I 

115TH CONGRESS 

1ST SESSION H. R. 1215 

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 24, 2017 

Mr. KING of Iowa 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 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Protecting Access to Care Act of 2017’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows: 

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Sec. 1. Short title; table of contents. 

Sec. 2. Findings and purpose. 

Sec. 3. Encouraging speedy resolution of claims. 

Sec. 4. Compensating patient injury. 

Sec. 5. Maximizing patient recovery. 

Sec. 6. Additional health benefits. 

Sec. 7. Authorization of payment of future damages to claimants in health care 

lawsuits. 

Sec. 8. Product liability for health care providers. 

Sec. 9. Definitions. 

Sec. 10. Effect on other laws. 

Sec. 11. Rules of construction. 

Sec. 12. Effective date. 

1 SEC. 2. FINDINGS AND PURPOSE. 

2 (a) FINDINGS.— 

3 (1) EFFECT ON HEALTH CARE ACCESS AND

4 COSTS.—Congress finds that the current civil justice 

5 system is adversely affecting patient access to health 

6 care services, better patient care, and cost-efficient 

7 health care, in that the health care liability system 

8 without reform is a costly and inefficient mechanism 

9 for resolving claims of health care liability and com10 pensating injured patients, and is a deterrent to the 

11 sharing of information among health care profes12 sionals which impedes efforts to improve patient 

13 safety and quality of care. 

14 (2) EFFECT ON FEDERAL SPENDING.— 

15 (A) Congress finds that the health care li16 ability litigation systems existing throughout 

17 the United States have a significant effect on 

18 the amount, distribution, and use of Federal 

19 funds because of— 

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1 (i) the large number of individuals 

2 who receive health care benefits under pro3 grams operated or financed by the Federal 

4 Government; 

5 (ii) the large number of individuals 

6 who benefit because of the exclusion from 

7 Federal taxes of the amounts spent to pro8 vide them with health insurance benefits; 

9 and 

10 (iii) the large number of health care 

11 providers who provide items or services for 

12 which the Federal Government makes pay13 ments. 

14 (B) Congress finds that the Federal deficit 

15 would be reduced by $62 billion over the next 

16 decade if Federal health care liability reforms 

17 were enacted, as verified by the Congressional 

18 Budget Office. 

19 (3) EFFECT ON INTERSTATE COMMERCE.— 

20 Congress finds that the health care and insurance 

21 industries are industries affecting interstate com22 merce and the health care liability litigation systems 

23 existing throughout the United States are activities 

24 that affect interstate commerce by contributing to 

25 the high costs of health care and premiums for 

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1 health care liability insurance purchased by health 

2 care system providers. 

3 (b) PURPOSE.—It is the purpose of this Act to imple4 ment reasonable, comprehensive, and effective health care 

5 liability reforms designed to— 

6 (1) improve the availability of health care serv7 ices in cases in which health care liability actions 

8 have been shown to be a factor in the decreased 

9 availability of services; 

10 (2) reduce the incidence of ‘‘defensive medi11 cine’’ and lower the cost of health care liability in12 surance, all of which contribute to the escalation of 

13 health care costs; 

14 (3) ensure that persons with meritorious health 

15 care injury claims receive fair and adequate com16 pensation, including reasonable noneconomic dam17 ages; 

18 (4) improve the fairness and cost-effectiveness 

19 of our current health care liability system to resolve 

20 disputes over, and provide compensation for, health 

21 care liability by reducing uncertainty in the amount 

22 of compensation provided to injured individuals; and 

23 (5) provide an increased sharing of information 

24 in the health care system which will reduce unin25 tended injury and improve patient care. 

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1 SEC. 3. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS. 

2 (a) STATUTE OF LIMITATIONS.—The time for the 

3 commencement of a health care lawsuit shall be 3 years 

4 after the date of injury or 1 year after the claimant dis5 covers, or through the use of reasonable diligence should 

6 have discovered, the injury, whichever occurs first. In no 

7 event shall the time for commencement of a health care 

8 lawsuit exceed 3 years after the date of injury unless tolled 

9 for any of the following— 

10 (1) upon proof of fraud; 

11 (2) intentional concealment; or 

12 (3) the presence of a foreign body, which has no 

13 therapeutic or diagnostic purpose or effect, in the 

14 person of the injured person. 

