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| 4. Standards for certification. The department shall issue a | certificate of public advantage for a cooperative agreement if it | determines the reviewing agencies determine that the applicants | have demonstrated by clear and convincing evidence that the likely | benefits resulting from the agreement outweigh any disadvantages | attributable to a reduction in competition that may result from the | agreement. |
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| A. In evaluating the potential benefits of a cooperative | agreement, the department reviewing agencies shall consider | whether one or more of the following benefits may result | from the cooperative agreement: |
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| (1) Enhancement of the quality of hospital or | nonprofit mental health care, mental health care or | related care provided to Maine citizens; |
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| (2) Preservation of hospital or nonprofit mental | health care provider and related facilities in | geographical proximity to the communities traditionally | served by those facilities; |
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| (3) Gains Lower costs and gains in the cost efficiency | of services provided by the hospitals or nonprofit | mental health care providers involved; |
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| (4) Improvements in the utilization of hospital or | nonprofit mental health care provider resources and | equipment; |
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| (5) Avoidance of duplication of hospital or nonprofit | mental health care resources; and |
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| (6) Continuation or establishment of needed | educational programs for health care professionals and | providers. |
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| In any certificate for a merger issued under this chapter, | the department reviewing agencies shall make specific | findings as to the nature and extent of any likely benefit | found under this paragraph. |
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| B. The department's reviewing agencies' evaluation of any | disadvantages attributable to any reduction in competition | likely to result from the agreement may include, but need | not be limited to, the following factors: |
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| (1) The extent of any likely adverse impact on the ability of | health maintenance organizations, preferred |
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