APPROVED CHAPTER
APRIL 22, 2024 648
BY GOVERNOR PUBLIC LAW
STATE OF MAINE
_____
IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-FOUR
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H.P. 148 - L.D. 227
An Act Regarding Legally Protected Health Care Activity in the State
Be it enacted by the People of the State of Maine as follows:
PART A
Sec. A-1. 14 MRSA c. 763 is enacted to read:
CHAPTER 763
LEGALLY PROTECTED HEALTH CARE ACTIVITY
§9001. Legislative findings and declaration of policy
The Legislature finds and declares that:
1. Legal right to gender-affirming health care services and reproductive health
care services. Access to gender-affirming health care services and reproductive health care
services in this State, as authorized under the laws of this State, is a legal right;
2. Interference with legally protected health care activity against public policy.
Whether or not under the color of law, interference with legally protected health care
activity and interference with aiding and assisting legally protected health care activity is
against the public policy of this State; and
3. Public acts in other states. Any public act of another state that prohibits,
criminalizes, sanctions, authorizes a person to bring a civil action against or otherwise
interferes with a person in this State who engages in legally protected health care activity
or who aids and assists legally protected health care activity:
A. Interferes with the exercise and enjoyment of the rights secured by this State; and
B. Is against the public policy of this State.
§9002. Definitions
As used in this chapter, unless the context otherwise indicates, the following terms
have the following meanings.
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 1. Aid and assist legally protected health care activity. "Aid and assist legally
protected health care activity" and "aiding and assisting legally protected health care
activity" mean:
A. Any act or omission of a person aiding or effectuating or attempting to aid or
effectuate any other person in legally protected health care activity; or
B. The provision or administration of, or attempted provision or administration of,
insurance coverage for gender-affirming health care services or reproductive health
care services to a beneficiary or a dependent of a beneficiary by any insurer, payor or
employer.
"Aiding and assisting legally protected health care activity" does not include any conduct
that deviates from the applicable standard of care or that could form the basis of a civil,
criminal or administrative action under the laws of this State had the course of conduct that
forms the basis for liability occurred entirely within this State.
2. Aggrieved person. "Aggrieved person" means:
A. A person against whom hostile litigation is filed or prosecuted or the legal
representative of a person against whom hostile litigation is filed or prosecuted;
B. The employer of a person against whom hostile litigation is filed or prosecuted if
the legally protected health care activity or aiding and assisting legally protected health
care activity of the person that forms the basis of the hostile litigation was performed
within the scope of the person's employment; or
C. A person in this State upon whom a subpoena seeking information concerning
legally protected health care activity or aiding and assisting legally protected health
care activity is served by any federal or state court in connection with hostile litigation.
3. Foreign judgment. "Foreign judgment" means any judgment, decree or order of a
court of another state.
4. Gender-affirming health care services. "Gender-affirming health care services"
means all supplies, care and services of a medical, behavioral health, mental health,
surgical, psychiatric, therapeutic, diagnostic, preventive, rehabilitative or supportive
nature, including medication, relating to the treatment of gender dysphoria and gender
incongruence in accordance with the accepted standard of care as defined by major medical
professional organizations and agencies with expertise in the field of gender-affirming
health care, including the Standards of Care for the Health of Transgender and Gender
Diverse People, Version 8, or subsequent version, published by the World Professional
Association for Transgender Health. "Gender-affirming health care services" does not
include conversion therapy as defined in Title 32, section 59-C, subsection 1.
5. Health care practitioner. "Health care practitioner" has the same meaning as in
Title 24, section 2502, subsection 1-A, except that "health care practitioner" does not
include a veterinarian. "Health care practitioner" also includes persons licensed under:
A. Title 32, chapter 18;
B. Title 32, chapter 32;
C. Title 32, chapter 83;
D. Title 32, chapter 117; and
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 E. Title 32, chapter 119.
6. Hostile litigation. "Hostile litigation" means any litigation or other legal action,
including civil, criminal or administrative action, to deter, prevent, sanction or punish any
health care practitioner or person assisting a health care practitioner who provides legally
protected health care activity or aids and assists legally protected health care activity by:
A. Filing or prosecuting any litigation or other legal action in any other state where
liability, in whole or in part, directly or indirectly, is based on legally protected health
care activity or aiding and assisting legally protected health care activity that occurred
in this State, including any action in which liability is based on any theory of vicarious,
joint or several liability; or
B. Attempting to enforce any order or judgment issued in connection with any litigation
or other legal action under paragraph A by any party to the action or by any person
acting on behalf of any party to the action.
