(a) Except as provided in sections nine, ten and eleven of this article, the following proposed health services may not be acquired, offered or developed within this state except upon approval of and receipt of a certificate of need as provided by this article:
(1) The construction, development, acquisition or other establishment of a health care facility;
(2) The partial or total closure of a health care facility with which a capital expenditure is associated;
(3) (A) An obligation for a capital expenditure incurred by or on behalf of a health care facility, in excess of the expenditure minimum; or
(B) An obligation for a capital expenditure incurred by a person to acquire a health care facility.
(4) An obligation for a capital expenditure is considered to be incurred by or on behalf of a health care facility:
(A) When a valid contract is entered into by or on behalf of the health care facility for the construction, acquisition, lease or financing of a capital asset;
(B) When the health care facility takes formal action to commit its own funds for a construction project undertaken by the health care facility as its own contractor; or
(C) In the case of donated property, on the date on which the gift is completed under state law.
(5) A substantial change to the bed capacity of a health care facility with which a capital expenditure is associated;
(6) The addition of ventilator services by a hospital;
(7) The elimination of health services previously offered on a regular basis by or on behalf of a health care facility which is associated with a capital expenditure;
(8) (A) A substantial change to the bed capacity or health services offered by or on behalf of a health care facility, whether or not the change is associated with a proposed capital expenditure;
(B) If the change is associated with a previous capital expenditure for which a certificate of need was issued; and
(C) If the change will occur within two years after the date the activity which was associated with the previously approved capital expenditure was undertaken.
(9) The acquisition of major medical equipment;
(10) A substantial change in an approved health service for which a certificate of need is in effect;
(11) An expansion of the service area for hospice or home health agency regardless of the time period in which the expansion is contemplated or made; and
(12) The addition of health services offered by or on behalf of a health care facility which were not offered on a regular basis by or on behalf of the health care facility within the twelve- month period prior to the time the services would be offered.
(b) The following health services are required to obtain a certificate of need regardless of the minimum expenditure:
(1) Constructing, developing, acquiring or establishing of a birthing center;
(2) Providing radiation therapy;
(3) Providing computed tomography;
(4) Providing positron emission tomography;
(5) Providing cardiac surgery;
(6) Providing fixed magnetic resonance imaging;
(7) Providing comprehensive medical rehabilitation;
(8) Establishing an ambulatory care center;
(9) Establishing an ambulatory surgical center;
(10) Providing diagnostic imaging;
(11) Providing cardiac catheterization services;
(12) Constructing, developing, acquiring or establishing of kidney disease treatment centers, including freestanding hemodialysis units;
(13) Providing megavoltage radiation therapy;
(14) Providing surgical services;
(15) Establishing operating rooms;
(16) Adding acute care beds;
(17) Providing intellectual developmental disabilities services;
(18) Providing organ and tissue transplants;
(19) Establishing an intermediate care facility for individuals with intellectual disabilities;
(20) Providing inpatient services;
(21) Providing hospice services;
(22) Establishing a home health agency; and
(23) Providing personal care services.
(c) A certificate of need previously approved under this article remains in effect unless revoked by the authority.