Si una organización para el mantenimiento de la salud o una facilidad de salud controlada directa o indirectamente por ésta, solicita un certificado de necesidad y conveniencia, el Secretario deberá aprobarlo si la transacción contemplada es indispensable para cubrir las necesidades de la matrícula actual y potencial de la misma y si la organización para el mantenimiento de la salud no puede proveer a través de sus facilidades, sus servicios de salud a un costo razonable consistente con la manera de operar de la organización por largos períodos de tiempo y con médicos y profesionales de la salud asociados con la facilidad sin llevar a cabo la transacción contemplada.
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