For purposes of this chapter, litigation or other legal action is based on legally protected
health care activity or aiding and assisting legally protected health care activity that
occurred in this State if any part of any act or omission involved in the course of conduct
that forms the basis for liability in the action occurs or is initiated in this State, whether or
not the act or omission is alleged or included in any pleading or other filing in the lawsuit.
7. Law enforcement agency. "Law enforcement agency" means any court,
department or agency of this State, a political subdivision of this State or a college or a
university in this State charged with the enforcement of laws or the custody of detained
persons. "Law enforcement agency" includes the Department of the Attorney General and
district attorneys' offices.
8. Legally protected health care activity. "Legally protected health care activity"
means:
A. The exercise and enjoyment or attempted exercise and enjoyment by any person of
the right secured by this State to gender-affirming health care services or reproductive
health care services; and
B. The provision or attempted provision of gender-affirming health care services or
reproductive health care services that are authorized under the laws of this State and
that are provided in accordance with the applicable standard of care by a health care
practitioner licensed under the laws of this State and physically present in this State,
regardless of whether the patient is located in this State or whether the health care
practitioner is licensed in the state where the patient is located at the time the services
are rendered.
"Legally protected health care activity" does not include any conduct that could form the
basis of a civil, criminal or administrative action under the laws of this State had the course
of conduct that forms the basis for liability occurred entirely within this State.
9. Reproductive health care services. "Reproductive health care services" means all
supplies, care and services of a medical, behavioral health, mental health, surgical,
psychiatric, therapeutic, diagnostic, preventive, rehabilitative or supportive nature,
including medication, relating to pregnancy, contraception, assisted reproduction,
pregnancy loss management or the termination of a pregnancy in accordance with the
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applicable standard of care as defined by major medical professional organizations and
agencies with expertise in the field of reproductive health care.
10. State. "State" means a state of the United States, the District of Columbia, Puerto
Rico, the United States Virgin Islands or any territory or insular possession subject to the
jurisdiction of the United States.
§9003. Tortious interference with legally protected health care activity
1. Civil action. An aggrieved person may bring a civil action for damages, punitive
damages, equitable relief, injunctive relief or any other appropriate relief against another
person that, whether or not acting under color of law, files or prosecutes hostile litigation.
For purposes of this subsection, "damages" may include the amount of any judgment issued
in connection with the hostile litigation as well as all other expenses, costs and reasonable
attorney's fees incurred in connection with the hostile litigation.
2. Attorney's fees and costs. An aggrieved person that prevails in an action brought
under this section is entitled to an award of attorney's fees and costs.
3. Exception. An aggrieved person may not bring an action under this section if the
hostile litigation is based on conduct for which a civil, criminal or administrative action
would exist under the laws of this State if the conduct or course of conduct that forms the
basis for liability in the hostile litigation had occurred entirely within this State.
§9004. Foreign judgments issued in connection with hostile litigation
1. Jurisdiction and due process required. A court of this State may not give any
force or effect to any foreign judgment in connection with hostile litigation if the court that
issued the foreign judgment did not:
A. Have personal jurisdiction over the defendant;
B. Have jurisdiction over the subject matter; or
C. Provide due process of law.
2. Limitations period. Notwithstanding any provision of law to the contrary, an action
on a foreign judgment in connection with hostile litigation must be commenced by filing a
new and independent action on the judgment within 5 years of the foreign judgment.
§9005. Testimony and documents in connection with hostile litigation
1. Court order. Notwithstanding any provision of state law or court rule to the
contrary and except as required by federal law, a court of this State may not order a person
who is domiciled or found within this State to give testimony or a statement or produce
documents or other information in any proceeding involving hostile litigation.
2. Subpoena. An aggrieved person may move to modify or quash any subpoena issued
in connection with hostile litigation on any grounds provided by law or court rule or on the
ground that the subpoena is inconsistent with the public policy of this State as provided in
section 9001.
3. Summons. Except as required by federal law, a court in this State may not issue a
summons or warrant in a case involving criminal prosecution or a pending grand jury
investigation under the criminal laws of another state for engaging in legally protected
health care activity or aiding and assisting legally protected health care activity unless the
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conduct forming the basis of the prosecution or grand jury investigation would also
constitute a criminal offense if the conduct occurred entirely within this State.
