[House Report 107-697]
[From the U.S. Government Publishing Office]
107th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 107-697
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PROVIDING FOR CONSIDERATION OF H.R. 4600, HELP EFFICIENT, ACCESSIBLE,
LOW COST, TIMELY HEALTH CARE (HEALTH) ACT OF 2002
_______
September 25, 2002.--Referred to the House Calendar and ordered to be
printed
_______
Mr. Reynolds, from the Committee on Rules, submitted the following
R E P O R T
[To accompany H. Res. 553]
The Committee on Rules, having had under consideration
House Resolution 553, by a record vote of 9 to 2, report the
same to the House with the recommendation that the resolution
be adopted.
SUMMARY OF PROVISIONS OF THE RESOLUTION
The resolution provides for consideration in the House of
H.R. 4600, the Help Efficient, Accessible, Low Cost, Timely
Health Care (HEALTH) Act of 2002, under a closed rule. The rule
provides one hour of debate on the bill, as amended, with 40
minutes equally divided and controlled by the chairman and
ranking minority member of the Committee on the Judiciary and
20 minutes equally divided and controlled by the chairman and
ranking minority member of the Committee on Energy and
Commerce. The rule waives all points of order against
consideration of the bill.
The rule provides that the bill shall be considered as read
for amendment. The rule further provides that in lieu of the
amendments recommended by the Committees on the Judiciary and
on Energy and Commerce now printed in the bill, the amendment
in the nature of a substitute printed in this report shall be
considered as adopted. Finally, the rule provides one motion to
recommit with or without instructions.
The waiver of all points of order includes a waiver of
clause 4(a) of rule XIII (requiring a three-day layover of the
committee report). The waiver of clause 4(a) of rule XIII is
needed because the report was not available until Wednesday,
September 25 and the bill may be considered by the House as
early as Thursday, September 26.
COMMITTEE VOTES
Pursuant to clause 3(b) of House rule XIII the results of
each record vote on an amendment or motion to report, together
with the names of those voting for and against, are printed
below:
Rules Committee Record Vote No. 173
Date: September 25, 2002.
Measure: H.R. 4600.
Motion by: Mr. McGovern.
Summary of motion: To grant an open rule.
Results: Defeated 2 to 8.
Vote by Members: Goss--Nay; Linder--Nay; Pryce--Nay; Diaz-
Balart--Nay; Hastings (WA)--Nay; Sessions--Nay; Reynolds--Nay;
McGovern--Yea; Hastings (FL)--Yea; Dreier--Nay.
Rules Committee Record Vote No. 174
Date: September 25, 2002.
Measure: H.R. 4600.
Motion by: Mr. McGovern.
Summary of motion: To make in order and grant the
appropriate waivers to the amendment offered by Representative
Markey requiring that savings realized by insurers as a result
of the $250,000 cap on damages for pain and suffering be passed
on to health care providers in the form of lower premiums.
Results: Defeated 2 to 8.
Vote by Members: Goss--Nay; Linder--Nay; Pryce--Nay; Diaz-
Balart--Nay; Hastings (WA)--Nay; Sessions--Nay; Reynolds--Nay;
McGovern--Yea; Hastings (FL)--Yea; Dreier--Nay.
Rules Committee Record Vote No. 175
Date: September 25, 2002.
Measure: H.R. 4600.
Motion by: Mr. Linder.
Summary of motion: To report the resolution.
Results: Agreed to 9 to 12.
Vote by Members: Goss--Yea; Linder--Yea; Pryce--Yea; Diaz-
Balart--Yea; Hastings (WA)--Yea; Myrick--Yea; Sessions--Yea;
Reynolds--Yea; McGovern--Nay; Hastings (FL)--Nay; Dreier--Yea.
SUMMARY OF AMENDMENT CONSIDERED AS ADOPTED
The amendment in the nature of a substitute consists of the
text of H.R. 4600 as reported from the Judiciary Committee with
the following changes:
Amendment to Section 3: This amendment clarifies the
underlying bill so that the statute of limitations is 3 years
from the date of manifestation of the injury or one year after
that claimant discovers, or through the use of reasonable
diligence should have discovered the injury, which ever occurs
first. The amendment also makes this section consistent with
California state law, which is the model for the underlying
bill by providing an exception to the 3-year limitation in
instances of fraud, intentional concealment, or the presence of
a foreign body that has no therapeutic effect.
