An Act to Increase the Availability and Affordability of Health Care by Eliminating Certificate of
Maine Legislature, Session 132, LD 0743
Committee Amendment CA_A_H96 (House)
Amends: 24-A MRSA §4303-F

COMMITTEE AMENDMENT " ?<" to H.P. 485, L.D. 743, "Aa Act to Increase the
Availability and AffordabiUty of Health Care by Eliminating Certificate of Need
Requirements"
• Amend the bill by striking out ati of section 11 and inserting the following:
'See. 11. 24-A MRSA §4303-F, sub-§l, ^E, as amended by PL 2025, c. 34, §1
and affected by §2, is further amended to read:
E. A carrier may not require a ground ambulance service provider to obtain prior
authorization before transportmg an enrollee to a hospital, between hospitals or from a
hospital to a nursing home, hospice care facility or other health care facility, ao defined
in Title 22, section 328, subsection 8. A carrier may not require an air ambulance
service provider that is a nonprofit organization to obtain prior authorization before
transporting an enrollee to a hospital or between hospitals for urgent care. For the
purposes of this oaraeraph. the followine terms have the followme meanines.
fit "Ambulatory suieical facility" means a facility, not part of a hosoital. that
provides surgical treatment to patients not requirmg hospitalization. Ambulatory
surgical facility" does not include the offices of private physicians or dentists.
whether in individual or eroun practice.
C2) "Health care facilitv" means a hospital, psychiatric hospital, nursme facility,
kidney disease treatment center includine a freestandme hemodialvsis facility.
rehabiUtatiQn facility, ambulatory sureical facility, indeoendent radioloeical
service center, independent cardiac catheterization center or cancer treatment
center. "Health care facility" does not include the office of a private healfh care
Dractitioaer. as defined in Title 24. section 2502. subsection 1-A. whether in
individual or sroun practice. In an ambulatory sureical facility that functions also
3 as_the office of a health care practitioner, the followine portions of the ambulatory
surgical facility are considered to be a health care facility:
fa) Operating rooms:
fb) Recovery rooms;
COMMITTEE AMENDMENT
COMMETTEE AMENDMENT " /V to H.P. 485, L.D. 743
fc) Waiting areas for ambulatory sureical facility patients:
Cd) Any space with major medical equipment; and
fe) Any other space used primarily to support the activities of the ambulatory
surgical facility.
(3) "Health services" means climcallv related services that are diagnostic.
treatment, rehabilitative services or nursing services provided by a nursing facility.
"Health services" iucludes alcohol or drug dependence, substance use disorder and
mental health services.
("41 "Hosmtal" means an mstitution that nrimarilv provides to inpatients. by or
under the supervision of phYsicjans^diagnQStip services and therapeutic services
for medical diagnosis. treatment and care of persons who are injured, disabled or
sick or rehabilitation services for the rehabilitation of persons who are miured.
disabled or_sick._^osoital" also includes psychiatric and tuberculosis hospitals.
(5) "Maior medical eauioment" means a single unit of medical eauioment or a
single system of componerLts with related functions used to orovide medical and
other health services that costs $3.200.000 or more. "Major medical equipment"
does__not mclude medical equipment acquired bY_or on behalf of a^ clinical
laboratory to provide clinical laboratcnrv services if the clinical laboratory is
mdependent of a physician's office and a hospital and has been determined to meet
the requirements of the United States Social Security Act, Title XVIH, Section
1861fsyi0 and 11). In determinine whether medical equipment costs more than
the threshold wovided in this suboaraeraoh. the cost of studies, surveys, designs.
plans, working drawings, specifications and other activities essential to acquirmg
the equipment must be included. If the eauioment is acquired for less than fair
market value, the cost includes the fair market value. The threshold amount for
review must be updated by the commissioner to reflect the_change in the Consumer
Price Index for medical care services as reported bv the United States DeBartment
of Labor. Bureau of Labor Statistics. with an effective date of January 1st each
year.
(6) "Nursing facility" means any facility defined under section 1812-A..
f7) "Rehabilitation facility" means an umatient faciliW that is operated for the
primary purpose of assistine in the rehabilitation of persons who_are .disabled
throueh an integrated oroeram of medical services and other services that_are
provided under comuetent professional suoervision.'
Amend the bill by insertmg after section 19 the followmg;
'See. 20. Appropriations and allocations. The following appropriations and
allocations are made.
