,i  #aad? ,,congress  #b;d ,session  ,h4
 ,r4 #dehi  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,febru>y #bc1 #bjaf   
,mr4 ,mac,arthur introduc$ ! foll[+     
bill2 :i* 0 ref]r$ to ! ,committee on ! 
,judici>y1 & 9 addition to ! ,committees
 on ,en]gy & ,comm]ce & ,ways & ,means1 
= a p]iod to be subsequ5tly det]m9$ by !
 ,speak]1 9 ea* case = consid]ation (   
su* provisions z fall )9 ! jurisdiction 
( ! committee conc]n$  ,a ,,bill  ,to   
am5d title ,,xviii ( ! ,social ,security
 ,act to repeal ! cap on ! ,m$ic>e      
,advantage /> rat+ bonuses1 & = o!r     
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,excell5ce 9 ,m$ic>e ,act4 
,i ,m$ic>e ,advantage  #aja4 ,repeal+   
cap on ,m$ic>e ,advantage /> rat+       
bonuses  7a7 ,9 g5]al ,section          
#ahec7n77#d7 ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #aciew-#bc7n77#d77 is    
am5d$ by /rik+ 7det]m9$ tak+ into acc\nt
 subsection 7o77 & ins]t+ det]m9$ be=e  
application ( subsection 7o774  7b7     
,effective date ,! am5dm5t made by      

subsection 7a7 %all apply beg9n+ )      
respect to #bjag4  ,,ii ,,heal? ,act    
#bja4 ,%ort title ,?is title may be cit$
 z ! ,m$ical ,malpractice ,re=m ,act (  
#bjae4  #bjb4 ,f9d+s & purpose  7a7     
,f9d+s  7#a7 ,effect on heal? c>e access
 & co/s ,congress f9ds t our curr5t     
civil ju/ice sy/em is adv]sely affect+  
pati5t access to heal? c>e s]vices1     
bett] pati5t c>e1 & co/-effici5t heal?  
c>e1 9 t ! heal? c>e liability sy/em is 
a co/ly & ineffective me*anism = resolv+
 claims ( heal? c>e liability &         
comp5sat+ injur$ pati5ts1 & is a det]r5t
 to ! %>+ ( in=mation among heal? c>e   
pr(essionals :i* imp$es ef=ts to improve
 pati5t safety & quality ( c>e4  7#b7   
,effect on int]/ate comm]ce ,congress   
f9ds t ! heal? c>e liability litigation 
sy/ems exi/+ ?r\gh\t ! ,unit$ ,/ates are
 activities t affect int]/ate comm]ce by
 contribut+ to ! high co/s ( heal? c>e &
 premiums = heal? c>e liability         
insurance pur*as$ by heal? c>e sy/em    
provid]s4  7#c7 ,effect on f$]al sp5d+  

,congress f9ds t ! heal? c>e liability  
litigation sy/ems exi/+ ?r\gh\t ! ,unit$
 ,/ates h a significant effect on !     
am\nt1 di/ribution1 & use ( ,f$]al funds
 because (--  7,a7 ! l>ge numb] (       
individuals :o receive heal? c>e b5efits
 "u programs op]at$ or f9anc$ by !      
,f$]al ,gov]nm5t2  7,b7 ! l>ge numb] (  
individuals :o b5efit because ( !       
exclusion f ,f$]al taxes ( ! am\nts sp5t
 to provide !m ) heal? insurance        
b5efits2 &  7,c7 ! l>ge numb] ( heal?   
c>e provid]s :o provide items or s]vices
 = :i* ! ,f$]al ,gov]nm5t makes paym5ts4
  7b7 ,purpose ,x is ! purpose ( ?is    
title to implem5t reasonable1           
compreh5sive1 & effective heal? c>e     
liability re=ms design$ to--  7#a7      
improve ! availability ( heal? c>e      
s]vices 9 cases 9 :i* heal? c>e         
liability actions h be5 %[n to be a     
factor 9 ! decreas$ availability (      
s]vices2  7#b7 r$uce ! incid5ce (       
def5sive m$ic9e & l[] ! co/ ( heal? c>e 
liability insurance1 all ( :i*          

