,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #cfef  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #i1 #bjai,mr4   
,hudson 7= himself1 ,mr4 ,m>%all1 & ,mr4
 ,buc%on7 introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ! ,judici>y1 
& 9 addition to ! ,committee on ,en]gy &
 ,comm]ce1 = 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 improve pati5t access to   
heal? c>e s]vices & provide improv$     
m$ical c>e by r$uc+ ! excessive burd5 ! 
liability sy/em places on ! heal? c>e   
deliv]y sy/em4  #a4 ,%ort title2 table (
 cont5ts  7a7 ,%ort title ,?is ,act may 
be cit$ z ! ,accessible ,c>e by ,curb+  
,excessive law,suit,s ,act ( #bjai or ! 
,,access ,act ( #bjai4  7b7 ,table (    
cont5ts ,! table ( cont5ts ( ?is ,act is
 z foll[s3  ,sec4 #a4 ,%ort title2 table
 ( cont5ts4 ,sec4 #b4 ,f9d+s & purpose4 
,sec4 #c4 ,enc\rag+ spe$y resolution (  
claims4 ,sec4 #d4 ,comp5sat+ pati5t     

injury4 ,sec4 #e4 ,maximiz+ pati5t      
recov]y4 ,sec4 #f4 ,additional heal?    
b5efits4 ,sec4 #g4 ,au?orization (      
paym5t ( future damages to claimants 9  
heal? c>e lawsuits4 ,sec4 #h4 ,product  
liability = heal? c>e provid]s4 ,sec4   
#i4 ,communications foll[+ unanticipat$ 
outcome4 ,sec4 #aj4 ,notice ( int5t to  
comm5ce lawsuit4 ,sec4 #aa4 ,affidavit (
 m]it4 ,sec4 #ab4 ,exp]t witness        
qualifications4 ,sec4 #ac4 ,def9itions4 
,sec4 #ad4 ,effect on o!r laws4 ,sec4   
#ae4 ,rules ( con/ruction4 ,sec4 #af4   
,effective date4  #b4 ,f9d+s & purpose  
7a7 ,f9d+s  7#a7 ,effect on heal? c>e   
access & co/s ,congress f9ds t ! 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 )\t
 re=m is a co/ly & ineffici5t 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 ,f$]al sp5d+  7,a7 ,congress 
f9ds t ! heal? c>e liability litigation 
sy/ems exi/+ ?r\gh\t ! ,unit$ ,/ates h a
 significant effect on ! am\nt1         
di/ribution1 & use ( ,f$]al funds       
because (--  7i7 ! l>ge numb] (         
individuals :o receive heal? c>e b5efits
 "u programs op]at$ or f9anc$ by !      
,f$]al ,gov]nm5t2  7ii7 ! l>ge numb] (  
individuals :o b5efit because ( !       
exclusion f ,f$]al taxes ( ! am\nts sp5t
 to provide !m ) heal? insurance        
b5efits2 &  7iii7 ! l>ge numb] ( heal?  
c>e provid]s :o provide items or s]vices
 = :i* ! ,f$]al ,gov]nm5t makes paym5ts4
  7,b7 ,congress f9ds t ! ,f$]al deficit
 w\ld be r$uc$ by #fb billion ov] ! next
 decade if ,f$]al heal? c>e liability   
re=ms 7 enact$1 z v]ifi$ by !           
,congressional ,budget ,(fice4  7#c7    
,effect on int]/ate comm]ce ,congress   
f9ds t ! heal? c>e & insurance indu/ries
 are indu/ries affect+ int]/ate comm]ce 
& ! 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  7b7 ,purpose ,x is ! purpose 
( ?is ,act 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  #c4 ,enc\rag+ spe$y
 resolution ( claims  7a7 ,/atute (     
limitations ,! "t = ! comm5cem5t ( a    
heal? c>e lawsuit %all be #c ye>s aft] !
 date ( 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 ( 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 ( ! injury  
except t actions by a m9or "u ! full age
 ( #f ye>s %all be comm5c$ )9 #c ye>s ( 
injury1 or #a ye> aft] ! injury is      
discov]$1 or ?r\gh ! use ( reasonable   

