An Act To Repeal the Maine Certificate of Need Act of 2002
Maine Legislature, Session 126, LD 0162
Committee Amendment CA_A_H366 (House)

COMMITTEE AMENDMENT "A" to H.P. 137, L.D. 162, Bill, "An Act To 
Repeal the Maine Certificate of Need Act of 2002" 
Amend the bill by inserting after section 1 the following: 
'Sec. 2. 22 MRSA c. 106 is enacted to read: 
CHAPTER 106 
PRIOR APPROVAL OF PROJECTS 
§375. Definitions 
As used in this chapter. "health care facility" or "facility" means a hospital. 
psychiatric hospital, nursing facility, intermediate care facility for persons with 
intellectual disabilities. end-stage renal disease facility. rehabilitation facility. residential 
care facility, ambulatory surgical facility, independent radiological service center, 
independent cardiac catheterization center or cancer treatment center. 
§376. Prior approval required 
A health care facility may not enter into any agreement for the financing of a project 
that requires funding from or will increase costs to the MaineCare program under chapter 
without first obtaining prior approval from the department in conformance with this 
chapter. 
1. Application. A health care facility that is subject to the prior approval process 
shall file an application with the department and complete the process required by rules. 
2. Factors to be considered. In determining whether to approve an application for 
prior approval under this section, the department shall take into consideration the 
qualifications and experience of the applicant. the economic feasibility of the proposed 
project, the public need for the project and compliance with standards for budget 
neutrality with respect to the MaineCare program. 
COMMITTEE AMENDMENT 
~ .. ,. 
COMMITTEE AMENDMENT ,A .. to H.P. 137, L.D. 162 
3. Public comment and participation. The process for prior approval of a project 
must include, prior to approval by the department, an opportunity for public comment. 
The process may include public information meetings, public hearings and notification, 
as specified by rule. 
4. Reserved beds. A health care facility may reserve for later use and exempt from 
the prior approval process facility beds that are removed from service if the facility 
notifies the department prior to the facility's removing the beds from service or within 30 
days after the facility removes the beds from service. 
5. MaineCare Facility Project Fund. The MaineCare Facility Project Fund is 
established within the department to receive the MaineCare funding that is released when 
a health care facility reduces its number of licensed MaineCare-funded beds and to make 
that MaineCare funding available to a facility that proposes in an application under this 
section to add licensed MaineCare-funded beds to facilities in areas of the State that need 
facility beds or to serve populations in the State that are in need of service. 
6. Rulemaking. The department shall adopt rules to administer the prior approval 
process, including the application form, review and approval process, public comment 
and participation, oversight, enforcement, imposition of sanctions, fees and use of the 
MaineCare Facility Project Fund. Rules adopted pursuant to this subsection are routine 
technical rules, except that rules establishing fees are major substantive rules, as defined 
in Title 5, chapter 375, subchapter 2-A.' 
Amend the bill by adding after section 18 the following: 
'Sec. 19. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
Nursing Facilities 0148 
Initiative: Provides funding for additional costs to MaineCare as a result of new nursing 
facility projects. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
2013-14 
$630,936 
$630,936 
2013-14 
$1,020,946 
$1,020,946 
2014-15 
$1,293,163 
$1,293,163 
2014-15 
$2,070,069 
$2,070,069 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
COMMITTEE AMENDMENT 
" .. ,. 
lO 
COMMITTEE AMENDMENT 'A" to H.P. 137, L.D. 162 
SUMMARY 
This amendment is the minority report of the committee. 
This amendment 
establishes a prior approval process for health care facility projects that will require 
funding from or will increase costs to the MaineCare program. "Health care facility" is 
defined as a hospital, psychiatric hospital, nursing facility, intermediate care facility for 
persons with intellectual disabilities, end-stage renal disease facility, rehabilitation 
facility, residential care facility, ambulatory surgical facility, independent radiological 
service center, independent cardiac catheterization center or cancer treatment center. The 
Department of Health and Human Services is directed to take into consideration the 
qualifications and experience of an applicant for prior approval, the economic feasibility 
of the proposed project, the public need for the project and compliance with standards for 
budget neutrality with respect to the MaineCare program. The prior approval process 
must include an opportunity for public comment and may include public information 
meetings, public hearings and notification, as specified by rule. Unused and reserved 
beds in a facility are exempt from the prior approval process. A fund is established to 
receive unused funding previously used for a facility bed funded under the MaineCare 
program and to assign that funding for use for new beds in underserved areas or for 
underserved populations. The department is authorized to adopt routine technical rules, 
except that rules regarding fees are major substantive rules. 
The amendment also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
• 
Approved: 06/02/13 
~ac:.. 
LD162 
LR 216(02) 
An Act To Repeal the Maine Certificate of Need Act of 2002 
Fiscal Note for Bill as Amended by Committee AmendmentA' {~-31.o(P) 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriationsl Allocations 
General Fund 
Federal Expenditures Fund 
Revenue 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2013-14 
$630,936 
$630,936 
$1,020,946 
($116,684) 
FY 2014-15 
$1,293,163 
$1,293,163 
$2,070,069 
($116,684) 
Projections 
FY 2015-16 
$1,974,865 
$1,974,865 
$3,161,325 
($116,684) 
Projections 
FY 2016-17 
$1,974,865 
$1,974,865 
$4,291,866 
($116,684) 
Provides an appropriation of $630,936 in 2013-14 and $1,293,163 in 2014-15 for the State's share of additional 
MaineCare costs as a result of new nursing facility projects. Also assumes a reduction in Certificate of Need 
application fees collected. 
LR0216(02) - Fiscal Note - Page 1 of 1