I 

114TH CONGRESS 

2D SESSION H. R. 4771 

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 

MARCH 17, 2016 

Mr. FRANKS of Arizona 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 ‘‘Help Efficient, Accessible, Low-cost, Timely Healthcare 

6 (HEALTH) Act of 2016’’. 


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

2 this Act is as follows: 

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. Punitive damages. 

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

lawsuits. 

Sec. 8. Definitions. 

Sec. 9. Effect on other laws. 

Sec. 10. State flexibility and protection of States’ rights. 

Sec. 11. Applicability; effective date. 

3 SEC. 2. FINDINGS AND PURPOSE. 

4 (a) FINDINGS.— 

5 (1) EFFECT ON HEALTH CARE ACCESS AND

6 COSTS.—Congress finds that our current civil justice 

7 system is adversely affecting patient access to health 

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

9 health care, in that the health care liability system 

10 is a costly and ineffective mechanism for resolving 

11 claims of health care liability and compensating in12 jured patients, and is a deterrent to the sharing of 

13 information among health care professionals which 

14 impedes efforts to improve patient safety and quality 

15 of care. 

16 (2) EFFECT ON INTERSTATE COMMERCE.— 

17 Congress finds that the health care and insurance 

18 industries are industries affecting interstate com19 merce and the health care liability litigation systems 

20 existing throughout the United States are activities 


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1 that affect interstate commerce by contributing to 

2 the high costs of health care and premiums for 

3 health care liability insurance purchased by health 

4 care system providers. 

5 (3) EFFECT ON FEDERAL SPENDING.—Con6 gress finds that the health care liability litigation 

7 systems existing throughout the United States have 

8 a significant effect on the amount, distribution, and 

9 use of Federal funds because of— 

10 (A) the large number of individuals who 

11 receive health care benefits under programs op12 erated or financed by the Federal Government; 

13 (B) the large number of individuals who 

14 benefit because of the exclusion from Federal 

15 taxes of the amounts spent to provide them 

16 with health insurance benefits; and 

17 (C) the large number of health care pro18 viders who provide items or services for which 

19 the Federal Government makes payments. 

20 (b) PURPOSE.—It is the purpose of this Act to imple21 ment reasonable, comprehensive, and effective health care 

22 liability reforms designed to— 

23 (1) improve the availability of health care serv24 ices in cases in which health care liability actions 


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1 have been shown to be a factor in the decreased 

2 availability of services; 

3 (2) reduce the incidence of ‘‘defensive medi4 cine’’ and lower the cost of health care liability in5 surance, all of which contribute to the escalation of 

6 health care costs; 

7 (3) ensure that persons with meritorious health 

8 care injury claims receive fair and adequate com9 pensation, including reasonable noneconomic dam10 ages; 

11 (4) improve the fairness and cost-effectiveness 

12 of our current health care liability system to resolve 

13 disputes over, and provide compensation for, health 

14 care liability by reducing uncertainty in the amount 

15 of compensation provided to injured individuals; and 

16 (5) provide an increased sharing of information 

17 in the health care system which will reduce unin18 tended injury and improve patient care. 

19 SEC. 3. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS. 

20 The time for the commencement of a health care law21 suit shall be 3 years after the date of manifestation of 

22 injury or 1 year after the claimant discovers, or through 

23 the use of reasonable diligence should have discovered, the 

24 injury, whichever occurs first. In no event shall the time 

25 for commencement of a health care lawsuit exceed 3 years 


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1 after the date of manifestation of injury unless tolled for 

2 any of the following— 

3 (1) upon proof of fraud; 

4 (2) intentional concealment; or 

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

6 therapeutic or diagnostic purpose or effect, in the 

7 person of the injured person. 

8 Actions by a minor shall be commenced within 3 years 

9 from the date of the alleged manifestation of injury except 

10 that actions by a minor under the full age of 6 years shall 

11 be commenced within 3 years of manifestation of injury 

12 or prior to the minor’s 8th birthday, whichever provides 

13 a longer period. Such time limitation shall be tolled for 

14 minors for any period during which a parent or guardian 

15 and a health care provider or health care organization 

16 have committed fraud or collusion in the failure to bring 

17 an action on behalf of the injured minor. 

