An Act To Amend the Patient's Bill of Rights Laws
Maine Legislature, Session 121, LD 0434
Committee: Insurance and Financial Services
Sponsors: LaFOUNTAIN, O'NEIL, MAYO, GLYNN, PERRY
Amends: 24-A MRSA §4301-A

Legislative Document 
No. 434 
S.P. 152 
In Senate, February 4, 2003 
An Act To Amend the Patient's Bill of Rights Laws 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Senator LaFOUNTAIN of York. 
Cosponsored by Representative O'NEIL of Saco and 
JOY J. O'BRIEN 
Secretary of the Senate 
Senator: MAYO of Sagadahoc, Representatives: GLYNN of South Portland, PERRY of 
Bangor. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. I. 24-A MRSA §4301-A, sub-§§15-A and 16-A are enacted to 
read: 
IS-A. 
Price list. 
"Price list" means 
a 
document 
that 
describes each service offered by a provider or the provider's 
employer and that for each such service states: 
A. 
The price charged by the provider or the provider's 
employer: 
B. 
The 
lowest 
reimbursement 
from 
a 
nonpublic 
source 
applicable as of January It 2004 to which the provider or 
the provider's employer has agreed: and 
C. 
The lowest reimbursement from a nonpublic source that 
the provider or the provider's employer has accepted within 
the preceding 90 days. 
16-A. 
Reimbursement. 
"Reimbursement" 
means 
the 
total 
financial payment to a provider for a specific service accepted 
or agreed to, 
including any payments made or to be made 
to 
fulfill a copayment or deductible requirement or any other form 
of financial payment by the patient. 
Sec. 2. 24-A MRSA §§4306-A. 4306-B and 4306-C are enacted to 
read: 
§4306-A. 
Price list required 
Effective January It 2004, 
each provider shall publish a 
price list. 
The price list must be published in a format that 
allows a person with a 6th grade reading level, as determined by 
a recognized instrument for measuring adult literacy levels, to 
understand the nature and purpose of each service or variation 
thereof. 
The price list must be made available to patients or 
customers at the initial visit to a provider and at any other 
time 
upon 
request. 
The 
price list must 
be 
published on 
a 
publicly accessible site on the Internet maintained by a provider 
or the provider's employer. 
The price list must be updated and 
published every 6 months. 
§4306-B. 
Price information for hospital stay 
1. 
Required. 
Effective January 1, 
2004, 
each hospital 
shall include in its price list information set forth in section 
4301-A, 
subsection 15 for all charges from that hospital that 
arose, 
from 
admission 
through 
discharge, 
for 
an 
admission 
scheduled for the 3 most frequently occurring variations under 
the International Classification of Diseases, 
Ninth Revision, 
Page l-LR0969(1) 
within the preceding calendar year for each of the following 
diagnostic related groupings: 
A. 
Coronary artery bypass; 
B. 
Coronary angioplasty; 
C. 
Abdominal aortic aneurysm; 
D. 
Carotid endarterectomy; 
E. 
Esophageal cancer surgery; 
F. 
Uterine 
and 
adnexa 
procedure 
for 
nonmalignancy 
(hysterectomy); 
G. 
Caesarean section; 
H. 
Major joint and limb reattachment of lower extremity 
(knee and hip replacement); 
I. 
Major small and large bowel procedures (surgery of the 
colon, small and large intestines); 
J. 
Appendectomy 
without 
complicated principal 
diagnosis 
(appendectomy, without peritonitis); 
K. 
Spinal fusion (spine surgery with fusion); 
L. 
Laparoscopic 
cholecystectomy 
without 
common 
duct 
exploration (laparoscopic gall bladder surgery); 
M. 
Back and neck procedures except spinal fusion (spine 
surgery without fusion); 
N. 
Lower extremity and humerus procedure except hip, foot 
or 
femur 
(surgery of 
arms 
and legs, 
excluding hips 
and 
knees); 
o. 
Stomach, 
esophageal 
and duodenal 
procedures 
(stomach 
surgery); 
P. 
Female 
reproductive 
system 
reconstructive 
procedures 
(reproductive reconstructive procedures); 
O. 
Appendectomy 
with 
complicated 
principal 
diagnosis 
(appendectomy with peritonitis); 
R. 
Major male pelvic procedures (prostatectomy); 
S. 
Major chest procedures (lung surgery); and 
T. 
Craniotomy except for trauma (brain surgery) 
§4306-C. 
Statement of price: required 
With the exception of emergency services, upon request of 
the patient or of someone requesting on behalf of the patient, a 
provider shall state the price of the service expected to be 
provided to the patient. 
If the price stated is different from 
the lowest price stated in the price list for that service, the 
provider shall explain why the lowest price is not available to 
the patient. 
Sec. 3. 24-A MRSA §§4315 to 4317 are enacted to read: 
§4315. 
Right of action and damages 
The State may bring a civil action in District Court or 
Superior Court for direct or indirect injury to any person, group 
of persons, the State or a political subdivision of the State 
caused by a violation of section 4306-A or 4306-B. 
If the State 
prevails, the defendant shall pay 3 times the amount of damages 
and the costs of the suit, including necessary and reasonable 
investigative 
costs, 
reasonable 
expert 
fees 
and 
reasonable 
attorney's fees. 
Punitive damages may be awarded for a willful 
violation of either of these sections. 
After deduction of the 
costs of distribution, the damages must be equitably distributed 
by the State to all injured parties. 
§4316. 
Civil violation 
Each violation of 
section 
4306-A or 
4306-B 
is 
a 
civil 
violation for which the Attorney General may obtain, in addition 
to other remedies, injunctive relief and a civil penalty in an 
amount not to exceed $10,000, plus the costs of suit. including 
necessary and reasonable investigative costs, reasonable expert 
fees and reasonable attorney's fees. 
§4311. 
Unfair trade practice 
In addition to 
a civil violation under section 4-316, 
a 
violation of section 4306-A or 4306-B is also a violation of the 
Maine Unfair Trade Practices Act. 
SUMMARY 
This 
bill 
requires 
that 
detailed information about the 
services. 
health 
care 
providers 
publish 
prices charged for health care