135 
volved, the value of the time and services con-
tributed by volunteers to carry out such services 
(at a rate determined by the Secretary), and 
the value of any donated material or building 
and the value of any lease on a building; 
‘‘(C) a local governmental agency that uses 
amounts as provided under this paragraph may 
coordinate or contract with other agencies and 
entities having particular capacities, specialties, 
or experience with respect to certain popu-
lations or constituencies, including elderly or 
disabled families or persons, to carry out activi-
ties described in subparagraph (A) with respect 
to such populations or constituencies; and 
‘‘(D) each local government agency that 
uses amounts as provided under this paragraph 
shall submit a report to the Secretary and the 
Administrator, not later than 12 months after 
such amounts are first received, which shall in-
clude such information as the Secretary and the 
Administrator jointly consider appropriate to 
describe the activities conducted using such 
amounts and the effect of such activities on the 
retention or acquisition of flood insurance cov-
erage.’’. 
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136 
SEC. 367. TECHNICAL CORRECTIONS. 
(a) FLOOD DISASTER PROTECTION ACT OF 1973.— 
The Flood Disaster Protection Act of 1973 (42 U.S.C. 
4002 et seq.) is amended— 
(1) by striking ‘‘Director’’ each place such term 
appears, except in section 102(f)(3) (42 U.S.C. 
4012a(f)(3)), and inserting ‘‘Administrator’’; and 
(2) in section 201(b) (42 U.S.C. 4105(b)), by 
striking ‘‘Director’s’’ and inserting ‘‘Administra-
tor’s’’. 
(b) NATIONAL FLOOD INSURANCE ACT OF 1968.— 
The National Flood Insurance Act of 1968 (42 U.S.C. 
4001 et seq.) is amended— 
(1) by striking ‘‘Director’’ each place such term 
appears and inserting ‘‘Administrator’’; and 
(2) in section 1363 (42 U.S.C. 4104), by strik-
ing ‘‘Director’s’’ each place such term appears and 
inserting ‘‘Administrator’s’’. 
(c) FEDERAL FLOOD INSURANCE ACT OF 1956.— 
Section 15(e) of the Federal Flood Insurance Act of 1956 
(42 U.S.C. 2414(e)) is amended by striking ‘‘Director’’ 
each place such term appears and inserting ‘‘Adminis-
trator’’. 
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137 
SEC. 368. REQUIRING COMPETITION FOR NATIONAL FLOOD 
INSURANCE PROGRAM POLICIES. 
(a) REPORT.—Not later than the expiration of the 
90-day period beginning upon the date of the enactment 
of this Act, the Administrator of the Federal Emergency 
Management Agency, in consultation with insurance com-
panies, insurance agents and other organizations with 
which the Administrator has contracted, shall submit to 
the Congress a report describing procedures and policies 
that the Administrator shall implement to limit the per-
centage of policies for flood insurance coverage under the 
national flood insurance program that are directly man-
aged by the Agency to not more than 10 percent of the 
aggregate number of flood insurance policies in force 
under such program. 
(b) IMPLEMENTATION.—Upon submission of the re-
port under subsection (a) to the Congress, the Adminis-
trator shall implement the policies and procedures de-
scribed in the report. The Administrator shall, not later 
than the expiration of the 12-month period beginning 
upon submission of such report, reduce the number of 
policies for flood insurance coverage that are directly man-
aged by the Agency, or by the Agency’s direct servicing 
contractor that is not an insurer, to not more than 10 
percent of the aggregate number of flood insurance poli-
cies in force as of the expiration of such 12-month period. 
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138 
(c) CONTINUATION OF CURRENT AGENT RELATION-
SHIPS.—In carrying out subsection (b), the Administrator 
shall ensure that— 
(1) agents selling or servicing policies described 
in such subsection are not prevented from con-
tinuing to sell or service such policies; and 
(2) insurance companies are not prevented from 
waiving any limitation such companies could other-
wise enforce to limit any such activity. 