Amendment to Section 7. This amendment clarifies the
underlying bill by providing a substantial compliance test for
firms whose products have been approved by the Food and Drug
Administration (FDA). This ensures that if the manufacturing
and distribution of a medical product was not in compliance
with the FDA regulations than it may be subject to punitive
damages in a health care lawsuit, as defined in the bill.
Amendment to Section 6. This amendment clarifies the
underlying bill so that it does not apply to two sections of
the Social Security Act.
Amendment to Section 13. This amendment is a sense of
Congress resolution that a health insurer should be liable for
damages for harm caused when it makes a decision as to what
care is medically necessary and appropriate.
TEXT OF AMENDMENT CONSIDERED AS ADOPTED
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Help Efficient, Accessible,
Low-cost, Timely Healthcare (HEALTH) Act of 2002''.
SEC. 2. FINDINGS AND PURPOSE.
(a) Findings.--
(1) Effect on health care access and costs.--Congress
finds that our current civil justice system is
adversely affecting patient access to health care
services, better patient care, and cost-efficient
health care, in that the health care liability system
is a costly and ineffective mechanism for resolving
claims of health care liability and compensating
injured patients, and is a deterrent to the sharing of
information among health care professionals which
impedes efforts to improve patient safety and quality
of care.
(2) Effect on interstate commerce.--Congress finds
that the health care and insurance industries are
industries affecting interstate commerce and the health
care liability litigation systems existing throughout
the United States are activities that affect interstate
commerce by contributing to the high costs of health
care and premiums for health care liability insurance
purchased by health care system providers.
(3) Effect on federal spending.--Congress finds that
the health care liability litigation systems existing
throughout the United States have a significant effect
on the amount, distribution, and use of Federal funds
because of--
(A) the large number of individuals who
receive health care benefits under programs
operated or financed by the Federal Government;
(B) the large number of individuals who
benefit because of the exclusion from Federal
taxes of the amounts spent to provide them with
health insurance benefits; and
(C) the large number of health care providers
who provide items or services for which the
Federal Government makes payments.
(b) Purpose.--It is the purpose of this Act to implement
reasonable, comprehensive, and effective health care liability
reforms designed to--
(1) improve the availability of health care services
in cases in which health care liability actions have
been shown to be a factor in the decreased availability
of services;
(2) reduce the incidence of ``defensive medicine''
and lower the cost of health care liability insurance,
all of which contribute to the escalation of health
care costs;
(3) ensure that persons with meritorious health care
injury claims receive fair and adequate compensation,
including reasonable noneconomic damages;
(4) improve the fairness and cost-effectiveness of
our current health care liability system to resolve
disputes over, and provide compensation for, health
care liability by reducing uncertainty in the amount of
compensation provided to injured individuals;
(5) provide an increased sharing of information in
the health care system which will reduce unintended
injury and improve patient care.
SEC. 3. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS.
The time for the commencement of a health care lawsuit shall
be 3 years after the date of manifestation of injury or 1 year
after the claimant discovers, or through the use of reasonable
diligence should have discovered, the injury, whichever occurs
first. In no event shall the time for commencement of a health
care lawsuit exceed 3 years after the date of manifestation of
injury unless tolled for any of the following:
(1) Upon proof of fraud;
(2) Intentional concealment; or
(3) The presence of a foreign body, which has no
therapeutic or diagnostic purpose or effect, in the
person of the injured person.
Actions by a minor shall be commenced within 3 years from the
date of the alleged manifestation of injury except that actions
by a minor under the full age of 6 years shall be commenced
within 3 years of manifestation of injury or prior to the
minor's 8th birthday, whichever provides a longer period. Such
time limitation shall be tolled for minors for any period
during which a parent or guardian and a health care provider or
health care organization have committed fraud or collusion in
the failure to bring an action on behalf of the injured minor.
SEC. 4. COMPENSATING PATIENT INJURY.
(a) Unlimited Amount of Damages for Actual Economic Losses in
Health Care Lawsuits.--In any health care lawsuit, the full
amount of a claimant's economic loss may be fully recovered
without limitation.
(b) Additional Noneconomic Damages.--In any health care
lawsuit, the amount of noneconomic damages recovered may be as
much as $250,000, regardless of the number of parties against
whom the action is brought or the number of separate claims or
actions brought with respect to the same occurrence.
