,,ib ,union ,calendar ,no4 #ca #aaeth ,,congress #ast ,session ,h4 ,r4 #abae ,report ,no4 #aae-ee1 ,part ,i ,,in ,,the ,,house ,,of ,,representatives ,february #bd1 #bjag ,mr4 ,king of ,iowa introduced the following bill2 which was referred to the ,committee on the ,judiciary1 and in addition to the ,committee on ,energy and ,commerce1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,march #bb1 #bjag;,additional sponsors3 ,mr4 ,goodlatte1 ,mr4 ,smith of ,texas1 and ,mr4 ,flores ,march #bb1 #bjag ,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 #bb1 #bjag,the ,committee on ,energy and ,commerce discharged2 committed to the ,committee of the ,whole ,house on the ,state of the ,union and ordered to be printed,for text of introduced bill1 see copy of bill as introduced on ,february #bd1 #bjag ,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 system4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,protecting ,access to ,care ,act of #bjag4 7b7 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,sec4 #b4 ,encouraging speedy resolution of claims4 ,sec4 #c4 ,compensating patient injury4 ,sec4 #d4 ,maximizing patient recovery4 ,sec4 #e4 ,authorization of payment of future damages to claimants in health care lawsuits4 ,sec4 #f4 ,product liability for health care providers4 ,sec4 #g4 ,definitions4 ,sec4 #h4 ,effect on other laws4 ,sec4 #i4 ,rules of construction4 ,sec4 #aj4 ,effective date4 #b4 ,encouraging speedy resolution of claims 7a7 ,statute of limitations ,the time for the commencement of a health care lawsuit shall be #c years after the date of injury or #a year after the claimant discovers1 or through the use of reasonable diligence should have discovered1 the injury1 whichever occurs first4 ,in no event shall the time for commencement of a health care lawsuit exceed #c years after the date of injury unless tolled for any of the following-- 7#a7 upon proof of fraud2 7#b7 intentional concealment2 or 7#c7 the presence of a foreign body1 which has no therapeutic or diagnostic purpose or effect1 in the person of the injured person4 ,actions by a minor shall be commenced within #c years from the date of the injury except that actions by a minor under the full age of #f years shall be commenced within #c years of injury1 or #a year after the injury is discovered1 or through the use of reasonable diligence should have been discovered1 or prior to the minor's #hth birthday1 whichever provides a longer period4 ,such time limitation shall be tolled for minors for any period during which a parent or guardian and a health care provider have committed fraud or collusion in the failure to bring an action on behalf of the injured minor4 7b7 ,state flexibility ,no provision of subsection 7a7 shall be construed to preempt any state law 7whether effective before1 on1 or after the date of the enactment of this ,act7 that-- 7#a7 specifies a time period of less than #c years after the date of injury or less than #a year after the claimant discovers1 or through the use of reasonable diligence should have discovered1 the injury1 for the filing of a health care lawsuit2 7#b7 that specifies a different time period for the filing of lawsuits by a minor2 7#c7 that triggers the time period based on the date of the alleged negligence2 or 7#d7 establishes a statute of repose for the filing of health care lawsuit4 #c4 ,compensating patient injury 7a7 ,unlimited amount of damages for actual economic losses in health care lawsuits ,in any health care lawsuit1 nothing in this ,act shall limit a claimant's recovery of the full amount of the available economic damages1 notwithstanding the limitation in subsection 7b74 7b7 ,additional noneconomic damages ,in any health care lawsuit1 the amount of noneconomic damages1 if available1 shall not exceed #bej1jjj1 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 injury4 7c7 ,no discount of award for noneconomic damages ,for purposes of applying the limitation in subsection 7b71 future noneconomic damages shall not be discounted to present value4 ,the jury shall not be informed about the maximum award for noneconomic damages4 ,an award for noneconomic damages in excess of #bej1jjj shall be reduced either before the entry of judgment1 or by amendment of the judgment after entry of judgment1 and such reduction shall be made before accounting for any other reduction in damages required by law4 ,if separate awards are rendered for past and future noneconomic damages and the combined awards exceed #bej1jjj1 the future noneconomic damages shall be reduced first4 7d7 ,fair share rule ,in any health