An Act To Amend the Laws Governing the Rural Medical Access Program
Maine Legislature, Session 122, LD 1472
Committee: Insurance and Financial Services
Sponsors: MARRACI-IE, MAYO, MILLETT, PERRY
Amends: 24-A MRSA §6303, 24-A MRSA §6304, 24-A MRSA §630, 24-A MRSA §6306

Legislative Document 
No. 1472 
H.P.1035 
House of Representatives, March 24, 2005 
An Act To Amend the Laws Governing the Rural Medical Access 
Program 
Submitted by the Department of Professional and Financial Regulation pursuant to Joint 
Rule 204. 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative MARRACI-IE of Waterville. 
Cosponsored by Senator MAYO of Sagadahoc and 
7l/~ 
1J7.11!dC~ 
MILLICENT M. MacFARLAND 
Clerk 
Representati ves: BRAUTIGAM of Fal mouth, MILLETT of Waterford, PERRY of Calais. 
Printed nn recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec.!. 24-A MRSA §6303. sub-§3, as enacted by PL 1989, c. 
931, §5, is amended to read: 
3. 
Self-insured. 
"Self -insured" 
means 
any 
physician, 
hospital 
or 
physician's 
employer 
insured 
against 
the 
physician's 
professional 
negligence 
or 
the 
hospital's 
professional liability through any entity other than an insurer 
as de fin e din sub sec t ion 1 . 
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......... i "'-s--'c""h 
........ 
a.&;ep:..>,t."e'-"'r'-','---"'a 
physician, 
hospital 
or 
physician's 
employer 
that 
does 
not 
purchase insurance is considered self-insured. 
Sec. 2. 24-A MRSA §6304, first 1[, as enacted by PL 1989, c. 
931, §5, is amended to read: 
To 
provide 
funds 
for 
the 
Rural 
Medical 
Access 
Program, 
insurers may collect pursuant to this chapter assessments from 
physiciansT licensed and practicing medicine in this State and 
hospitals and physician's employers located in the State. 
Sec. 3. 24-A MRSA §6304, sub-§4, as 
600, Pt. 
B, 
§§21 and 22 
and PL 
2003, 
further amended to read: 
amended 
c. 
689, 
by PL 
Pta 
B, 
1993, 
§6, 
c. 
is 
4. 
Determination of assessments paid. 
After review of the 
records provided by the Board of Licensure in Medicine, the Board 
of Osteopathic Licensure and the Department of Health and Human 
Services, 
Division 
of 
Licensure 
and 
Certification, 
and 
the 
assessment 
receipts 
of 
the 
malpractice 
insurers, 
the 
superintendent 
shall 
eeF~i~y 
determine 
those 
physicians, 
hospi tals and pRysieiaHs.!.. physician's employers that have paid 
the required assessments. 
Sec. 4. 24-A MRSA §630S, sub-§ I. 1[C, as enac ted by PL 1989, c. 
931, §5, is amended to read: 
C. 
The amount of the assessment for 
on or after July 1, 
1991T is 50°" 
savings determined under 
paragraph 
$500,000. 
This paragraph is repealed 
policy years beginning 
of the amount of the 
A, 
but not exceeding 
June 30, 2006. 
Sec. S. 24-A MRSA §630S, sub-§I, 1[D, as enacted by PL 1989, c. 
931, §5; ~ 
repealed. 
Sec. 6. 24-A 'MRSA §630S, sub-§2, as amended by PL 1999, c. 
668, §113, is repeal~ 
Sec. 7. 24-A MRSA §630S, sub-§3 is enacted to read: 
3. 
Assessment rates; program fund balance. 
For assessment 
years prior to July 1, 2006, the assessment is 1. 25
Q
" of premium. 
For 
assessment years 
commencing July 1, 
2006 
and after, 
the 
assessment is .75
% 
of premium unless adjusted pursuant to this 
subsection. 
The 
assessment 
rate 
is 
intended 
to 
result 
in 
collections no greater than $500,000 per assessment year. 
When 
the program fund balance is $50,000 or less, the assessment rate 
must increase to 1% of premium. 
When the program fund balance is 
more than $50,000, the assessment rate must decrease to .75
% 
of 
premium. 
The superintendent shall notify affected parties of any 
assessment 
rate 
adjustment 
and 
the 
effective 
date 
of 
that 
adjustment. 
The 
program 
fund 
balance 
may 
be 
used to 
pay assistance 
to 
qualified eligible physicians in prior years for which there were 
insufficient 
funds. 
If all 
prior 
years' 
eligible qualified 
physicians have received assistance, 
any excess funds must be 
carr ied forward to subsequent plan years as part of the program 
fund 
balance. 
Excess 
funds 
must 
be 
applied 
first 
to 
the 
assessment 
year 
commencing 
July 
1, 
1998 
and 
then 
to 
each 
successive assessment year. 
For the purposes of this section, "program fund balance" means 
the total funds collected in excess of assistance paid for all 
years. 
Sec. S. 24-A MRSA §6306. as enacted by PL 1989, c. 931, §5, 
is amended to read: 
§6306. Funds held by insurers 
Insurers may shall invest assessments collected subject to 
chapter 13. 
Interest earned on investments must be credited to 
the Rural Medical Access Program. 
734, 
read: 
Sec. 9. 24-A MRSA §630S, sub-§2, 
§5 and PL 2003, c. 689, Pt. B, 
as amended by PL 1991, c. 
§7, is further amended to 
2. 
Determination of participants 
in the 
program. 
The 
superintendent 
shall 
apply 
the 
standards 
of 
prioritization 
adopted by the Commissioner of Health and Human 
Services 
to 
determine the physicians who are eligible for the program. 
The 
funding available for each qualified physician is the 
amount 
equal 
to 
the 
difference 
between 
the 
physician's 
medical 
malpractice insurance premiums with obstetrical care coverage and 
the 
physician's 
premiums 
without 
obstetrical 
care 
coverage; 
however, the 
funding must be at least $5,000 but may not be more 
than 
$lQTQQQ 
$15,000 
as 
determined 
by 
the 
superintendent. 
Program payments must be made to the individual or entity paying 
the medical malpractice premium for the qualified physician. 
SUMMARY 
This 
bill 
clarifies 
physician's 
employer 
that 
considered self-insured for 
Access Program. 
that 
a 
physician, 
does 
not 
purchase 
the purposes of the 
hospital 
or 
insurance 
is 
Rural Medical 
The 
bill limits 
assessments 
to 
physicians 
licensed 
and 
practicing medicine in this State and removes the requirement 
that the Superintendent of Insurance certify that all physicians, 
hospitals and physician's employers have paid the assessment. 
The 
bill 
removes 
a 
provision 
that 
the 
assessment 
be 
distributed on a prorated basis. 
The assessment is made as a 
percentage of premium. 
The maximum assessment rate of 1.25°" is 
the current rate. 
That rate will be reduced to .75°" effective 
July 1, 2006. 
The assessment rate will be adjusted automatically 
based upon the level of excess funds that have accumulated. 
The 
bill also provides that the program fund balance may be used to 
pay assistance to qualified eligible physicians in prior years 
for which there were insufficient funds. 
If all prior years' 
eligible 
qualified 
physicians 
have 
received 
assistance, 
any 
excess funds must be carried forward to subsequent plan years as 
part of the program fund balance. 
The bill requires, rather than permits, an insurer to invest 
collected assessments. 
The bill increases the maximum assistance level to $15,000 
from $10,000.