dilig5ce %\ld h be5 discov]$1 or prior  
to ! m9or's #h? bir?day1 :i*ev] provides
 a long] p]iod4 ,su* "t limitation %all 
be toll$ = m9ors = any p]iod dur+ :i* a 
p>5t or gu>dian & a heal? c>e provid] h 
committ$ fraud or collusion 9 ! failure 
to br+ an action on behalf ( ! injur$   
m9or4  7b7 ,/ate flexibility ,no        
provision ( ,subsection 7a7 %all be     
con/ru$ to preempt any /ate law 7:e!r   
effective be=e1 on1 or aft] ! date ( !  
enactm5t ( ?is ,act7 t--  7#a7 specifies
 a "t p]iod ( less ?an #c ye>s aft] !   
date ( injury or less ?an #a ye> aft] ! 
claimant discov]s1 or ?r\gh ! use (     
reasonable dilig5ce %\ld h discov]$1 !  
injury1 = ! fil+ ( a heal? c>e lawsuit2 
7#b7 t specifies a diff]5t "t p]iod = ! 
fil+ ( lawsuits by a m9or2  7#c7 t      
trigg]s ! "t p]iod bas$ on ! date ( !   
alleg$ neglig5ce2 or  7#d7 e/abli%es a  
/atute ( repose = ! fil+ ( heal? c>e    
lawsuit4  #d4 ,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 ,act  
%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 %all 
n exce$ #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  7e7 ,/ate flexibility ,no        
provision ( ?is section %all be con/ru$ 
to preempt 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 ( economic or noneconomic 
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 

section4  #e4 ,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  7c7 ,/ate        
flexibility ,no provision ( ?is section 
%all be con/ru$ to preempt any ,/ate law
 7:e!r effective be=e1 on1 or aft] !    
date ( ! enactm5t ( ?is ,act7 t         
specifies a less] p]c5tage or less]     
total value ( damages :i* may be claim$ 
by an attorney repres5t+ a claimant 9 a 
heal? c>e lawsuit4  #f4 ,additional     
heal? b5efits  7a7 ,collat]al s\rce     
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  7b7      
,subrogation ,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  7c7   
,applicability ,?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  7d7 ,/ate flexibility ,no        
provision ( subsection 7a7 %all be      

con/ru$ to preempt any ,/ate law 7:e!r  
effective be=e1 on1 or aft] ! date ( !  
enactm5t ( ?is ,act7 t specifies a      
m&atory (fset ( collat]al s\rce b5efits 
aga9/ an aw>d 9 a heal? c>e liability   
lawsuit4  #g4 ,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 ,act4  7c7 ,/ate ,flexibility ,no  
provision ( ?is section %all be con/ru$ 
to preempt any ,/ate law 7:e!r effective

 be=e1 on1 or aft] ! date ( ! enactm5t (
 ?is ,act7 t specifies p]iodic paym5ts =
 future damages at any am\nt o!r ?an    
#ej1jjj or t m&ates su* paym5ts abs5t ! 
reque/ ( ei!r p>ty4  #h4 ,product       
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  #i4           
,communications foll[+ unanticipat$     
outcome  7a7 ,provid] communications ,9 
any heal? c>e liability action1 any &   
all /atem5ts1 affirmations1 ge/ures1 or 
conduct express+ apology1 fault1        
sympa?y1 commis]ation1 condol5ce1       
compassion1 or a g5]al s5se ( b5evol5ce 
:i* are made by a heal? c>e provid] or  
an employee ( a heal? c>e provid] to !  
pati5t1 a relative ( ! pati5t1 or a     

repres5tative ( ! pati5t & :i* relate to
 ! discom=t1 pa91 suff]+1 injury1 or    
dea? ( ! pati5t z ! result ( !          
unanticipat$ outcome ( m$ical c>e %all  
be inadmissible = any purpose z evid5ce 
( an admission ( liability or z evid5ce 
( an admission aga9/ int]e/4  7b7 ,/ate 
,flexibility ,no provision ( ?is section
 %all be con/ru$ to preempt any ,/ate   
law 7:e!r effective be=e1 on1 or aft] ! 
date ( ! enactm5t ( ?is ,act7 t makes   
additional communications inadmissible z
 evid5ce ( an admission ( liability or z
 evid5ce ( an admission aga9/ int]e/4   
#aj4 ,notice ( int5t to comm5ce lawsuit 
7a7 ,advance notice ,a p]son %all n     
comm5ce an action aga9/ a heal? c>e     
provid] unless ! p]son has giv5 ! heal? 
c>e provid] #ij days writt5 notice be=e 
! action is comm5c$4  7b7 ,exceptions ,a
 lawsuit aga9/ a heal? c>e provid] fil$ 
)9 #f mon?s ( ! /atute ( limitations    
expir+ z to any claimant1 or )9 #a ye> (
 ! /atute ( repose expir+ z to any      
claimant1 %all be exempt f compliance ) 