contribute to ! escalation ( heal? c>e  
co/s2  7#c7 ensure t p]sons ) m]itori\s 
heal? c>e injury claims receive fair &  
adequate comp5sation1 includ+ reasonable
 noneconomic damages2  7#d7 improve !   
fairness & co/-effectiv5ess ( our curr5t
 heal? c>e liability sy/em to resolve   
disputes ov]1 & provide comp5sation =1  
heal? c>e liability by r$uc+ unc]ta9ty 9
 ! am\nt ( comp5sation provid$ to injur$
 individuals2 &  7#e7 provide an        
increas$ %>+ ( in=mation 9 ! heal? c>e  
sy/em :i* w r$uce un9t5d$ injury &      
improve pati5t c>e4  #bjc4 ,enc\rag+    
spe$y resolution ( claims ,! "t = !     
comm5cem5t ( a heal? c>e lawsuit %all be
 #c ye>s aft] ! date ( manife/ation (   
injury or #a ye> aft] ! claimant        
discov]s1 or ?r\gh ! use ( reasonable   
dilig5ce %\ld h discov]$1 ! injury1     
:i*ev] occurs fir/4 ,9 no ev5t %all ! "t
 = comm5cem5t ( a heal? c>e lawsuit     
exce$ #c ye>s aft] ! date ( manife/ation
 ( injury unless toll$ = any ( !        
foll[+--  7#a7 ^u pro( ( fraud2  7#b7   

int5tional concealm5t2 or  7#c7 !       
pres5ce ( a =eign body1 :i* has no      
!rapeutic or diagno/ic purpose or       
effect1 9 ! p]son ( ! injur$ p]son4     
,actions by a m9or %all be comm5c$ )9 #c
 ye>s f ! date ( ! alleg$ manife/ation (
 injury except t actions by a m9or "u ! 
full age ( #f ye>s %all be comm5c$ )9 #c
 ye>s ( manife/ation ( injury or prior  
to ! m9or's #h? bir?day1 :i*ev] provides
 a long] p]iod4 ,su* "t limitation %all 
be toll$ = m9ors = any p]iod dur+ :i* a 
p>5t or gu>dian & a heal? c>e provid] or
 heal? c>e organization h committ$ fraud
 or collusion 9 ! failure to br+ an     
action on behalf ( ! injur$ m9or4  #bjd4
 ,comp5sat+ pati5t injury  7a7 ,unlimit$
 ,am\nt ( ,damages = ,actual ,economic  
,losses 9 ,heal? ,c>e ,lawsuits ,9 any  
heal? c>e lawsuit1 no?+ 9 ?is title %all
 limit a claimant's recov]y ( ! full    
am\nt ( ! available economic damages1   
not)/&+ ! limitation 9 subsection 7b74  
7b7 ,additional ,noneconomic ,damages ,9
 any heal? c>e lawsuit1 ! am\nt (       

noneconomic damages1 if available1 may  
be z mu* z #bej1jjj1 reg>dless ( ! numb]
 ( p>ties aga9/ :om ! action is br\ght  
or ! numb] ( sep>ate claims or actions  
br\ght ) respect to ! same injury4  7c7 
,no ,disc\nt ( ,aw>d = ,noneconomic     
,damages ,= purposes ( apply+ !         
limitation 9 subsection 7b71 future     
noneconomic damages %all n be disc\nt$  
to pres5t value4 ,! jury %all n be in=m$
 ab\t ! maximum aw>d = noneconomic      
damages4 ,an aw>d = noneconomic damages 
9 excess ( #bej1jjj %all be r$uc$ ei!r  
be=e ! entry ( judgm5t1 or by am5dm5t ( 
! judgm5t aft] entry ( judgm5t1 & su*   
r$uction %all be made be=e acc\nt+ = any
 o!r r$uction 9 damages requir$ by law4 
,if sep>ate aw>ds are r5d]$ = pa/ &     
future noneconomic damages & ! comb9$   
aw>ds exce$ #bej1jjj1 ! future          
noneconomic damages %all be r$uc$ fir/4 
7d7 ,fair ,%>e ,rule ,9 any heal? c>e   
lawsuit1 ea* p>ty %all be liable = t    
p>ty's sev]al %>e ( any damages only & n
 = ! %>e ( any o!r p]son4 ,ea* p>ty %all

 be liable only = ! am\nt ( damages     
allocat$ to su* p>ty 9 direct proportion
 to su* p>ty's p]c5tage (               
responsibility4 ,:5ev] a judgm5t (      
liability is r5d]$ z to any p>ty1 a     
sep>ate judgm5t %all be r5d]$ aga9/ ea* 
su* p>ty = ! am\nt allocat$ to su* p>ty4
 ,= purposes ( ?is section1 ! tri] (    
fact %all det]m9e ! proportion (        
responsibility ( ea* p>ty = ! claimant's
 h>m4  #bje4 ,maximiz+ pati5t recov]y   
7a7 ,c\rt ,sup]vision ( ,%>e ( ,damages 
,actually ,paid to ,claimants ,9 any    
heal? c>e lawsuit1 ! c\rt %all sup]vise 
! arrangem5ts = paym5t ( damages to     
protect aga9/ conflicts ( int]e/ t may h
 ! effect ( r$uc+ ! am\nt ( damages     
aw>d$ t are actually paid to claimants4 
,9 p>ticul>1 9 any heal? c>e lawsuit 9  
:i* ! attorney = a p>ty claims a        
f9ancial /ake 9 ! outcome by virtue ( a 
cont+5t fee1 ! c\rt %all h ! p[] to     
re/rict ! paym5t ( a claimant's damage  
recov]y to su* attorney1 & to r$irect   
su* damages to ! claimant bas$ ^u !     