(c) No Discount of Award for Noneconomic Damages.--In any
health care lawsuit, an award for future noneconomic damages
shall not be discounted to present value. The jury shall not be
informed about the maximum award for noneconomic damages. An
award for noneconomic damages in excess of $250,000 shall be
reduced either before the entry of judgment, or by amendment of
the judgment after entry of judgment, and such reduction shall
be made before accounting for any other reduction in damages
required by law. If separate awards are rendered for past and
future noneconomic damages and the combined awards exceed
$250,000, the future noneconomic damages shall be reduced
first.
(d) Fair Share Rule.--In any health care lawsuit, each party
shall be liable for that party's several share of any damages
only and not for the share of any other person. Each party
shall be liable only for the amount of damages allocated to
such party in direct proportion to such party's percentage of
responsibility. A separate judgment shall be rendered against
each such party for the amount allocated to such party. For
purposes of this section, the trier of fact shall determine the
proportion of responsibility of each party for the claimant's
harm.
SEC. 5. MAXIMIZING PATIENT RECOVERY.
(a) Court Supervision of Share of Damages Actually Paid to
Claimants.--In any health care lawsuit, the court shall
supervise the arrangements for payment of damages to protect
against conflicts of interest that may have the effect of
reducing the amount of damages awarded that are actually paid
to claimants. In particular, in any health care lawsuit in
which the attorney for a party claims a financial stake in the
outcome by virtue of a contingent fee, the court shall have the
power to restrict the payment of a claimant's damage recovery
to such attorney, and to redirect such damages to the claimant
based upon the interests of justice and principles of equity.
In no event shall the total of all contingent fees for
representing all claimants in a health care lawsuit exceed the
following limits:
(1) 40 percent of the first $50,000 recovered by the
claimant(s).
(2) 33\1/3\ percent of the next $50,000 recovered by
the claimant(s).
(3) 25 percent of the next $500,000 recovered by the
claimant(s).
(4) 15 percent of any amount by which the recovery by
the claimant(s) is in excess of $600,000.
(b) Applicability.--The limitations in this section shall
apply whether the recovery is by judgment, settlement,
mediation, arbitration, or any other form of alternative
dispute resolution. In a health care lawsuit involving a minor
or incompetent person, a court retains the authority to
authorize or approve a fee that is less than the maximum
permitted under this section.
SEC. 6. ADDITIONAL HEALTH BENEFITS.
In any health care lawsuit, any party may introduce evidence
of collateral source benefits. If a party elects to introduce
such evidence, any opposing party may introduce evidence of any
amount paid or contributed or reasonably likely to be paid or
contributed in the future by or on behalf of the opposing party
to secure the right to such collateral source benefits. No
provider of collateral source benefits shall recover any amount
against the claimant or receive any lien or credit against the
claimant's recovery or be equitably or legally subrogated to
the right of the claimant in a health care lawsuit. This
section shall apply to any health care lawsuit that is settled
as well as a health care lawsuit that is resolved by a fact
finder. This section shall not apply to section 1862(b) (42
U.S.C. 1395y(b)) or section 1902(a)(25) (42 U.S.C.
1396a(a)(25)) of the Social Security Act.
SEC. 7. PUNITIVE DAMAGES.
(a) In General.--Punitive damages may, if otherwise permitted
by applicable State or Federal law, be awarded against any
person in a health care lawsuit only if it is proven by clear
and convincing evidence that such person acted with malicious
intent to injure the claimant, or that such person deliberately
failed to avoid unnecessary injury that such person knew the
claimant was substantially certain to suffer. In any health
care lawsuit where no judgment for compensatory damages is
rendered against such person, no punitive damages may be
awarded with respect to the claim in such lawsuit. No demand
for punitive damages shall be included in a health care lawsuit
as initially filed. A court may allow a claimant to file an
amended pleading for punitive damages only upon a motion by the
claimant and after a finding by the court, upon review of
supporting and opposing affidavits or after a hearing, after
weighing the evidence, that the claimant has established by a
substantial probability that the claimant will prevail on the
claim for punitive damages. At the request of any party in a
health care lawsuit, the trier of fact shall consider in a
separate proceeding--
(1) whether punitive damages are to be awarded and
the amount of such award; and
(2) the amount of punitive damages following a
determination of punitive liability.
If a separate proceeding is requested, evidence relevant only
to the claim for punitive damages, as determined by applicable
State law, shall be inadmissible in any proceeding to determine
whether compensatory damages are to be awarded.