SEC. 369. STUDIES OF VOLUNTARY COMMUNITY-BASED 
FLOOD INSURANCE OPTIONS. 
(a) STUDIES.—The Administrator of the Federal 
Emergency Management Agency and the Comptroller 
General of the United States shall each conduct a separate 
study to assess options, methods, and strategies for offer-
ing voluntary community-based flood insurance policy op-
tions and incorporating such options into the national 
flood insurance program. Such studies shall take into con-
sideration and analyze how the policy options would affect 
communities having varying economic bases, geographic 
locations, flood hazard characteristics or classifications, 
and flood management approaches. 
(b) REPORTS.—Not later than the expiration of the 
18-month period beginning on the date of the enactment 
of this Act, the Administrator of the Federal Emergency 
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Management Agency and the Comptroller General of the 
United States shall each submit a report to the Committee 
on Financial Services of the House of Representatives and 
the Committee on Banking, Housing, and Urban Affairs 
of the Senate on the results and conclusions of the study 
such agency conducted under subsection (a), and each 
such report shall include recommendations for the best 
manner to incorporate voluntary community-based flood 
insurance options into the national flood insurance pro-
gram and for a strategy to implement such options that 
would encourage communities to undertake flood mitiga-
tion activities. 
SEC. 370. REPORT ON INCLUSION OF BUILDING CODES IN 
FLOODPLAIN MANAGEMENT CRITERIA. 
Not later than the expiration of the 6-month period 
beginning on the date of the enactment of this Act, the 
Administrator of the Federal Emergency Management 
Agency shall conduct a study and submit a report to the 
Committee on Financial Services of the House of Rep-
resentatives and the Committee on Banking, Housing, and 
Urban Affairs of the Senate regarding the impact, effec-
tiveness, and feasibility of amending section 1361 of the 
National Flood Insurance Act of 1968 (42 U.S.C. 4102) 
to include widely used and nationally recognized building 
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codes as part of the floodplain management criteria devel-
oped under such section, and shall determine— 
(1) the regulatory, financial, and economic im-
pacts of such a building code requirement on home-
owners, States and local communities, local land use 
policies, and the Federal Emergency Management 
Agency; 
(2) the resources required of State and local 
communities to administer and enforce such a build-
ing code requirement; 
(3) the effectiveness of such a building code re-
quirement in reducing flood-related damage to build-
ings and contents; 
(4) the impact of such a building code require-
ment on the actuarial soundness of the National 
Flood Insurance Program; 
(5) the effectiveness of nationally recognized 
codes in allowing innovative materials and systems 
for flood-resistant construction; 
(6) the feasibility and effectiveness of providing 
an incentive in lower premium rates for flood insur-
ance coverage under such Act for structures meeting 
whichever of such widely used and nationally recog-
nized building code or any applicable local building 
code provides greater protection from flood damage; 
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141 
(7) the impact of such a building code require-
ment on rural communities with different building 
code challenges than more urban environments; and 
(8) the impact of such a building code require-
ment on Indian reservations. 
SEC. 371. STUDY ON GRADUATED RISK. 
(a) STUDY.—The National Academy of Sciences shall 
conduct a study exploring methods for understanding 
graduated risk behind levees and the associated land de-
velopment, insurance, and risk communication dimensions, 
which shall— 
(1) research, review, and recommend current 
best practices for estimating direct annualized flood 
losses behind levees for residential and commercial 
structures; 
(2) rank such practices based on their best 
value, balancing cost, scientific integrity, and the in-
herent uncertainties associated with all aspects of 
the loss estimate, including geotechnical engineering, 
flood frequency estimates, economic value, and direct 
damages; 
(3) research, review, and identify current best 
floodplain management and land use practices be-
hind levees that effectively balance social, economic, 
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142 
and environmental considerations as part of an over-
all flood risk management strategy; 
(4) identify examples where such practices have 
proven effective and recommend methods and proc-
esses by which they could be applied more broadly 
across the United States, given the variety of dif-
ferent flood risks, State and local legal frameworks, 
and evolving judicial opinions; 
(5) research, review, and identify a variety of 
flood insurance pricing options for flood hazards be-
hind levees which are actuarially sound and based on 
the flood risk data developed using the top three 
best value approaches identified pursuant to para-
graph (1); 
(6) evaluate and recommend methods to reduce 
insurance costs through creative arrangements be-
tween insureds and insurers while keeping a clear 
accounting of how much financial risk is being borne 
by various parties such that the entire risk is ac-
counted for, including establishment of explicit limits 
on disaster aid or other assistance in the event of a 
flood; and 
(7) taking into consideration the recommenda-
tions pursuant to paragraphs (1) through (3), rec-
ommend approaches to communicating the associ-
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143 
ated risks to community officials, homeowners, and 
other residents. 