int]e/s ( ju/ice & pr9ciples ( equity4  
,9 no ev5t %all ! total ( all cont+5t   
fees = repres5t+ all claimants 9 a heal?
 c>e lawsuit exce$ ! foll[+ limits3     
7#a7 ,=ty p]c5t ( ! fir/ #ej1jjj recov]$
 by ! claimant7s74  7#b7 ,?irty-?ree &  
"o-?ird p]c5t ( ! next #ej1jjj recov]$  
by ! claimant7s74  7#c7 ,tw5ty-five     
p]c5t ( ! next #ejj1jjj recov]$ by !    
claimant7s74  7#d7 ,fifte5 p]c5t ( any  
am\nt by :i* ! recov]y by ! claimant7s7 
is 9 excess ( #fjj1jjj4  7b7            
,applicability ,! limitations 9 ?is     
section %all apply :e!r ! recov]y is by 
judgm5t1 settlem5t1 m$iation1           
arbitration1 or any o!r =m ( alt]native 
dispute resolution4 ,9 a heal? c>e      
lawsuit involv+ a m9or or incompet5t    
p]son1 a c\rt reta9s ! au?ority to      
au?orize or approve a fee t is less ?an 
! maximum p]mitt$ "u ?is section4 ,!    
requirem5t = c\rt sup]vision 9 ! fir/   
two s5t5ces ( subsection 7a7 applies    
only 9 civil actions4  #bjf4 ,additional
 b5efits ,9 any heal? c>e lawsuit       

involv+ injury or wrongful dea?1 any    
p>ty may introduce evid5ce ( collat]al  
s\rce b5efits4 ,if a p>ty elects to     
introduce su* evid5ce1 any oppos+ p>ty  
may introduce evid5ce ( any am\nt paid  
or contribut$ or reasonably likely to be
 paid or contribut$ 9 ! future by or on 
behalf ( ! oppos+ p>ty to secure ! "r to
 su* collat]al s\rce b5efits4 ,no       
provid] ( collat]al s\rce b5efits %all  
recov] any am\nt aga9/ ! claimant or    
receive any li5 or cr$it aga9/ !        
claimant's recov]y or be equitably or   
legally subrogat$ to ! "r ( ! claimant 9
 a heal? c>e lawsuit involv+ injury or  
wrongful dea?4 ,?is section %all apply  
to any heal? c>e lawsuit t is settl$ z  
well z a heal? c>e lawsuit t is resolv$ 
by a fact f9d]4 ,?is section %all n     
apply to section #ahfb7;b7 7#db         
,u4,s4,c4 #aciey7b77 or section         
#aijb7;a77#be7 7#db ,u4,s4,c4           
#acif;a7a77#be77 ( ! ,social ,security  
,act4  #bjg4 ,punitive damages  7a7 ,9  
,g5]al ,punitive damages may1 if o!rwise

 p]mitt$ by applicable ,/ate or ,f$]al  
law1 be aw>d$ aga9/ any p]son 9 a heal? 
c>e lawsuit only if x is prov5 by cle> &
 conv9c+ evid5ce t su* p]son act$ )     
malici\s int5t to injure ! claimant1 or 
t su* p]son delib]ately fail$ to avoid  
unnecess>y injury t su* p]son knew !    
claimant 0 sub/antially c]ta9 to suff]4 
,9 any heal? c>e lawsuit :]e no judgm5t 
= comp5satory damages is r5d]$ aga9/ su*
 p]son1 no punitive damages may be aw>d$
 ) respect to ! claim 9 su* lawsuit4 ,no
 dem& = punitive damages %all be includ$
 9 a heal? c>e lawsuit z initially fil$4
 ,a c\rt may all[ a claimant to file an 
am5d$ plead+ = punitive damages only ^u 
a motion by ! claimant & aft] a f9d+ by 
! c\rt1 ^u review ( support+ & oppos+   
affidavits or aft] a he>+1 aft] weigh+ !
 evid5ce1 t ! claimant has e/abli%$ by a
 sub/antial probability t ! claimant w  
prevail on ! claim = punitive damages4  
,at ! reque/ ( any p>ty 9 a heal? c>e   
lawsuit1 ! tri] ( fact %all consid] 9 a 
sep>ate proce$+--  7#a7 :e!r punitive   

