I
103D CONGRESS
2D SESSION
H. R. 4659
To impose certain requirements on health care liability claims.
IN THE HOUSE OF REPRESENTATIVES
JUNE 27, 1994
Mr. STUMP introduced the following bill; which was referred to the Committee
on the Judiciary
A BILL
To impose certain requirements on health care liability
claims.
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
‘‘Federal Health Care Liability Reform Act of 1994’’.
(b) TABLE OF CONTENTS.—The table of contents for
this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—GENERAL PROVISIONS
Sec. 101. Federal reform of medical injury compensation.
Sec. 102. Preemption of State law.
Sec. 103. Definitions.
Sec. 104. Effective date.
TITLE II—HEALTH CARE LIABILITY REFORM
Subtitle A—Reform Described
Sec. 201. Requirement for initial resolution of action through alternative dis-
pute resolution.
Sec. 202. Statute of limitations.
Sec. 203. Attorneys’ fees.
Sec. 204. Calculation and payment of damages.
Sec. 205. Joint and several liability.
Sec. 206. Injunctive relief.
Sec. 207. Permitting State professional societies to participate in disciplinary
activities.
Subtitle B—Requirements for State Alternative Dispute Resolution Systems
(ADR)
Sec. 211. Basic requirements.
Sec. 212. Certification of State systems; applicability of alternative Federal sys-
tem.
Sec. 213. Reports on implementation and effectiveness of alternative dispute
resolution systems.
TITLE I—GENERAL PROVISIONS
SEC. 101. FEDERAL REFORM OF MEDICAL INJURY COM-
PENSATION.
(a) CONGRESSIONAL FINDINGS.—
(1) EFFECT ON INTERSTATE COMMERCE.—The
Congress finds that the health care and insurance
industries are industries affecting interstate com-
merce and the medical malpractice litigation systems
existing throughout the United States affect inter-
state commerce by contributing to the high cost of
health care and premiums for malpractice insurance
purchased by health care providers.
(2) EFFECT
ON
FEDERAL
SPENDING.—The
Congress finds that the medical malpractice litiga-
tion systems existing throughout the United States
have a significant effect on the amount, distribution,
and use of Federal funds because of—
(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 by their employers
to provide them with health insurance benefits;
(C) the large number of health care provid-
ers and health care professionals who provide
items or services for which the Federal Govern-
ment makes payments; and
(D) the large number of such providers
and professionals who have received direct or
indirect financial assistance from the Federal
Government because of their status as such
professionals or providers.
(b) APPLICABILITY.—This Act shall apply with re-
spect to any health care liability claim and to any health
care liability action brought in any State or Federal court,
except that this Act shall not apply to—
(1) a claim or action for damages arising from
a vaccine-related injury or death to the extent that
title XXI of the Public Health Service Act applies to
the claim or action; or
(2) a claim or action in which the claimant’s
sole allegation is an allegation of an injury arising
from the use of a medical product.
(c) FEDERAL COURT JURISDICTION NOT ESTAB-
LISHED ON FEDERAL QUESTION GROUNDS.—Nothing in
this Act shall be construed to establish any jurisdiction
in the district courts of the United States over health care
liability actions on the basis of section 1331 or 1337 of
title 28, United States Code.
SEC. 102. PREEMPTION OF STATE LAW.
(a) IN GENERAL.—Subject to the provisions con-
tained in subsection (b) of this section, the provisions gov-
erning health care liability actions set forth in this Act
supersede State law to the extent that State law differs
from any provisions of law established by or under this
Act with respect to the limitation contained in such provi-
sions. Any issue that is not governed by any provision of
law established herein will be governed by otherwise appli-
cable State or Federal law.
(b) LIMITATIONS.—The provisions of this Act will su-
persede any State law, with respect to both procedural and
substantive matters, only to the extent that State law per-
mits the recovery of a greater amount of damages by a
plaintiff than that authorized under section 204, permits
the awarding of a greater amount of attorneys’ fees than
what is authorized under section 203, reduces the applica-
bility or scope of the regulation of periodic payment of
future damages authorized under section 204(b), or estab-
lishes a longer period during which a health care liability
claim may be initiated than that permitted under section
202. The provisions of this Act shall supersede any Fed-
eral or State law which mandates reimbursement from the
plaintiff’s recovery for the cost of collateral source bene-
fits. The provisions of this Act shall not preempt any State
law that imposes greater restrictions on liability or dam-
ages than those provided herein.