(b) REPORT.—Not later than the expiration of the 
12-month period beginning on the date of the enactment 
of this Act, the National Academy of Sciences shall submit 
a report to the Committees on Financial Services and 
Science, Space, and Technology of the House of Rep-
resentatives and the Committees on Banking, Housing, 
and Urban Affairs and Commerce, Science and Transpor-
tation of the Senate on the study under subsection (a) in-
cluding the information and recommendations required 
under such subsection. 
SEC. 372. REPORT ON FLOOD-IN-PROGRESS DETERMINA-
TION. 
The Administrator of the Federal Emergency Man-
agement Agency shall review the processes and procedures 
for determining that a flood event has commenced or is 
in progress for purposes of flood insurance coverage made 
available under the national flood insurance program 
under the National Flood Insurance Act of 1968 and for 
providing public notification that such an event has com-
menced or is in progress. In such review, the Adminis-
trator shall take into consideration the effects and implica-
tions that weather conditions, such as rainfall, snowfall, 
projected snowmelt, existing water levels, and other condi-
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144 
tions have on the determination that a flood event has 
commenced or is in progress. Not later than the expiration 
of the 6-month period beginning upon the date of the en-
actment of this Act, the Administrator shall submit a re-
port to the Congress setting forth the results and conclu-
sions of the review undertaken pursuant to this section 
and any actions undertaken or proposed actions to be 
taken to provide for a more precise and technical deter-
mination that a flooding event has commenced or is in 
progress. 
SEC. 373. STUDY ON REPAYING FLOOD INSURANCE DEBT. 
Not later than the expiration of the 6-month period 
beginning on the date of the enactment of this Act, the 
Administrator of the Federal Emergency Management 
Agency shall submit a report to the Congress setting forth 
a plan for repaying within 10 years all amounts, including 
any amounts previously borrowed but not yet repaid, owed 
pursuant to clause (2) of subsection (a) of section 1309 
of the National Flood Insurance Act of 1968 (42 U.S.C. 
4016(a)(2)). 
SEC. 374. NO CAUSE OF ACTION. 
No cause of action shall exist and no claim may be 
brought against the United States for violation of any no-
tification requirement imposed upon the United States by 
this subtitle or any amendment made by this subtitle. 
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145 
SEC. 375. AUTHORITY FOR THE CORPS OF ENGINEERS TO 
PROVIDE SPECIALIZED OR TECHNICAL SERV-
ICES. 
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, upon the request of a State or local govern-
ment, the Secretary of the Army may evaluate a levee sys-
tem that was designed or constructed by the Secretary for 
the purposes of the National Flood Insurance Program es-
tablished under chapter 1 of the National Flood Insurance 
Act of 1968 (42 U.S.C. 4011 et seq.). 
(b) REQUIREMENTS.—A levee system evaluation 
under subsection (a) shall— 
(1) comply with applicable regulations related 
to areas protected by a levee system; 
(2) be carried out in accordance with such pro-
cedures as the Secretary, in consultation with the 
Administrator of the Federal Emergency Manage-
ment Agency, may establish; and 
(3) be carried out only if the State or local gov-
ernment agrees to reimburse the Secretary for all 
cost associated with the performance of the activi-
ties. 
