I 
109TH CONGRESS 
1ST SESSION H. R. 3359 
To limit frivolous medical malpractice lawsuits, to reform the medical mal-
practice insurance business in order to reduce the cost of medical mal-
practice insurance, to enhance patient access to medical care, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 20, 2005 
Mr. CONYERS (for himself and Mr. DINGELL) 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 subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To limit frivolous medical malpractice lawsuits, to reform 
the medical malpractice insurance business in order to 
reduce the cost of medical malpractice insurance, to en-
hance patient access to medical care, and for other pur-
poses. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Medical Malpractice and Insurance Reform Act of 
2005’’.
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—LIMITING FRIVOLOUS MEDICAL MALPRACTICE 
LAWSUITS 
Sec. 101. Statute of limitations. 
Sec. 102. Health care specialist affidavit. 
Sec. 103. Sanctions for frivolous actions and pleadings. 
Sec. 104. Mandatory mediation. 
Sec. 105. Limitation on punitive damages. 
Sec. 106. Reduction in premiums paid by physicians for medical malpractice in-
surance coverage. 
Sec. 107. Definitions. 
Sec. 108. Applicability. 
TITLE II—MEDICAL MALPRACTICE INSURANCE REFORM 
Sec. 201. Prohibition on anticompetitive activities by medical malpractice insur-
ers. 
Sec. 202. Medical malpractice insurance price comparison. 
Sec. 203. Procedural requirements for medical malpractice insurers’ proposed 
rate increases. 
TITLE III—ENHANCING PATIENT ACCESS TO CARE THROUGH 
DIRECT ASSISTANCE 
Sec. 301. Grants and contracts regarding health provider shortages. 
Sec. 302. Health professional assignments to trauma centers through National 
Health Service Corps. 
TITLE IV—INDEPENDENT ADVISORY COMMISSION ON MEDICAL 
MALPRACTICE INSURANCE 
Sec. 401. Establishment. 
Sec. 402. Duties. 
Sec. 403. Report. 
Sec. 404. Membership. 
Sec. 405. Director and staff; experts and consultants. 
Sec. 406. Powers. 
Sec. 407. Authorization of appropriations. 
TITLE V—MEDICAL MALPRACTICE INSURANCE INFORMATION 
ADMINISTRATION 
Sec. 501. Establishment.
TITLE I—LIMITING FRIVOLOUS 
MEDICAL MALPRACTICE LAW-
SUITS 
SEC. 101. STATUTE OF LIMITATIONS. 
(a) IN GENERAL.—A medical malpractice action shall 
be barred unless the complaint is filed within 3 years after 
the right of action accrues. 
(b) ACCRUAL.—A right of action referred to in sub-
section (a) accrues upon the last to occur of the following 
dates: 
(1) The date of the injury. 
(2) The date on which the claimant discovers, 
or through the use of reasonable diligence should 
have discovered, the injury. 
(3) The date on which the claimant becomes 18 
years of age. 
(c) APPLICABILITY.—This section shall apply to any 
injury occurring after the date of the enactment of this 
Act. 
SEC. 102. HEALTH CARE SPECIALIST AFFIDAVIT. 
(a) REQUIRING SUBMISSION WITH COMPLAINT.—No 
medical malpractice action may be brought by any indi-
vidual unless, at the time the individual brings the action 
(except as provided in subsection (b)(1)), it is accom-
panied by the affidavit of a qualified specialist that in-
cludes the specialist’s statement of belief that, based on 
a review of the available medical record and other relevant 
material, there is a reasonable and meritorious cause for 
the filing of the action against the defendant. 
(b) EXTENSION IN CERTAIN INSTANCES.— 
(1) IN GENERAL.—Subject to paragraph (2), 
subsection (a) shall not apply with respect to an in-
dividual who brings a medical malpractice action 
without submitting an affidavit described in such 
subsection if, as of the time the individual brings the 
action, the individual has been unable to obtain ade-
quate medical records or other information necessary 
to prepare the affidavit. 
(2) DEADLINE
FOR
SUBMISSION
WHERE
EX-
TENSION APPLIES.—In the case of an individual who 
brings an action for which paragraph (1) applies, 
the action shall be dismissed unless the individual 
(or the individual’s attorney) submits the affidavit 
described in subsection (a) not later than 90 days 
after obtaining the information described in such 
paragraph. 
(c) QUALIFIED
SPECIALIST
DEFINED.—In sub-
section (a), a ‘‘qualified specialist’’ means, with respect 
to a medical malpractice action, a health care professional
who is reasonably believed by the individual bringing the 
action (or the individual’s attorney)— 
(1) to be knowledgeable in the relevant issues 
involved in the action; 
(2) to practice (or to have practiced) or to teach 
(or to have taught) in the same area of health care 
or medicine that is at issue in the action; and 
(3) in the case of an action against a physician, 
to be board certified in a specialty relating to that 
area of medicine. 
(d) CONFIDENTIALITY
OF
SPECIALIST.—Upon a 
showing of good cause by a defendant, the court may as-
certain the identity of a specialist referred to in subsection 
(a) while preserving confidentiality. 
SEC. 103. SANCTIONS FOR FRIVOLOUS ACTIONS AND 
PLEADINGS. 
(a) SIGNATURE REQUIRED.—Every pleading, written 
motion, and other paper in any medical malpractice action 
shall be signed by at least 1 attorney of record in the at-
torney’s individual name, or, if the party is not rep-
resented by an attorney, shall be signed by the party. Each 
paper shall state the signer’s address and telephone num-
ber, if any. An unsigned paper shall be stricken unless 
omission of the signature is corrected promptly after being 
called to the attention of the attorney or party.
(b) CERTIFICATE OF MERIT.—A medical malpractice 
action shall be dismissed unless the attorney or unrepre-
sented party presenting the complaint certifies that, to the 
best of the person’s knowledge, information, and belief, 
formed after an inquiry reasonable under the cir-
cumstances,— 
(1) it is not being presented for any improper 
purpose, such as to harass or to cause unnecessary 
delay or needless increase in the cost of litigation; 
(2) the claims and other legal contentions 
therein are warranted by existing law or by a non-
frivolous argument for the extension, modification, 
or reversal of existing law or the establishment of 
new law; and 
(3) the allegations and other factual contentions 
have evidentiary support or, if specifically so identi-
fied, are likely to have evidentiary support after a 
reasonable opportunity for further investigation and 
discovery. 
(c) MANDATORY SANCTIONS.— 
(1) FIRST VIOLATION.—If, after notice and a 
reasonable opportunity to respond, a court, upon 
motion or upon its own initiative, determines that 
subsection (b) has been violated, the court shall find 
each attorney or party in violation in contempt of