market in a State shall offer a catastrophic plan in such 
State in such market. 
‘‘(b) COVERAGE REQUIREMENTS.—To meet the re-
quirements of this section, a catastrophic plan must pro-
vide for the essential health benefits, as defined by the 
Secretary under subsection (c). 
‘‘(c) ESSENTIAL
HEALTH
BENEFITS.—The Sec-
retary shall define the essential health benefits, except 
that such benefits shall include— 
‘‘(1) coverage for at least three primary care 
visits during a plan year; and 
‘‘(2) at least the following general categories 
and the items and services covered within the cat-
egories: 
‘‘(A) Ambulatory patient services. 
‘‘(B) Emergency services. 
‘‘(C) Hospitalization. 
‘‘(D) Maternity and newborn care. 
‘‘(E) Mental health and substance use dis-
order services, including behavioral health treat-
ment. 
‘‘(F) Prescription drugs. 
‘‘(G) Rehabilitative and habilitative serv-
ices and devices. 
‘‘(H) Laboratory services. 
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‘‘(I) Preventive and wellness services and 
chronic disease management. 
‘‘(J) Pediatric services, including oral and 
vision care. 
‘‘(d) RESTRICTION TO INDIVIDUAL MARKET.—If a 
health insurance issuer offers a health plan described in 
this section, the issuer may only offer the plan in the indi-
vidual market.’’. 
SEC. 11. GRANTS FOR HEALTH INSURANCE RISK ADJUST-
MENT MECHANISMS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall make grants to States for planning 
for the establishment and implementation of health insur-
ance risk adjustment mechanisms. 
(b) AMOUNT.— 
(1) IN GENERAL.—The Secretary shall deter-
mine the amount of a grant made to a State under 
this section pursuant to a formula, issued by rule 
not later than one year after the date of the enact-
ment of the PPACA repeal legislation described in 
section 2(b), that takes into account the number of 
high-risk individuals in such State. 
(2) LIMITATION.—The amount of a grant made 
to a State under this section shall not exceed 
$1,000,000 for any fiscal year. 
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(c) USE OF FUNDS.—The grant funds made available 
to a State under this section may only be used by a State 
for the cost associated with planning for the establishment 
and implementation of health insurance risk adjustment 
mechanisms. Such funds may not be used for costs related 
to administering such mechanisms. 
(d) DEFINITIONS.—For purposes of this section: 
(1) HIGH-RISK INDIVIDUAL.—The term ‘‘high- 
risk individual’’ means an individual who— 
(A) is a citizen or national of the United 
States or is lawfully present in the United 
States; 
(B) has not been covered under creditable 
coverage (as defined in section 2701(c)(1) of 
the Public Health Service Act as in effect on 
March 22, 2010) during the previous 6-month 
period; and 
(C) has a preexisting condition, as deter-
mined in a manner consistent with guidance 
issued by the Secretary. 
(2) HEALTH
INSURANCE
RISK-ADJUSTMENT 
MECHANISMS.— 
(A) IN
GENERAL.—With respect to a 
State, the term ‘‘health insurance risk-adjust-
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ment mechanism’’ shall be a mechanism that 
applies to— 
(i) all health insurance issuers who 
offer health insurance coverage in such 
State; and 
(ii) all covered lives for health insur-
ance coverage offered in such State that is 
subject to the requirements of section 2711 
or section 2741 of the Public Health Serv-
ice Act, as added by section 3 of this Act. 
(B) FURTHER DEFINITION.—With respect 
to a State, any further definition of such term 
shall be determined by the State insurance com-
missioner, acting in cooperation with health in-
surance issuers who offer health insurance cov-
erage in such State. 
(3) STATE.—The term ‘‘State’’ means each of 
the 50 States and the District of Columbia. 
(e) SUNSET DATE.—The Secretary may not make 
any grants under this section after the date that is 2 years 
after the date of the enactment of the PPACA repeal legis-
lation described in section 2(b). 
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SEC. 12. LIABILITY PROTECTIONS FOR HEALTH CARE PRO-
VIDERS. 
(a) HEALTH CARE PROVIDERS PROTECTED.—The li-
ability protections in subsection (c) shall apply in any civil 
action, including an action before any court of any State, 
against a health care provider, arising from health care 
goods or services that— 
(1) were provided by a health care provider in 
a hospital to which the requirements of section 1867 
of the Social Security Act (42 U.S.C. 1395dd) apply; 
and 
(2) were provided only because they were re-
quired under section 1867 of the Social Security Act 
(42 U.S.C. 1395dd). 
(b) BURDEN OF PROOF.—In any proceeding under 
subsection (a), the burden of proof shall be on the defend-
ant to establish the elements in paragraphs (1) and (2) 
of subsection (a). 