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146 
Subtitle E—Repeal of the Office of 
Financial Research 
SEC. 381. REPEAL OF THE OFFICE OF FINANCIAL RE-
SEARCH. 
(a) IN GENERAL.—Subtitle B of title I of the Dodd- 
Frank Wall Street Reform and Consumer Protection Act 
is hereby repealed. 
(b) CONFORMING AMENDMENTS
TO
THE DODD- 
FRANK ACT.—The Dodd-Frank Wall Street Reform and 
Consumer Protection Act is amended— 
(1) in section 102(a), by striking paragraph 
(5); 
(2) in section 111— 
(A) in subsection (b)(2)— 
(i) by striking subparagraph (A); and 
(ii) by redesignating subparagraphs 
(B), (C), (D), and (E) as subparagraphs 
(A), (B), (C), and (D), respectively; 
(B) in subsection (c)(1), by striking ‘‘sub-
paragraphs (C), (D), and (E)’’ and inserting 
‘‘subparagraphs (B), (C), and (D)’’; 
(3) in section 112— 
(A) in subsection (a)(2)— 
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(i) in subparagraph (A), by striking 
‘‘direct the Office of Financial Research 
to’’; 
(ii) by striking subparagraph (B); and 
(iii) by redesignating subparagraphs 
(C), (D), (E), (F), (G), (H), (I), (J), (K), 
(L), (M), and (N) as subparagraphs (B), 
(C), (D), (E), (F), (G), (H), (I), (J), (K), 
(L), and (M), respectively; and 
(B) in subsection (d)— 
(i) in paragraph (1), by striking ‘‘the 
Office of Financial Research, member 
agencies, and’’ and inserting ‘‘member 
agencies and’’; 
(ii) in paragraph (2), by striking ‘‘the 
Office of Financial Research, any member 
agency, and’’ and inserting ‘‘any member 
agency and’’; 
(iii) in paragraph (3)— 
(I) by striking ‘‘, acting through 
the Office of Financial Research,’’ 
each place it appears; and 
(II) in subparagraph (B), by 
striking ‘‘the Office of Financial Re-
search or’’; and 
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148 
(iv) in paragraph (5)(A), by striking 
‘‘, the Office of Financial Research,’’; 
(4) in section 116, by striking ‘‘, acting through 
the Office of Financial Research,’’ each place it ap-
pears; and 
(5) by striking section 118. 
(c) CONFORMING AMENDMENT TO THE PAPERWORK 
REDUCTION ACT.—Effective as of the date specified in 
section 1100H of the Dodd-Frank Wall Street Reform and 
Consumer Protection Act, section 1100D(a) of such Act 
is amended to read as follows: 
‘‘(a) DESIGNATION AS AN INDEPENDENT AGENCY.— 
Section 3502(5) of subchapter I of chapter 35 of title 44, 
United States Code (commonly known as the Paperwork 
Reduction Act) is amended by inserting ‘the Bureau of 
Consumer Financial Protection,’ after ‘the Securities and 
Exchange Commission,’.’’. 
(d) TECHNICAL AMENDMENTS.—The table of con-
tents for the Dodd-Frank Wall Street Reform and Con-
sumer Protection Act is amended— 
(1) by striking the item relating to section 118; 
and 
(2) by striking the items relating to subtitle B 
of title I. 
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149 
TITLE IV—COMMITTEE ON THE 
JUDICIARY 
SEC. 401. SHORT TITLE. 
This title may be cited as the ‘‘Help Efficient, Acces-
sible, Low-cost, Timely Healthcare (HEALTH) Act of 
2011’’. 
SEC. 402. 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 
be commenced within 3 years of manifestation of injury 
or prior to the minor’s 8th birthday, whichever provides 
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a longer period. Such time limitation shall be tolled for 
minors for any period during which a parent or guardian 
and a health care provider or health care organization 
have committed fraud or collusion in the failure to bring 
an action on behalf of the injured minor. 
SEC. 403. COMPENSATING PATIENT INJURY. 