(b) Determining Amount of Punitive Damages.--
(1) Factors considered.--In determining the amount of
punitive damages, the trier of fact shall consider only
the following:
(A) the severity of the harm caused by the
conduct of such party;
(B) the duration of the conduct or any
concealment of it by such party;
(C) the profitability of the conduct to such
party;
(D) the number of products sold or medical
procedures rendered for compensation, as the
case may be, by such party, of the kind causing
the harm complained of by the claimant;
(E) any criminal penalties imposed on such
party, as a result of the conduct complained of
by the claimant; and
(F) the amount of any civil fines assessed
against such party as a result of the conduct
complained of by the claimant.
(2) Maximum award.--The amount of punitive damages
awarded in a health care lawsuit may be up to as much
as two times the amount of economic damages awarded or
$250,000, whichever is greater. The jury shall not be
informed of this limitation.
(c) No Civil Monetary Penalties for Products That Comply With
FDA Standards.--
(1) In general.--No punitive damages may be awarded
against the manufacturer or distributor of a medical
product based on a claim that such product caused the
claimant's harm where--
(A)(i) such medical product was subject to
premarket approval or clearance by the Food and
Drug Administration with respect to the safety
of the formulation or performance of the aspect
of such medical product which caused the
claimant's harm or the adequacy of the
packaging or labeling of such medical product;
and
(ii) such medical product was so approved or
cleared; or
(B) such medical product is generally
recognized among qualified experts as safe and
effective pursuant to conditions established by
the Food and Drug Administration and applicable
Food and Drug Administration regulations,
including without limitation those related to
packaging and labeling, unless the Food and
Drug Administration has determined that such
medical product was not manufactured or
distributed in substantial compliance with
applicable Food and Drug Administration
statutes and regulations.
(2) Liability of health care providers.--A health
care provider who prescribes a drug or device
(including blood products) approved by the Food and
Drug Administration shall not be named as a party to a
product liability lawsuit involving such drug or device
and shall not be liable to a claimant in a class action
lawsuit against the manufacturer, distributor, or
product seller of such drug or device.
(3) Packaging.--In a health care lawsuit for harm
which is alleged to relate to the adequacy of the
packaging or labeling of a drug which is required to
have tamper-resistant packaging under regulations of
the Secretary of Health and Human Services (including
labeling regulations related to such packaging), the
manufacturer or product seller of the drug shall not be
held liable for punitive damages unless such packaging
or labeling is found by the trier of fact by clear and
convincing evidence to be substantially out of
compliance with such regulations.
(4) Exception.--Paragraph (1) shall not apply in any
health care lawsuit in which--
(A) a person, before or after premarket
approval or clearance of such medical product,
knowingly misrepresented to or withheld from
the Food and Drug Administration information
that is required to be submitted under the
Federal Food, Drug, and Cosmetic Act (21 U.S.C.
301 et seq.) or section 351 of the Public
Health Service Act (42 U.S.C. 262) that is
material and is causally related to the harm
which the claimant allegedly suffered; or
(B) a person made an illegal payment to an
official of the Food and Drug Administration
for the purpose of either securing or
maintaining approval or clearance of such
medical product.
SEC. 8. AUTHORIZATION OF PAYMENT OF FUTURE DAMAGES TO CLAIMANTS IN
HEALTH CARE LAWSUITS.
(a) In General.--In any health care lawsuit, if an award of
future damages, without reduction to present value, equaling or
exceeding $50,000 is made against a party with sufficient
insurance or other assets to fund a periodic payment of such a
judgment, the court shall, at the request of any party, enter a
judgment ordering that the future damages be paid by periodic
payments in accordance with the Uniform Periodic Payment of
Judgments Act promulgated by the National Conference of
Commissioners on Uniform State Laws.
(b) Applicability.--This section applies to all actions which
have not been first set for trial or retrial before the
effective date of this Act.
SEC. 9. DEFINITIONS.
In this Act:
(1) Alternative dispute resolution system; adr.--The
term ``alternative dispute resolution system'' or
``ADR'' means a system that provides for the resolution
of health care lawsuits in a manner other than through
a civil action brought in a State or Federal court.
(2) Claimant.--The term ``claimant'' means any person
who brings a health care lawsuit, including a person
who asserts or claims a right to legal or equitable
contribution, indemnity or subrogation, arising out of
a health care liability claim or action, and any person
on whose behalf such a claim is asserted or such an
action is brought, whether deceased, incompetent, or a
minor.