damages are to be aw>d$ & ! am\nt ( su* 
aw>d2 &  7#b7 ! am\nt ( punitive damages
 foll[+ a det]m9ation ( punitive        
liability4  ,if a sep>ate proce$+ is    
reque/$1 evid5ce relevant only to !     
claim = punitive damages1 z det]m9$ by  
applicable ,/ate law1 %all be           
inadmissible 9 any proce$+ to det]m9e   
:e!r comp5satory damages are to be      
aw>d$4  7b7 ,det]m9+ ,am\nt ( ,punitive 
,damages  7#a7 ,factors consid]$ ,9     
det]m9+ ! am\nt ( punitive damages1 if  
aw>d$1 9 a heal? c>e lawsuit1 ! tri] (  
fact %all consid] only ! foll[+3  7,a7  
,! sev]ity ( ! h>m caus$ by ! conduct ( 
su* p>ty4  7,b7 ,! duration ( ! conduct 
or any concealm5t ( x by su* p>ty4  7,c7
 ,! pr(itability ( ! conduct to su*     
p>ty4  7,d7 ,! numb] ( products sold or 
m$ical proc$ures r5d]$ = comp5sation1 z 
! case may be1 by su* p>ty1 ( ! k9d     
caus+ ! h>m compla9$ ( by ! claimant4   
7,e7 ,any crim9al p5alties impos$ on su*
 p>ty1 z a result ( ! conduct compla9$ (
 by ! claimant4  7,f7 ,! am\nt ( any    

civil f9es assess$ aga9/ su* p>ty z a   
result ( ! conduct compla9$ ( by !      
claimant4  7#b7 ,maximum aw>d ,! am\nt (
 punitive damages1 if aw>d$1 9 a heal?  
c>e lawsuit may be z mu* z #bej1jjj or z
 mu* z two times ! am\nt ( economic     
damages aw>d$1 :i*ev] is great]4 ,! jury
 %all n be in=m$ ( ?is limitation4  7c7 
,no ,punitive ,damages = ,products ,t   
,comply ,) ,,fda ,/&>ds  7#a7 ,9 g5]al  
7,a7 ,no punitive damages may be aw>d$  
aga9/ ! manufactur] or di/ributor ( a   
m$ical product1 or a suppli] ( any      
compon5t or raw mat]ial ( su* m$ical    
product1 bas$ on a claim t su* product  
caus$ ! claimant's h>m :]e--  7i7  7,i7 
su* m$ical product 0 subject to prem>ket
 approval1 cle>ance1 or lic5sure by !   
,food & ,drug ,adm9i/ration ) respect to
 ! safety ( ! =mulation or p]=mance ( ! 
aspect ( su* m$ical product :i* caus$ ! 
claimant's h>m or ! adequacy ( ! packag+
 or label+ ( su* m$ical product2 &      
7,,ii7 su* m$ical product 0 s approv$1  
cle>$1 or lic5s$2 or  7ii7 su* m$ical   

product is g5]ally recogniz$ among      
qualifi$ exp]ts z safe & effective      
pursuant to conditions e/abli%$ by !    
,food & ,drug ,adm9i/ration & applicable
 ,food & ,drug ,adm9i/ration            
regulations1 includ+ )\t limitation ^?  
relat$ to packag+ & label+1 unless !    
,food & ,drug ,adm9i/ration has det]m9$ 
t su* m$ical product 0 n manufactur$ or 
di/ribut$ 9 sub/antial compliance )     
applicable ,food & ,drug ,adm9i/ration  
/atutes & regulations4  7,b7 ,rule (    
con/ruction ,subp>agraph 7,a7 may n be  
con/ru$ z e/abli%+ ! obligation ( !     
,food & ,drug ,adm9i/ration to          
demon/rate affirmatively t a            
manufactur]1 di/ributor1 or suppli]     
ref]r$ to 9 su* subp>agraph meets any ( 
! conditions describ$ 9 su* subp>agraph4
  7#b7 ,liability ( heal? c>e provid]s  
,a heal? c>e provid] :o prescribes1 or  
:o disp5ses pursuant to a prescription1 
a m$ical product approv$1 lic5s$1 or    
cle>$ by ! ,food & ,drug ,adm9i/ration  
%all n be nam$ z a p>ty to a product    

