PROVIDENCE – Nearly two years after first announcing their plan to merge, the Lifespan and Care New England health systems have filed a nearly 110,000-page application with the R.I. Department of Health and the state attorney general they hope will make the plan a reality.

The two nonprofit companies, which operate seven hospitals along with affiliated research, clinical and educational programs, had applied to merge once before, but that application lapsed, never having been deemed complete due to disagreements with state officials over the extent of the information that would have to be disclosed.

Since then, a smaller merger, between St. Joseph Health Services and Roger Williams Medical Center, has been proposed, and that application has been accepted and is now under review, the first to go through the process outlined by the state Hospital Conversions Act.

In a news release, leaders of both Lifespan and Care New England said their own merger plan, which envisions the creation of a major academic medical center in Providence, along with enhanced clinical and research capabilities across the board, is as valuable as ever.

“The benefits of a combined health care system are even more compelling today, given the significant change in the economic environment since we first announced our intent to affiliate,” said George A. Vecchione, president and CEO of Lifespan. “In fact, our ability to continue to offer high quality, cost-effective care; provide and enhance good jobs, and maintain a stable health system is more important than ever to help Rhode Island’s economy move into recovery and growth.”

“Rhode Islanders want and deserve high-quality care, which will only remain in the state if we are able to compete with hospitals in Boston that have expanded their reach into Rhode Island,” said John J. Hynes, president and CEO of Care New England. “Our first commitment is to ensure that the affiliation moves forward in a way that improves health care in our state so that patients stay in Rhode Island for care, and that enhances our ability to continue to attract federal research dollars into Rhode Island in an even more competitive environment.”

The merger would also help both systems and their member hospitals withstand the “challenging financial environment” and anticipated changes to come with health care reform, both sides said, by putting them on a “stronger financial footing.”

The plan has already been cleared by the Federal Trade Commission, which had also approved the previous application, focusing on potential anti-trust issues.

As outlined in the Hospital Conversions Act, the next step in this process will be for the attorney general and the Department of Health to review the application and determine, within 30 calendar days, whether it is complete.

If there are questions, Lifespan and Care New England have 30 business days to respond, and then state officials would have 10 business days to determine if the application is complete. If the application is accepted, the attorney general has up to 30 more business days to rule on any confidentiality issues. Within 180 days, the state has to hold public hearings and make a determination on the merger plan.

Lifespan is a nonprofit health care system that includes The Miriam, Bradley, Newport and Rhode Island/Hasbro Children’s hospitals. Additional information is available at Lifespan.org.

Based in Providence, Care New England is a nonprofit health care system offering a continuum of care, with Women & Infants and Butler hospitals affiliated with The Warren Alpert Medical School of Brown University, Kent Hospital (a community hospital), as well as a visiting nurse and home care/hospice agency, and a wellness center. For more information, go to CareNewEngland.org.