(c) LIABILITY PROTECTIONS.— 
(1) CAP
ON
NONECONOMIC
DAMAGES.—The 
amount of noneconomic damages, if available, shall 
not exceed $250,000, regardless of the number of 
parties against whom the action is brought with re-
spect to the same injury. An award for noneconomic 
damages in excess of $250,000 shall be reduced ei-
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ther before entry of the order granting judgment, or 
by amendment of such order. 
(2) INSTALLMENT
PAYMENTS.—If the award 
for damages exceeds $50,000, the defendant may 
pay such damages in installments, as determined by 
the court. 
(3) ATTORNEY FEES.—Any contingent fee for a 
party’s attorney shall not exceed— 
(A) 40 percent of the portion of the award 
amount that does not exceed $50,000; 
(B) 331⁄3 percent of the portion of the 
award amount that exceeds $50,000 but does 
not exceed $100,000; 
(C) 25 percent of the portion of the award 
amount that exceeds $100,000 but does not ex-
ceed $600,000; and 
(D) 15 percent of the portion of the award 
amount that exceeds $600,000. 
(4) DISCLOSURE OF COLLATERAL SOURCE BEN-
EFITS.—Any person bringing a civil action described 
in subsection (a) shall, and any party may, disclose 
or introduce evidence of collateral source benefits. 
(5) PREEMPTION.— 
(A) IN GENERAL.—The provisions of this 
Act preempt, subject to subparagraphs (B) and 
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(C), State law to the extent that State law pre-
vents the application of any provisions of law 
established by or under this Act. The provisions 
governing an action described in subsection (a) 
set forth in this Act supersede chapter 171 of 
title 28, United States Code, to the extent that 
such chapter— 
(i) provides for a greater amount of 
damages or contingent fees, a longer pe-
riod in which a health care lawsuit may be 
commenced, or a reduced applicability or 
scope of periodic payment of future dam-
ages, than provided in this Act; or 
(ii) prohibits the introduction of evi-
dence regarding collateral source benefits, 
or mandates or permits subrogation or a 
lien on collateral source benefits. 
(B) 
GREATER
PROTECTIONS
PRE-
SERVED.—This Act shall not preempt or super-
sede any State or Federal law that imposes 
greater procedural or substantive protections 
for health care providers from liability, loss, or 
damages than those provided by this Act or cre-
ate a cause of action. 
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(C) RULE OF CONSTRUCTION.—No provi-
sion of this Act shall be construed to preempt— 
(i) any State law (whether effective 
before, on, or after the date of the enact-
ment of this Act) that specifies a par-
ticular monetary amount of compensatory 
or punitive damages (or the total amount 
of damages) that may be awarded in an 
action described in subsection (a), regard-
less of whether such monetary amount is 
greater or lesser than is provided for under 
this Act; or 
(ii) any defense available to a party in 
an action described in subsection (a) under 
any other provision of State or Federal 
law. 
(6) DEFINITIONS.— 
(A) COLLATERAL SOURCE BENEFITS.—As 
used in this section, the term ‘‘collateral source 
benefits’’ means any amount paid or reasonably 
likely to be paid in the future to or on behalf 
of the claimant, or any service, product, or 
other benefit provided or reasonably likely to be 
provided in the future to or on behalf of the 
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claimant, as a result of the personal harm, pur-
suant to— 
(i) any State or Federal health, sick-
ness, income-disability, accident, or work-
ers’ compensation law; 
(ii) any health, sickness, income-dis-
ability, or accident insurance that provides 
health benefits or income-disability cov-
erage; 
(iii) any contract or agreement of any 
group, organization, partnership, or cor-
poration to provide, pay for, or reimburse 
the cost of medical, hospital, dental, or in-
come-disability benefits; and 
(iv) any other publicly or privately 
funded program. 
(B) NONECONOMIC DAMAGES.—As used in 
this section, the term ‘‘noneconomic damages’’ 
means damages for physical and emotional 
pain, suffering, inconvenience, physical impair-
ment, mental anguish, disfigurement, loss of en-
joyment of life, loss of society and companion-
ship, loss of consortium (other than loss of do-
mestic service), hedonic damages, injury to rep-
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utation, and all other nonpecuniary losses of 
any kind or nature. 
(C) HEALTH CARE PROVIDER.—As used in 
this section, the term ‘‘health care provider’’ 
means any person or entity required by State or 
Federal laws or regulations to be licensed, reg-
istered, or certified to provide health care serv-
ices, and being either so licensed, registered, or 
certified, or exempted from such requirement by 
other statute. 
(D) HEALTH CARE GOODS OR SERVICES.— 
As used in this section, the term ‘‘health care 
goods or services’’ means any goods or services 
provided by a health care organization, pro-
vider, or by any individual working under the 
supervision of a health care provider, that re-
lates to the diagnosis, prevention, or treatment 
of any human disease or impairment, or the as-
sessment or care of the health of human beings. 
Æ 
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