(c) 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 Federal rule of law under title XXI of the
Public Health Service Act does not apply, then this
Act or otherwise applicable law (as determined
under this Act) will apply to such aspect of such
action.
(d) OTHER FEDERAL LAW.—Except as provided in
this section, nothing in this Act shall be deemed to effect
any defense available to a defendant in a health care liabil-
ity claim or action under any other provision of Federal
law.
SEC. 103. DEFINITIONS.
As used in this Act:
(1) ALTERNATIVE DISPUTE RESOLUTION SYS-
TEM; ADR.—The term ‘‘alternative dispute resolution
system’’ or ‘‘ADR’’ means a system that provides
for the resolution of health care liability claims in a
manner other than through health care liability ac-
tions brought in the State or Federal courts.
(2) CLAIMANT.—The term ‘‘claimant’’ means
any person who asserts a health care liability claim
or bring a health care liability action, including a
person who asserts or claims a right to legal or equi-
table contribution, indemnity or subrogation, arising
out of a health care liability claim or action, and any
person on whose behalf such a claim is asserted or
such an action is brought, whether deceased, incom-
petent or a minor.
(3) DERIVATIVE CLAIM.—The term ‘‘derivative
claim’’ means any third-party claim arising from the
claim of injury of a person by a health care service
or product, such as loss of consortium, emotional
distress, injury to an unborn child, or wrongful
death.
(4) ECONOMIC DAMAGES.—The term ‘‘economic
damages’’ means objectively verifiable monetary
losses incurred as a result of the provision of (or
failure to provide) health care services or the use of
a medical product, such as past and future medical
expenses, loss of past and future earnings, cost of
obtaining domestic services, loss of employment, and
loss of business or employment opportunities.
(5) HEALTH
CARE
LIABILITY
ACTION.—The
term ‘‘health care liability action’’ means a civil ac-
tion brought in a State or Federal court or pursuant
to ADR, against a health care provider, a health
care organization, or the manufacturer, distributor
or supplier of a medical product, regardless of the
theory of liability on which the claim is based, or the
number of plaintiffs, or defendants or causes of ac-
tion, in which the claimant alleges a health care li-
ability claim.
(6) 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 organiza-
tion, or the manufacturer, distributor or supplier of
a medical product, including, but not limited to,
third-party claims, cross-claims, counter-claims or
contribution claims, which are based upon the provi-
sion of (or the failure to provide) health care serv-
ices or the use of a medical product, regardless of
the theory of liability on which the claim is based,
or the number of plaintiffs, defendants, or causes of
action.
(7) HEALTH CARE ORGANIZATION.—The term
‘‘health care organization’’ means any person or en-
tity which is obligated to provide health benefits
under any health plans, including any person or en-
tity acting under a contract or arrangement with a
health care organization to provide or administer
any health benefit.
(8) 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.
(9) 
HEALTH
CARE
SERVICES.—The 
term
‘‘health care services’’ means any service provided by
a health care 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
of the health of human beings.
(10) MEDICAL PRODUCT.—The term ‘‘medical
product’’ means a drug (as defined in section
201(g)(1) of the Federal Food, Drug and Cosmetic
Act (21 U.S.C. 321(g)(1))) or a medical device as
defined in section 201(h) of the Federal Food, Drug
and Cosmetic Act (21 U.S.C. 321(h)), including any
component or raw material used therein, but exclud-
ing health care services, as defined in paragraph (1)
of this section.
(11) 
NONECONOMIC
DAMAGES.—The 
term
‘‘noneconomic damages’’ means damages for phys-
ical and emotional pain, suffering, inconvenience,
physical impairment, mental anguish, disfigurement,
loss of enjoyment of life, loss of society and compan-