15 Actions by a minor shall be commenced within 3 years 

16 from the date of the injury except that actions by a minor 

17 under the full age of 6 years shall be commenced within 

18 3 years of injury, or 1 year after the injury is discovered, 

19 or through the use of reasonable diligence should have 

20 been discovered, or prior to the minor’s 8th birthday, 

21 whichever provides a longer period. Such time limitation 

22 shall be tolled for minors for any period during which a 

23 parent or guardian and a health care provider have com24 mitted fraud or collusion in the failure to bring an action 

25 on behalf of the injured minor. 

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1 (b) STATE FLEXIBILITY.—No provision of subsection 

2 (a) shall be construed to preempt any State law (whether 

3 effective before, on, or after the date of the enactment of 

4 this Act) that— 

5 (1) specifies a time period of less than 3 years 

6 after the date of injury or less than 1 year after the 

7 claimant discovers, or through the use of reasonable 

8 diligence should have discovered, the injury, for the 

9 filing of a health care lawsuit; 

10 (2) that specifies a different time period for the 

11 filing of lawsuits by a minor; 

12 (3) that triggers the time period based on the 

13 date of the alleged negligence; or 

14 (4) establishes a statute of repose for the filing 

15 of health care lawsuit. 

16 SEC. 4. COMPENSATING PATIENT INJURY. 

17 (a) UNLIMITED AMOUNT OF DAMAGES FOR ACTUAL

18 ECONOMIC LOSSES IN HEALTH CARE LAWSUITS.—In any 

19 health care lawsuit, nothing in this Act shall limit a claim20 ant’s recovery of the full amount of the available economic 

21 damages, notwithstanding the limitation in subsection (b). 

22 (b) ADDITIONAL NONECONOMIC DAMAGES.—In any 

23 health care lawsuit, the amount of noneconomic damages, 

24 if available, shall not exceed $250,000, regardless of the 

25 number of parties against whom the action is brought or 

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1 the number of separate claims or actions brought with re2 spect to the same injury. 

3 (c) NO DISCOUNT OF AWARD FOR NONECONOMIC

4 DAMAGES.—For purposes of applying the limitation in 

5 subsection (b), future noneconomic damages shall not be 

6 discounted to present value. The jury shall not be in7 formed about the maximum award for noneconomic dam8 ages. An award for noneconomic damages in excess of 

9 $250,000 shall be reduced either before the entry of judg10 ment, or by amendment of the judgment after entry of 

11 judgment, and such reduction shall be made before ac12 counting for any other reduction in damages required by 

13 law. If separate awards are rendered for past and future 

14 noneconomic damages and the combined awards exceed 

15 $250,000, the future noneconomic damages shall be re16 duced first. 

17 (d) FAIR SHARE RULE.—In any health care lawsuit, 

18 each party shall be liable for that party’s several share 

19 of any damages only and not for the share of any other 

20 person. Each party shall be liable only for the amount of 

21 damages allocated to such party in direct proportion to 

22 such party’s percentage of responsibility. Whenever a 

23 judgment of liability is rendered as to any party, a sepa24 rate judgment shall be rendered against each such party 

25 for the amount allocated to such party. For purposes of 

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1 this section, the trier of fact shall determine the propor2 tion of responsibility of each party for the claimant’s 

3 harm. 

4 (e) STATE FLEXIBILITY.—No provision of this sec5 tion shall be construed to preempt any State law (whether 

6 effective before, on, or after the date of the enactment of 

7 this Act) that specifies a particular monetary amount of 

8 economic or noneconomic damages (or the total amount 

9 of damages) that may be awarded in a health care lawsuit, 

10 regardless of whether such monetary amount is greater 

11 or lesser than is provided for under this section. 