18 SEC. 4. COMPENSATING PATIENT INJURY. 

19 (a) UNLIMITED AMOUNT OF DAMAGES FOR ACTUAL

20 ECONOMIC LOSSES IN HEALTH CARE LAWSUITS.—In any 

21 health care lawsuit, nothing in this Act shall limit a claim22 ant’s recovery of the full amount of the available economic 

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

24 (b) ADDITIONAL NONECONOMIC DAMAGES.—In any 

25 health care lawsuit, the amount of noneconomic damages, 


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1 if available, may be as much as $250,000, regardless of 

2 the number of parties against whom the action is brought 

3 or the number of separate claims or actions brought with 

4 respect to the same injury. 

5 (c) NO DISCOUNT OF AWARD FOR NONECONOMIC

6 DAMAGES.—For purposes of applying the limitation in 

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

8 discounted to present value. The jury shall not be in9 formed about the maximum award for noneconomic dam10 ages. An award for noneconomic damages in excess of 

11 $250,000 shall be reduced either before the entry of judg12 ment, or by amendment of the judgment after entry of 

13 judgment, and such reduction shall be made before ac14 counting for any other reduction in damages required by 

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

16 noneconomic damages and the combined awards exceed 

17 $250,000, the future noneconomic damages shall be re18 duced first. 

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

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

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

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

23 damages allocated to such party in direct proportion to 

24 such party’s percentage of responsibility. Whenever a 

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1 rate judgment shall be rendered against each such party 

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

3 this section, the trier of fact shall determine the propor4 tion of responsibility of each party for the claimant’s 

5 harm. 

6 SEC. 5. MAXIMIZING PATIENT RECOVERY. 

7 (a) COURT SUPERVISION OF SHARE OF DAMAGES

8 ACTUALLY PAID TO CLAIMANTS.—In any health care law9 suit, the court shall supervise the arrangements for pay10 ment of damages to protect against conflicts of interest 

11 that may have the effect of reducing the amount of dam12 ages awarded that are actually paid to claimants. In par13 ticular, in any health care lawsuit in which the attorney 

14 for a party claims a financial stake in the outcome by vir15 tue of a contingent fee, the court shall have the power 

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

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

18 claimant based upon the interests of justice and principles 

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

20 for representing all claimants in a health care lawsuit ex21 ceed the following limits: 

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

23 by the claimant(s). 

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

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


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

2 recovered by the claimant(s). 

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

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

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

6 shall apply whether the recovery is by judgment, settle7 ment, mediation, arbitration, or any other form of alter8 native dispute resolution. In a health care lawsuit involv9 ing a minor or incompetent person, a court retains the 

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

11 the maximum permitted under this section. The require12 ment for court supervision in the first two sentences of 

13 subsection (a) applies only in civil actions. 

14 SEC. 6. PUNITIVE DAMAGES. 

15 (a) IN GENERAL.—Punitive damages may, if other16 wise permitted by applicable State or Federal law, be 

17 awarded against any person in a health care lawsuit only 

18 if it is proven by clear and convincing evidence that such 

19 person acted with malicious intent to injure the claimant, 

20 or that such person deliberately failed to avoid unneces21 sary injury that such person knew the claimant was sub22 stantially certain to suffer. In any health care lawsuit 

23 where no judgment for compensatory damages is rendered 

24 against such person, no punitive damages may be awarded 

25 with respect to the claim in such lawsuit. No demand for 


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1 punitive damages shall be included in a health care lawsuit 

2 as initially filed. A court may allow a claimant to file an 

3 amended pleading for punitive damages only upon a mo4 tion by the claimant and after a finding by the court, upon 

5 review of supporting and opposing affidavits or after a 

6 hearing, after weighing the evidence, that the claimant has 

7 established by a substantial probability that the claimant 

8 will prevail on the claim for punitive damages. At the re9 quest of any party in a health care lawsuit, the trier of 

10 fact shall consider in a separate proceeding— 

11 (1) whether punitive damages are to be award12 ed and the amount of such award; and 

13 (2) the amount of punitive damages following a 

14 determination of punitive liability. 

