3266

LAWS OF MARYLAND

Ch. 681

(b)  The Commission may set an application fee for a
certificate of need for facilities not assessed a user fee under
Section 19-121.

(c)  The Commission shall adopt rules and regulations for
applying for and issuing certificates of need.

(d)  The Commission may adopt, after October 1, 1983, new
thresholds or methods for determining the circumstances or
minimum cost requirements under which a certificate of need
application must be filed. The Commission shall study
alternative approaches and recommend alternatives that will
streamline the current process, and provide incentives for
management flexibility through the reduction of instances in
which applicants must file for a certificate of need.

(e)  A person shall have a certificate of need   issued by the
Commission before the person develops, operates, or     participates
in any of the following health care projects     for which a
certificate of need is required under this section.

(f)  A certificate of need is required before a new health
care facility is built, developed, or established.

(g)  (1) A certificate of need is required before a health
care facility is moved to another site.

(2) This subsection does not apply if the Commission
adopts limits for relocations and the proposed relocation does
not exceed those limits.

(h) (1) A certificate of need is required before the bed
capacity of a health care facility is changed.

(2) This subsection does not apply to any increase or
decrease in bed capacity if, during a 2 year period, the increase
or decrease would not exceed the lesser of 10 percent of the
total bed capacity or 10 beds.

(i) A certificate of need is required before the number of
kidney dialysis stations of a health care facility is changed.

(j) (1) A certificate of need is required before the type
or scope of any health care service is changed if the health care
service is offered:

(i) By a health care facility;

(ii) In space that is leased from a health care
facility; or

(iii) In space that is on land leased from a
health care facility.