(a) UNLIMITED AMOUNT OF DAMAGES FOR ACTUAL 
ECONOMIC LOSSES IN HEALTH CARE LAWSUITS.—In any 
health care lawsuit, nothing in this title shall limit a claim-
ant’s recovery of the full amount of the available economic 
damages, notwithstanding the limitation in subsection (b). 
(b) ADDITIONAL NONECONOMIC DAMAGES.—In any 
health care lawsuit, the amount of noneconomic damages, 
if available, may be as much as $250,000, regardless of 
the number of parties against whom the action is brought 
or the number of separate claims or actions brought with 
respect to the same injury. 
(c) NO DISCOUNT OF AWARD FOR NONECONOMIC 
DAMAGES.—For purposes of applying the limitation in 
subsection (b), future noneconomic damages shall not be 
discounted to present value. The jury shall not be in-
formed about the maximum award for noneconomic dam-
ages. An award for noneconomic damages in excess of 
$250,000 shall be reduced either before the entry of judg-
ment, or by amendment of the judgment after entry of 
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151 
judgment, and such reduction shall be made before ac-
counting for any other reduction in damages required by 
law. If separate awards are rendered for past and future 
noneconomic damages and the combined awards exceed 
$250,000, the future noneconomic damages shall be re-
duced first. 
(d) FAIR SHARE RULE.—In any health care lawsuit, 
each party shall be liable for that party’s several share 
of any damages only and not for the share of any other 
person. Each party shall be liable only for the amount of 
damages allocated to such party in direct proportion to 
such party’s percentage of responsibility. Whenever a 
judgment of liability is rendered as to any party, a sepa-
rate judgment shall be rendered against each such party 
for the amount allocated to such party. For purposes of 
this section, the trier of fact shall determine the propor-
tion of responsibility of each party for the claimant’s 
harm. 
SEC. 404. MAXIMIZING PATIENT RECOVERY. 
(a) COURT SUPERVISION OF SHARE OF DAMAGES 
ACTUALLY PAID TO CLAIMANTS.—In any health care law-
suit, the court shall supervise the arrangements for pay-
ment of damages to protect against conflicts of interest 
that may have the effect of reducing the amount of dam-
ages awarded that are actually paid to claimants. In par-
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ticular, in any health care lawsuit in which the attorney 
for a party claims a financial stake in the outcome by vir-
tue of a contingent fee, the court shall have the power 
to restrict the payment of a claimant’s damage recovery 
to such attorney, and to redirect such damages to the 
claimant based upon the interests of justice and principles 
of equity. In no event shall the total of all contingent fees 
for representing all claimants in a health care lawsuit ex-
ceed the following limits: 
(1) Forty percent of the first $50,000 recovered 
by the claimant(s). 
(2) Thirty-three and one-third percent of the 
next $50,000 recovered by the claimant(s). 
(3) Twenty-five percent of the next $500,000 
recovered by the claimant(s). 
(4) Fifteen percent of any amount by which the 
recovery by the claimant(s) is in excess of $600,000. 
(b) APPLICABILITY.—The limitations in this section 
shall apply whether the recovery is by judgment, settle-
ment, mediation, arbitration, or any other form of alter-
native dispute resolution. In a health care lawsuit involv-
ing a minor or incompetent person, a court retains the 
authority to authorize or approve a fee that is less than 
the maximum permitted under this section. The require-
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ment for court supervision in the first two sentences of 
subsection (a) applies only in civil actions. 
SEC. 405. PUNITIVE DAMAGES. 