care lawsuit1 each party shall be liable for that party's several share of any damages only and not for the share of any other person4 ,each party shall be liable only for the amount of damages allocated to such party in direct proportion to such party's percentage of responsibility4 ,whenever a judgment of liability is rendered as to any party1 a separate judgment shall be rendered against each such party for the amount allocated to such party4 ,for purposes of this section1 the trier of fact shall determine the proportion of responsibility of each party for the claimant's harm4 7e7 ,state flexibility ,no provision of this section shall be construed to preempt any ,state law 7whether effective before1 on1 or after the date of the enactment of this ,act7 that specifies a particular monetary amount of economic or noneconomic damages 7or the total amount of damages7 that may be awarded in a health care lawsuit1 regardless of whether such monetary amount is greater or lesser than is provided for under this section4 #d4 ,maximizing patient recovery 7a7 ,court supervision of share of damages actually paid to claimants ,in any health care lawsuit1 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 claimants4 ,in particular1 in any health care lawsuit in which the attorney for a party claims a financial stake in the outcome by virtue of a contingent fee1 the court shall have the power to restrict the payment of a claimant's damage recovery to such attorney1 and to redirect such damages to the claimant based upon the interests of justice and principles of equity4 ,in no event shall the total of all contingent fees for representing all claimants in a health care lawsuit exceed the following limits3 7#a7 ,forty percent of the first #ej1jjj recovered by the claimant7s74 7#b7 ,thirty-three and one-third percent of the next #ej1jjj recovered by the claimant7s74 7#c7 ,twenty-five percent of the next #ejj1jjj recovered by the claimant7s74 7#d7 ,fifteen percent of any amount by which the recovery by the claimant7s7 is in excess of #fjj1jjj4 7b7 ,applicability ,the limitations in this section shall apply whether the recovery is by judgment1 settlement1 mediation1 arbitration1 or any other form of alternative dispute resolution4 ,in a health care lawsuit involving a minor or incompetent person1 a court retains the authority to authorize or approve a fee that is less than the maximum permitted under this section4 ,the requirement for court supervision in the first two sentences of subsection 7a7 applies only in civil actions4 7c7 ,state flexibility ,no provision of this section shall be construed to preempt any ,state law 7whether effective before1 on1 or after the date of the enactment of this ,act7 that specifies a lesser percentage or lesser total value of damages which may be claimed by an attorney representing a claimant in a health care lawsuit4 #e4 ,authorization of payment of future damages to claimants in health care lawsuits 7a7 ,in general ,in any health care lawsuit1 if an award of future damages1 without reduction to present value1 equaling or exceeding #ej1jjj is made against a party with sufficient insurance or other assets to fund a periodic payment of such a judgment1 the court shall1 at the request of any party1 enter a judgment ordering that the future damages be paid by periodic payments1 in accordance with the ,uniform ,periodic ,payment of ,judgments ,act promulgated by the ,national ,conference of ,commissioners on ,uniform ,state ,laws4 7b7 ,applicability ,this section applies to all actions which have not been first set for trial or retrial before the effective date of this ,act4 7c7 ,state ,flexibility ,no provision of this section shall be construed to preempt any ,state law 7whether effective before1 on1 or after the date of the enactment of this ,act7 that specifies periodic payments for future damages at any amount other than #ej1jjj or that mandates such payments absent the request of either party4 #f4 ,product liability for health care providers ,a health care provider who prescribes1 or who dispenses pursuant to a prescription1 a medical product approved1 licensed1 or cleared by the ,food and ,drug ,administration shall not be named as a party to a product liability lawsuit involving such product and shall not be liable to a claimant in a class action lawsuit against the manufacturer1 distributor1 or seller of such product4 #g4 ,definitions ,in this ,act3 7#a7 ,alternative dispute resolution system2 ,,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 court4 7#b7 ,claimant ,the term claimant means