I 
109TH CONGRESS 
1ST SESSION H. R. 2399
To establish an Office of Health Care Competition within the Department 
of Health and Human Services to administer the National Practitioner 
Data Base and to collect and make available to the public more informa-
tion on medical malpractice insurance under that Data Base. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 17, 2005
Mr. DEFAZIO (for himself, Mrs. CHRISTENSEN, Mr. CROWLEY, and Mr. HIN-
CHEY) introduced the following bill; which was referred to the Committee 
on Energy and Commerce 
A BILL 
To establish an Office of Health Care Competition within 
the Department of Health and Human Services to ad-
minister the National Practitioner Data Base and to 
collect and make available to the public more information 
on medical malpractice insurance under that Data Base.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Improved Medical Mal-
practice Information Reporting and Competition Act of 
2005’’.
SEC. 2. ESTABLISHMENT OF OFFICE OF HEALTH CARE 
COMPETITION WITHIN THE DEPARTMENT OF 
HEALTH AND HUMAN SERVICES. 
(a) IN GENERAL.—There is established within the 
Department of Health and Human Services an Office to 
be known as the Office of Health Care Competition Policy 
(in this section referred to as the ‘‘Office’’). The Office 
shall be headed by a Director, who shall be appointed by 
the Secretary of such Department. 
(b) DUTIES.—
(1) RESPONSIBILITY
FOR
NATIONAL
PRACTI-
TIONER DATA BASE.—The Office shall be responsible 
for activities of the Secretary under part B of title 
IV of the Health Care Quality Improvement Act of 
1986 (title IV of Public Law 99–660), including the 
National Practitioner Data Base under such part. 
(2) ANNUAL REPORT.—The Director of the Of-
fice shall submit a report each year to the Secretary 
of Health and Human Services on activities con-
ducted under such part. 
SEC. 3. CHANGES IN NATIONAL PRACTITIONER DATA BASE 
PROVISIONS. 
(a) REQUIRING ADDITIONAL REPORTS ON MEDICAL 
MALPRACTICE INSURANCE AND CLAIMS.—Part B of title 
IV of the Health Care Quality Improvement Act of 1986
(title IV of Public Law 99–660) is amended by inserting 
after section 421 the following new section: 
‘‘SEC. 421A. REQUIRING REPORTS ON MEDICAL MAL-
PRACTICE INSURANCE AND CLAIMS. 
‘‘(a) IN GENERAL.—Each entity (including an insur-
ance company) which underwrites a policy of insurance for 
medical malpractice actions or claims shall report, in ac-
cordance with section 424, information respecting such in-
surance and claims for payment under such policy. Such 
information shall be in addition to, and may be coordi-
nated with, the information required to be reported under 
section 421. 
‘‘(b) INFORMATION TO BE REPORTED.—
‘‘(1) IN GENERAL.—The information to be re-
ported under subsection (a) by an entity with re-
spect to a medical malpractice insurance policy in-
cludes the following: 
‘‘(A) Direct premiums written. 
‘‘(B) Direct premiums earned. 
‘‘(C) Net investment income, including net 
realized capital gains and losses, using appro-
priate estimates where necessary. 
‘‘(D) Incurred claims, developed as the 
sum of the following (the report shall include 
data for each of the following):
‘‘(i) Dollar amount of claims closed 
with payment; plus. 
‘‘(ii) Reserves for reported claims at 
the end of the current year; minus. 
‘‘(iii) Reserves for reported claims at 
the end of the previous year; plus. 
‘‘(iv) Reserves for incurred but not re-
ported claims at the end of the current 
year; minus. 
‘‘(v) Reserves for incurred but not re-
ported claims at the end of the previous 
year; plus. 
‘‘(vi) Loss adjustment expenses for 
claims closed; plus. 
‘‘(vii) Reserves for loss adjustment ex-
pense at the end of the current year; 
minus. 
‘‘(viii) Reserves for loss adjustment 
expense at the end of the previous year. 
‘‘(E) Actual incurred expenses allocated 
separately to loss adjustment, commissions, 
other acquisition costs, advertising, general of-
fice expenses, taxes, licenses and fees, and all 
other expenses. 
‘‘(F) Net underwriting gain or loss.
‘‘(G) Net operation gain or loss, including 
net investment income. 
‘‘(H) The number and dollar amount of 
claims closed with payment by year incurred, 
the amount reserved for each claim, the year(s) 
in which the reserves were set, and the amounts 
set in each year. 
