Maine Certificate of Need Requirements: Facility Guide
Certificate of Need (CON) programs mandate that certain healthcare providers and projects gain approval before making significant changes to the broader healthcare system. While some states have this regulatory mechanism in place, others don’t. In Maine, certificate of need approval is required before opening new healthcare facilities or merging existing facilities, among other endeavors.
The Maine CON program has a wide scope compared to CON programs in other states, and the application process may involve significant fees. If you’re looking into the process, this guide can help you determine whether you’ll need to obtain a CON, understand the key laws, and — if you need to move forward — organize your application efforts.
Maine Certificate of Need Laws at a Glance
Unlike nearby Vermont, which scaled back CON requirements in 2025, Maine’s healthcare oversight program remains expansive. Changes that would extend the scope of the program continue to be proposed and debated making this an important area of healthcare law for facilities to monitor.
In Maine, as in other states, the purpose of the CON program is multifaceted. It involves preventing excessive duplication of health services and protecting health equity for the state’s residents. Let’s take a closer look at the key provisions and takeaways of the program.
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Legal Authorities |
Maine Revised Statutes Annotated, Title 22, Chapter 103-A: Code of Maine Rules:
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Covered Entities, Services, or Actions |
Under Maine’s certificate of need laws, regulations apply to some actions undertaken by healthcare facilities, which can include:
CON regulations apply when healthcare facilities engage in specific activities, such as:
Some provider offices are excluded from the definition of healthcare facilities, and therefore fall outside the scope of CON regulations, such as offices of private healthcare practitioners (individual or group practices). CON requirements also don’t apply to certain types of facilities, such as:
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Establishment of Need |
Reviewers evaluate CON applications based on multiple factors, such as whether the proposal supports the provision of high-quality health services in a way that promotes cost-effective care and health equity. Reviewers may conduct an analysis of:
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Duration of Process |
For the expanded review process, a decision will be made within 90 days of the date that the application was certified as complete. For the simplified review process, a decision will be made within 60 days of the date of certified application completion. A 30-day extension period may apply. |
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Enforcement Agency |
Department of Health and Human Services (DHHS): Division of Licensing and Certification |
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Fees |
The fee for applying for a certificate of need in Maine depends on the facility type involved. For CON applications related to healthcare facilities other than nursing homes, the fee is $1,000 per $1,000,000 of the proposed capital expenditure, with a minimum fee of $5,000 and a maximum of $250,000. For CON applications related to nursing homes, the fee is $1,000 per $1,000,000 of the proposed capital expenditure or the third year operating costs (whichever is higher), with a minimum of $1,000. |
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Application Forms |
The application and review process involves a letter of intent to the DHHS, a meeting with program staff, and submission of completed application forms. |
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Penalties |
Entities or providers that are found to be in violation of Maine’s CON regulations may face monetary fines, revocation of a CON, and other potential penalties. |
A Brief History of Maine’s CON Laws
Maine’s CON program was initiated in 1978 in response to the National Health Planning and Resources Development Act of 1974 (NHPRDA). Under NHPRDA, states without CON programs were potentially in a position to lose federal funding. Maine, like all other states, developed a CON program (in part) to keep federal funding secure.
NHPRDA was repealed in 1986, leading many certificate of need states to retire or scale back their programs. Maine was not among them. Maine’s original CON laws were replaced more than two decades later, with the Maine Certificate of Need Act of 2002, which ushered in organizational changes and strengthened the program.
Considerations When Pursuing a Certificate of Need in Maine
Because Maine’s CON program is extensive, it’s important to be prepared for the process. Having sufficient data on hand may help you successfully navigate the different phases. A public hearing or public informational meeting may be requested during the review period, for example. Members of the public (or competing providers) will have a chance to ask you questions about your project. Your ability to present evidence to support your proposal will be important.
Looking through previous reviews, including the briefing memos, is one way to prepare for the types of public comments that may come up and need to be addressed.
Get the Information You Need for Your Facility’s Growth
Pursuing your Maine certificate of need is a critical step in your efforts to start or expand your healthcare services, but we know that there are many more items on your to-do list. We’re here to support you and save you some valuable time with our expert-backed, trusted healthcare guides and resources.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.