?is section4  7c7 ,/ate ,flexibility ,no
 provision ( ?is section %all be con/ru$
 to preempt any ,/ate law 7:e!r         
effective be=e1 on1 or aft] ! date ( !  
enactm5t ( ?is ,act7 t e/abli%es a      
diff]5t "t p]iod = ! fil+ ( writt5      
notice4  #aa4 ,affidavit ( m]it  7a7    
,requir$ fil+ ,subject to subsection    
7b71 ! pla9tiff 9 an action alleg+      
m$ical neglig5ce or1 if ! pla9tiff is   
repres5t$ by an attorney1 ! pla9tiff's  
attorney %all file simultane\sly ) !    
heal? c>e lawsuit an affidavit ( m]it   
sign$ by a heal? pr(essional :o meets ! 
requirem5ts = an exp]t witness "u ,sec4 
#ab ( ?is ,act4 ,! affidavit ( m]it %all
 c]tify t ! heal? pr(essional has       
review$ ! notice & all m$ical records   
suppli$ to him or h] by ! pla9tiff's    
attorney conc]n+ ! allegations conta9$ 9
 ! notice & %all conta9 a /atem5t ( ea* 
( ! foll[+3  7#a7 ,! applicable /&>d (  
practice or c>e4  7#b7 ,! heal?         
pr(essional's op9ion t ! applicable /&>d
 ( practice or c>e 0 brea*$ by ! heal?  

pr(essional or heal? facility receiv+ ! 
notice4  7#c7 ,! actions t %\ld h be5   
tak5 or omitt$ by ! heal? pr(essional or
 heal? facility 9 ord] to h compli$ ) ! 
applicable /&>d ( practice or c>e4  7#d7
 ,! mann] 9 :i* ! brea* ( ! /&>d (      
practice or c>e 0 ! proximate cause ( ! 
injury alleg$ 9 ! notice4  7#e7 ,a li/+ 
( ! m$ical records review$4  7b7 ,fil+  
ext5sion ,^u motion ( a p>ty = good     
cause %[n1 ! c\rt 9 :i* ! compla9t is   
fil$ may grant ! pla9tiff or1 if !      
pla9tiff is repres5t$ by an attorney1 ! 
pla9tiff's attorney an additional #bh   
days 9 :i* to file ! affidavit requir$  
"u subsection 7#a74  7c7 ,/ate          
,flexibility ,no provision ( ?is section
 %all be con/ru$ to preempt any ,/ate   
law 7:e!r effective be=e1 on1 or aft] ! 
date ( ! enactm5t ( ?is ,act7 t         
e/abli%es additional requirem5ts = !    
fil+ ( an affidavit ( m]it or simil>    
pre-litigation docum5tation4  #ab4      
,exp]t witness qualifications  7a7 ,9   
g5]al ,9 any heal? c>e lawsuit1 an      

individual %all n give exp]t te/imony on
 ! appropriate /&>d ( practice or c>e   
involv$ unless ! individual is lic5s$ z 
a heal? pr(essional 9 #a or m ,/ates & !
 individual meets ! foll[+ crit]ia3     
7#a7 ,if ! p>ty aga9/ :om or on ^:      
behalf ! te/imony is to be (f]$ is or   
claims to be a speciali/1 ! exp]t       
witness %all specialize at ! "t ( !     
occurr5ce t is ! basis = ! lawsuit 9 !  
same specialty or claim$ specialty z !  
p>ty aga9/ :om or on ^: behalf !        
te/imony is to be (f]$4 ,if ! p>ty aga9/
 :om or on ^: behalf ! te/imony is to be
 (f]$ is or claims to be a speciali/ :o 
is bo>d c]tifi$1 ! exp]t witness %all be
 a speciali/ :o is bo>d c]tifi$ 9 t     
specialty or claim$ specialty4  7#b7    
,dur+ ! #a-ye> p]iod imm$iately prec$+ !
 occurr5ce ( ! action t gave rise to !  
lawsuit1 ! exp]t witness %all h devot$ a
 majority ( ! individual's pr(essional  
"t to "o or m ( ! foll[+3  7,a7 ,!      
active cl9ical practice ( ! same heal?  
pr(ession z ! def5dant &1 if ! def5dant 