(a) IN GENERAL.—Punitive damages may, if other-
wise permitted by applicable State or Federal law, be 
awarded against any person in a health care lawsuit only 
if it is proven by clear and convincing evidence that such 
person acted with malicious intent to injure the claimant, 
or that such person deliberately failed to avoid unneces-
sary injury that such person knew the claimant was sub-
stantially certain to suffer. In any health care lawsuit 
where no judgment for compensatory damages is rendered 
against such person, no punitive damages may be awarded 
with respect to the claim in such lawsuit. No demand for 
punitive damages shall be included in a health care lawsuit 
as initially filed. A court may allow a claimant to file an 
amended pleading for punitive damages only upon a mo-
tion by the claimant and after a finding by the court, upon 
review of supporting and opposing affidavits or after a 
hearing, after weighing the evidence, that the claimant has 
established by a substantial probability that the claimant 
will prevail on the claim for punitive damages. At the re-
quest of any party in a health care lawsuit, the trier of 
fact shall consider in a separate proceeding— 
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(1) whether punitive damages are to be award-
ed and the amount of such award; and 
(2) the amount of punitive damages following a 
determination of punitive liability. 
If a separate proceeding is requested, evidence relevant 
only to the claim for punitive damages, as determined by 
applicable State law, shall be inadmissible in any pro-
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 
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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. 
(2) MAXIMUM AWARD.—The amount of punitive 
damages, if awarded, in a health care lawsuit may 
be as much as $250,000 or as much as two times 
the amount of economic damages awarded, which-
ever is greater. The jury shall not be informed of 
this limitation. 
(c) NO PUNITIVE DAMAGES FOR PRODUCTS THAT 
COMPLY WITH FDA STANDARDS.— 
(1) IN GENERAL.— 
(A) No punitive damages may be awarded 
against the manufacturer or distributor of a 
medical product, or a supplier of any compo-
nent or raw material of such medical product, 
based on a claim that such product caused the 
claimant’s harm where— 
(i)(I) such medical product was sub-
ject to premarket approval, clearance, or li-
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censure by the Food and Drug Administra-
tion with respect to the safety of the for-
mulation or performance of the aspect of 
such medical product which caused the 
claimant’s harm or the adequacy of the 
packaging or labeling of such medical 
product; and 
(II) such medical product was so ap-
proved, cleared, or licensed; or 
(ii) such medical product is generally 
recognized among qualified experts as safe 
and effective pursuant to conditions estab-
lished by the Food and Drug Administra-
tion and applicable Food and Drug Admin-
istration regulations, including without 
limitation those related to packaging and 
labeling, unless the Food and Drug Admin-
istration has determined that such medical 
product was not manufactured or distrib-
uted in substantial compliance with appli-
cable Food and Drug Administration stat-
utes and regulations. 
(B) RULE OF CONSTRUCTION.—Subpara-
graph (A) may not be construed as establishing 
the obligation of the Food and Drug Adminis-
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tration to demonstrate affirmatively that a 
manufacturer, distributor, or supplier referred 
to in such subparagraph meets any of the con-
ditions described in such subparagraph. 
(2) LIABILITY OF HEALTH CARE PROVIDERS.— 
A health care provider who prescribes, or who dis-
penses pursuant to a prescription, a medical product 
approved, licensed, or cleared by the Food and Drug 
Administration shall not be named as a party to a 
product liability lawsuit involving such product and 
shall not be liable to a claimant in a class action 
lawsuit against the manufacturer, distributor, or 
seller of such product. Nothing in this paragraph 
prevents a court from consolidating cases involving 
health care providers and cases involving products li-
ability claims against the manufacturer, distributor, 
or product seller of such medical product. 
(3) PACKAGING.—In a health care lawsuit for 
harm which is alleged to relate to the adequacy of 
the packaging or labeling of a drug which is required 
to have tamper-resistant packaging under regula-
tions of the Secretary of Health and Human Serv-
ices (including labeling regulations related to such 
packaging), the manufacturer or product seller of 
the drug shall not be held liable for punitive dam-
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ages unless such packaging or labeling is found by 
the trier of fact by clear and convincing evidence to 
be substantially out of compliance with such regula-
tions. 