12 SEC. 5. MAXIMIZING PATIENT RECOVERY. 

13 (a) COURT SUPERVISION OF SHARE OF DAMAGES

14 ACTUALLY PAID TO CLAIMANTS.—In any health care law15 suit, the court shall supervise the arrangements for pay16 ment of damages to protect against conflicts of interest 

17 that may have the effect of reducing the amount of dam18 ages awarded that are actually paid to claimants. In par19 ticular, in any health care lawsuit in which the attorney 

20 for a party claims a financial stake in the outcome by vir21 tue of a contingent fee, the court shall have the power 

22 to restrict the payment of a claimant’s damage recovery 

23 to such attorney, and to redirect such damages to the 

24 claimant based upon the interests of justice and principles 

25 of equity. In no event shall the total of all contingent fees 

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1 for representing all claimants in a health care lawsuit ex2 ceed the following limits: 

3 (1) Forty percent of the first $50,000 recovered 

4 by the claimant(s). 

5 (2) Thirty-three and one-third percent of the 

6 next $50,000 recovered by the claimant(s). 

7 (3) Twenty-five percent of the next $500,000 

8 recovered by the claimant(s). 

9 (4) Fifteen percent of any amount by which the 

10 recovery by the claimant(s) is in excess of $600,000. 

11 (b) APPLICABILITY.—The limitations in this section 

12 shall apply whether the recovery is by judgment, settle13 ment, mediation, arbitration, or any other form of alter14 native dispute resolution. In a health care lawsuit involv15 ing a minor or incompetent person, a court retains the 

16 authority to authorize or approve a fee that is less than 

17 the maximum permitted under this section. The require18 ment for court supervision in the first two sentences of 

19 subsection (a) applies only in civil actions. 

20 (c) STATE FLEXIBILITY.—No provision of this sec21 tion shall be construed to preempt any State law (whether 

22 effective before, on, or after the date of the enactment of 

23 this Act) that specifies a lesser percentage or lesser total 

24 value of damages which may be claimed by an attorney 

25 representing a claimant in a health care lawsuit. 

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1 SEC. 6. ADDITIONAL HEALTH BENEFITS. 

2 (a) COLLATERAL SOURCE BENEFITS.—In any health 

3 care lawsuit involving injury or wrongful death, any party 

4 may introduce evidence of collateral source benefits. If a 

5 party elects to introduce such evidence, any opposing party 

6 may introduce evidence of any amount paid or contributed 

7 or reasonably likely to be paid or contributed in the future 

8 by or on behalf of the opposing party to secure the right 

9 to such collateral source benefits. 

10 (b) SUBROGATION.—No provider of collateral source 

11 benefits shall recover any amount against the claimant or 

12 receive any lien or credit against the claimant’s recovery 

13 or be equitably or legally subrogated to the right of the 

14 claimant in a health care lawsuit involving injury or 

15 wrongful death. 

16 (c) APPLICABILITY.—This section shall apply to any 

17 health care lawsuit that is settled as well as a health care 

18 lawsuit that is resolved by a fact finder. This section shall 

19 not apply to section 1862(b) (42 U.S.C. 1395y(b)) or sec20 tion 1902(a)(25) (42 U.S.C. 1396a(a)(25)) of the Social 

21 Security Act. 

22 (d) STATE FLEXIBILITY.—No provision of subsection 

23 (a) shall be construed to preempt any State law (whether 

24 effective before, on, or after the date of the enactment of 

25 this Act) that specifies a mandatory offset of collateral 

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1 source benefits against an award in a health care liability 

2 lawsuit. 