8 HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Division of Licensing and Certification Z036
Initiative: Deallocations from the elimination of one Senior Health Care Financial Analyst
position and the loss of the certificate of need application fee revenue.
OTHER SPECIAL REVENUE FUNDS 2025-26 2026-27
COMMITTEE AMENDMENT
COMMHTEE AMENDMENT " /\^' to H.P, 485, L.D. 743
..^,
POSITIONS - LEGISLATIVE COUNT (1.000) (1.000)
Personal Services ($150,270) ($154,294)
AUOther ($137,558) ($137,651)
OTHER SPECIAL REVENUE FUNDS TOTAL ($287,828) ($291,945)
Medical Care - Payments to Providers 0147
Initiative: Provides funding due to the elimination of the certificate of need process.
GENERAL FUND 2025-26 2026-27
AllOther $423,796 $425,886
GENERAL FUND TOTAL $423,796 $425,886
FEDERAL EXPENDITURES FUND 2025-26 2026-27
All Other $676,400 $674,310
FEDERAL EXPENDITURES FUND TOTAL $676,400 $674,310
Nursing Facilities 0148
Initiative: Provides funding due to the elimination of the certificate of need process.
GENERAL FUND 2025-26 2026-27
AllOther $4,123,579 $4,147,671
GENERAL FUND TOTAL
FEDERAL EXPENDITURES FUND
All Other
FEDERAL EXPENDITURES FUND TOTAL
OTHER SPECIAL REVENUE FUNDS
All Other
$4,123,579
2025-26
$7,795,745
$7,795,745
2025-26
$760,808
$4,147,671
2026-27
$7,771,653
$7,771,653
2026-27
$760,808
OTHER SPECIAL REVENUE RJNDS TOTAL $760,808 $760,808
HEALTH AND HUMAN SERVICES,
DEPARTMENT OF
DEPARTMENT TOTALS 2025-26 2026-27
GENERAL FUND $4,547,375 $4,573,557
FEDERAL EXPENDITURES FUND $8,472,145 $8,445,963
OTHER SPECIAL REVENUE FUNDS $472,980 $468,863
DEPARTMENT TOTAL - ALL FUNDS $13,492,500 $13,488,383
COMMITTEE AMENDMENT
COMMITTEE AMENDMENT " A/" to H.P. 485, L.D. 743
"h'{
Amend the bill by reletteriag or renumbering any nonconsecutive Part letter or section
number to read consecutively.
SUMMARY
This amendment, which is the minority report of the committee, adds an appropriations
and allocations section. The amendment also updates a section of the bill to reflect changes
made by Public Law 2025, chapter 34.
FISCAL NOTE REQUIRED
(See attached)
Page4-132LR0865(02)
COMMITTEE AMENDMENT
Approved: 03/27/25 1-KL-
LD 743 LR 865(02)
An Act to Increase the Availability and Affordability of Health Care by Eliminating Certificate of
Need Requirements
Fiscal Note for Bill as Amended by Committee Amendment "/-V ()4 -t"
Committee: Health Coverage, Insurance and Financial Services
Fiscal Note Required: Yes
Fiscal Note
Projections Projections
FY 2025-26 FY 2026-27 FY 2027-28 FY 2028-29
$4,547,375 $4,573,557 $4,573,557 $4,573,557
Net Cost (Savings)
General Fund
Appropriations/Allocations
General Fund
Federal Expenditures Fund
Other Special Revenue Funds
Revenue
Federal Expenditures Fund
Other Special Revenue Funds
Fiscal Detail and Notes
The bill includes General Fund appropriations to the Department of Health and Human Services of $4,547,375 in
fiscal year 2025-26 and $4,573,557 in fiscal year 2026-27 due to the elimuiation of the certificate of need process,
Federal Expenditures Fund allocations are also included for the PMAP match and Other Special Revenue Funds
allocations for the Nursing Facility Tax,
$4,547,375
$8,472,145
$472,980
$8,472,145
$634,161
$4,573,557
$8,445,963
$468,863
$8,445,963
$634,161
$4,573,557
$8,445,963
$468,863
$8,445,963
$634,161
$4,573,557
$8,445,963
$468,863
$8,445,963
$634,161
LR0865(02) - Fiscal Note - Page 1 of 1