or the number of causes of action, in which the claim-
ant alleges a health care liability claim. 
(8) HEALTH CARE LIABILITY CLAIM.—The term 
‘‘health care liability claim’’ means a demand by any 
person, whether or not pursuant to ADR, against a 
health care provider, health care organization, or the 
manufacturer, distributor, supplier, marketer, pro-
moter, or seller of a medical product, including, but 
not limited to, third-party claims, cross-claims, 
counter-claims, or contribution claims, which are 
based upon the provision of, use of, or payment for 
(or the failure to provide, use, or pay for) health care 
services or medical products, regardless of the theory 
of liability on which the claim is based, or the num-
ber of plaintiffs, defendants, or other parties, or the 
number of causes of action. 
(9) HEALTH
CARE
ORGANIZATION.—The term 
‘‘health care organization’’ means any person or enti-
ty which is obligated to provide or pay for health ben-
efits under any health plan, including any person or 
entity acting under a contract or arrangement with 
a health care organization to provide or administer 
any health benefit. 
(10) 
HEALTH
CARE
PROVIDER.—The 
term 
‘‘health care provider’’ means any person or entity re-
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quired by State or Federal laws or regulations to be 
licensed, registered, or certified to provide health care 
services, and being either so licensed, registered, or 
certified, or exempted from such requirement by other 
statute or regulation. 
(11) HEALTH CARE GOODS OR SERVICES.—The 
term ‘‘health care goods or services’’ means any goods 
or services provided by a health care organization, 
provider, or by any individual working under the su-
pervision of a health care provider, that relates to the 
diagnosis, prevention, or treatment of any human dis-
ease or impairment, or the assessment or care of the 
health of human beings. 
(12) MALICIOUS INTENT TO INJURE.—The term 
‘‘malicious intent to injure’’ means intentionally 
causing or attempting to cause physical injury other 
than providing health care goods or services. 
(13) MEDICAL
PRODUCT.—The term ‘‘medical 
product’’ means a drug, device, or biological product 
intended for humans, and the terms ‘‘drug’’, ‘‘device’’, 
and ‘‘biological product’’ have the meanings given 
such terms in sections 201(g)(1) and 201(h) of the 
Federal Food, Drug and Cosmetic Act (21 U.S.C. 
321(g)(1) and (h)) and section 351(a) of the Public 
Health Service Act (42 U.S.C. 262(a)), respectively, 
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including any component or raw material used there-
in, but excluding health care services. 
(14) NONECONOMIC DAMAGES.—The term ‘‘non-
economic damages’’ means damages for physical and 
emotional pain, suffering, inconvenience, physical im-
pairment, mental anguish, disfigurement, loss of en-
joyment of life, loss of society and companionship, 
loss of consortium (other than loss of domestic serv-
ice), hedonic damages, injury to reputation, and all 
other nonpecuniary losses of any kind or nature. 
(15) PUNITIVE DAMAGES.—The term ‘‘punitive 
damages’’ means damages awarded, for the purpose of 
punishment or deterrence, and not solely for compen-
satory purposes, against a health care provider, 
health care organization, or a manufacturer, dis-
tributor, or supplier of a medical product. Punitive 
damages are neither economic nor noneconomic dam-
ages. 
(16) RECOVERY.—The term ‘‘recovery’’ means 
the net sum recovered after deducting any disburse-
ments or costs incurred in connection with prosecu-
tion or settlement of the claim, including all costs 
paid or advanced by any person. Costs of health care 
incurred by the plaintiff and the attorneys’ office 
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overhead costs or charges for legal services are not de-
ductible disbursements or costs for such purpose. 
(17) STATE.—The term ‘‘State’’ means each of 
the several States, the District of Columbia, the Com-
monwealth of Puerto Rico, the Virgin Islands, Guam, 
American Samoa, the Northern Mariana Islands, the 
Trust Territory of the Pacific Islands, and any other 
territory or possession of the United States, or any 
political subdivision thereof. 
SEC. 9. EFFECT ON OTHER LAWS. 
(a) VACCINE INJURY.— 
(1) To the extent that title XXI of the Public 
Health Service Act establishes a Federal rule of law 
applicable to a civil action brought for a vaccine-re-
lated injury or death— 
(A) this Act does not affect the application 
of the rule of law to such an action; and 
(B) any rule of law prescribed by this Act 
in conflict with a rule of law of such title XXI 
shall not apply to such action. 
(2) If there is an aspect of a civil action brought 
for a vaccine-related injury or death to which a Fed-
eral rule of law under title XXI of the Public Health 
Service Act does not apply, then this Act or otherwise 
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applicable law (as determined under this Act) will 
apply to such aspect of such action. 
(b) OTHER FEDERAL LAW.—Except as provided in 
this section, nothing in this Act shall be deemed to affect 
any defense available to a defendant in a health care law-
suit or action under any other provision of Federal law. 
SEC. 10. STATE FLEXIBILITY AND PROTECTION OF STATES’ 
RIGHTS. 
(a) HEALTH CARE LAWSUITS.—The provisions gov-
erning health care lawsuits set forth in this Act preempt, 
subject to subsections (b) and (c), State law to the extent 
that State law prevents the application of any provisions 
of law established by or under this Act. The provisions gov-
erning health care lawsuits set forth in this Act supersede 
chapter 171 of title 28, United States Code, to the extent 
that such chapter— 
(1) provides for a greater amount of damages or 
contingent fees, a longer period in which a health care 
lawsuit may be commenced, or a reduced applica-
bility or scope of periodic payment of future damages, 
than provided in this Act; or 
(2) prohibits the introduction of evidence regard-
ing collateral source benefits, or mandates or permits 
subrogation or a lien on collateral source benefits. 