liability lawsuit involv+ su* product & 
%all n be liable to a claimant 9 a class
 action lawsuit aga9/ ! manufactur]1    
di/ributor1 or sell] ( su* product4     
,no?+ 9 ?is p>agraph prev5ts a c\rt f   
consolidat+ cases involv+ heal? c>e     
provid]s & cases involv+ products       
liability claims aga9/ ! manufactur]1   
di/ributor1 or product sell] ( su*      
m$ical product4  7#c7 ,packag+ ,9 a     
heal? c>e lawsuit = h>m :i* is alleg$ to
 relate to ! adequacy ( ! packag+ or    
label+ ( a drug :i* is requir$ to h     
tamp]-resi/ant packag+ "u regulations ( 
! ,secret>y ( ,heal? & ,human ,s]vices  
7includ+ label+ regulations relat$ to   
su* packag+71 ! manufactur] or product  
sell] ( ! drug %all n be held liable =  
punitive damages unless su* packag+ or  
label+ is f\nd by ! tri] ( fact by cle> 
& conv9c+ evid5ce to be sub/antially out
 ( compliance ) su* regulations4  7#d7  
,exception ,p>agraph 7#a7 %all n apply 9
 any heal? c>e lawsuit 9 :i*-- 7,a7 a   
p]son1 be=e or aft] prem>ket approval1  

cle>ance1 or lic5sure ( su* m$ical      
product1 kn[+ly misrepres5t$ to or )held
 f ! ,food & ,drug ,adm9i/ration        
in=mation t is requir$ to be submitt$ "u
 ! ,f$]al ,food1 ,drug1 & ,cosmetic ,act
 7#ba ,u4,s4,c4 #cja et seq47 or section
 #cea ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #bfb7 t is mat]ial & is  
causally relat$ to ! h>m :i* ! claimant 
alleg$ly suff]$2 or  7,b7 a p]son made  
an illegal paym5t to an (ficial ( !     
,food & ,drug ,adm9i/ration = ! purpose 
( ei!r secur+ or ma9ta9+ approval1      
cle>ance1 or lic5sure ( su* m$ical      
product4  #bjh4 ,au?orization ( paym5t (
 future damages to claimants 9 heal? c>e
 lawsuits  7a7 ,9 ,g5]al ,9 any heal?   
c>e lawsuit1 if an aw>d ( future        
damages1 )\t r$uction to pres5t value1  
equal+ or exce$+ #ej1jjj is made aga9/ a
 p>ty ) suffici5t insurance or o!r      
assets to fund a p]iodic paym5t ( su* a 
judgm5t1 ! c\rt %all1 at ! reque/ ( any 
p>ty1 ent] a judgm5t ord]+ t ! future   
damages be paid by p]iodic paym5ts1 9   

accordance ) ! ,uni=m ,p]iodic ,paym5t (
 ,judgm5ts ,act promulgat$ by !         
,national ,conf]5ce ( ,commission]s on  
,uni=m ,/ate ,laws4  7b7 ,applicability 
,?is section applies to all actions :i* 
h n be5 fir/ set = trial or retrial be=e
 ! effective date ( ?is title4  #bji4   
,def9itions ,9 ?is title3 7#a7          
,alt]native dispute resolution sy/em2   
,,adr ,! t]m alt]native dispute         
resolution sy/em or ,,adr means a sy/em 
t provides = ! resolution ( heal? c>e   
lawsuits 9 a mann] o!r ?an ?r\gh a civil
 action br\ght 9 a ,/ate or ,f$]al c\rt4
  7#b7 ,claimant ,! t]m claimant means  
any p]son :o br+s a heal? c>e lawsuit1  
includ+ a p]son :o ass]ts or claims a "r
 to legal or equitable contribution1    
indemnity1 or subrogation1 aris+ out ( a
 heal? c>e liability claim or action1 & 
any p]son on ^: behalf su* a claim is   
ass]t$ or su* an action is br\ght1 :e!r 
deceas$1 incompet5t1 or a m9or4  7#c7   
,collat]al s\rce b5efits ,! t]m         
collat]al s\rce b5efits means any am\nt 