15 If a separate proceeding is requested, evidence relevant 

16 only to the claim for punitive damages, as determined by 

17 applicable State law, shall be inadmissible in any pro18 ceeding to determine whether compensatory damages are 

19 to be awarded. 

20 (b) DETERMINING AMOUNT OF PUNITIVE DAM21 AGES.— 

22 (1) FACTORS CONSIDERED.—In determining 

23 the amount of punitive damages, if awarded, in a 

24 health care lawsuit, the trier of fact shall consider 

25 only the following— 


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1 (A) the severity of the harm caused by the 

2 conduct of such party; 

3 (B) the duration of the conduct or any 

4 concealment of it by such party; 

5 (C) the profitability of the conduct to such 

6 party; 

7 (D) the number of products sold or med8 ical procedures rendered for compensation, as 

9 the case may be, by such party, of the kind 

10 causing the harm complained of by the claim11 ant; 

12 (E) any criminal penalties imposed on such 

13 party, as a result of the conduct complained of 

14 by the claimant; and 

15 (F) the amount of any civil fines assessed 

16 against such party as a result of the conduct 

17 complained of by the claimant. 

18 (2) MAXIMUM AWARD.—The amount of punitive 

19 damages, if awarded, in a health care lawsuit may 

20 be as much as $250,000 or as much as two times 

21 the amount of economic damages awarded, which22 ever is greater. The jury shall not be informed of 

23 this limitation. 

24 (c) NO PUNITIVE DAMAGES FOR PRODUCTS THAT

25 COMPLY WITH FDA STANDARDS.— 


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1 (1) IN GENERAL.— 

2 (A) No punitive damages may be awarded 

3 against the manufacturer or distributor of a 

4 medical product, or a supplier of any compo5 nent or raw material of such medical product, 

6 based on a claim that such product caused the 

7 claimant’s harm where— 

8 (i)(I) such medical product was sub9 ject to premarket approval, clearance, or li10 censure by the Food and Drug Administra11 tion with respect to the safety of the for12 mulation or performance of the aspect of 

13 such medical product which caused the 

14 claimant’s harm or the adequacy of the 

15 packaging or labeling of such medical 

16 product; and 

17 (II) such medical product was so ap18 proved, cleared, or licensed; or 

19 (ii) such medical product is generally 

20 recognized among qualified experts as safe 

21 and effective pursuant to conditions estab22 lished by the Food and Drug Administra23 tion and applicable Food and Drug Admin24 istration regulations, including without 

25 limitation those related to packaging and 


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1 labeling, unless the Food and Drug Admin2 istration has determined that such medical 

3 product was not manufactured or distrib4 uted in substantial compliance with appli5 cable Food and Drug Administration stat6 utes and regulations. 

7 (B) RULE OF CONSTRUCTION.—Subpara8 graph (A) may not be construed as establishing 

9 the obligation of the Food and Drug Adminis10 tration to demonstrate affirmatively that a 

11 manufacturer, distributor, or supplier referred 

12 to in such subparagraph meets any of the con13 ditions described in such subparagraph. 

14 (2) LIABILITY OF HEALTH CARE PROVIDERS.— 

15 A health care provider who prescribes, or who dis16 penses pursuant to a prescription, a medical product 

17 approved, licensed, or cleared by the Food and Drug 

18 Administration shall not be named as a party to a 

19 product liability lawsuit involving such product and 

20 shall not be liable to a claimant in a class action 

21 lawsuit against the manufacturer, distributor, or 

22 seller of such product. Nothing in this paragraph 

23 prevents a court from consolidating cases involving 

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1 ability claims against the manufacturer, distributor, 

2 or product seller of such medical product. 

