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Union Calendar No. 20
108th CONGRESS
1st Session
H. R. 5
[Report No. 108-32, Parts I and II]
To improve patient access to health care services and provide improved
medical care by reducing the excessive burden the liability system
places on the health care delivery system.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 5, 2003
Mr. Greenwood (for himself, Mr. Murtha, Mr. Cox, Mr. Sensenbrenner, Mr.
Tauzin, Mr. Thomas, Mr. Goode, Mr. Ferguson, Mr. Gerlach, Mrs. Capito,
Mr. Feeney, Mr. Kirk, Mrs. Biggert, Mr. Platts, Mr. Shays, Mr.
Frelinghuysen, Mr. Murphy, Mr. Peterson of Minnesota, Mr. Lucas of
Kentucky, Mr. Stenholm, Mr. Taylor of Mississippi, Mr. Hobson, Ms.
Granger, Mrs. Johnson of Connecticut, Ms. Dunn, Mr. Rogers of Michigan,
Ms. Ginny Brown-Waite of Florida, Mr. Hayes, Mr. Leach, Mr. Otter, Mr.
Graves, Mr. LaTourette, Mr. Fletcher, Mr. Weldon of Florida, Mr.
Tiberi, Mr. Hayworth, Mr. Crane, Mr. Portman, Mr. Sullivan, Mr. Souder,
Mr. Cannon, Mr. Shaw, Mr. McHugh, Mr. McKeon, Mr. Lewis of Kentucky,
Mrs. Northup, Mr. Sessions, Mr. Hulshof, Mr. Putnam, Mr. Gilchrest, Mr.
Knollenberg, Mr. Houghton, Mr. Regula, Mr. Tom Davis of Virginia, Mr.
Forbes, Mr. Peterson of Pennsylvania, Mr. LoBiondo, Mr. Boehlert, Mr.
Nussle, Mr. Shuster, Mr. Tiahrt, Mr. Stearns, Mr. Gillmor, Ms. Hart,
Mr. Walsh, Mr. Crenshaw, Mr. Barton of Texas, Mr. Keller, and Mr.
Collins) introduced the following bill; which was referred to the
Committee on the Judiciary, and in addition to the Committee on Energy
and Commerce, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
March 11, 2003
Additional sponsors: Mr. Goodlatte, Mr. Burgess, Mr. Pickering, Mrs.
Kelly, Mr. Toomey, Mr. Chabot, Mr. Pence, Mrs. Emerson, Mr. Rogers of
Alabama, Mr. Smith of Texas, Mr. McInnis, Mr. Bordallo, Mr. Gingrey,
Mr. Everett, Mr. Mica, Mrs. Jo Ann Davis of Virginia, Mr. Cunningham,
Mr. Burr, Mr. Dreier, Mr. Cantor, Mr. Gallegly, Mr. Gary G. Miller of
Californina, Mr. Ney, Mr. Radanovich, Mr. Fossella, Mr. Wamp, Mr.
Weller, Mr. Kingston, Mr. Whitfield, Mr. Thornberry, Mr. Wolf, Mr.
Pitts, Mr. Kennedy of Minnesota, Mrs. Myrick, Mr. Cole, Mr. Beauprez,
Mrs. Cubin, Mrs. Bono, Mr. Issa, Mr. Saxton, Mr. Brady of Texas, Mr.
Blunt, Mr. Aderholt, Mrs. Musgrave, Mr. Lucas of Oklahoma, Mr.
Hensarling, Mr. King of Iowa, Mr. Bass, Mr. Barrett of South Carolina,
Mr. Hastings of Washington, Mr. Boozman, Mr. Combest, Mr. Brown of
South Carolina, Mr. Holden, Mr. DeMint, Mr. Sweeney, Mr. LaHood, Mr.
Bradley of New Hampshire, Mr. Manzullo, and Mr. Simpson
March 11, 2003
Reported from the Committee on the Judiciary with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
March 11, 2003
Reported from the Committee on Energy and Commerce with an amendment;
committed to the Committee of the Whole House on the State of the Union
and ordered to be printed
[Strike out all after the enacting clause and insert the part printed
in boldface roman]
[For text of introduced bill, see copy of bill as introduced on
February 5, 2003]
_______________________________________________________________________
A BILL
To improve patient access to health care services and provide improved
medical care by reducing the excessive burden the liability system
places on the health care delivery system.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Help Efficient, Accessible, Low-
cost, Timely Healthcare (HEALTH) Act of 2003''.
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; and
(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, if awarded, in a health care lawsuit, 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, if
awarded, in a health care lawsuit may be as much as $250,000 or
as much as two times the amount of economic damages awarded,
whichever is greater. The jury shall not be informed of this
limitation.
(c) No Punitive Damages for Products That Comply With FDA
Standards.--
(1) In general.--No punitive damages may be awarded against
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