To establish an Office of Health Care Competition within the Department of Health and Human Services to administer the National Practitioner Data Base and to collect and make available to the public more information on medical malpractice insurance under that Data Base.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Improved Medical Malpractice 
Information Reporting and Competition Act of 2003''.

SEC. 2. ESTABLISHMENT OF OFFICE OF HEALTH CARE COMPETITION WITHIN THE 
              DEPARTMENT OF HEALTH AND HUMAN SERVICES.

    (a) In General.--There is established within the Department of 
Health and Human Services an Office to be known as the Office of Health 
Care Competition Policy (in this section referred to as the 
``Office''). The Office shall be headed by a Director, who shall be 
appointed by the Secretary of such Department.
    (b) Duties.--
            (1) Responsibility for national practitioner data base.--
        The Office shall be responsible for activities of the Secretary 
        under part B of title IV of the Health Care Quality Improvement 
        Act of 1986 (title IV of Public Law 99-660), including the 
        National Practitioner Data Base under such part.
            (2) Annual report.--The Director of the Office shall submit 
        a report each year to the Secretary of Health and Human 
        Services on activities conducted under such part.

SEC. 3. CHANGES IN NATIONAL PRACTITIONER DATA BASE PROVISIONS.

    (a) Requiring Additional Reports on Medical Malpractice Insurance 
and Claims.--Part B of title IV of the Health Care Quality Improvement 
Act of 1986 (title IV of Public Law 99-660) is amended by inserting 
after section 421 the following new section:

``SEC. 421A. REQUIRING REPORTS ON MEDICAL MALPRACTICE INSURANCE AND 
              CLAIMS.