(4) EXCEPTION.—Paragraph (1) shall not 
apply in any health care lawsuit in which— 
(A) a person, before or after premarket ap-
proval, clearance, or licensure of such medical 
product, knowingly misrepresented to or with-
held from the Food and Drug Administration 
information that is required to be submitted 
under the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 301 et seq.) or section 351 of 
the Public Health Service Act (42 U.S.C. 262) 
that is material and is causally related to the 
harm which the claimant allegedly suffered 
(B) a person made an illegal payment to 
an official of the Food and Drug Administra-
tion for the purpose of either securing or main-
taining approval, clearance, or licensure of such 
medical product; or 
(C) the defendant caused the medical prod-
uct which caused the claimant’s harm to be 
misbranded or adulterated (as such terms are 
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used in chapter V of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 351 et seq.)). 
SEC. 406. AUTHORIZATION OF PAYMENT OF FUTURE DAM-
AGES TO CLAIMANTS IN HEALTH CARE LAW-
SUITS. 
(a) IN GENERAL.—In any health care lawsuit, if an 
award of future damages, without reduction to present 
value, equaling or exceeding $50,000 is made against a 
party with sufficient insurance or other assets to fund a 
periodic payment of such a judgment, the court shall, at 
the request of any party, enter a judgment ordering that 
the future damages be paid by periodic payments, in ac-
cordance with the Uniform Periodic Payment of Judg-
ments Act promulgated by the National Conference of 
Commissioners on Uniform State Laws. 
(b) APPLICABILITY.—This section applies to all ac-
tions which have not been first set for trial or retrial be-
fore the effective date of this title. 
SEC. 407. DEFINITIONS. 
In this title: 
(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 lawsuits in a man-
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160 
ner other than through a civil action brought in a 
State or Federal court. 
(2) CLAIMANT.—The term ‘‘claimant’’ means 
any person who brings a health care lawsuit, includ-
ing a person who asserts or claims a right to legal 
or equitable contribution, indemnity, or subrogation, 
arising out of a health care liability claim or action, 
and any person on whose behalf such a claim is as-
serted or such an action is brought, whether de-
ceased, incompetent, or a minor. 
(3) 
COMPENSATORY
DAMAGES.—The 
term 
‘‘compensatory 
damages’’ 
means 
objectively 
verifiable monetary losses incurred as a result of the 
provision of, use of, or payment for (or failure to 
provide, use, or pay for) health care services or med-
ical products, such as past and future medical ex-
penses, loss of past and future earnings, cost of ob-
taining domestic services, loss of employment, and 
loss of business or employment opportunities, dam-
ages for physical and emotional pain, suffering, in-
convenience, physical impairment, mental anguish, 
disfigurement, loss of enjoyment of life, loss of soci-
ety and companionship, loss of consortium (other 
than loss of domestic service), hedonic damages, in-
jury to reputation, and all other nonpecuniary losses 
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of any kind or nature. The term ‘‘compensatory 
damages’’ includes economic damages and non-
economic damages, as such terms are defined in this 
section. 
(4) CONTINGENT FEE.—The term ‘‘contingent 
fee’’ includes all compensation to any person or per-
sons which is payable only if a recovery is effected 
on behalf of one or more claimants. 
(5) ECONOMIC DAMAGES.—The term ‘‘economic 
damages’’ means objectively verifiable monetary 
losses incurred as a result of the provision of, use 
of, or payment for (or failure to provide, use, or pay 
for) health care services or medical products, 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 employ-
ment opportunities. 
(6) 
HEALTH
CARE
LAWSUIT.—The 
term 
‘‘health care lawsuit’’ means any health care liability 
claim concerning the provision of health care goods 
or services or any medical product affecting inter-
state commerce, or any health care liability action 
concerning the provision of health care goods or 
services or any medical product affecting interstate 
commerce, brought in a State or Federal court or 
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pursuant to an alternative dispute resolution system, 
against a health care provider, a health care organi-
zation, or the manufacturer, distributor, supplier, 
marketer, promoter, or seller of a medical product, 
regardless of the theory of liability on which the 
claim is based, or the number of claimants, plain-
tiffs, defendants, or other parties, or the number of 
claims or causes of action, in which the claimant al-
leges a health care liability claim. Such term does 
not include a claim or action which is based on 
criminal liability; which seeks civil fines or penalties 
paid to Federal, State, or local government; or which 
is grounded in antitrust. 
