An Act To Repeal Certificate of Need as It Applies to Hospitals, Ambulatory Surgical Units and Physician Offices
Maine Legislature, Session 122, LD 1487
Committee Amendment CA_A_H652 (House)
Amends: 22 MRSA §328

COMMITTEE AMENDMENT "4,, to H.P. 1043, L.D. 1487, Bill, "An 
Act To Repeal Certificate of Need as It Applies to Hospitals, 
Ambulatory Surgical Units and Physician Offices" 
Amend the bill by striking out the title and substituting 
the following: 
'An 
Act 
Physicians' 
Facilities' 
To 
Repeal 
Offices 
Certificate 
of 
Need 
Requirements 
for 
and 
Physician-owned 
Ambulatory 
Surgical 
Further amend the bill by striking out everything after the 
enacting clause and before the summary and inserting in its place 
the following: 
'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 
requ~r~ng hospitalization. 
"Ambulatory surgical facility" does not include the offices of 
private physicians or dentists, whether in individual or group 
practice or ambulatory surgical facilities owned wholly or in 
part by one or more physicians. 
Sec. 2. 22 MRS A §328, sub-§17-A, as corrected by RR 2003, c. 
1, §15, is amended to read: 
l7-A. 
New health service. 
"New health service" means: 
A. 
The obligation of any capital expenditures by or on 
behalf of a health care facility of $110,000 or more that is 
associated with the addition of a health service that was 
Page l-LRl102(2) 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ·A" to H.P. 1043, L.D. 1487 
not offered on a regular basis by or on benalf of the health 
care facility within the l2-month period prior to the time 
the services would be offered; or 
B. 
The addition of a health service that is to be offered 
by or on behalf of a health care facility that was not 
offered on a regular basis by or on behalf of the health 
care facility within the l2-month period prior to the time 
the services would be offered and that, for the 3rd fiscal 
year of operation, including a partial first year following 
addition of that service, is projected to entail incremental 
annual operating costs directly attributable to the addition 
of that health service of at least $400,000f-e~~ 
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"New health service" does not include a health care facility 
extends a current service within the defined primary service 
of the health care facility by purchasing within a 12-month 
period new equipment costing in the aggregate less than 
threshold provided in section 328, subsection 16; 
that 
area 
time 
the 
Sec. 
3. 
Appropriations 
and 
allocations. 
appropriations and allocations are made. 
The 
following 
HEALTH AIm HDMAR SERVICES, DEPARTMENT OF 
Medical Care - Payments to Providers 0147 
Initiative: 
cost to the 
need statute 
Appropriates and allocates funds for the increased 
MaineCare program of changes to the certificate of 
related to the ambulatory surgical facilities. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2005-06 
$0 
$0 
2006-07 
$184,135 
$184,135 
COMMITTEE AMENDMENT 
0. 't 
COMMITTEE AMENDMENT .. 4, to H.P. 1043, L.D. 1487 
FEDERAL EXPENDITURES FUND 
A11 Other 
FEDERAL EXPENDITURES FUND TOTAL 
SUMMARY 
2005-06 
$0 
$0 
2006-07 
$312,185 
$312,185' 
This amendment is the minority report of the committee. 
The 
amendment 
replaces 
the title and 
the bill. 
It 
amends 
the 
definition of ambulatory surgical facility so that it excludes 
facilities owned wholly or in part by one or more physicians. 
This change in definition excludes those types of facilities from 
a certificate of need requirement. 
It amends the definition of 
new health service to exclude additions of new technology in the 
private office of a health care practitioner from a certificate 
of need requirement. 
The amendment also adds an appropriations 
and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 06/02/05 ~ac:.. 
--
LD 1487 
LR 1102(02) 
An Act To Repeal Certificate of Need as It Applies to Hospitals, Ambulatory Surgical Units and 
Physician Offices 
Fiscal Note for Bill as Amended by Committee Amendment ,A" 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Minority Report 
Fiscal Note 
Projections 
2005-06 
2006-07 
2007-08 
Net Cost (Savings) 
General Fund 
$0 
$184,135 
$198,865 
Appropriations/Allocations 
General Fund 
$0 
$184,135 
$198,865 
Federal Expenditures Fund 
$0 
$312,185 
$337,160 
Revenue 
Federal Expenditures Fund 
$0 
$312,185 
$337,160 
Fiscal Detail and Notes 
Projections 
2008-09 
$214,775 
$214,77:' 
$364,133 
$364,133 
For the purposes of estimating the impact on the MaineCare program, assumes three new ambulatory surgical faclilties 
will be added as a result of this legislation. Further assumes 220 MaineCare procedures at each new facility per year 
(the current MaineCare average for existing ambulatory surgical facilities) at an average reimbursement rate of $752 
per procedure (current MaineCare average for existing ambulatory surgical facilities). Assumes additional 
MaineCare costs will not be incurred until the second year of the biennium. 
LRII02(2) - Fiscal Note - Page 1 of 1