An Act To Support Medical Practice Protocols in Patient Care
Maine Legislature, Session 123, LD 0996
Committee: Health and Human Services
Sponsors: PERRY
Amends: 24-A MRSA §2762, 24-A MRSA §2847-M, 24-A MRSA §4253

Legislative Document 
~o.9% 
S.P.313 
March 2, 2007 
An Act To Support Medical Practice Protocols in Patient Care 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Senator PERRY of Penobscot. 
Printed on recycled pap(,1 
JOY J. O'BRIEN 
Secretary of the Senate 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24 MRSA c. 21, sub-c. 9-A is enacted to read: 
SUBCHAPTER9-A 
MEDICAL PRACTICE PROTOCOLS 
§2981. Practice protocols; presumption that the standard of medical care has been 
met 
1. Establishment of practice protocols. The Maine Quality Forum, established in 
Title 24-A, section 6951, may develop practice protocols in any medical specialty area. 
The practice protocols must define appropriate clinical indications and methods of 
treatment within the medical specialty area and must be consistent with appropriate 
standards of care and levels of quality. The Maine Quality Forum shall consult with the 
Maine Quality Forum Advisory Council established in Title 24-A, section 6952, the 
Board of Licensure in Medicine, the Board of Osteopathic Licensure and other relevant 
medical licensing boards in development of the practice protocols. The Maine Quality 
Forum shall adopt the practice protocols as major substantive rules under the Maine 
Administrative Procedure Act. 
2. Application to professional negligence claims. In any claim for professional 
negligence against a health care practitioner or a health care provider in which a violation 
of the standard of care has been alleged, the defendant may introduce into evidence, as a 
presumption that the applicable standard of care has been met, practice protocols 
developed and adopted pursuant to subsection 1. A defendant who pleads compliance 
with the practice protocols as a presumption that the applicable standard of care has been 
met and as the basis for a determination that the health care practitioner's or health care 
provider's conduct did not constitute professional negligence has the burden of proving 
compliance with those practice protocols by a preponderance of the evidence. 
If a 
defendant introduces at trial evidence of compliance with the practice protocols, the 
plaintiff may introduce evidence on the issue of compliance and to rebut the presumption 
that the applicable standard of care has been met. This subsection does not affect the 
plaintiffs burden to prove the plaintiffs cause of action by a preponderance of the 
evidence as otherwise provided by law. 
Sec. 2. 24-A MRSA §2762 is enacted to read: 
§2762. 
Coverage may be declined for treatment not consistent with practice 
protocols 
An insurer that issues an individual insurance policy or contract may decline to 
provide coverage for treatment that is not consistent with practice protocols adopted as 
rules by the Maine Quality Forum pursuant to Title 24, section 2981 and that is not 
documented as a reasonable deviation from those practice protocols by a health care 
practitioner or a health care provider. 
Page! - 123LR1l52(Ol)-1 
Sec. 3. 24-A MRSA §2847-M is enacted to read: 
§2847-M. Coverage may be declined for treatment not consistent with practice 
protocols 
An insurer that issues a group insurance policy or contract may decline to provide 
coverage for treatment that is not consistent with practice protocols adopted as rules by 
the Maine Quality Forum pursuant to Title 24, section 2981 and that is not documented as 
a reasonable deviation from those practice protocols by a health care practitioner or a 
health care provider. 
Sec. 4. 24-A MRSA §4253 is enacted to read: 
§4253. 
Coverage may be declined for treatment not consistent with practice 
1 
protocols 
A carrier or insurer that issues a health maintenance organization individual or group 
policy, contract or certificate may decline to provide coverage for treatment that is not 
consistent with practice protocols adopted as rules by the Maine Quality Forum pursuant 
to Title 24, section 2981 and that is not documented as a reasonable deviation from those 
practice protocols by a health care practitioner or a health care provider. 
SUMMARY 
This bill authorizes the Maine Quality Forum to develop practice protocols in any 
medical specialty area and permits compliance with those practice protocols to be 
asserted in medical malpractice actions as a presumption that the applicable standard of 
care has been met. 
The bill also allows an insurer to decline to provide coverage for treatment that is not 
consistent with those practice protocols and that is not documented as a reasonable 
deviation from those practice protocols by a health care practitioner or a health care 
provider.