(3) Collateral source benefits.--The term
``collateral source benefits'' means any amount paid or
reasonably likely to be paid in the future to or on
behalf of the claimant, or any service, product or
other benefit provided or reasonably likely to be
provided in the future to or on behalf of the claimant,
as a result of the injury or wrongful death, pursuant
to--
(A) any State or Federal health, sickness,
income-disability, accident, or workers'
compensation law;
(B) any health, sickness, income-disability,
or accident insurance that provides health
benefits or income-disability coverage;
(C) any contract or agreement of any group,
organization, partnership, or corporation to
provide, pay for, or reimburse the cost of
medical, hospital, dental, or income disability
benefits; and
(D) any other publicly or privately funded
program.
(4) Compensatory damages.--The term ``compensatory
damages'' means objectively verifiable monetary losses
incurred as a result of the provision of, use of, or
payment for (or failure to provide, use, or pay for)
health care services or medical products, such as past
and future medical expenses, loss of past and future
earnings, cost of obtaining domestic services, loss of
employment, and loss of business or employment
opportunities, damages for physical and emotional pain,
suffering, inconvenience, physical impairment, mental
anguish, disfigurement, loss of enjoyment of life, loss
of society and companionship, loss of consortium (other
than loss of domestic service), hedonic damages, injury
to reputation, and all other nonpecuniary losses of any
kind or nature. The term ``compensatory damages''
includes economic damages and noneconomic damages, as
such terms are defined in this section.
(5) Contingent fee.--The term ``contingent fee''
includes all compensation to any person or persons
which is payable only if a recovery is effected on
behalf of one or more claimants.
(6) Economic damages.--The term ``economic damages''
means objectively verifiable monetary losses incurred
as a result of the provision of, use of, or payment for
(or failure to provide, use, or pay for) health care
services or medical products, such as past and future
medical expenses, loss of past and future earnings,
cost of obtaining domestic services, loss of
employment, and loss of business or employment
opportunities.
(7) Health care lawsuit.--The term ``health care
lawsuit'' means any health care liability claim
concerning the provision of health care goods or
services affecting interstate commerce, or any health
care liability action concerning the provision of
health care goods or services affecting interstate
commerce, brought in a State or Federal court or
pursuant to an alternative dispute resolution system,
against a health care provider, a health care
organization, or the manufacturer, distributor,
supplier, marketer, promoter, or seller of a medical
product, regardless of the theory of liability on which
the claim is based, or the number of claimants,
plaintiffs, defendants, or other parties, or the number
of claims or causes of action, in which the claimant
alleges a health care liability claim.
(8) Health care liability action.--The term ``health
care liability action'' means a civil action brought in
a State or Federal Court or pursuant to an alternative
dispute resolution system, against a health care
provider, a health care organization, or the
manufacturer, distributor, supplier, marketer,
promoter, or seller of a medical product, regardless of
the theory of liability on which the claim is based, or
the number of plaintiffs, defendants, or other parties,
or the number of causes of action, in which the
claimant alleges a health care liability claim.
(9) Health care liability claim.--The term ``health
care liability claim'' means a demand by any person,
whether or not pursuant to ADR, against a health care
provider, health care organization, or the
manufacturer, distributor, supplier, marketer,
promoter, or seller of a medical product, including,
but not limited to, third-party claims, cross-claims,
counter-claims, or contribution claims, which are based
upon the provision of, use of, or payment for (or the
failure to provide, use, or pay for) health care
services or medical products, regardless of the theory
of liability on which the claim is based, or the number
of plaintiffs, defendants, or other parties, or the
number of causes of action.
(10) Health care organization.--The term ``health
care organization'' means any person or entity which is
obligated to provide or pay for health benefits under
any health plan, including any person or entity acting
under a contract or arrangement with a health care
organization to provide or administer any health
benefit.
(11) Health care provider.--The term ``health care
provider'' means any person or entity required by State
or Federal laws or regulations to be licensed,
registered, or certified to provide health care
services, and being either so licensed, registered, or
certified, or exempted from such requirement by other
statute or regulation.
(12) Health care goods or services.--The term
``health care goods or services'' means any goods or
services provided by a health care organization,
provider, or by any individual working under the
supervision of a health care provider, that relates to
the diagnosis, prevention, or treatment of any human
disease or impairment, or the assessment of the health
of human beings.
(13) Malicious intent to injure.--The term
``malicious intent to injure'' means intentionally
causing or attempting to cause physical injury other
than providing health care goods or services.
(14) Medical product.--The term ``medical product''
means a drug or device intended for humans, and the
terms ``drug'' and ``device'' have the meanings given
such terms in sections 201(g)(1) and 201(h) of the
Federal Food, Drug and Cosmetic Act (21 U.S.C. 321),
respectively, including any component or raw material
used therein, but excluding health care services.