§9006. Prohibition on expenditure of public resources; noncooperation
1. Prohibition on expenditure of public resources. Notwithstanding any provision
of state law to the contrary and except as required by federal law, a public agency, including
a law enforcement agency, and an employee, appointee, officer or official or any other
person acting on behalf of a public agency may not knowingly provide any information or
expend or use time, money, facilities, property, equipment, personnel or other resources in
furtherance of any interstate investigation or proceeding seeking to impose civil,
administrative or criminal liability upon a person or entity for:
A. Legally protected health care activity; or
B. Aiding and assisting legally protected health care activity.
2. Noncooperation. Notwithstanding any provision of state law to the contrary and
except as required by federal law, an officer or employee of a law enforcement agency,
while acting under color of law, may not knowingly provide information or assistance to a
federal law enforcement agency, to any law enforcement agency in another state or political
subdivision of another state or to any private citizen in relation to an investigation or inquiry
into services constituting legally protected health care activity or aiding and assisting
legally protected health care activity.
3. No arrest. Notwithstanding any provision of state law to the contrary and except as
required by federal law, arrest of a person in this State is prohibited if the arrest is related
to criminal liability that is based on legally protected health care activity or aiding and
assisting legally protected health care activity.
4. Exceptions. This section does not apply to a public agency, including a law
enforcement agency, or an employee, appointee, officer or official or any other person
acting on behalf of a public agency:
A. When responding to a warrant or extradition demand on the good faith belief that
the warrant or demand is valid in this State; or
B. When exigent circumstances make compliance with this section impossible. For the
purposes of this paragraph, "exigent circumstances" means circumstances in which
there is insufficient time to comply with this section and there is a compelling need for
action due to the presence of an imminent danger to public safety.
§9007. Choice of law
Notwithstanding any general or special law or common law conflict of law rule to the
contrary, the laws of this State govern in any case or controversy heard in this State
involving legally protected health care activity or aiding and assisting legally protected
health care activity.
PART B
Sec. B-1. 14 MRSA §402, sub-§2-A is enacted to read:
2-A. Aiding and assisting legally protected health care activity. "Aiding and
assisting legally protected health care activity" has the same meaning as in section 9002,
subsection 1.
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 Sec. B-2. 14 MRSA §402, sub-§2-B is enacted to read:
2-B. Legally protected health care activity. "Legally protected health care activity"
has the same meaning as in section 9002, subsection 8.
Sec. B-3. 14 MRSA §403, sub-§1-A is enacted to read:
1-A. Attestation. A request for issuance of a subpoena under this section must be
accompanied by an affidavit stating whether the foreign subpoena seeks documents,
information, inspection or testimony related to the provision or receipt of or attempted
provision or receipt of legally protected health care activity or aiding and assisting legally
protected health care activity. The court shall provide a form for the completion of the
affidavit. The form must contain a statement informing the affiant that making a false
statement on the affidavit may be punishable as the crime of false swearing under the laws
of this State.
Sec. B-4. 14 MRSA §403, sub-§2, as enacted by PL 2019, c. 109, §1, is amended
to read:
2. Submission of foreign subpoena. When Except as provided in subsection 4, when
a party submits a foreign subpoena to a clerk of court in the State, the clerk, in accordance
with that court's procedure, shall promptly issue a subpoena for service upon the person to
which the foreign subpoena is directed.
Sec. B-5. 14 MRSA §403, sub-§4 is enacted to read:
4. Prohibition. A clerk of court in this State may not issue a subpoena under
subsection 2 and must present the request to the court if the attestation submitted under
subsection 1-A indicates that the foreign subpoena seeks documents, information,
inspection or testimony related to the provision or receipt of or attempted provision or
receipt of legally protected health care activity or aiding and assisting legally protected
health care activity. After reviewing the request and attestation, if the court finds that the
foreign subpoena seeks documents, information, inspection or testimony related to the
provision or receipt of or attempted provision or receipt of legally protected health care
activity or aiding and assisting legally protected health care activity, the court shall deny
the request for issuance of a subpoena and quash any subpoena previously issued by the
court in connection with the request unless the court finds that the foreign subpoena seeks
documents, information, inspection or testimony related to:
A. An action in a foreign jurisdiction founded in tort, contract or statute brought by
the person who sought or received legally protected health care activity, or the person's
legal representative, for damages suffered by the person or damages derived from an
individual's loss of consortium of the person if a similar claim would exist under the
laws of this State;
B. An action in a foreign jurisdiction founded in contract that is brought by a person
with a contractual relationship to the individual whose documents or information are
the subject of the subpoena if a similar