Conning the Competition

Maine requires CONs within five broad categories—hospital beds, beds outside hospitals, equipment, facilities and services. Maine’s CON program contains 42 independent CON requirements but exempts some commonly regulated services such as home healthcare and hospice. 10-144-503 Me. Code R. § 4-2(C), (D). Maine’s CON requirements allow providers to increase bed capacity without obtaining a CON if the increase is less than 10% of capacity. 10-144-503 Me. Code R. §§ 4-1(B)(5). The CON application fee can cost up to $250,000. 10-144-503 Me. Code R. § 6-8(A)-(D).

COVID-19 Response

On April 10, 2020, the Division of Licensing and Certification issued guidance allowing hospitals and nursing homes to apply for emergency CONs to increase bed capacity in response to the pandemic. Any approvals granted were temporary and expired 60 days after the Governor declared an end to the state of emergency.

Application Process

In Maine, the CON application process takes 90 days from the start of the review. 10-144-503 Me. Code R. § 7-1(B). Applications can be submitted at any time. The application fee is nonrefundable and it ranges from $5,000 to $250,000, calculated at $1,000 per $1 million in proposed capital expenditures. 10-144-503 Me. Code R. §§ 6-8(A)-(D). Competitors can intervene in the application process and offer evidence or argument as to why an application should be denied. 10-144-503 Me. Code R. § 6-6, see also § 7-1(C)(1)-(4). Applications that primarily involve maintenance of an existing healthcare facility may undergo a simplified review process. 10-144-503 Me. Code R. § 7-9.