3 SEC. 7. AUTHORIZATION OF PAYMENT OF FUTURE DAM4 AGES TO CLAIMANTS IN HEALTH CARE LAW5 SUITS. 

6 (a) IN GENERAL.—In any health care lawsuit, if an 

7 award of future damages, without reduction to present 

8 value, equaling or exceeding $50,000 is made against a 

9 party with sufficient insurance or other assets to fund a 

10 periodic payment of such a judgment, the court shall, at 

11 the request of any party, enter a judgment ordering that 

12 the future damages be paid by periodic payments, in ac13 cordance with the Uniform Periodic Payment of Judg14 ments Act promulgated by the National Conference of 

15 Commissioners on Uniform State Laws. 

16 (b) APPLICABILITY.—This section applies to all ac17 tions which have not been first set for trial or retrial be18 fore the effective date of this Act. 

19 (c) STATE FLEXIBILITY.—No provision of this sec20 tion shall be construed to preempt any State law (whether 

21 effective before, on, or after the date of the enactment of 

22 this Act) that specifies periodic payments for future dam23 ages at any amount other than $50,000 or that mandates 

24 such payments absent the request of either party. 

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1 SEC. 8. PRODUCT LIABILITY FOR HEALTH CARE PRO2 VIDERS. 

3 A health care provider who prescribes, or who dis4 penses pursuant to a prescription, a medical product ap5 proved, licensed, or cleared by the Food and Drug Admin6 istration shall not be named as a party to a product liabil7 ity lawsuit involving such product and shall not be liable 

8 to a claimant in a class action lawsuit against the manu9 facturer, distributor, or seller of such product. 

10 SEC. 9. DEFINITIONS. 

11 In this Act: 

12 (1) ALTERNATIVE DISPUTE RESOLUTION SYS13 TEM; ADR.—The term ‘‘alternative dispute resolution 

14 system’’ or ‘‘ADR’’ means a system that provides 

15 for the resolution of health care lawsuits in a man16 ner other than through a civil action brought in a 

17 State or Federal court. 

18 (2) CLAIMANT.—The term ‘‘claimant’’ means 

19 any person who brings a health care lawsuit, includ20 ing a person who asserts or claims a right to legal 

21 or equitable contribution, indemnity, or subrogation, 

22 arising out of a health care liability claim or action, 

23 and any person on whose behalf such a claim is as24 serted or such an action is brought, whether de25 ceased, incompetent, or a minor. 

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1 (3) COLLATERAL SOURCE BENEFITS.—The 

2 term ‘‘collateral source benefits’’ means any amount 

3 paid or reasonably likely to be paid in the future to 

4 or on behalf of the claimant, or any service, product, 

5 or other benefit provided or reasonably likely to be 

6 provided in the future to or on behalf of the claim7 ant, as a result of the injury or wrongful death, pur8 suant to— 

9 (A) any State or Federal health, sickness, 

10 income-disability, accident, or workers’ com11 pensation law; 

12 (B) any health, sickness, income-disability, 

13 or accident insurance that provides health bene14 fits or income-disability coverage; 

15 (C) any contract or agreement of any 

16 group, organization, partnership, or corporation 

17 to provide, pay for, or reimburse the cost of 

18 medical, hospital, dental, or income-disability 

19 benefits; and 

20 (D) any other publicly or privately funded 

21 program. 

22 (4) CONTINGENT FEE.—The term ‘‘contingent 

23 fee’’ includes all compensation to any person or per24 sons which is payable only if a recovery is effected 

25 on behalf of one or more claimants. 

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1 (5) ECONOMIC DAMAGES.—The term ‘‘economic 

2 damages’’ means objectively verifiable monetary 

3 losses incurred as a result of the provision or use of 

4 (or failure to provide or use) health care services or 

5 medical products, such as past and future medical 

6 expenses, loss of past and future earnings, cost of 

7 obtaining domestic services, loss of employment, and 

8 loss of business or employment opportunities, unless 

9 otherwise defined under applicable State law. In no 

10 circumstances shall damages for health care services 

11 or medical products exceed the amount actually paid 

12 or incurred by or on behalf of the claimant. 

13 (6) FUTURE DAMAGES.—The term ‘‘future 

14 damages’’ means any damages that are incurred 

15 after the date of judgment, settlement, or other reso16 lution (including mediation, or any other form of al17 ternative dispute resolution). 