3 (3) PACKAGING.—In a health care lawsuit for 

4 harm which is alleged to relate to the adequacy of 

5 the packaging or labeling of a drug which is required 

6 to have tamper-resistant packaging under regula7 tions of the Secretary of Health and Human Serv8 ices (including labeling regulations related to such 

9 packaging), the manufacturer or product seller of 

10 the drug shall not be held liable for punitive dam11 ages unless such packaging or labeling is found by 

12 the trier of fact by clear and convincing evidence to 

13 be substantially out of compliance with such regula14 tions. 

15 (4) EXCEPTION.—Paragraph (1) shall not 

16 apply in any health care lawsuit in which— 

17 (A) a person, before or after premarket ap18 proval, clearance, or licensure of such medical 

19 product, knowingly misrepresented to or with20 held from the Food and Drug Administration 

21 information that is required to be submitted 

22 under the Federal Food, Drug, and Cosmetic 

23 Act (21 U.S.C. 301 et seq.) or section 351 of 

24 the Public Health Service Act (42 U.S.C. 262) 


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1 that is material and is causally related to the 

2 harm which the claimant allegedly suffered; or 

3 (B) a person made an illegal payment to 

4 an official of the Food and Drug Administra5 tion for the purpose of either securing or main6 taining approval, clearance, or licensure of such 

7 medical product. 

8 SEC. 7. AUTHORIZATION OF PAYMENT OF FUTURE DAM9 AGES TO CLAIMANTS IN HEALTH CARE LAW10 SUITS. 

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

12 award of future damages, without reduction to present 

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

14 party with sufficient insurance or other assets to fund a 

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

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

17 the future damages be paid by periodic payments, in ac18 cordance with the Uniform Periodic Payment of Judg19 ments Act promulgated by the National Conference of 

20 Commissioners on Uniform State Laws. 

21 (b) APPLICABILITY.—This section applies to all ac22 tions which have not been first set for trial or retrial be23 fore the effective date of this Act. 

24 SEC. 8. DEFINITIONS. 

25 In this Act: 


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1 (1) ALTERNATIVE DISPUTE RESOLUTION SYS2 TEM; ADR.—The term ‘‘alternative dispute resolution 

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

4 for the resolution of health care lawsuits in a man5 ner other than through a civil action brought in a 

6 State or Federal court. 

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

8 any person who brings a health care lawsuit, includ9 ing a person who asserts or claims a right to legal 

10 or equitable contribution, indemnity, or subrogation, 

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

12 and any person on whose behalf such a claim is as13 serted or such an action is brought, whether de14 ceased, incompetent, or a minor. 

15 (3) COMPENSATORY DAMAGES.—The term 

16 ‘‘compensatory damages’’ means objectively 

17 verifiable monetary losses incurred as a result of the 

18 provision of, use of, or payment for (or failure to 

19 provide, use, or pay for) health care services or med20 ical products, such as past and future medical ex21 penses, loss of past and future earnings, cost of ob22 taining domestic services, loss of employment, and 

23 loss of business or employment opportunities, dam24 ages for physical and emotional pain, suffering, in25 convenience, physical impairment, mental anguish, 


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1 disfigurement, loss of enjoyment of life, loss of soci2 ety and companionship, loss of consortium (other 

3 than loss of domestic service), hedonic damages, in4 jury to reputation, and all other nonpecuniary losses 

5 of any kind or nature. The term ‘‘compensatory 

6 damages’’ includes economic damages and non7 economic damages, as such terms are defined in this 

8 section. 

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

10 fee’’ includes all compensation to any person or per11 sons which is payable only if a recovery is effected 

12 on behalf of one or more claimants. 

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

14 damages’’ means objectively verifiable monetary 

15 losses incurred as a result of the provision of, use 

16 of, or payment for (or failure to provide, use, or pay 

17 for) health care services or medical products, such as 

18 past and future medical expenses, loss of past and 

19 future earnings, cost of obtaining domestic services, 

20 loss of employment, and loss of business or employ21 ment opportunities. 