any person who brings a health care lawsuit1 including a person who asserts or claims a right to legal or equitable contribution1 indemnity1 or subrogation1 arising out of a health care liability claim or action1 and any person on whose behalf such a claim is asserted or such an action is brought1 whether deceased1 incompetent1 or a minor4 7#c7 ,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 claimant1 or any service1 product1 or other benefit provided or reasonably likely to be provided in the future to or on behalf of the claimant1 as a result of the injury or wrongful death1 pursuant to-- 7,a7 any ,state or ,federal health1 sickness1 income-disability1 accident1 or workers' compensation law2 7,b7 any health1 sickness1 income-disability1 or accident insurance that provides health benefits or income-disability coverage2 7,c7 any contract or agreement of any group1 organization1 partnership1 or corporation to provide1 pay for1 or reimburse the cost of medical1 hospital1 dental1 or income-disability benefits2 and 7,d7 any other publicly or privately funded program4 7#d7 ,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 claimants4 7#e7 ,economic damages ,the term economic damages means objectively verifiable monetary losses incurred as a result of the provision or use of 7or failure to provide or use7 health care services or medical products1 such as past and future medical expenses1 loss of past and future earnings1 cost of obtaining domestic services1 loss of employment1 and loss of business or employment opportunities1 unless otherwise defined under applicable state law4 ,in no circumstances shall damages for health care services or medical products exceed the amount actually paid or incurred by or on behalf of the claimant4 7#f7 ,future damages ,the term future damages means any damages that are incurred after the date of judgment1 settlement1 or other resolution 7including mediation1 or any other form of alternative dispute resolution74 7#g7 ,health care lawsuit ,the term health care lawsuit means any health care liability claim concerning the provision of goods or services for which coverage was provided in whole or in part via a ,federal program1 subsidy or tax benefit1 or any health care liability action concerning the provision of goods or services for which coverage was provided in whole or in part via a ,federal program1 subsidy or tax benefit1 brought in a ,state or ,federal court or pursuant to an alternative dispute resolution system1 against a health care provider regardless of the theory of liability on which the claim is based1 or the number of claimants1 plaintiffs1 defendants1 or other parties1 or the number of claims or causes of action1 in which the claimant alleges a health care liability claim4 ,such term does not include a claim or action which is based on criminal liability2 which seeks civil fines or penalties paid to ,federal1 ,state1 or local government2 or which is grounded in antitrust4 7#h7 ,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 system1 against a health care provider regardless of the theory of liability on which the claim is based1 or the number of plaintiffs1 defendants1 or other parties1 or the number of causes of action1 in which the claimant alleges a health care liability claim4 7#i7 ,health care liability claim ,the term health care liability claim means a demand by any person1 whether or not pursuant to ,,adr1 against a health care provider1 including1 but not limited to1 third-party claims1 cross-claims1 counter-claims1 or contribution claims1 which are based upon the provision or use of 7or the failure to provide or use7 health care services or medical products1 regardless of the theory of liability on which the claim is based1 or the number of plaintiffs1 defendants1 or other parties1 or the number of causes of action4 7#aj7 ,health care provider ,the term health care provider means any person or entity required by ,state or ,federal laws or regulations to be licensed1 registered1 or certified to provide health care services1 and being either so licensed1 registered1 or certified1 or exempted from such requirement by other statute or regulation1 as well as any other individual or entity defined as a health care provider1 health care professional1 or health care institution under state law4 7#aa7 ,health care services ,the term health care services means the provision of any goods or services by a health care provider1 or by any individual working under the supervision of a health care provider1 that relates to the diagnosis1 prevention1 or treatment of