the care and survival of our most vulnerable newborns and the AAP Section on Neonatal-Perinatal Medicine (SONPM), formed in 1975, is dedicated to educating pediatricians and neonatologists on clinical best practices for newborns and infants.

The work of the AAP NICU Verification Program began in 2013 when the state of Texas mandated that all Texas facilities caring for newborns required a neonatal level of care designation to receive Medicaid payment for neonatal services and announced a plan to engage survey agencies to verify levels of neonatal care. The AAP was identified as 1 of 2 Texas-approved survey agencies to pilot the verification survey process in 2016, and the NICU Verification Program was officially launched. Since then, the NICU Verification Program has provided third-party surveys by experienced and credentialed neonatologists, neonatal nurses, and pediatric surgeons to assess compliance with state-specific risk-appropriate neonatal care standards in Texas, Georgia, and Missouri.  

While all states regulate health care facilities, specifications for levels of neonatal care and adherence to requirements vary widely.  As of 2021, only half of states in the U.S. had neonatal level-of-care policies, and only 20 percent of states required verification by a third-party agency or health official. Recognizing the need for a national neonatal verification and designation program to ensure high-quality, equitable care, the AAP NICU Verification Program published the Standards for Levels of Neonatal Care: II, III, and IV in 2023. 

Broad adoption of risk-appropriate neonatal care standards and verification processes assures newborns receive care in facilities equipped with the right expertise and resources, helping to reduce disparities, improve outcomes, increase transparency of capabilities, and advance health equity. By engaging with the AAP to achieve AAP neonatal verification and designation, it ensures infants receive care in a facility with the resources appropriate for their needs and condition.