paid or reasonably likely to be paid 9 !
 future to or on behalf ( ! claimant1 or
 any s]vice1 product1 or o!r b5efit     
provid$ or reasonably likely to be      
provid$ 9 ! future to or on behalf ( !  
claimant1 z a result ( ! injury or      
wrongful dea?1 pursuant to--  7,a7 any  
,/ate or ,f$]al heal?1 sickness1        
income-disability1 accid5t1 or work]s'  
comp5sation law2  7,b7 any heal?1       
sickness1 income-disability1 or accid5t 
insurance t provides heal? b5efits or   
income-disability cov]age2  7,c7 any    
contract or agreem5t ( any gr\p1        
organization1 p>tn]%ip1 or corporation  
to provide1 pay =1 or reimburse ! co/ ( 
m$ical1 hospital1 d5tal1 or             
income-disability b5efits2 &  7,d7 any  
o!r publicly or privately fund$ program4
  7#d7 ,comp5satory damages ,! t]m      
comp5satory damages means objectively   
v]ifiable monet>y losses incurr$ z a    
result ( ! provision (1 use (1 or paym5t
 = 7or failure to provide1 use1 or pay  
=7 heal? c>e s]vices or m$ical products1

 su* z pa/ & future m$ical exp5ses1 loss
 ( pa/ & future e>n+s1 co/ ( obta9+     
dome/ic s]vices1 loss ( employm5t1 &    
loss ( bus9ess or employm5t             
opportunities1 damages = physical &     
emotional pa91 suff]+1 inconv5i5ce1     
physical impairm5t1 m5tal angui%1       
disfigurem5t1 loss ( enjoym5t ( life1   
loss ( society & companion%ip1 loss (   
consortium 7o!r ?an loss ( dome/ic      
s]vice71 h$onic damages1 injury to      
reputation1 & all o!r nonpecuni>y losses
 ( any k9d or nature4 ,! t]m comp5satory
 damages includes economic damages &    
noneconomic damages1 z su* t]ms are     
def9$ 9 ?is section4  7#e7 ,cont+5t fee 
,! t]m cont+5t fee includes all         
comp5sation to any p]son or p]sons :i*  
is payable only if a recov]y is effect$ 
on behalf ( "o or m claimants4  7#f7    
,economic damages ,! t]m economic       
damages means objectively v]ifiable     
monet>y losses incurr$ z a result ( !   
provision (1 use (1 or paym5t = 7or     
failure to provide1 use1 or pay =7 heal?

 c>e s]vices or m$ical products1 su* z  
pa/ & future m$ical exp5ses1 loss ( pa/ 
& future e>n+s1 co/ ( obta9+ dome/ic    
s]vices1 loss ( employm5t1 & loss (     
bus9ess or employm5t opportunities4     
7#g7 ,heal? c>e lawsuit ,! t]m heal? c>e
 lawsuit means any heal? c>e liability  
claim conc]n+ ! provision ( heal? c>e   
goods or s]vices or any m$ical product  
affect+ int]/ate comm]ce1 or any heal?  
c>e liability action conc]n+ ! provision
 ( heal? c>e goods or s]vices or any    
m$ical product affect+ int]/ate comm]ce1
 br\ght 9 a ,/ate or ,f$]al c\rt or     
pursuant to an alt]native dispute       
resolution sy/em1 aga9/ a heal? c>e     
provid]1 a heal? c>e organization1 or ! 
manufactur]1 di/ributor1 suppli]1       
m>ket]1 promot]1 or sell] ( a m$ical    
product1 reg>dless ( ! !ory ( liability 
on :i* ! claim is bas$1 or ! numb] (    
claimants1 pla9tiffs1 def5dants1 or o!r 
p>ties1 or ! numb] ( claims or causes ( 
action1 9 :i* ! claimant alleges a heal?
 c>e liability claim4 ,su* t]m does n   

include a claim or action :i* is bas$ on
 crim9al liability2 :i* seeks civil f9es
 or p5alties paid to ,f$]al1 ,/ate1 or  
local gov]nm5t2 or :i* is gr\nd$ 9      
antitru/4  7#h7 ,heal? c>e liability    
action ,! t]m heal? c>e liability action
 means a civil action br\ght 9 a ,/ate  
or ,f$]al c\rt or pursuant to an        
alt]native dispute resolution sy/em1    
aga9/ a heal? c>e provid]1 a heal? c>e  
organization1 or ! manufactur]1         
di/ributor1 suppli]1 m>ket]1 promot]1 or
 sell] ( a m$ical product1 reg>dless ( !
 !ory ( liability on :i* ! claim is     
bas$1 or ! numb] ( pla9tiffs1 def5dants1
 or o!r p>ties1 or ! numb] ( causes (   
action1 9 :i* ! claimant alleges a heal?
 c>e liability claim4  7#i7 ,heal? c>e  
liability claim ,! t]m heal? c>e        
liability claim means a dem& by any     
p]son1 :e!r or n pursuant to ,,adr1     
aga9/ a heal? c>e provid]1 heal? c>e    
organization1 or ! manufactur]1         
di/ributor1 suppli]1 m>ket]1 promot]1 or
 sell] ( a m$ical product1 includ+1 b n 