is or claims to be a speciali/1 9 ! same
 specialty or claim$ specialty4  7,b7 ,!
 in/ruction ( /ud5ts 9 an accr$it$ heal?
 pr(essional s*ool or accr$it$ resid5cy 
or cl9ical rese>* program 9 ! same heal?
 pr(ession z ! def5dant &1 if ! def5dant
 is or claims to be a speciali/1 9 an   
accr$it$ heal? pr(essional s*ool or     
accr$it$ resid5cy or cl9ical rese>*     
program 9 ! same specialty or claim$    
specialty4  7#c7 ,if ! def5dant is a    
g5]al practition]1 ! exp]t witness %all 
h devot$ a majority ( ! witness's       
pr(essional "t 9 ! #a-ye> p]iod prec$+ !
 occurr5ce ( ! action giv+ rise to !    
lawsuit to "o or m ( ! foll[+3  7,a7    
,active cl9ical practice z a g5]al      
practition]4  7,b7 ,in/ruction ( /ud5ts 
9 an accr$it$ heal? pr(essional s*ool or
 accr$it$ resid5cy or cl9ical rese>*    
program 9 ! same heal? pr(ession z !    
def5dant4  7b7 ,lawsuits aga9/ entities 
,if ! def5dant 9 a heal? c>e lawsuit is 
an entity t employs a p]son aga9/ :om or
 on ^: behalf ! te/imony is (f]$1 !     

provisions ( p>agraph 7#a7 apply z if ! 
p]son 7 ! p>ty or def5dant aga9/ :om or 
on ^: behalf ! te/imony is (f]$4  7c7   
,p[] ( c\rt ,no?+ 9 ?is subsection %all 
limit ! p[] ( ! trial c\rt 9 a heal? c>e
 lawsuit to disqualify an exp]t witness 
on gr\nds o!r ?an ! qualifications set  
=? "u ?is subsection4  7d7 ,limitation  
,an exp]t witness 9 a heal? c>e lawsuit 
%all n be p]mitt$ to te/ify if ! fee ( !
 witness is 9 any way cont+5t on !      
outcome ( ! lawsuit4  7e7 ,/ate         
flexibility ,no provision ( ?is section 
%all be con/ru$ to preempt any ,/ate law
 7:e!r effective be=e1 on1 or aft] !    
date ( ! enactm5t ( ?is ,act7 t places  
additional qualification requirem5ts ^u 
any individual te/ify+ z an exp]t       
witness4  #ac4 ,def9itions ,9 ?is ,act3 
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 ,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#e7 ,economic damages ,!   
t]m economic damages means objectively  
v]ifiable monet>y losses incurr$ z a    
result ( ! provision or use ( 7or       
failure to provide or use7 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     
unless o!rwise def9$ "u applicable /ate 
law4 ,9 no circum/ances %all damages =  
heal? c>e s]vices or m$ical products    
exce$ ! am\nt actually paid or incurr$  
by or on behalf ( ! claimant4  7#f7     
,future damages ,! t]m future damages   