22 (6) HEALTH CARE LAWSUIT.—The term 

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

24 claim concerning the provision of health care goods 

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1 state commerce, or any health care liability action 

2 concerning the provision of health care goods or 

3 services or any medical product affecting interstate 

4 commerce, brought in a State or Federal court or 

5 pursuant to an alternative dispute resolution system, 

6 against a health care provider, a health care organi7 zation, or the manufacturer, distributor, supplier, 

8 marketer, promoter, or seller of a medical product, 

9 regardless of the theory of liability on which the 

10 claim is based, or the number of claimants, plain11 tiffs, defendants, or other parties, or the number of 

12 claims or causes of action, in which the claimant al13 leges a health care liability claim. Such term does 

14 not include a claim or action which is based on 

15 criminal liability; which seeks civil fines or penalties 

16 paid to Federal, State, or local government; or which 

17 is grounded in antitrust. 

18 (7) HEALTH CARE LIABILITY ACTION.—The 

19 term ‘‘health care liability action’’ means a civil ac20 tion brought in a State or Federal court or pursuant 

21 to an alternative dispute resolution system, against 

22 a health care provider, a health care organization, or 

23 the manufacturer, distributor, supplier, marketer, 

24 promoter, or seller of a medical product, regardless 

25 of the theory of liability on which the claim is based, 


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1 or the number of plaintiffs, defendants, or other par2 ties, or the number of causes of action, in which the 

3 claimant alleges a health care liability claim. 

4 (8) HEALTH CARE LIABILITY CLAIM.—The 

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

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

7 against a health care provider, health care organiza8 tion, or the manufacturer, distributor, supplier, mar9 keter, promoter, or seller of a medical product, in10 cluding, but not limited to, third-party claims, cross11 claims, counter-claims, or contribution claims, which 

12 are based upon the provision of, use of, or payment 

13 for (or the failure to provide, use, or pay for) health 

14 care services or medical products, regardless of the 

15 theory of liability on which the claim is based, or the 

16 number of plaintiffs, defendants, or other parties, or 

17 the number of causes of action. 

18 (9) HEALTH CARE ORGANIZATION.—The term 

19 ‘‘health care organization’’ means any person or en20 tity which is obligated to provide or pay for health 

21 benefits under any health plan, including any person 

22 or entity acting under a contract or arrangement 

23 with a health care organization to provide or admin24 ister any health benefit. 


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1 (10) HEALTH CARE PROVIDER.—The term 

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

3 required by State or Federal laws or regulations to 

4 be licensed, registered, or certified to provide health 

5 care services, and being either so licensed, reg6 istered, or certified, or exempted from such require7 ment by other statute or regulation. 

8 (11) HEALTH CARE GOODS OR SERVICES.—The 

9 term ‘‘health care goods or services’’ means any 

10 goods or services provided by a health care organiza11 tion, provider, or by any individual working under 

12 the supervision of a health care provider, that relates 

13 to the diagnosis, prevention, or treatment of any 

14 human disease or impairment, or the assessment or 

15 care of the health of human beings. 

16 (12) MALICIOUS INTENT TO INJURE.—The 

17 term ‘‘malicious intent to injure’’ means inten18 tionally causing or attempting to cause physical in19 jury other than providing health care goods or serv20 ices. 

21 (13) MEDICAL PRODUCT.—The term ‘‘medical 

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

23 intended for humans, and the terms ‘‘drug’’, ‘‘de24 vice’’, and ‘‘biological product’’ have the meanings 

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


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

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

3 Public Health Service Act (42 U.S.C. 262(a)), re4 spectively, including any component or raw material 

5 used therein, but excluding health care services. 