18 (7) HEALTH CARE LAWSUIT.—The term 

19 ‘‘health care lawsuit’’ means any health care liability 

20 claim concerning the provision of goods or services 

21 for which coverage was provided in whole or in part 

22 via a Federal program, subsidy or tax benefit, or 

23 any health care liability action concerning the provi24 sion of goods or services for which coverage was pro25 vided in whole or in part via a Federal program, 

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1 subsidy or tax benefit, brought in a State or Federal 

2 court or pursuant to an alternative dispute resolu3 tion system, against a health care provider regard4 less of the theory of liability on which the claim is 

5 based, or the number of claimants, plaintiffs, de6 fendants, or other parties, or the number of claims 

7 or causes of action, in which the claimant alleges a 

8 health care liability claim. Such term does not in9 clude a claim or action which is based on criminal 

10 liability; which seeks civil fines or penalties paid to 

11 Federal, State, or local government; or which is 

12 grounded in antitrust. 

13 (8) HEALTH CARE LIABILITY ACTION.—The 

14 term ‘‘health care liability action’’ means a civil ac15 tion brought in a State or Federal court or pursuant 

16 to an alternative dispute resolution system, against 

17 a health care provider regardless of the theory of li18 ability on which the claim is based, or the number 

19 of plaintiffs, defendants, or other parties, or the 

20 number of causes of action, in which the claimant al21 leges a health care liability claim. 

22 (9) HEALTH CARE LIABILITY CLAIM.—The 

23 term ‘‘health care liability claim’’ means a demand 

24 by any person, whether or not pursuant to ADR, 

25 against a health care provider, including, but not 

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1 limited to, third-party claims, cross-claims, counter2 claims, or contribution claims, which are based upon 

3 the provision or use of (or the failure to provide or 

4 use) health care services or medical products, re5 gardless of the theory of liability on which the claim 

6 is based, or the number of plaintiffs, defendants, or 

7 other parties, or the number of causes of action. 

8 (10) HEALTH CARE PROVIDER.—The term 

9 ‘‘health care provider’’ means any person or entity 

10 required by State or Federal laws or regulations to 

11 be licensed, registered, or certified to provide health 

12 care services, and being either so licensed, reg13 istered, or certified, or exempted from such require14 ment by other statute or regulation, as well as any 

15 other individual or entity defined as a health care 

16 provider, health care professional, or health care in17 stitution under State law. 

18 (11) HEALTH CARE SERVICES.—The term 

19 ‘‘health care services’’ means the provision of any 

20 goods or services by a health care provider, or by 

21 any individual working under the supervision of a 

22 health care provider, that relates to the diagnosis, 

23 prevention, or treatment of any human disease or 

24 impairment, or the assessment or care of the health 

25 of human beings. 

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1 (12) MEDICAL PRODUCT.—The term ‘‘medical 

2 product’’ means a drug, device, or biological product 

3 intended for humans, and the terms ‘‘drug’’, ‘‘de4 vice’’, and ‘‘biological product’’ have the meanings 

5 given such terms in sections 201(g)(1) and 201(h) 

6 of the Federal Food, Drug, and Cosmetic Act (21 

7 U.S.C. 321(g)(1) and (h)) and section 351(a) of the 

8 Public Health Service Act (42 U.S.C. 262(a)), re9 spectively, including any component or raw material 

10 used therein, but excluding health care services. 

11 (13) NONECONOMIC DAMAGES.—The term 

12 ‘‘noneconomic damages’’ means damages for phys13 ical and emotional pain, suffering, inconvenience, 

14 physical impairment, mental anguish, disfigurement, 

15 loss of enjoyment of life, loss of society and compan16 ionship, loss of consortium (other than loss of do17 mestic service), hedonic damages, injury to reputa18 tion, and all other nonpecuniary losses of any kind 

19 or nature incurred as a result of the provision or use 

20 of (or failure to provide or use) health care services 

21 or medical products, unless otherwise defined under 

22 applicable State law. 