limit$ to1 ?ird-p>ty claims1            
cross-claims1 c\nt]-claims1 or          
contribution claims1 :i* are bas$ ^u !  
provision (1 use (1 or paym5t = 7or !   
failure to provide1 use1 or pay =7 heal?
 c>e s]vices or m$ical products1        
reg>dless ( ! !ory ( liability on :i* ! 
claim is bas$1 or ! numb] ( pla9tiffs1  
def5dants1 or o!r p>ties1 or ! numb] (  
causes ( action4  7#aj7 ,heal? c>e      
organization ,! t]m heal? c>e           
organization means any p]son or entity  
:i* is obligat$ to provide or pay =     
heal? b5efits "u any heal? plan1 includ+
 any p]son or entity act+ "u a contract 
or arrangem5t ) a heal? c>e organization
 to provide or adm9i/] any heal? b5efit4
  7#aa7 ,heal? c>e provid] ,! t]m heal? 
c>e provid] means any p]son or entity   
requir$ by ,/ate or ,f$]al laws or      
regulations to be lic5s$1 regi/]$1 or   
c]tifi$ to provide heal? c>e s]vices1 & 
be+ ei!r s lic5s$1 regi/]$1 or c]tifi$1 
or exempt$ f su* requirem5t by o!r      
/atute or regulation4  7#ab7 ,heal? c>e 

goods or s]vices ,! t]m heal? c>e goods 
or s]vices means any goods or s]vices   
provid$ by a heal? c>e organization1    
provid]1 or by any individual work+ "u !
 sup]vision ( a heal? c>e provid]1 t    
relates to ! diagnosis1 prev5tion1 or   
treatm5t ( any human disease or         
impairm5t1 or ! assessm5t or c>e ( !    
heal? ( human be+s4  7#ac7 ,malici\s    
int5t to injure ,! t]m malici\s int5t to
 injure means int5tionally caus+ or     
attempt+ to cause physical injury o!r   
?an provid+ heal? c>e goods or s]vices4 
7#ad7 ,m$ical product ,! t]m m$ical     
product means a drug1 device1 or        
biological product int5d$ = humans1 & ! 
t]ms drug1 device1 & biological product 
h ! mean+s giv5 su* t]ms 9 sections     
#bja7;g77#a7 & #bja7;h7 ( ! ,f$]al      
,food1 ,drug1 & ,cosmetic ,act 7#ba     
,u4,s4,c4 #cba7;g77#a7 & 7h77 & section 
#cea7;a7 ( ! ,public ,heal? ,s]vice ,act
 7#db ,u4,s4,c4 #bfb7;a771 respectively1
 includ+ any compon5t or raw mat]ial us$
 !re91 b exclud+ heal? c>e s]vices4     

7#ae7 ,noneconomic damages ,! t]m       
noneconomic damages means damages =     
physical & emotional pa91 suff]+1       
inconv5i5ce1 physical impairm5t1 m5tal  
angui%1 disfigurem5t1 loss ( enjoym5t ( 
life1 loss ( society & companion%ip1    
loss ( consortium 7o!r ?an loss (       
dome/ic s]vice71 h$onic damages1 injury 
to reputation1 & all o!r nonpecuni>y    
losses ( any k9d or nature4  7#af7      
,punitive damages ,! t]m punitive       
damages means damages aw>d$1 = ! purpose
 ( puni%m5t or det]r5ce1 & n solely =   
comp5satory purposes1 aga9/ a heal? c>e 
provid]1 heal? c>e organization1 or a   
manufactur]1 di/ributor1 or suppli] ( a 
m$ical product4 ,punitive damages are   
nei!r economic nor noneconomic damages4 
7#ag7 ,recov]y ,! t]m recov]y means !   
net sum recov]$ aft] d$uct+ any         
disbursem5ts or co/s incurr$ 9          
connection ) prosecution or settlem5t ( 
! claim1 includ+ all co/s paid or       
advanc$ by any p]son4 ,co/s ( heal? c>e 
incurr$ by ! pla9tiff & ! attorneys'    

