I 

108TH CONGRESS 

1ST SESSION H. R. 447 

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. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 29, 2003 

Mr. DEFAZIO introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

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. 

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. 

4 This Act may be cited as the ‘‘Improved Medical Mal5 practice Information Reporting and Competition Act of 

6 2003’’. 

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1 SEC. 2. ESTABLISHMENT OF OFFICE OF HEALTH CARE 

2 COMPETITION WITHIN THE DEPARTMENT OF 

3 HEALTH AND HUMAN SERVICES. 

4 (a) IN GENERAL.—There is established within the 

5 Department of Health and Human Services an Office to 

6 be known as the Office of Health Care Competition Policy 

7 (in this section referred to as the ‘‘Office’’). The Office 

8 shall be headed by a Director, who shall be appointed by 

9 the Secretary of such Department. 

10 (b) DUTIES.— 

11 (1) RESPONSIBILITY FOR NATIONAL PRACTI12 TIONER DATA BASE.—The Office shall be responsible 

13 for activities of the Secretary under part B of title 

14 IV of the Health Care Quality Improvement Act of 

15 1986 (title IV of Public Law 99–660), including the 

16 National Practitioner Data Base under such part. 

17 (2) ANNUAL REPORT.—The Director of the Of18 fice shall submit a report each year to the Secretary 

19 of Health and Human Services on activities con20 ducted under such part. 

21 SEC. 3. CHANGES IN NATIONAL PRACTITIONER DATA BASE 

22 PROVISIONS. 

23 (a) REQUIRING ADDITIONAL REPORTS ON MEDICAL

24 MALPRACTICE INSURANCE AND CLAIMS.—Part B of title 

25 IV of the Health Care Quality Improvement Act of 1986 

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1 (title IV of Public Law 99–660) is amended by inserting 

2 after section 421 the following new section: 

3 ‘‘SEC. 421A. REQUIRING REPORTS ON MEDICAL MAL4 PRACTICE INSURANCE AND CLAIMS. 

5 ‘‘(a) IN GENERAL.—Each entity (including an insur6 ance company) which underwrites a policy of insurance for 

7 medical malpractice actions or claims shall report, in ac8 cordance with section 424, information respecting such in9 surance and claims for payment under such policy. Such 

10 information shall be in addition to, and may be coordi11 nated with, the information required to be reported under 

12 section 421. 

13 ‘‘(b) INFORMATION TO BE REPORTED.— 

14 ‘‘(1) IN GENERAL.—The information to be re15 ported under subsection (a) by an entity with re16 spect to a medical malpractice insurance policy in17 cludes the following: 

18 ‘‘(A) Direct premiums written. 

19 ‘‘(B) Direct premiums earned. 

20 ‘‘(C) Net investment income, including net 

21 realized capital gains and losses, using appro22 priate estimates where necessary. 

23 ‘‘(D) Incurred claims, developed as the 

24 sum of the following (the report shall include 

25 data for each of the following: 

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1 ‘‘(i) Dollar amount of claims closed 

2 with payment; plus. 

3 ‘‘(ii) Reserves for reported claims at 

4 the end of the current year; minus. 

5 ‘‘(iii) Reserves for reported claims at 

6 the end of the previous year; plus. 

7 ‘‘(iv) Reserves for incurred but not re8 ported claims at the end of the current 

9 year; minus. 

10 ‘‘(v) Reserves for incurred but not re11 ported claims at the end of the previous 

12 year; plus. 

13 ‘‘(vi) Loss adjustment expenses for 

14 claims closed; plus. 

15 ‘‘(vii) Reserves for loss adjustment ex16 pense at the end of the current year; 

17 minus. 

18 ‘‘(viii) Reserves for loss adjustment 

19 expense at the end of the previous year. 

20 (categories used to develop the sum of incurred 

21 claims). 

22 ‘‘(E) Actual incurred expenses allocated 

23 separately to loss adjustment, commissions, 

24 other acquisition costs, advertising, general ofmmaher on MIKETEMP with BILLS

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1 fice expenses, taxes, licenses and fees, and all 

2 other expenses. 

3 ‘‘(F) Net underwriting gain or loss. 

4 ‘‘(G) Net operation gain or loss, including 

5 net investment income. 

6 ‘‘(H) The number and dollar amount of 

7 claims closed with payment by year incurred, 

8 the amount reserved for each claim, the year(s) 

9 in which the reserves were set, and the amounts 

10 set in each year. 

11 ‘‘(I) The number of claims closed without 

12 payment, the dollar amount reserved for each 

13 claim, the years in which reserves were set, and 

14 the amounts set in each. 

15 ‘‘(J) The number of claims pending at the 

16 end of each year, the amount of reserve[d] for 

17 each claim, the year(s) in which the reserves 

18 were set, and the amounts set in each year. 

