hospital rates of more than $1,500,000 for the capital costs associated with the project
as determined by the Commission, after consultation with the Health Services Cost
Review Commission;

3. At least 45 days before the proposed expenditure is made,
the hospital notifies the Commission and within 45 day's of receipt of the relevant
financial information, the Commission makes the financial determination required
under item 2 of this subparagraph; and

4. The relevant financial information to be submitted by the
hospital is defined in regulations promulgated by the Commission, after consultation
with the Health Services Cost Review Commission; or

(ix) A plant donated to a hospital as defined in § 19-301 of this title,
which does not require a cumulative increase in patient charges or hospital rates of
more than $1,500,000 for capital costs associated with the donated plant as
determined by the Commission, after consultation with the Health Services Cost
Review Commission that:

1. At least 45 days before the proposed donation is made, the
hospital notifies the Commission and within 45 days of receipt of the relevant
financial information, the Commission makes the financial determination required
under this subparagraph; and

2. The relevant financial information to be submitted by the
hospital is defined in regulations promulgated by the Commission after consultation
with the Health Services Cost Review Commission.

(6) Paragraph (5)(vi), (vii), (viii), and (ix) of this subsection may not be
construed to permit a facility to offer a new health care service for which a certificate
of need is otherwise required.

(7) Subject to the notice requirements of paragraph (5)(ii) of this
subsection, a hospital may acquire a freestanding ambulatory surgical facility or
office of one or more health care practitioners or a group practice with one or more
operating rooms used primarily for the purpose of providing ambulatory surgical
services if the facility, office, or group practice:

(i) Has obtained a certificate of need;

(ii) Has obtained an exemption from certificate of need
requirements; or

(iii) Did not require a certificate of need in order to provide
ambulatory surgical services after June 1, 1995.

(8) Nothing in this subsection may be construed to permit a hospital to
build or expand its ambulatory surgical capacity in any setting owned or controlled by
the hospital without obtaining a certificate of need from the Commission if the
building or expansion would increase the surgical capacity of the State's health care
system.