    ``(a) In General.--Each entity (including an insurance company) 
which underwrites a policy of insurance for medical malpractice actions 
or claims shall report, in accordance with section 424, information 
respecting such insurance and claims for payment under such policy. 
Such information shall be in addition to, and may be coordinated with, 
the information required to be reported under section 421.
    ``(b) Information to Be Reported.--
            ``(1) In general.--The information to be reported under 
        subsection (a) by an entity with respect to a medical 
        malpractice insurance policy includes the following:
                    ``(A) Direct premiums written.
                    ``(B) Direct premiums earned.
                    ``(C) Net investment income, including net realized 
                capital gains and losses, using appropriate estimates 
                where necessary.
                    ``(D) Incurred claims, developed as the sum of the 
                following (the report shall include data for each of 
                the following:
                            ``(i) Dollar amount of claims closed with 
                        payment; plus.
                            ``(ii) Reserves for reported claims at the 
                        end of the current year; minus.
                            ``(iii) Reserves for reported claims at the 
                        end of the previous year; plus.
                            ``(iv) Reserves for incurred but not 
                        reported claims at the end of the current year; 
                        minus.
                            ``(v) Reserves for incurred but not 
                        reported claims at the end of the previous 
                        year; plus.
                            ``(vi) Loss adjustment expenses for claims 
                        closed; plus.
                            ``(vii) Reserves for loss adjustment 
                        expense at the end of the current year; minus.
                            ``(viii) Reserves for loss adjustment 
                        expense at the end of the previous year.
                (categories used to develop the sum of incurred 
                claims).
                    ``(E) Actual incurred expenses allocated separately 
                to loss adjustment, commissions, other acquisition 
                costs, advertising, general office expenses, taxes, 
                licenses and fees, and all other expenses.
                    ``(F) Net underwriting gain or loss.
                    ``(G) Net operation gain or loss, including net 
                investment income.
                    ``(H) The number and dollar amount of claims closed 
                with payment by year incurred, the amount reserved for 
                each claim, the year(s) in which the reserves were set, 
                and the amounts set in each year.
                    ``(I) The number of claims closed without payment, 
                the dollar amount reserved for each claim, the years in 
                which reserves were set, and the amounts set in each.
                    ``(J) The number of claims pending at the end of 
                each year, the amount of reserve[d] for each claim, the 
                year(s) in which the reserves were set, and the amounts 
                set in each year.
            ``(2) Claims paid.--Such report shall also include the 
        following:
                    ``(A) For claims paid by the insurer during the 
                calendar year, in which a verdict had at any time been 
                rendered.
                            ``(i) The dollar amount paid by the 
                        insurance company; and
                            ``(ii) The dollar amount of the original 
                        verdict.
                    ``(B) For claims paid by the insurer during the 
                calendar year, in which a verdict had at any time been 
                rendered.
                            ``(i) The dollar amount of the original 
                        verdict, broken out as follows:
                                    ``(I) The total amount of past 
                                economic damages assessed by the trier 
                                of fact.
                                    ``(II) The total amount of future 
                                economic damages assessed by the trier 
                                of fact.
                                    ``(III) The total amount of 
                                compensatory non-economic damages 
                                assessed by the trier of fact.
                                    ``(IV) The total amount of punitive 
                                damages assessed by the trier of fact.
                            ``(ii) The dollar amount paid by all 
                        parties.
                            ``(iii) The dollar amount paid by the 
                        insurer.
                            ``(iv) The number of claims paid by the 
                        insurer.
                    ``(C) For claims paid by the insurer during the 
                calendar year, in which a verdict had never been 
                rendered.
                            ``(i) The total amount paid by the insurer 
                        broken out as follows:
                                    ``(I) The amount of the plaintiff's 
                                past economic damages, as submitted by 
                                the plaintiff.
                                    ``(II) The amount of the 
                                plaintiff's future economic damages, as 
                                estimated by the insurer.
                                    ``(III) The amount paid by the 
                                insurer for other damages.
                            ``(ii) The number of claims paid by the 
                        insurer.
                    ``(D) The number of claims in which the insurer 
                paid--
                            ``(i) more than $250,000 in non-economic 
                        damages; and
                            ``(ii) more than $500,000 in non-economic 
                        damages.
                    ``(E) For claims paid by the insurer during the 
                calendar year, the number of claims in which--
                            ``(i) punitive damages were assessed by the 
                        trier of fact;
                            ``(ii) punitive damages were paid by any 
                        party; and
                            ``(iii) punitive damages were paid by the 
                        insurer.
                    ``(F) For claims paid by the insurer during the 
                calendar year--
                            ``(i) the dollar amount of punitive damages 
                        assessed by the trier of fact;
                            ``(ii) the dollar amount of punitive 
                        damages paid by all parties; and
                            ``(iii) the dollar amount of punitive 
                        damages paid by the insurer.
                    ``(G) The number and dollar amount of claims paid 
                by the insurer during the calendar year in which 
                parties other than the insured--
                            ``(i) had at any time been found liable by 
                        the trier of fact; or
                            ``(ii) had been estimated by the insurance 
                        company to have some liability.
                    ``(H) For those claims identified in paragraph (7), 
                the amount by which the amount paid by the insurer 
                exceeds the amount proportional to the insured's 
                percentage of responsibility.
                    ``(I) Such other information as the Secretary 
                determines is required for appropriate interpretation 
                of information reported under this section.
    ``(c) Sanctions for Failure to Report.--The provisions of section 
421(c) shall apply to information required to be reported under this 
section in the same manner as they apply to the reporting of 
information on a payment required to be reported under section 421.
    ``(d) Coordination of Information Reporting.--The Secretary shall 
provide for the coordination of reporting of information under this 
section with the reporting of related information under section 421.''.
    (b) Inclusion and Availability of Information.--Section 427(b) of 
such Act (42 U.S.C. 11137(b)) is amended by adding at the end the 
following new paragraph:
            ``(4) Availability of public file data.--Notwithstanding 
        the previous provisions of this subsection, the Secretary shall 
        make available, for free from the website maintained in 
        connection with the data base established to carry out this 
        part, information reported under sections 421 and 421A which 
        does not provide for individually identifiable information.''.
    (c) Effective Date.--The amendments made by this section shall take 
effect 6 months after the date of the enactment of this Act .

Summary: Improved Medical Malpractice Information Reporting and Competition Act of 2003 - Establishes an Office of Health Care Competition Policy in the Department of Health and Human Services, to be headed by a Director appointed by the Secretary. Declares that the Office shall be responsible for certain activities of the Secretary delineated in the Health Care Quality Improvement Act of 1986, including for the National Practitioner Database under such Act. Amends the Health Care Quality Improvement Act of 1986 to require each entity which underwrites a policy of insurance for medical malpractice actions or claims to report information respecting such insurance or claims. Specifies material that such reports should contain, including: (1) direct premiums written and earned. (2) net investment income, including net realized capital gains and losses, (3) incurred claims, (4) actual incurred expenses. And (5) certain information on claims paid, including verdict amounts. Prescribes a civil penalty of not more than $10,000 for each instance of a payment required to be reported under this Act which is not reported. Provides for the coordination of the information collected under this Act with information reported on medical malpractice payments, with the Secretary to make both sets of data available for free on the Internet without individually identifiable information.