An Act To Strengthen the Maine Certificate of Need Act of 2002
Maine Legislature, Session 121, LD 0584
Committee: Health and Human Services
Sponsors: TRAHAN
Amends: 22 MRSA §328, 22 MRSA §329, 22 MRSA §330, 22 MRSA §332, 22 MRSA §337, 22 MRSA §343, 22 MRSA §346

Legislative Document 
No. 584 
H.P.447 
House of Representatives, February 11,2003 
An Act To Strengthen the Maine Certificate of Need Act of 2002 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Representative TRAHAN of Waldoboro. 
Printed on recycled paper 
/Jl~ 
111· 7IltJ£~ 
MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA §328, sub-§2, as enacted by PL 2001, c. 664, 
§2, is amended to read: 
2. 
Ambulatory 
surgical 
facility. 
"Ambulatory 
surgical 
facility" means a facility, not part of a hospital, that provides 
surgical treatment to patients not requiring hospitalization and 
that is required to be licensed under section 1812-E or is 
certified as 
an ambulatory surgical facility by 
the 
federal 
Medicare program. "Ambulatory surgical facility" does not include 
the 
offices 
of 
private 
physicians 
or 
dentists, 
whether 
in 
individual or group practice, unless the offices are required to 
be 
licensed 
under 
section 
1812-E 
or 
are 
certified 
as 
an 
ambulatory surgical facility by the federal Medicare program. 
Sec. 2. 22 MRSA §328, sub-§8, as enacted by PL 2001, c. 664, 
§2, is amended to read: 
8. 
Health care facility. 
"Health care facility" means a 
hospital, psychiatric hospital, nursing facility, kidney disease 
treatment center including a freestanding hemodialysis facility, 
rehabilitation 
facility, 
ambulatory 
surgical 
facility, 
independent 
radiological 
service 
center 
providing 
imaging 
services, 
including, 
but 
not 
limited to, 
magnetic 
resonance 
imaging, 
computerized 
tomography, 
mammography 
and 
radiology, 
independent 
cardiac 
catheteri~ation 
center 
that 
provides 
services, inCluding, but not limited to, cardiac catheterization 
and angiography or cancer treatment center, endoscopy centers, 
and medical laboratory licensed in accordance with chapter 411 or 
licensed 
by 
an 
equivalent 
out-of-state 
licensing 
authority. 
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Sec. 3. 22 MRSA §329. sub-§7. ~B. as enacted by PL 2001, c. 
664, §2, is amended to read: 
B. 
If a person adds a health service not subject to review 
under subsection 4, paragraph A and not subject to review 
under 
subsection 
4, 
paragraph 
B 
at 
the 
time 
it 
was 
established 
and 
not 
reviewed 
and 
approved 
prior 
to 
establishment at the 
request of 
the applicant, 
and its 
actual 
3rd 
fiscal 
year 
operating 
cost 
exceeds 
the 
expenditure minimum for annual operating costs in the 3rd 
fiscal 
year 
of 
operation 
following 
addition 
of 
these 
services; aBel 
Sec. 4. 22 MRSA §329, sub-~8. as enacted by PL 2001, c. 664, 
§2, is amended to read: 
Page l-LR1675(1) 
8. 
Related projects. 
Any projects that the department 
determines are related projects if such projects, considered in 
the aggregate, 
would otherwise require a certificate of need 
under this sectionT~ 
Sec. 5. 22 MRSA §329, sub-§9 is enacted to read: 
9. 
Bew 
ambulatory 
surgical 
facilities; 
e~pansions. 
renovations. 
new 
e~nditures 
and 
new 
services. 
The 
construction. development, establishment or licensure of a new 
ambulatory surgical facility or the expansion. renovation or new 
expenditure or new service by an existing ambulatory surgical 
facility. 
Sec. 6. 22 MRSA §330, sub-§§6 and 7, as enacted by PL 2001, c. 
664, §2, are amended to read: 
6. 
Existing capacity. 
The use by an ambulatory surgical 
facility licensed on January 1, 1998 of capacity in existence on 
January 1, 1998. except that any expansion. renovation or new 
expenditure 
or 
service 
by 
such facility taking place 
after 
January L 
1998 that would otherwise be subject to review under 
this chapter is not exempt; and 
7. 
Critical access hospitals. 
Conversion by a critical 
access hospital of acute care beds or beds voluntarily reduced 
under section 333. subsection 1 to hospital swing beds. 
Sec. 7. 22 MRSA §332. as amended by PL 2001, c. 710, §9. is 
repealed. 
Sec. 8. 22 MRSA §337, sub-§3, as enacted by PL 2001, c. 664, 
§2, is amended to read: 
3. Application content. 
An application for a certificate of 
need must describe with specificity how the proposed project 
meets each of the conditions for granting a certificate of need 
required by this chapter. 
A statement or statements that the 
project will meet the conditions without supporting facts backed 
by 
relevant 
documentation 
and 
analysis 
constitute sufficient 
cause to deny the application. 
An application subject to full 
review must contain, if available and relevant to the particular 
service 
or 
technology, 
information 
on 
heal th 
status. 
characteristics of the payor mix for the population to be served, 
public 
health 
need 
for 
the 
service 
or 
technology, 
quality 
assurance processes and prevention programs. 
Sec. 9. 22 MRSA §343. as enacted by PL 2001, c. 664, §2, is 
amended to read: 
§343. Public information 
The department shall prepare and publish at least annually a 
report on its activities conducted pursuant to this Act. 
The 
annual report must include information on all certificates of 
need granted and denied. 
With regard to all certificates granted 
on a conditional basis, the report must include a 
summary of 
iB'9~mati9B-£~pe£~~~-~~-~~~~-~~~-aBe any accompanying 
statements by the commissioner or department staff submitted 
regarding the reports. 
Sec. 10. 22 MRSA §346, sub-§3, as enacted by PL 2001, c. 664, 
§2, is amended to read: 
3. 
Periodic review. 
After the issuance of a certificate of 
need, the department shall periodically review the progress of 
the holder of the certificate in meeting the timetable for making 
the service or equipment available or for completing the project 
specified in the approved application. 
A certificate of need 
expires if the project for which the certificate has been issued 
is not commenced within 12 months following the issuance of the 
certificate. 
The 
department 
may 
grant 
an 
extension 
of 
a 
certificate for an additional specified time not to exceed 12 
months if good cause is shown why the project has not commenced. 
The department may require evidence of the continuing feasibility 
and availability of financing 
f~r a project as a condition for 
extending the life of the certificate. 
In addition, if on the 
basis of its periodic review of progress under the certificate 
the department determines that the holder of a certificate is not 
otherwise meeting the timetable and is not making a good faith 
effort to meet it, the department may, after a hearing, withdraw 
the certificate of 
need. 
The 
applicant shall issue to 
the 
department periodic reports as designated in the certificate of 
need approval notification on the impact of the service on the 
health status, quality of care 
aBe~ health outcomes 
of 
the 
population served and the characteristics of the payor mix for 
the population served. 
These reports may not be 
~n less than 
12-month intervals following the start of service approved in the 
certificate of need. 
The department shall adopt rules for the 
withdrawal of certificates of need. 
SUMMARY 
This bill proposes to increase the applicability of the 
certificate of need law to health care facilities, regardless of 
ownership. 
It repeals provisions for subsequent review following 
approval of a certificate of need. 
The bill expands the scope of 
the periodic reports to the Department of Human Services by an 
applicant who has been granted c. certificate of need. 
It exempts 
from the certificate of need process the conversion by a critical 
access hospital of banked hospital beds to swing beds.