(ii) that violation proximately caused 
the claimant’s alleged injury; and 
(iii) the claimant suffered damages as 
a result of the injury. 
(3) USE
AT
TRIAL.—The finding under this 
subsection may be received into evidence by the 
court. If the independent medical review panel made 
any finding under paragraph (2)(D) that there was 
no reasonable probability of the matters described in 
clauses (i) through (iii), the court may issue a sum-
mary judgment in favor of the applicable eligible 
professional unless the claimant is able to show oth-
erwise by clear and convincing evidence. If the panel 
made a finding under subparagraphs (A) through 
(C) of paragraph (2) that there was an applicable 
clinical practice guideline that the defendant adhered 
to, the court shall issue summary judgment in favor 
of the applicable eligible professional unless the 
claimant is able to show otherwise by clear and con-
vincing evidence. Any preliminary finding that the 
defendant applicable eligible professional did not 
breach the standard of care as set forth under the 
prescribed medical practice guidelines or that the de-
fendant applicable eligible professional’s nonadher-
ence to the applicable standard was neither the 
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cause in fact nor the proximate cause of the plain-
tiff’s injury or that the plaintiff did not incur any 
damages as a result shall be given deference by the 
court and shall entitle the defendant applicable eligi-
ble professional to summary judgment unless the 
plaintiff is able to show by clear and convincing evi-
dence that the independent medical review panel was 
in error and that there is a genuine issue as to a 
material fact in the case. 
SEC. 10. DEFINITIONS. 
In this Act: 
(1) APPLICABLE
ELIGIBLE
PROFESSIONAL.— 
The term ‘‘applicable eligible professional’’ means a 
physician practicing within clinical practice guide-
lines submitted by an eligible professional organiza-
tion and includes employees and agents of a physi-
cian. 
(2) APPROPRIATE
USE
CRITERIA.—The term 
‘‘appropriate use criteria’’ means established evi-
dence-based guidelines developed or endorsed by an 
eligible professional organization that specify when 
the health benefits of a procedure or service exceed 
the expected health risks by a significantly wide 
margin. 
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(3) CLINICAL PRACTICE GUIDELINE.—The term 
‘‘clinical practice guideline’’ means systematically de-
veloped statements based on the review of clinical 
evidence for assisting a health care provider to de-
termine the appropriate health care in specific clin-
ical circumstances. 
(4) DIAGNOSTIC GUIDELINE.—The term ‘‘diag-
nostic guideline’’ means a clinical practice guideline 
that provides recommendation regarding the utility 
of diagnosis procedures for a specific clinical sce-
nario. 
(5) ELIGIBLE PROFESSIONAL ORGANIZATION.— 
The term ‘‘eligible professional organization’’ means 
a national or State medical society or medical spe-
cialty society. 
(6) FEDERAL
PAYOR.—The term ‘‘Federal 
payor’’ includes reimbursements made under the 
Medicare program under title XVIII of the Social 
Security Act or the Medicaid program under title 
XIX of the Social Security Act, premium tax credits 
under section 36B of the Internal Revenue Code of 
1986 or cost-sharing reductions under section 1402 
of the Patient Protection and Affordable Care Act, 
or medical screenings, treatments, or transfer serv-
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ices provided pursuant to section 1867 of the Social 
Security Act. 
(7) HEALTH CARE GOODS OR SERVICES.—The 
term ‘‘health care goods or services’’ means any 
goods or services provided by a health care organiza-
tion, provider, or by any individual working under 
the supervision of a health care provider, that relates 
to the diagnosis, prevention, or treatment of any 
human disease or impairment, or the assessment or 
care of the health of human beings. 
(8) HEALTH
CARE
LIABILITY
ACTION.—The 
term ‘‘health care liability action’’ means a civil ac-
tion against an applicable eligible professional, a 
health care provider, or a health care organization, 
regardless of the theory of liability on which the 
claim is based, or the number of plaintiffs, defend-
ants, or other parties, or the number of causes of ac-
tion, in which the claimant alleges a health care li-
ability claim. 
(9) HEALTH
CARE
LIABILITY
CLAIM.—The 
term ‘‘health care liability claim’’ means a claim by 
any person against an applicable eligible profes-
sional, a health care provider, or a health care orga-
nization which is based upon the provision of, use of, 
or payment for (or the failure to provide, use, or pay 
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for) health care goods or services for which at least 
partial payment was made by a Federal payor or 
which was mandated by Federal law, regardless of 
the theory of liability on which the claim is based. 
(10) HEALTH CARE ORGANIZATION.—The term 
‘‘health care organization’’ means any person or en-
tity which is obligated to provide or pay for health 
benefits under any health plan, including any person 
or entity acting under a contract or arrangement 
with a health care organization to provide or admin-
ister any health benefit. 
(11) HEALTH
CARE
PROVIDER.—The term 
‘‘health care provider’’ means any person or entity 
required by State or Federal laws or regulations to 
be licensed, registered, or certified to provide health 
care services, and being either so licensed, reg-
istered, or certified, or exempted from such require-
ment by other statute or regulation. 
(12) 
SECRETARY.—The 
term 
‘‘Secretary’’ 
means the Secretary of Health and Human Services. 
Æ 
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