(1) Regardless of what is written in the existing law, the university and the council cannot give affiliation to any educational institution for matters that are not their own program.
(2) Regardless of what is written in sub-section (1), the relevant university may, on the recommendation of the Commission, give affiliation to educational institutions with the necessary academic and physical infrastructure and managerial capacity to conduct new educational programs that are not being conducted in Nepal.
(3) The university cannot give affiliation to more than one medical or dental teaching institution in one district.
(4) Notwithstanding anything written in sub-section (3), there shall be no obstacle to affiliation of more than one medical or dental educational institution in the district as deemed appropriate by the Commission in view of the population, available educational institutions, geographical features, access of citizens to health services and social justice.
(5) Notwithstanding anything contained in sub-sections (2) and (3), the University shall not grant affiliation to an educational institution in the following cases:-
(a) Not fulfilling the conditions mentioned in the letter of intent taken in accordance with the prevailing law,
(b) Has not fully operated his own hospital for three years after taking approval in accordance with the prevailing law regarding hospital operation. (c)     not fulfilling the criteria prescribed by the Commission,
(D) Failure to fulfill other conditions or criteria to be fulfilled according to the prevailing law.
(6) Notwithstanding anything contained elsewhere in this Act, a University shall not, after the promulgation of this Act, grant affiliation to more than five educational institutions. However, this provision will not apply to educational institutions outside the Kathmandu Valley, which have given their affiliation before the promulgation of this Act and have met the criteria by taking letters of intent. In the case of other educational institutions outside the Kathmandu valley, if the commission decides, it will be wamojim. Nothing in this Act shall prejudice the decision of the Commission.