‘‘(I) The number of claims closed without 
payment, the dollar amount reserved for each 
claim, the years in which reserves were set, and 
the amounts set in each. 
‘‘(J) The number of claims pending at the 
end of each year, the amount of reserve[d] for 
each claim, the year(s) in which the reserves 
were set, and the amounts set in each year. 
‘‘(2) CLAIMS PAID.—Such report shall also in-
clude the following: 
‘‘(A) For claims paid by the insurer during 
the calendar year, in which a verdict had at any 
time been rendered. 
‘‘(i) The dollar amount paid by the in-
surance company; and 
‘‘(ii) The dollar amount of the original 
verdict.
‘‘(B) For claims paid by the insurer during 
the calendar year, in which a verdict had at any 
time been rendered. 
‘‘(i) The dollar amount of the original 
verdict, broken out as follows: 
‘‘(I) The total amount of past 
economic damages assessed by the 
trier of fact. 
‘‘(II) The total amount of future 
economic damages assessed by the 
trier of fact. 
‘‘(III) The total amount of com-
pensatory non-economic damages as-
sessed by the trier of fact. 
‘‘(IV) The total amount of puni-
tive damages assessed by the trier of 
fact. 
‘‘(ii) The dollar amount paid by all 
parties. 
‘‘(iii) The dollar amount paid by the 
insurer. 
‘‘(iv) The number of claims paid by 
the insurer.
‘‘(C) For claims paid by the insurer during 
the calendar year, in which a verdict had never 
been rendered. 
‘‘(i) The total amount paid by the in-
surer broken out as follows: 
‘‘(I) The amount of the plaintiff’s 
past economic damages, as submitted 
by the plaintiff. 
‘‘(II) The amount of the plain-
tiff’s future economic damages, as es-
timated by the insurer. 
‘‘(III) The amount paid by the 
insurer for other damages. 
‘‘(ii) The number of claims paid by 
the insurer. 
‘‘(D) The number of claims in which the 
insurer paid—
‘‘(i) more than $250,000 in non-eco-
nomic damages; and 
‘‘(ii) more than $500,000 in non-eco-
nomic damages. 
‘‘(E) For claims paid by the insurer during 
the calendar year, the number of claims in 
which—
‘‘(i) punitive damages were assessed 
by the trier of fact; 
‘‘(ii) punitive damages were paid by 
any party; and 
‘‘(iii) punitive damages were paid by 
the insurer. 
‘‘(F) For claims paid by the insurer during 
the calendar year—
‘‘(i) the dollar amount of punitive 
damages assessed by the trier of fact; 
‘‘(ii) the dollar amount of punitive 
damages paid by all parties; and 
‘‘(iii) the dollar amount of punitive 
damages paid by the insurer. 
‘‘(G) The number and dollar amount of 
claims paid by the insurer during the calendar 
year in which parties other than the insured—
‘‘(i) had at any time been found liable 
by the trier of fact; or 
‘‘(ii) had been estimated by the insur-
ance company to have some liability. 
‘‘(H) For those claims identified in para-
graph (7), the amount by which the amount 
paid by the insurer exceeds the amount propor-
tional to the insured’s percentage of responsi-
bility. 
‘‘(I) Such other information as the Sec-
retary determines is required for appropriate 
interpretation of information reported under 
this section. 
‘‘(c) SANCTIONS FOR FAILURE TO REPORT.—The 
provisions of section 421(c) shall apply to information re-
quired to be reported under this section in the same man-
ner as they apply to the reporting of information on a pay-
ment required to be reported under section 421. 
‘‘(d) COORDINATION
OF
INFORMATION
REPORT-
ING.—The Secretary shall provide for the coordination of 
reporting of information under this section with the re-
porting of related information under section 421.’’. 
(b) INCLUSION
AND AVAILABILITY
OF INFORMA-
TION.—Section 427(b) of such Act (42 U.S.C. 11137(b)) 
is amended by adding at the end the following new para-
graph: 
‘‘(4) AVAILABILITY OF PUBLIC FILE DATA.—
Notwithstanding the previous provisions of this sub-
section, the Secretary shall make available, for free 
from the website maintained in connection with the 
data base established to carry out this part, informa-
tion reported under sections 421 and 421A which
does not provide for individually identifiable infor-
mation.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall take effect 6 months after the date of 
the enactment of this Act.
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