2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1 - Health Care Planning and Systems Regulation › Part II - Health Planning and Development › Section 19-126 - Certificate of Need -- Action on Applications

(a)    If the Commission receives an application for a certificate of need for a change in the bed capacity of a health care facility, as required under § 19–120 of this subtitle, or for a health care project that would create a new health care service or abolish an existing health care service, the Commission shall give notice of the filing by publication in the Maryland Register and give the following notice to:
(1)    Each member of the General Assembly in whose district the action is planned;
(2)    Each member of the governing body for the county where the action is planned;
(3)    The county executive, mayor, or chief executive officer, if any, in whose county or city the action is planned; and
(4)    Any health care provider, third party payor, local planning agency, or any other person the Commission knows has an interest in the application.
(b)    Failure to give notice shall not adversely affect the application.
(c)    (1)    All decisions of the Commission on an application for a certificate of need, except in emergency circumstances posing a threat to public health, shall be consistent with the State health plan and the standards for review established by the Commission.
(2)    The mere failure of the State health plan to address any particular project or health care service shall not alone be deemed to render the project inconsistent with the State health plan.
(3)    Unless the Commission finds that the facility or service for which the proposed expenditure is to be made is not needed or is not consistent with the State health plan, the Commission shall approve an application for a certificate of need required under § 19–120(k) of this subtitle to the extent that the expenditure is to be made to:
(i)    Eliminate or prevent an imminent safety hazard, as defined by federal, State, or local fire, building, or life safety codes or regulations;
(ii)    Comply with State licensing standards; or
(iii)    Comply with accreditation standards for reimbursement under Title XVIII of the Social Security Act or under the State Medical Assistance Program approved under Title XIX of the Social Security Act.
(d)    (1)    The Commission alone shall have final nondelegable authority to act upon an application for a certificate of need, except as provided in this subsection.
(2)    A majority of the full authorized membership of the Commission shall be a quorum to act on an application for a certificate of need.
(3)    After an application is filed, the staff of the Commission:
(i)    Shall review the application for completeness within 10 working days of the filing of the application; and
(ii)    May request further information from the applicant.
(4)    The Commission may delegate to a reviewer the responsibility for review of an application for a certificate of need, including:
(i)    The holding of an evidentiary hearing if the Commission, in accordance with criteria it has adopted by regulation, considers an evidentiary hearing appropriate due to the magnitude of the impact the proposed project may have on the health care delivery system; and
(ii)    Preparation of a recommended decision for consideration by the full Commission.
(5)    The Commission shall designate a single Commissioner to act as a reviewer for the application and any competing applications.
(6)    The Commission shall delegate to its staff the responsibility for an initial review of an application, including, in the event that no written comments on an application are submitted by any interested party other than the staff of the Commission, the preparation of a recommended decision for consideration by the full Commission.
(7)    Any “interested party” may submit written comments on the application in accordance with procedural regulations adopted by the Commission.
(8)    The Commission shall define the term “interested party” to include, at a minimum:
(i)    The staff of the Commission;
(ii)    Any applicant who has submitted a competing application;
(iii)    Any other person who can demonstrate that the person would be adversely affected by the decision of the Commission on the application;
(iv)    A local health planning agency for a jurisdiction or region in which the proposed facility or service will be located; and
(v)    In the review of a replacement acute general hospital project proposed by or on behalf of a regional health system that serves multiple contiguous jurisdictions, a jurisdiction within the region served by the regional health system that does not contain the proposed replacement acute general hospital project.
(9)    The reviewer shall review the application, any written comments on the application, and any other materials permitted by this section or by the Commission’s regulations, and present a recommended decision on the application to the full Commission.
(10)    (i)    An applicant and any interested party may request the opportunity to present oral argument to the reviewer, in accordance with regulations adopted by the Commission, before the reviewer prepares a recommended decision on the application for consideration by the full Commission.
(ii)    The reviewer may grant, deny, or impose limitations on an interested party’s request to present oral argument to the reviewer.
(11)    Any interested party who has submitted written comments under paragraph (7) of this subsection may submit written exceptions to the proposed decision and make oral argument to the Commission, in accordance with regulations adopted by the Commission, before the Commission takes final action on the application.
(12)    The Commission shall, after determining that the recommended decision is complete, vote to approve, approve with conditions, or deny the application on the basis of the recommended decision, the record before the staff or the reviewer, and exceptions and arguments, if any, before the Commission.
(13)    The decision of the Commission shall be by a majority of the quorum present and voting.
(e)    Where the State health plan identifies a need for additional hospital bed capacity in a region or subregion, in a comparative review of 2 or more applicants for hospital bed expansion projects, a certificate of need shall be granted to 1 or more applicants in that region or subregion that:
(1)    Have satisfactorily met all applicable standards;
(2)    (i)    Have within the preceding 10 years voluntarily delicensed the greater of 10 beds or 10 percent of total licensed bed capacity to the extent of the beds that are voluntarily delicensed; or
(ii)    Have been previously granted a certificate of need which was not recertified by the Commission within the preceding 10 years; and
(3)    The Commission finds at least comparable to all other applicants.
(f)    (1)    If any party or interested person requests an evidentiary hearing with respect to a certificate of need application for any health care facility other than an ambulatory surgical facility and the Commission, in accordance with criteria it has adopted by regulation, considers an evidentiary hearing appropriate due to the magnitude of the impact that the proposed project may have on the health care delivery system, the Commission or a committee of the Commission shall hold the hearing in accordance with the contested case procedures of the Administrative Procedure Act.
(2)    Except as provided in this section or in regulations adopted by the Commission to implement the provisions of this section, the review of an application for a certificate of need for an ambulatory surgical facility is not subject to the contested case procedures of Title 10, Subtitle 2 of the State Government Article.
(g)    (1)    An application for a certificate of need shall be acted upon by the Commission no later than 150 days after the application was docketed.
(2)    If an evidentiary hearing is not requested, the Commission’s decision on an application shall be made no later than 90 days after the application was docketed.
(h)    (1)    The applicant or any aggrieved party, as defined in § 19–128(a) of this subtitle, may petition the Commission within 15 days for a reconsideration.
(2)    The Commission shall decide whether or not it will reconsider its decision within 30 days of receipt of the petition for reconsideration.
(3)    The Commission shall issue its reconsideration decision within 30 days of its decision on the petition.
(i)    (1)    Except as provided in paragraph (2) of this subsection, if the Commission does not act on an application within the required period, the applicant may file with a court of competent jurisdiction within 60 days after expiration of the period a petition to require the Commission to act on the application.
(2)    (i)    This paragraph does not apply to an application for a certificate of need involving:
1.    The establishment of a health care facility;
2.    The relocation of a health care facility; or
3.    The introduction by a hospital of cardiac surgery or organ transplantation.
(ii)    A certificate of need filed after October 1, 2019, shall be deemed approved if:
1.    The certificate of need is uncontested; and
2.    Final action by the Commission does not occur within 120 days after the application for the certificate of need was docketed.