19 ‘‘(2) CLAIMS PAID.—Such report shall also in20 clude the following: 

21 ‘‘(A) For claims paid by the insurer during 

22 the calendar year, in which a verdict had at any 

23 time been rendered. 

24 ‘‘(i) The dollar amount paid by the in25 surance company; and 

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1 ‘‘(ii) The dollar amount of the original 

2 verdict. 

3 ‘‘(B) For claims paid by the insurer during 

4 the calendar year, in which a verdict had at any 

5 time been rendered. 

6 ‘‘(i) The dollar amount of the original 

7 verdict, broken out as follows: 

8 ‘‘(I) The total amount of past 

9 economic damages assessed by the 

10 trier of fact. 

11 ‘‘(II) The total amount of future 

12 economic damages assessed by the 

13 trier of fact. 

14 ‘‘(III) The total amount of com15 pensatory non-economic damages as16 sessed by the trier of fact. 

17 ‘‘(IV) The total amount of puni18 tive damages assessed by the trier of 

19 fact. 

20 ‘‘(ii) The dollar amount paid by all 

21 parties. 

22 ‘‘(iii) The dollar amount paid by the 

23 insurer. 

24 ‘‘(iv) The number of claims paid by 

25 the insurer. 

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1 ‘‘(C) For claims paid by the insurer during 

2 the calendar year, in which a verdict had never 

3 been rendered. 

4 ‘‘(i) The total amount paid by the in5 surer broken out as follows: 

6 ‘‘(I) The amount of the plaintiff’s 

7 past economic damages, as submitted 

8 by the plaintiff. 

9 ‘‘(II) The amount of the plain10 tiff’s future economic damages, as es11 timated by the insurer. 

12 ‘‘(III) The amount paid by the 

13 insurer for other damages. 

14 ‘‘(ii) The number of claims paid by 

15 the insurer. 

16 ‘‘(D) The number of claims in which the 

17 insurer paid— 

18 ‘‘(i) more than $250,000 in non-eco19 nomic damages; and 

20 ‘‘(ii) more than $500,000 in non-eco21 nomic damages. 

22 ‘‘(E) For claims paid by the insurer during 

23 the calendar year, the number of claims in 

24 which— 

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1 ‘‘(i) punitive damages were assessed 

2 by the trier of fact; 

3 ‘‘(ii) punitive damages were paid by 

4 any party; and 

5 ‘‘(iii) punitive damages were paid by 

6 the insurer. 

7 ‘‘(F) For claims paid by the insurer during 

8 the calendar year— 

9 ‘‘(i) the dollar amount of punitive 

10 damages assessed by the trier of fact; 

11 ‘‘(ii) the dollar amount of punitive 

12 damages paid by all parties; and 

13 ‘‘(iii) the dollar amount of punitive 

14 damages paid by the insurer. 

15 ‘‘(G) The number and dollar amount of 

16 claims paid by the insurer during the calendar 

17 year in which parties other than the insured— 

18 ‘‘(i) had at any time been found liable 

19 by the trier of fact; or 

20 ‘‘(ii) had been estimated by the insur21 ance company to have some liability. 

22 ‘‘(H) For those claims identified in para23 graph (7), the amount by which the amount 

24 paid by the insurer exceeds the amount propormmaher on MIKETEMP with BILLS

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1 tional to the insured’s percentage of responsi2 bility. 

3 ‘‘(I) Such other information as the Sec4 retary determines is required for appropriate 

5 interpretation of information reported under 

6 this section. 

7 ‘‘(c) SANCTIONS FOR FAILURE TO REPORT.—The 

8 provisions of section 421(c) shall apply to information re9 quired to be reported under this section in the same man10 ner as they apply to the reporting of information on a pay11 ment required to be reported under section 421. 

12 ‘‘(d) COORDINATION OF INFORMATION REPORT13 ING.—The Secretary shall provide for the coordination of 

14 reporting of information under this section with the re15 porting of related information under section 421.’’. 

16 (b) INCLUSION AND AVAILABILITY OF INFORMA17 TION.—Section 427(b) of such Act (42 U.S.C. 11137(b)) 

18 is amended by adding at the end the following new para19 graph: 

20 ‘‘(4) AVAILABILITY OF PUBLIC FILE DATA.— 

21 Notwithstanding the previous provisions of this sub22 section, the Secretary shall make available, for free 

23 from the website maintained in connection with the 

24 data base established to carry out this part, informa25 tion reported under sections 421 and 421A which 

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1 does not provide for individually identifiable infor2 mation.’’. 

3 (c) EFFECTIVE DATE.—The amendments made by 

4 this section shall take effect 6 months after the date of 

5 the enactment of this Act . 

Æ 

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