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(b) PROTECTION OF STATES’ RIGHTS AND OTHER 
LAWS.—(1) Any issue that is not governed by any provision 
of law established by or under this Act (including State 
standards of negligence) shall be governed by otherwise ap-
plicable State or Federal law. 
(2) This Act shall not preempt or supersede any State 
or Federal law that imposes greater procedural or sub-
stantive protections for health care providers and health 
care organizations from liability, loss, or damages than 
those provided by this Act or create a cause of action. 
(c) STATE FLEXIBILITY.—No provision of this Act 
shall be construed to preempt— 
(1) any State law (whether effective before, on, or 
after the date of the enactment of this Act) that speci-
fies a particular monetary amount of compensatory 
or punitive damages (or the total amount of damages) 
that may be awarded in a health care lawsuit, re-
gardless of whether such monetary amount is greater 
or lesser than is provided for under this Act, notwith-
standing section 4(a); or 
(2) any defense available to a party in a health 
care lawsuit under any other provision of State or 
Federal law. 
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SEC. 11. APPLICABILITY; EFFECTIVE DATE. 
This Act shall apply to any health care lawsuit 
brought in a Federal or State court, or subject to an alter-
native dispute resolution system, that is initiated on or 
after the date of the enactment of this Act, except that any 
health care lawsuit arising from an injury occurring prior 
to the date of the enactment of this Act shall be governed 
by the applicable statute of limitations provisions in effect 
at the time the injury occurred. 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Help Efficient, Accessible, Low-cost, Timely Healthcare 
(HEALTH) Act of 2011’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
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. Additional HEALTH benefits. 
Sec. 7. Punitive damages. 
Sec. 8. Authorization of payment of future damages to claimants in HEALTH 
care lawsuits. 
Sec. 9. Definitions. 
Sec. 10. Effect on other laws. 
Sec. 11. State flexibility and protection of States’ rights. 
Sec. 12. Applicability; effective date. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.— 
(1) EFFECT
ON
HEALTH
CARE
ACCESS
AND 
COSTS.—Congress finds that our current civil justice 
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system is adversely affecting patient access to health 
care services, better patient care, and cost-efficient 
health care, in that the health care liability system 
is a costly and ineffective mechanism for resolving 
claims of health care liability and compensating in-
jured patients, and is a deterrent to the sharing of 
information among health care professionals which 
impedes efforts to improve patient safety and quality 
of care. 
(2) EFFECT
ON
INTERSTATE
COMMERCE.— 
Congress finds that the health care and insurance 
industries are industries affecting interstate com-
merce and the health care liability litigation systems 
existing throughout the United States are activities 
that affect interstate commerce by contributing to 
the high costs of health care and premiums for 
health care liability insurance purchased by health 
care system providers. 
(3) EFFECT
ON
FEDERAL
SPENDING.—Con-
gress finds that the health care liability litigation 
systems existing throughout the United States have 
a significant effect on the amount, distribution, and 
use of Federal funds because of— 
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(A) the large number of individuals who 
receive health care benefits under programs op-
erated or financed by the Federal Government; 
(B) the large number of individuals who 
benefit because of the exclusion from Federal 
taxes of the amounts spent to provide them 
with health insurance benefits; and 
(C) the large number of health care pro-
viders who provide items or services for which 
the Federal Government makes payments. 
(b) PURPOSE.—It is the purpose of this Act to imple-
ment reasonable, comprehensive, and effective health care 
liability reforms designed to— 
(1) improve the availability of health care serv-
ices in cases in which health care liability actions 
have been shown to be a factor in the decreased 
availability of services; 
(2) reduce the incidence of ‘‘defensive medi-
cine’’ and lower the cost of health care liability in-
surance, all of which contribute to the escalation of 
health care costs; 
(3) ensure that persons with meritorious health 
care injury claims receive fair and adequate com-
pensation, including reasonable noneconomic dam-
ages; 
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(4) improve the fairness and cost-effectiveness 
of our current health care liability system to resolve 
disputes over, and provide compensation for, health 
care liability by reducing uncertainty in the amount 
of compensation provided to injured individuals; and 
(5) provide an increased sharing of information 
in the health care system which will reduce unin-
tended injury and improve patient care. 
SEC. 3. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS. 
The time for the commencement of a health care law-
suit shall be 3 years after the date of manifestation of 
injury or 1 year after the claimant discovers, or through 
the use of reasonable diligence should have discovered, the 
injury, whichever occurs first. In no event shall the time 
for commencement of a health care lawsuit exceed 3 years 
after the date of manifestation of injury unless tolled for 
any of the following— 
(1) upon proof of fraud; 
(2) intentional concealment; or 
(3) the presence of a foreign body, which has no 
therapeutic or diagnostic purpose or effect, in the 
person of the injured person. 
Actions by a minor shall be commenced within 3 years 
from the date of the alleged manifestation of injury except 
that actions by a minor under the full age of 6 years shall 
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ceeding to determine whether compensatory damages are 
to be awarded. 
(b) DETERMINING AMOUNT
OF PUNITIVE DAM-
AGES.— 
(1) FACTORS
CONSIDERED.—In determining 
the amount of punitive damages, if awarded, in a 
health care lawsuit, the trier of fact shall consider 
only the following— 
(A) the severity of the harm caused by the 
conduct of such party; 
(B) the duration of the conduct or any 
concealment of it by such party; 
(C) the profitability of the conduct to such 
party; 
(D) the number of products sold or med-
ical procedures rendered for compensation, as 
the case may be, by such party, of the kind 
causing the harm complained of by the claim-
ant; 
(E) any criminal penalties imposed on such 
party, as a result of the conduct complained of 
by the claimant; and 
(F) the amount of any civil fines assessed 
against such party as a result of the conduct 
complained of by the claimant. 
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