(7) 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 an alternative dispute resolution system, against 
a health care provider, a health care organization, or 
the manufacturer, distributor, supplier, marketer, 
promoter, or seller of a medical product, regardless 
of the theory of liability on which the claim is based, 
or the number of plaintiffs, defendants, or other par-
ties, or the number of causes of action, in which the 
claimant alleges a health care liability claim. 
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163 
(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 organiza-
tion, or the manufacturer, distributor, supplier, mar-
keter, promoter, or seller of a medical product, in-
cluding, 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 
number 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 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. 
(10) 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 
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care services, and being either so licensed, reg-
istered, or certified, or exempted from such require-
ment 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 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. 
(12) MALICIOUS
INTENT
TO
INJURE.—The 
term ‘‘malicious intent to injure’’ means inten-
tionally causing or attempting to cause physical in-
jury other than providing health care goods or serv-
ices. 
(13) MEDICAL PRODUCT.—The term ‘‘medical 
product’’ means a drug, device, or biological product 
intended for humans, and the terms ‘‘drug’’, ‘‘de-
vice’’, 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)), re-
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spectively, including any component or raw material 
used therein, but excluding health care services. 
(14) 
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-
ionship, loss of consortium (other than loss of do-
mestic service), hedonic damages, injury to reputa-
tion, 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 com-
pensatory 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 
damages. 
(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 
deductible disbursements or costs for such purpose. 
(17) STATE.—The term ‘‘State’’ means each of 
the several States, the District of Columbia, the 
Commonwealth of Puerto Rico, the Virgin Islands, 
Guam, American Samoa, the Northern Mariana Is-
lands, the Trust Territory of the Pacific Islands, and 
any other territory or possession of the United 
States, or any political subdivision thereof. 
SEC. 408. 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 title does not affect the application 
of the rule of law to such an action; and 
(B) any rule of law prescribed by this title 
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 
title or otherwise applicable law (as determined 
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under this title) will apply to such aspect of such ac-
tion. 
(b) OTHER FEDERAL LAW.—Except as provided in 
this section, nothing in this title 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. 
409. 
STATE 
FLEXIBILITY 
AND 
PROTECTION 
OF 
STATES’ RIGHTS. 
(a) HEALTH CARE LAWSUITS.—The provisions gov-
erning health care lawsuits set forth in this title 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 title. The provisions 
governing health care lawsuits set forth in this title super-
sede 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 appli-
cability or scope of periodic payment of future dam-
ages, than provided in this title; or 
(2) prohibits the introduction of evidence re-
garding collateral source benefits, or mandates or 
permits subrogation or a lien on collateral source 
benefits. 
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creased under this subclause, if applicable), plus 
an additional 1.5 percentage points; and 
‘‘(II) for a period in any calendar year 
after 2017, be equal to the applicable percent-
age under this paragraph for calendar year 
2017 (as determined under subclause (I)).’’; 
and 
(3) in subparagraph (C) (as so redesignated by 
paragraph (1))— 
(A) by striking ‘‘9.3’’ each place it appears 
and inserting ‘‘12’’; and 
(B) by striking ‘‘9.8’’ each place it appears 
and inserting ‘‘12.5’’. 
SEC. 502. ANNUITY SUPPLEMENT. 
Section 8421(a) of title 5, United States Code, is 
amended— 
(1) in paragraph (1), by striking ‘‘paragraph 
(3)’’ and inserting ‘‘paragraphs (3) and (4)’’; 
(2) in paragraph (2), by striking ‘‘paragraph 
(3)’’ and inserting ‘‘paragraphs (3) and (4)’’; and 
(3) by adding at the end the following: 
‘‘(4)(A) Except as provided in subparagraph (B), no 
annuity supplement under this section shall be payable in 
the case of an individual who first becomes subject to this 
chapter after December 31, 2012. 
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