(fice ov]head co/s or *>ges = legal     
s]vices are n d$uctible disbursem5ts or 
co/s = su* purpose4  7#ah7 ,/ate ,! t]m 
,/ate means ea* ( ! sev]al ,/ates1 !    
,di/rict ( ,columbia1 ! ,commonweal? (  
,pu]to ,rico1 ! ,virg9 ,isl&s1 ,guam1   
,am]ican ,samoa1 ! ,nor!rn ,m>iana      
,isl&s1 ! ,tru/ ,t]ritory ( ! ,pacific  
,isl&s1 & any o!r t]ritory or possession
 ( ! ,unit$ ,/ates1 or any political    
subdivision !re(4  #baj4 ,effect on o!r 
laws  7a7 ,vacc9e ,injury  7#a7 ,to !   
ext5t t title ,,xxi ( ! ,public ,heal?  
,s]vice ,act e/abli%es a ,f$]al rule (  
law applicable to a civil action br\ght 
= a vacc9e-relat$ injury or dea?--  7,a7
 ?is title does n affect ! application (
 ! rule ( law to su* an action2 &  7,b7 
any rule ( law prescrib$ by ?is title 9 
conflict ) a rule ( law ( su* title     
,,xxi %all n apply to su* action4  7#b7 
,if !re is an aspect ( a civil action   
br\ght = a vacc9e-relat$ injury or dea? 
to :i* a ,f$]al rule ( law "u title     
,,xxi ( ! ,public ,heal? ,s]vice ,act   

does n apply1 !n ?is title or o!rwise   
applicable law 7z det]m9$ "u ?is title7 
w apply to su* aspect ( su* action4  7b7
 ,o!r ,f$]al ,law ,except z provid$ 9   
?is section1 no?+ 9 ?is title %all be   
deem$ to affect any def5se available to 
a def5dant 9 a heal? c>e lawsuit or     
action "u any o!r provision ( ,f$]al    
law4  #baa4 ,/ate flexibility &         
protection ( ,/ates' rights  7a7 ,heal? 
,c>e ,lawsuits ,! provisions gov]n+     
heal? c>e lawsuits set =? 9 ?is title   
preempt1 subject to subsections 7b7 &   
7c71 ,/ate law to ! ext5t t ,/ate law   
prev5ts ! application ( any provisions (
 law e/abli%$ by or "u ?is title4 ,!    
provisions gov]n+ heal? c>e lawsuits set
 =? 9 ?is title sup]s$e *apt] #aga (    
title #bh1 ,unit$ ,/ates ,code1 to !    
ext5t t su* *apt]--  7#a7 provides = a  
great] am\nt ( damages or cont+5t fees1 
a long] p]iod 9 :i* a heal? c>e lawsuit 
may be comm5c$1 or a r$uc$ applicability
 or scope ( p]iodic paym5t ( future     
damages1 ?an provid$ 9 ?is title2 or    

7#b7 prohibits ! introduction ( evid5ce 
reg>d+ collat]al s\rce b5efits1 or      
m&ates or p]mits subrogation or a li5 on
 collat]al s\rce b5efits4  7b7          
,protection ( ,/ates' ,rights & ,o!r    
,laws  7#a7 ,any issue t is n gov]n$ by 
any provision ( law e/abli%$ by or "u   
?is title 7includ+ ,/ate /&>ds (        
neglig5ce7 %all be gov]n$ by o!rwise    
applicable ,/ate or ,f$]al law4  7#b7   
,?is title %all n preempt or sup]s$e any
 ,/ate or ,f$]al law t imposes great]   
proc$ural or sub/antive protections =   
heal? c>e provid]s & heal? c>e          
organizations f liability1 loss1 or     
damages ?an ^? provid$ by ?is title or  
create a cause ( action4  7c7 ,/ate     
,flexibility ,no provision ( ?is title  
%all be con/ru$ to preempt-- 7#a7 any   
,/ate law 7:e!r effective be=e1 on1 or  
aft] ! date ( ! enactm5t ( ?is ,act7 t  
specifies a p>ticul> monet>y am\nt (    
comp5satory or punitive damages 7or !   
total am\nt ( damages7 t may be aw>d$ 9 
a heal? c>e lawsuit1 reg>dless ( :e!r   

su* monet>y am\nt is great] or less] ?an
 is provid$ = "u ?is title1 not)/&+     
section #bjd7;a72 or  7#b7 any def5se   
available to a p>ty 9 a heal? c>e       
lawsuit "u any o!r provision ( ,/ate or 
,f$]al law4  #bab4 ,applicability2      
effective date ,?is title %all apply to 
any heal? c>e lawsuit br\ght 9 a ,f$]al 
or ,/ate c\rt1 or subject to an         
alt]native dispute resolution sy/em1 t  
is initiat$ on or aft] ! date ( !       
enactm5t ( ?is ,act1 except t any heal? 
c>e lawsuit aris+ f an injury occurr+   
prior to ! date ( ! enactm5t ( ?is ,act 
%all be gov]n$ by ! applicable /atute ( 
limitations provisions 9 effect at ! "t 
! injury occurr$4