An Act To Require That Death Certificates Be Signed Using an Electronic Signature System
Maine Legislature, Session 127, LD 0478
Committee: Health and Human Services
Sponsors: STANLEY
Amends: 22 MRSA §2841, 22 MRSA §2842

Legislative Document 
No. 478 
H.P. 317 
House of Representatives, February 24, 2015 
An Act To Require That Death Certificates Be Signed Using an 
Electronic Signature System 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
ROBERT B. HUNT 
Clerk 
Presented by Representative STANLEY of Medway. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §2841, sub-§2, as amended by PL 1989, c. 274, §3, is further 
amended to read: 
2.  Medical certificate by physician.  The medical certification shall must be 
completed and signed using an electronic signature within 5 days after delivery by the 
physician in attendance at or after the delivery, except when an inquiry as to the cause of 
fetal death is required by law.  For the purposes of this subsection, "electronic signature" 
has the same meaning as in Title 10, section 9402, subsection 8. 
Sec. 2.  22 MRSA §2842, sub-§§2 and 2-A, as amended by PL 2009, c. 601, 
§25, are further amended to read: 
2.  Medical certificate by physician, nurse practitioner or physician assistant.  
The medical certification of the cause of death must be completed and signed using an 
electronic signature in a timely manner, as specified by department rule, by a physician, 
nurse practitioner or physician assistant authorized to practice in the State who has 
knowledge of the patient's recent medical condition, in accordance with department rules 
and other laws detailing who can certify and in what time frame, except when the death 
falls under the jurisdiction of the medical examiner as provided in section 3025.  If the 
patient was a resident of a nursing home licensed under section 1817 at the time of death 
and if the health care provider in charge of the patient's care or another health care 
provider designated by the health care provider in charge had not examined the patient 
within 48 hours prior to death, or within 2 weeks prior to death in the case of a terminally 
ill patient, the health care provider in charge or another health care provider designated 
by the health care provider in charge shall examine the body prior to completing the 
certification of death process.  Any health care provider who fails to complete the 
medical certification of the cause of death fully, in a timely manner, or who fails to 
examine the body of a nursing home resident prior to certifying cause of death as required 
by this section must be reported to the Board of Licensure in Medicine, the Board of 
Osteopathic Licensure or the State Board of Nursing, whichever is appropriate, by the 
State Registrar of Vital Statistics of the Department of Health and Human Services. 
For the purposes of this subsection, the following terms have the following meanings. 
A.  "Life-sustaining procedure" means any medical procedure or intervention that, 
when administered to a qualified patient, will serve only to prolong the dying process 
and does not include nutrition and hydration. 
B.  "Terminally ill patient" means a patient who has been diagnosed as having an 
incurable or irreversible condition that, without the administration of life-sustaining 
procedures, will, in the opinion of the attending health care provider, result in death 
within a short time. 
C.  "Health care provider" means a physician authorized to practice in this State, 
nurse practitioner or physician assistant. 
D.  "Nurse practitioner" means an advanced practice registered nurse who is a 
certified nurse practitioner authorized to practice without the supervision of a 
physician pursuant to Title 32, chapter 31. 
E.  "Physician assistant" means a person who has graduated from a physician 
assistant or surgeon assistant program accredited by the American Medical 
Association Committee on Allied Health Education and Accreditation or the 
Commission on Accreditation of Allied Health Education Programs or its successor 
and who has passed the certifying examination administered by the National 
Commission on Certification of Physician Assistants or its successor. 
F.  "Electronic signature" has the same meaning as in Title 10, section 9402, 
subsection 8. 
2-A.  Medical certification.  Notwithstanding subsection 2, with respect to a person 
who dies within the State naturally and for whom the physician, nurse practitioner or 
physician assistant was the attending health care provider, the medical certification of the 
cause of death may be completed and signed using an electronic signature by a physician, 
nurse practitioner or physician assistant authorized to practice at the United States 
Department of Veterans Affairs at Togus or at another federal medical facility within the 
State or by a physician, an advanced practice registered nurse or physician assistant 
licensed to practice in New Hampshire, Vermont or Massachusetts who, at the request of 
the Chief Medical Examiner, is willing to do so.  For the purposes of this subsection, 
"electronic signature" has the same meaning as in Title 10, section 9402, subsection 8. 
Sec. 3.  22 MRSA §2842, sub-§3, as amended by PL 2013, c. 31, §1, is further 
amended to read: 
3.  Medical certificate by medical examiner or the Office of the Chief Medical 
Examiner.  When a death occurs under circumstances that make it a medical examiner 
case as defined in section 3025, or when inquiry as to the cause of death is required by 
law, the medical examiner or the Office of the Chief Medical Examiner shall complete 
the medical certification of the cause of death as specified by department rule and sign 
the death certificate using an electronic signature.  A certification need not be completed 
before the remains are ready for release.  For the purposes of this subsection, "electronic 
signature" has the same meaning as in Title 10, section 9402, subsection 8. 
The medical examiner or the Office of the Chief Medical Examiner is responsible for the 
identity of the deceased and the time, date, place, cause, manner and circumstances of 
death on the death certificate.  Entries may be left "pending" if further study is needed; or, 
at the specific direction of the Attorney General relative to cases under investigation by 
the Attorney General's office, entries must be left "withheld" until such time as the 
Attorney General, in the Attorney General's sole discretion, determines that any criminal 
investigation and prosecution will not be harmed by public disclosure of such 
information.  Notwithstanding section 2706, subsection 4, unless directed otherwise by 
the Attorney General as specified in this subsection, this information for which the 
medical examiner is responsible may be made available to the general public by the 
Office of the Chief Medical Examiner. 
SUMMARY 
This bill requires death certificates to be signed using an electronic signature.  
"Electronic signature" has the same meaning as in the Uniform Electronic Transactions 
Act, an electronic sound, symbol or process attached to or logically associated with a 
record and executed or adopted by a person with the intent to sign the record.