6 (14) NONECONOMIC DAMAGES.—The term 

7 ‘‘noneconomic damages’’ means damages for phys8 ical and emotional pain, suffering, inconvenience, 

9 physical impairment, mental anguish, disfigurement, 

10 loss of enjoyment of life, loss of society and compan11 ionship, loss of consortium (other than loss of do12 mestic service), hedonic damages, injury to reputa13 tion, and all other nonpecuniary losses of any kind 

14 or nature. 

15 (15) PUNITIVE DAMAGES.—The term ‘‘punitive 

16 damages’’ means damages awarded, for the purpose 

17 of punishment or deterrence, and not solely for com18 pensatory purposes, against a health care provider, 

19 health care organization, or a manufacturer, dis20 tributor, or supplier of a medical product. Punitive 

21 damages are neither economic nor noneconomic 

22 damages. 

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

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

7 the several States, the District of Columbia, the 

8 Commonwealth of Puerto Rico, the Virgin Islands, 

9 Guam, American Samoa, the Northern Mariana Is10 lands, the Trust Territory of the Pacific Islands, and 

11 any other territory or possession of the United 

12 States, or any political subdivision thereof. 

13 SEC. 9. EFFECT ON OTHER LAWS. 

14 (a) VACCINE INJURY.— 

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

16 Health Service Act establishes a Federal rule of law 

17 applicable to a civil action brought for a vaccine-re18 lated injury or death— 

19 (A) this Act does not affect the application 

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

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

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

23 shall not apply to such action. 

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

25 brought for a vaccine-related injury or death to 


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

2 Public Health Service Act does not apply, then this 

3 Act or otherwise applicable law (as determined 

4 under this Act) will apply to such aspect of such ac5 tion. 

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

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

8 any defense available to a defendant in a health care law9 suit or action under any other provision of Federal law. 

10 SEC. 10. STATE FLEXIBILITY AND PROTECTION OF STATES’ 

11 RIGHTS. 

12 (a) HEALTH CARE LAWSUITS.—The provisions gov13 erning health care lawsuits set forth in this Act preempt, 

14 subject to subsections (b) and (c), State law to the extent 

15 that State law prevents the application of any provisions 

16 of law established by or under this Act. The provisions 

17 governing health care lawsuits set forth in this Act super18 sede chapter 171 of title 28, United States Code, to the 

19 extent that such chapter— 

20 (1) provides for a greater amount of damages 

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

22 care lawsuit may be commenced, or a reduced appli23 cability or scope of periodic payment of future dam24 ages, than provided in this Act; or 


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1 (2) prohibits the introduction of evidence re2 garding collateral source benefits, or mandates or 

3 permits subrogation or a lien on collateral source 

4 benefits. 

5 (b) PROTECTION OF STATES’ RIGHTS AND OTHER

6 LAWS.—(1) Any issue that is not governed by any provi7 sion of law established by or under this Act (including 

8 State standards of negligence) shall be governed by other9 wise applicable State or Federal law. 

10 (2) This Act shall not preempt or supersede any State 

11 or Federal law that imposes greater procedural or sub12 stantive protections for health care providers and health 

13 care organizations from liability, loss, or damages than 

14 those provided by this Act or create a cause of action. 

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

16 shall be construed to preempt— 

17 (1) any State law (whether effective before, on, 

18 or after the date of the enactment of this Act) that 

19 specifies a particular monetary amount of compen20 satory or punitive damages (or the total amount of 

21 damages) that may be awarded in a health care law22 suit, regardless of whether such monetary amount is 

23 greater or lesser than is provided for under this Act, 

24 notwithstanding section 4(a); or 


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1 (2) any defense available to a party in a health 

2 care lawsuit under any other provision of State or 

3 Federal law. 

4 SEC. 11. APPLICABILITY; EFFECTIVE DATE. 

5 This Act shall apply to any health care lawsuit 

6 brought in a Federal or State court, or subject to an alter7 native dispute resolution system, that is initiated on or 

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

9 any health care lawsuit arising from an injury occurring 

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

11 governed by the applicable statute of limitations provisions 

12 in effect at the time the injury occurred. 

Æ 


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