Certificate of Need (CON) Overview

Like many other states, Maryland has an extensive CON process in place for healthcare services and facilities. Winning approval for a CON application is often a time consuming and difficult undertaking. Working with RPC provides clients with a team of consultants with experience working with CON projects.

When working on a CON project, RPC can prepare the entire CON application or sections of the application as the client prefers. When the client is defining the project and deciding whether to file an application, RPC can help assess the market and regulatory situation to determine the relative likelihood of success for a project. RPC not only works to create a thorough market, need and financial analysis, but also works seamlessly with the client’s staff, architects, engineers and, other outside consultants to create a solid CON application.

RPC is led by Ron Luke, JD, PhD, who has prepared CON applications and presented testimony in CON hearings since 1981 in more than 20 states.  RPC’s work on CON projects includes the opening of new acute care hospitals, hospices, physical rehabilitation and psychiatric specialty hospitals, and nursing homes, the relocation and addition of beds, and the acquisition of major medical equipment. Working with RPC during the CON process gives the applicant the advantage of a skilled expert team that can provide expert advice and produce an effective CON application.

State Agencies

Maryland Health Care Commission
Maryland Health Care Commission “MHCC” is responsible for administering the CON program in Maryland. MHCC reviews CON applications and grants or denies CONs.

Maryland Department of Health

Maryland Health Care Commission
4160 Patterson Avenue, Baltimore, MD 21215

1 (877) 245-1762.

Services that Require CON

Maryland’s CON program is designed to ensure services and facilities are only developed if need is determined. It is also designed to ensure all CON applications prove to be cost-effective, high quality, geographically/financially accessible, financially viable, and will not have a significant negative impact of costs, quality and viability of existing health facilities and services. The following facilities and services require a CON:

  • Hospitals
  • Limited service hospitals
  • Related institutions
  • Ambulatory surgical facilities
  • Rehabilitation facilities
  • Home health agencies
  • Hospices
  • Other health institutions, services or programs that may be specified as requiring a CON

What criteria are used to review a CON?

Maryland requires six criteria to be considered by MHCC when reviewing all CON applications:

  1. Evaluation of project with State Health Plan standards, policies and criteria.
  2. Application of applicable State Health Plan need If no analysis is applicable, the applicant must demonstrate unmet need in the population to be served and how the proposed project will meet the need.
  3. Comparison of availability of more cost effectiveness alternatives through either an existing facility(s) or through a competitive application as part of a competitive review.
  4. Viability of the Proposal through means of financial and nonfinancial resources (e.g. community support) must be available for the project to be completed within the required time frames, as well as resources necessary for the project’s sustainability.
  5. Applicant must demonstrate compliance with all previous CON conditions and commitments. If conditions or commitment are not met, written notice with an explanation must be provided to MHCC.
  6. Information and analysis on the impact of the proposed project on existing health care providers, including geographic and demographic access to service, occupancy, costs and charges of other provider and cost to health care delivery must be provided.

 

Additional Sources

(links good as of December 2019)

Maryland Health Care Commission https://mhcc.maryland.gov/mhcc/default.aspx

CON Regulations (COMAR 10.24.01) http://www.dsd.state.md.us/comar/SubtitleSearch.aspx?search=10.24.01.*

State Health Plan https://mhcc.maryland.gov/mhcc/pages/hcfs/hcfs_shp/hcfs_shp.aspx

Criteria and Standards for Certificate of Need
https://mhcc.maryland.gov/mhcc/pages/hcfs/hcfs_con/hcfs_con_overview.aspx

CON Application Forms
http://mhcc.maryland.gov/mhcc/Pages/hcfs/hcfs_con/hcfs_con_applications.aspx

Contact RPC Consulting
Should you or your client need an expert team to help you with the
Maryland Certificate of Need Process (CON)
please contact Dr. Ron Luke at 512-371-8166.

Disclaimer: The information on this page has been compiled by RPC in June 2010 based on sources believed to be reliable. It was updated in December 2019. Where possible we have had the material reviewed by state CON officials or others knowledgeable of the state’s CON program. The information is not offered as legal advice. A state may change its rules, forms and procedures at any time and RPC offers no assurance that the information will be correct on the date it is viewed. Therefore, the reader is urged to use this information only as a starting point for any CON application and to speak with state officials or seek legal or consulting advice early in the process.