(15) Noneconomic damages.--The term ``noneconomic
damages'' means damages for physical and emotional
pain, suffering, inconvenience, physical impairment,
mental anguish, disfigurement, loss of enjoyment of
life, loss of society and companionship, loss of
consortium (other than loss of domestic service),
hedonic damages, injury to reputation, and all other
nonpecuniary losses of any kind or nature.
(16) Punitive damages.--The term ``punitive damages''
means damages awarded, for the purpose of punishment or
deterrence, and not solely for compensatory purposes,
against a health care provider, health care
organization, or a manufacturer, distributor, or
supplier of a medical product. Punitive damages are
neither economic nor noneconomic damages.
(17) Recovery.--The term ``recovery'' means the net
sum recovered after deducting any disbursements or
costs incurred in connection with prosecution or
settlement of the claim, including all costs paid or
advanced by any person. Costs of health care incurred
by the plaintiff and the attorneys' office overhead
costs or charges for legal services are not deductible
disbursements or costs for such purpose.
(18) State.--The term ``State'' means each of the
several States, the District of Columbia, the
Commonwealth of Puerto Rico, the Virgin Islands, Guam,
American Samoa, the Northern Mariana Islands, the Trust
Territory of the Pacific Islands, and any other
territory or possession of the United States, or any
political subdivision thereof.
SEC. 10. EFFECT ON OTHER LAWS.
(a) Vaccine Injury.--
(1) To the extent that title XXI of the Public Health
Service Act establishes a Federal rule of law
applicable to a civil action brought for a vaccine-
related injury or death--
(A) this Act does not affect the application
of the rule of law to such an action; and
(B) any rule of law prescribed by this Act in
conflict with a rule of law of such title XXI
shall not apply to such action.
(2) If there is an aspect of a civil action brought
for a vaccine-related injury or death to which a
Federal rule of law under title XXI of the Public
Health Service Act does not apply, then this Act or
otherwise applicable law (as determined under this Act)
will apply to such aspect of such action.
(b) Other Federal Law.--Except as provided in this section,
nothing in this Act shall be deemed to affect any defense
available to a defendant in a health care lawsuit or action
under any other provision of Federal law.
SEC. 11. STATE FLEXIBILITY AND PROTECTION OF STATES' RIGHTS.
(a) Health Care Lawsuits.--The provisions governing health
care lawsuits set forth in this Act preempt, subject to
subsections (b) and (c), State law to the extent that State law
prevents the application of any provisions of law established
by or under this Act. The provisions governing health care
lawsuits set forth in this Act supersede chapter 171 of title
28, United States Code, to the extent that such chapter--
(1) provides for a greater amount of damages or
contingent fees, a longer period in which a health care
lawsuit may be commenced, or a reduced applicability or
scope of periodic payment of future damages, than
provided in this Act; or
(2) prohibits the introduction of evidence regarding
collateral source benefits, or mandates or permits
subrogation or a lien on collateral source benefits.
(b) Protection of States' Rights.--Any issue that is not
governed by any provision of law established by or under this
Act (including State standards of negligence) shall be governed
by otherwise applicable State or Federal law. This Act does not
preempt or supersede any law that imposes greater protections
(such as a shorter statute of limitations) for health care
providers and health care organizations from liability, loss,
or damages than those provided by this Act.
(c) State Flexibility.--No provision of this Act shall be
construed to preempt--
(1) any State statutory limit (whether enacted
before, on, or after the date of the enactment of this
Act) on the amount of compensatory or punitive damages
(or the total amount of damages) that may be awarded in
a health care lawsuit, whether or not such State limit
permits the recovery of a specific dollar amount of
damages that is greater or lesser than is provided for
under this Act, notwithstanding section 4(a); or
(2) any defense available to a party in a health care
lawsuit under any other provision of State or Federal
law.
SEC. 12. APPLICABILITY; EFFECTIVE DATE.
This Act shall apply to any health care lawsuit brought in a
Federal or State court, or subject to an alternative dispute
resolution system, that is initiated on or after the date of
the enactment of this Act, except that any health care lawsuit
arising from an injury occurring prior to the date of the
enactment of this Act shall be governed by the applicable
statute of limitations provisions in effect at the time the
injury occurred.
SEC. 13. SENSE OF CONGRESS.
It is the sense of Congress that a health insurer should be
liable for damages for harm caused when it makes a decision as
to what care is medically necessary and appropriate.