23 (14) RECOVERY.—The term ‘‘recovery’’ means 

24 the net sum recovered after deducting any disburse25 ments or costs incurred in connection with prosecumstockstill on DSK3G9T082PROD with BILLS

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1 tion or settlement of the claim, including all costs 

2 paid or advanced by any person. Costs of health care 

3 incurred by the plaintiff and the attorneys’ office 

4 overhead costs or charges for legal services are not 

5 deductible disbursements or costs for such purpose. 

6 (15) REPRESENTATIVE.—The term ‘‘represent7 ative’’ means a legal guardian, attorney, person des8 ignated to make decisions on behalf of a patient 

9 under a medical power of attorney, or any person 

10 recognized in law or custom as a patient’s agent. 

11 (16) STATE.—The term ‘‘State’’ means each of 

12 the several States, the District of Columbia, the 

13 Commonwealth of Puerto Rico, the Virgin Islands, 

14 Guam, American Samoa, the Northern Mariana Is15 lands, the Trust Territory of the Pacific Islands, and 

16 any other territory or possession of the United 

17 States, or any political subdivision thereof. 

18 SEC. 10. EFFECT ON OTHER LAWS. 

19 (a) VACCINE INJURY.— 

20 (1) To the extent that title XXI of the Public 

21 Health Service Act establishes a Federal rule of law 

22 applicable to a civil action brought for a vaccine-re23 lated injury or death— 

24 (A) this Act does not affect the application 

25 of the rule of law to such an action; and 

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1 (B) any rule of law prescribed by this Act 

2 in conflict with a rule of law of such title XXI 

3 shall not apply to such action. 

4 (2) If there is an aspect of a civil action 

5 brought for a vaccine-related injury or death to 

6 which a Federal rule of law under title XXI of the 

7 Public Health Service Act does not apply, then this 

8 Act or otherwise applicable law (as determined 

9 under this Act) will apply to such aspect of such ac10 tion. 

11 (b) OTHER FEDERAL LAW.—Except as provided in 

12 this section, nothing in this Act shall be deemed to affect 

13 any defense available to a defendant in a health care law14 suit or action under any other provision of Federal law. 

15 SEC. 11. RULES OF CONSTRUCTION. 

16 (a) HEALTH CARE LAWSUITS.—Unless otherwise 

17 specified in this Act, the provisions governing health care 

18 lawsuits set forth in this Act preempt, subject to sub19 sections (b) and (c), State law to the extent that State 

20 law prevents the application of any provisions of law estab21 lished by or under this Act. The provisions governing 

22 health care lawsuits set forth in this Act supersede chapter 

23 171 of title 28, United States Code, to the extent that 

24 such chapter— 

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1 (1) provides for a greater amount of damages 

2 or contingent fees, a longer period in which a health 

3 care lawsuit may be commenced, or a reduced appli4 cability or scope of periodic payment of future dam5 ages, than provided in this Act; or 

6 (2) prohibits the introduction of evidence re7 garding collateral source benefits, or mandates or 

8 permits subrogation or a lien on collateral source 

9 benefits. 

10 (b) PROTECTION OF STATES’ RIGHTS AND OTHER

11 LAWS.—Any issue that is not governed by any provision 

12 of law established by or under this Act (including State 

13 standards of negligence) shall be governed by otherwise 

14 applicable State or Federal law. 

15 (c) STATE FLEXIBILITY.—No provision of this Act 

16 shall be construed to preempt any defense available to a 

17 party in a health care lawsuit under any other provision 

18 of State or Federal law. 

19 SEC. 12. EFFECTIVE DATE. 

20 This Act shall apply to any health care lawsuit 

21 brought in a Federal or State court, or subject to an alter22 native dispute resolution system, that is initiated on or 

23 after the date of the enactment of this Act, except that 

24 any health care lawsuit arising from an injury occurring 

25 prior to the date of the enactment of this Act shall be 

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1 governed by the applicable statute of limitations provisions 

2 in effect at the time the cause of action accrued. 

Æ 

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