An Act To Amend the Maine Certificate of Need Act of 2002
Maine Legislature, Session 123, LD 2301
Amends: 22 MRSA §328, 22 MRSA §333-A, 22 MRSA §350-A

Legislative Document 
No. 2301 
H.P.1659 
House of Representatives, April 4, 2008 
An Act To Amend the Maine Certificate of Need Act of 2002 
(EMERGENCY) 
Reported by Representative PERRY of Calais for the Joint Standing Committee on Health 
and Human Services pursuant to Resolve 2007, chapter 110. 
Printed I'n rt'!.:ydt:Li r~trer 
'77/~ 111· 7l?dC~{ 
MIlLICENT M. MacFARLAND 
Clerk 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, the Maine Certificate of Need Act of 2002 is an important tool in the 
planning and development of affordable health care services in the State; and 
Whereas, this legislation is necessary immediately for the enhancement of the 
strength and clarity of the Maine Certificate of Need Act of 2002; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, 
II 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA §328, sub-§16, as amended by PL 2003, c. 469, Pt. C, §4, is 
further amended to read: 
16. Major medical equipment. "Major medical equipment" means a single unit of 
medical equipment or a single system of components with related functions used to 
provide medical and other health services that costs $1,200,000 or more. "Major medical 
equipment" does not include medical equipment acquired by or on behalf of a clinical 
laboratory to provide clinical laboratory services if the clinical laboratory is independent 
of a physician's office and a hospital and has been determined to meet the requirements of 
the United States Social Security Act, Title XVIII, Section 1861(s), paragraphs 10 and 
11. In determining whether medical equipment costs more than the threshold provided in 
this subsection, the cost of studies, surveys, designs, plans, working drawings, 
specifications and other activities essential to acquiring the equipment must be included. 
If the equipment is acquired for less than fair market value, the term "cost" includes the 
fair market value. 
Beginning September 30, 2004 January 1, 2009 and annually 
thereafter, the threshold amount for review must be updated by the commissioner to 
reflect the change in the Consumer Price Index, medical index. 
Sec. 2. 22 MRSA §328, sub-§17-A, ~C, as corrected by RR 2003, c. 1, §15, is 
amended to read: 
C. 
The addition in the private office of a health care practitioner, as defined in Title 
24, section 2502, subsection I-A, of new technology that costs $1,200,000 or more. 
The department shall consult with the Maine Quality Forum Advisory Council 
established pursuant to Title 24-A, section 6952, prior to determining whether a 
project qualifies as a new technology in the office of a private practitioner. 
Beginning September 30,2004 January 1, 2009 and annually thereafter, the threshold 
amount for review must be updated by the commissioner to reflect the change in the 
Consumer Price Index medical index. With regard to the private office of a health 
care practitioner, "new health service" does not include the location of a new 
practitioner in a geographic area. 
Page I - 123LR3602(OI)-1 
I 
Sec. 3. 22 MRS A §329, sub-§3, as amended by PL 2003, c. 469, Pt. C, §7, is 
further amended to read: 
3. Capital expenditures. Except as provided in subsection 6, the obligation by or 
on behalf of a health care facility of any capital expenditure of $2,400,000 or more. 
Capital expenditures in the case of a natural disaster, major accident or equipment failure 
for replacement equipment or for parking lots and garages, information and 
communications systems and physician office space do not require a certificate of need. 