means any damages t are incurr$ aft] !  
date ( judgm5t1 settlem5t1 or o!r       
resolution 7includ+ m$iation1 or any o!r
 =m ( alt]native dispute resolution74   
7#g7 ,heal? c>e lawsuit ,! t]m heal? c>e
 lawsuit means any heal? c>e liability  
claim conc]n+ ! provision ( goods or    
s]vices = :i* cov]age 0 provid$ 9 :ole  
or 9 "p via a ,f$]al program1 subsidy or
 tax b5efit1 or any heal? c>e liability 
action conc]n+ ! provision ( goods or   
s]vices = :i* cov]age 0 provid$ 9 :ole  
or 9 "p via a ,f$]al program1 subsidy or
 tax b5efit1 br\ght 9 a ,/ate or ,f$]al 
c\rt or pursuant to an alt]native       
dispute resolution sy/em1 aga9/ a heal? 
c>e provid] 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] reg>dless ( ! !ory ( liability  
on :i* ! claim is bas$1 or ! numb] (    
pla9tiffs1 def5dants1 or o!r p>ties1 or 
! numb] ( causes ( action1 9 :i* !      
claimant alleges a heal? c>e liability  
claim4  7#i7 ,heal? c>e liability claim 
,! t]m heal? c>e liability claim means a
 dem& by any p]son1 :e!r or n pursuant  
to ,,adr1 aga9/ a heal? c>e provid]1    
includ+1 b n limit$ to1 ?ird-p>ty       
claims1 cross-claims1 c\nt]-claims1 or  
contribution claims1 :i* are bas$ ^u !  
provision or use ( 7or ! failure to     
provide or use7 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 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 regulation1 z well z any o!r  
individual or entity def9$ z a heal? c>e
 provid]1 heal? c>e pr(essional1 or     
heal? c>e in/itution "u /ate law4  7#aa7
 ,heal? c>e s]vices ,! t]m heal? c>e    
s]vices means ! provision ( any goods or
 s]vices by a heal? c>e 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#ab7 ,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 ,drug & ,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#ac7 ,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$onic damages1 injury 
to reputation1 & all o!r nonpecuni>y    
losses ( any k9d or nature incurr$ z a  
result ( ! provision or use ( 7or       
failure to provide or use7 heal? c>e    
s]vices or m$ical products1 unless      
o!rwise def9$ "u applicable /ate law4   
7#ad7 ,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$uctible disbursem5ts or 
co/s = su* purpose4  7#ae7 ,relative ,! 
t]m relative means a victim's sp\se1    
p>5t1 gr&p>5t1 /epfa!r1 /epmo!r1 *ild1  
gr&*ild1 bro!r1 si/]1 half bro!r1 half  
si/]1 or sp\se's p>5ts4 ,! t]m includes 
said relation%ips t are creat$ z a      
result ( adoption4  7#af7 ,repres5tative
 ,! t]m repres5tative means a legal     
gu>dian1 attorney1 p]son designat$ to   
make decisions on behalf ( a pati5t "u a
 m$ical p[] ( attorney1 or any p]son    
recogniz$ 9 law or cu/om z a pati5t's   
ag5t4  7#ag7 ,/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  7#ah7 ,unanticipat$  

outcome ,! t]m unanticipat$ outcome     
means ! outcome ( a m$ical treatm5t or  
proc$ure t diff]s f an expect$ result4  
#ad4 ,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 ,act does n  
affect ! application ( ! rule ( law to  
su* an action2 &  7,b7 any rule ( law   
prescrib$ by ?is ,act 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$]al rule ( law "u title ,,xxi ( !    
,public ,heal? ,s]vice ,act does n      
apply1 !n ?is ,act or o!rwise applicable
 law 7z det]m9$ "u ?is ,act7 w apply to 
su* aspect ( su* action4  7b7 ,o!r      
,f$]al law ,except z provid$ 9 ?is      
section1 no?+ 9 ?is ,act %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$]al law4     
#ae4 ,rules ( con/ruction  7a7 ,heal?   
c>e lawsuits ,unless o!rwise specifi$ 9 
?is ,act1 ! provisions gov]n+ heal? c>e 
lawsuits set =? 9 ?is ,act preempt1     
subject to subsections 7b7 & 7c71 ,/ate 
law to ! ext5t t ,/ate law prev5ts !    
application ( any provisions ( law      
e/abli%$ by or "u ?is ,act4 ,!          
provisions gov]n+ heal? c>e lawsuits set
 =? 9 ?is ,act 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 ,act2 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 
,any issue t is n gov]n$ by any         
provision ( law e/abli%$ by or "u ?is   

,act 7includ+ ,/ate /&>ds ( neglig5ce7  
%all be gov]n$ by o!rwise applicable    
,/ate or ,f$]al law4  7c7 ,/ate         
,flexibility ,no provision ( ?is ,act   
%all be con/ru$ to preempt any def5se   
available to a p>ty 9 a heal? c>e       
lawsuit "u any o!r provision ( ,/ate or 
,f$]al law4  #af4 ,effective date ,?is  
,act %all apply to any heal? c>e lawsuit
 br\ght 9 a ,f$]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 ! cause (   
action accru$4