MD HB944

Repeals the certificate of need exemption for hospital mergers, requiring mergers to now undergo the same regulatory review as other health care facility changes

Requires health care entities with at least $10 million in assets or annual revenues to provide 90-day advance notice to the Maryland Health Care Commission and the public before completing material change transactions, including mergers, acquisitions, affiliations, or sales

Establishes a public interest review process where the Executive Director has 30 days to determine if a transaction requires review, based on factors such as market power (defined as 30% or more market share), impact on competition, and effects on cost, quality, equity, or access to care

Authorizes the Executive Director to approve, approve with conditions, or deny transactions within 60 days of initiating a public interest review, with decisions appealable to the full Commission and then to circuit court

Empowers the Commission to impose civil penalties up to 1% of the transaction value for violations, monitor compliance with conditions placed on approved transactions, and adopt regulations including fees to cover administrative costs