Beginning September 30, 2004 January I, 2009 and annually thereafter, the threshold 
amount for review must be updated by the commissioner to reflect the change in the 
Consumer Price Index medical index; 
II 
Sec. 4. 22 MRSA §333-A, sub-§2, as enacted by PL 2007, c. 440, § 11, IS 
amended to read: 
2. Procedure. The balance of the nursing facility MaineCare funding pool must be 
used for development of additional nursing facility beds in areas of the State where 
additional beds are needed to meet the community need. The department must assess 
needs throughout the State and issue requests for proposals for the development of 
additional beds in areas where need has been identified by the department, except in the 
event of an emergency, when the department may use a sole source process. Proposals 
must be evaluated based on consideration of quality of care and cost, and preference must 
be given to existing nursing facilities in the identified need area that may increase 
licensed capacity by adding on to or renovating the existing facility. Projects that exceed 
the review thresholds require a certificate of need, but no additional assessment of need 
will be conducted as part of that process. Except as set forth in section 334-A, subsection 
2, a project requiring certificate of need approval may not increase MaineCare costs 
beyond the total amount appropriated for nursing facility care plus the available balance 
of the nursing facility MaineCare funding pool. 
Sec. 5. 22 MRSA §333-A, sub-§3, as enacted by PL 2007, c. 440, § 11, IS 
repealed and the following enacted in its place: 
3. Emergencies and necessary renovations. The department may determine an 
emergency exists and may approve a necessary nursing facility certificate of need 
application, as described in paragraph A, that is not limited by the nursing facility 
MaineCare funding pool set forth in subsection I. 
A. The department may approve a nursing facility certificate of need application 
when the applicant proposes capital expenditures for renovation~ and improvements 
that are necessary: 
(I) To achieve compliance with code and related regulatory requirements; 
(2) To comply with the federal Health Insurance Portability and Accountability 
Act of 1996 and related patient privacy standards; 
(3) To address other patient safety requirements and standards, consistent with 
the priorities set forth in the current State Health Plan; or 
(4) To address other necessary and time-sensitive patient safety or compliance 
Issues. 
B. Certificate of need projects described in paragraph A are not subject to or limited 
by the nursing facility MaineCare funding pool. Any accompanying increases in 
MaineCare costs may be approved by the department as long as the project fulfills all 
other pertinent requirements. 
Sec. 6. 22 MRSA §333-A, sub-§4, as enacted by PL 2007, c. 440, § II, IS 
amended to read: 
4. Rulemaking. The department may establish rules regarding the a> .... ard of pooled 
savings to implement this section. Rules adopted pursuant to this subsection are routine 
technical rules as defined in Title 5, chapter 375, subchapter 2-A. 
Sec. 7. 
MRSA §350-A, as amended by PL 2007, c. 440, §21, IS further 
amended to read: 
§350-A. Cost-of-Iiving adjustment 
IS 
E'lery 2 years, beginning Jan Hal)' 1, 2005 Beginning January I, 2009 and annually 
thereafter, the department shall review the monetary figures contained in this chapter. 
The department shall publish revised figures to correspond to changes in the Consumer 
Price Index medical index. 
Emergency clause. 
In view of the emergency cited In the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This bill amends the Maine Certificate of Need Act of2002 in the following ways. 
1. It standardizes January 1 st as the date when the Commissioner of Health and 
Human Services must update the threshold amount for review to reflect the change in the 
Consumer Price Index medical index. 
2. It clarifies when the Department of Health and Human Services may approve 
nursing facility certificate of need applications for capital expenditures for necessary 
renovations and improvements. 
FISCAL .\OTE REQUIRED 
(See attach~~)_ 
Approved: 03/31108 
fraC! 
LD d30 \ 
LR3602(01) 
An Act To Amend the Maine Certificate of Need Act of 2002 
Net Cost (Savings) 
General Fund 
, ppropriationsl Allocations 
General Fund 
Federal Expenditures Fund 
Fiscal Detail and Notes 
Fiscal Note for Original Bill 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
2007-08 
$0 
$0 
$0 
2008-09 
$0 
$0 
$0 
Projections 
2009-10 
$27,518 
$27,518 
$47,483 
Projections 
2010-11 
$27,518 
$27,518 
$27,518 
Assumes the bill will result in one additional nursing facility project being approved at an annual cost beginning in 
fiscal year 2009-10 of approximately $75,000 in combined state and federal funds. 
LR3602(O I) - Fiscal Note - Page I of I