any human disease or impairment1 or the assessment or care of the health of human beings4 7#ab7 ,medical product ,the term medical product means a drug1 device1 or biological product intended for humans1 and the terms drug1 device1 and biological product have the meanings given such terms in sections #bja7;g77#a7 and #bja7;h7 of the ,federal ,food1 ,drug and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba7;g77#a7 and 7h77 and section #cea7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bfb7;a771 respectively1 including any component or raw material used therein1 but excluding health care services4 7#ac7 ,noneconomic damages ,the term noneconomic damages means damages for physical and emotional pain1 suffering1 inconvenience1 physical impairment1 mental anguish1 disfigurement1 loss of enjoyment of life1 loss of society and companionship1 loss of consortium 7other than loss of domestic service71 hedonic damages1 injury to reputation1 and all other nonpecuniary losses of any kind or nature incurred as a result of the provision or use of 7or failure to provide or use7 health care services or medical products1 unless otherwise defined under applicable state law4 7#ad7 ,recovery ,the term recovery means the net sum recovered after deducting any disbursements or costs incurred in connection with prosecution or settlement of the claim1 including all costs paid or advanced by any person4 ,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 purpose4 7#ae7 ,representative ,the term representative means a legal guardian1 attorney1 person designated to make decisions on behalf of a patient under a medical power of attorney1 or any person recognized in law or custom as a patient's agent4 7#af7 ,state ,the term ,state means each of the several ,states1 the ,district of ,columbia1 the ,commonwealth of ,puerto ,rico1 the ,virgin ,islands1 ,guam1 ,american ,samoa1 the ,northern ,mariana ,islands1 the ,trust ,territory of the ,pacific ,islands1 and any other territory or possession of the ,united ,states1 or any political subdivision thereof4 #h4 ,effect on other laws 7a7 ,vaccine injury 7#a7 ,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-- 7,a7 this ,act does not affect the application of the rule of law to such an action2 and 7,b7 any rule of law prescribed by this ,act in conflict with a rule of law of such title ,,xxi shall not apply to such action4 7#b7 ,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 apply1 then this ,act or otherwise applicable law 7as determined under this ,act7 will apply to such aspect of such action4 7b7 ,other ,federal law ,except as provided in this section1 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 law4 #i4 ,rules of construction 7a7 ,health care lawsuits ,unless otherwise specified in this ,act1 the provisions governing health care lawsuits set forth in this ,act preempt1 subject to subsections 7b7 and 7c71 ,state law to the extent that ,state law prevents the application of any provisions of law established by or under this ,act4 ,the provisions governing health care lawsuits set forth in this ,act supersede chapter #aga of title #bh1 ,united ,states ,code1 to the extent that such chapter-- 7#a7 provides for a greater amount of damages or contingent fees1 a longer period in which a health care lawsuit may be commenced1 or a reduced applicability or scope of periodic payment of future damages1 than provided in this ,act2 or 7#b7 prohibits the introduction of evidence regarding collateral source benefits1 or mandates or permits subrogation or a lien on collateral source benefits4 7b7 ,protection of ,states' rights and other laws ,any issue that is not governed by any provision of law established by or under this ,act 7including ,state standards of negligence7 shall be governed by otherwise applicable ,state or ,federal law 7c7 ,state ,flexibility ,no provision of this ,act shall be construed to preempt any defense available to a party in a health care lawsuit under any other provision of ,state or ,federal law4 #aj4 ,effective date ,this ,act shall apply to any health care lawsuit brought in a ,federal or ,state court1 or subject to an alternative dispute resolution system1 that is initiated on or after the date of the enactment of this ,act1 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 cause of action accrued4 ,march #bb1 #bjag ,reported from the ,committee on the ,judiciary with an amendment,march #bb1 #bjag,the ,committee on ,energy and ,commerce discharged2 committed to the ,committee of the ,whole ,house on the ,state of the ,union and ordered to be printed