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‘‘(A) makes the medical liability system 
more reliable by increasing the availability of 
prompt and fair resolution of disputes; 
‘‘(B) encourages the efficient resolution of 
disputes; 
‘‘(C) encourages the disclosure of health care 
errors; 
‘‘(D) enhances patient safety by detecting, 
analyzing, and helping to reduce medical errors 
and adverse events; 
‘‘(E) improves access to liability insurance; 
‘‘(F) fully informs patients about the dif-
ferences in the alternative and current tort liti-
gation; 
‘‘(G) provides patients the ability to opt out 
of or voluntarily withdraw from participating in 
the alternative at any time and to pursue other 
options, including litigation, outside the alter-
native; 
‘‘(H) would not conflict with State law at 
the time of the application in a way that would 
prohibit the adoption of an alternative to current 
tort litigation; and 
‘‘(I) would not limit or curtail a patient’s 
existing legal rights, ability to file a claim in or 
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access a State’s legal system, or otherwise abro-
gate a patient’s ability to file a medical mal-
practice claim. 
‘‘(3) SOURCES OF COMPENSATION.—Each State 
desiring a grant under subsection (a) shall identify 
the sources from and methods by which compensation 
would be paid for claims resolved under the proposed 
alternative to current tort litigation, which may in-
clude public or private funding sources, or a com-
bination of such sources. Funding methods shall to the 
extent practicable provide financial incentives for ac-
tivities that improve patient safety. 
‘‘(4) SCOPE.— 
‘‘(A) IN GENERAL.—Each State desiring a 
grant under subsection (a) shall establish a scope 
of jurisdiction (such as Statewide, designated ge-
ographic region, a designated area of health care 
practice, or a designated group of health care 
providers or health care organizations) for the 
proposed alternative to current tort litigation 
that is sufficient to evaluate the effects of the al-
ternative. No scope of jurisdiction shall be estab-
lished under this paragraph that is based on a 
health care payer or patient population. 
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‘‘(B) NOTIFICATION OF PATIENTS.—A State 
shall demonstrate how patients would be notified 
that they are receiving health care services that 
fall within such scope, and the process by which 
they may opt out of or voluntarily withdraw 
from participating in the alternative. The deci-
sion of the patient whether to participate or con-
tinue participating in the alternative process 
shall be made at any time and shall not be lim-
ited in any way. 
‘‘(5) PREFERENCE
IN
AWARDING
DEMONSTRA-
TION GRANTS.—In awarding grants under subsection 
(a), the Secretary shall give preference to States— 
‘‘(A) that have developed the proposed alter-
native through substantive consultation with rel-
evant stakeholders, including patient advocates, 
health care providers and health care organiza-
tions, attorneys with expertise in representing 
patients and health care providers, medical mal-
practice insurers, and patient safety experts; 
‘‘(B) that make proposals that are likely to 
enhance patient safety by detecting, analyzing, 
and helping to reduce medical errors and adverse 
events; and 
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‘‘(C) that make proposals that are likely to 
improve access to liability insurance. 
‘‘(d) APPLICATION.— 
‘‘(1) IN GENERAL.—Each State desiring a grant 
under subsection (a) shall submit to the Secretary an 
application, at such time, in such manner, and con-
taining such information as the Secretary may re-
quire. 
‘‘(2) REVIEW PANEL.— 
‘‘(A) IN GENERAL.—In reviewing applica-
tions under paragraph (1), the Secretary shall 
consult with a review panel composed of relevant 
experts appointed by the Comptroller General. 
‘‘(B) COMPOSITION.— 
‘‘(i) NOMINATIONS.—The Comptroller 
General shall solicit nominations from the 
public for individuals to serve on the review 
panel. 
‘‘(ii) APPOINTMENT.—The Comptroller 
General shall appoint, at least 9 but not 
more than 13, highly qualified and knowl-
edgeable individuals to serve on the review 
panel and shall ensure that the following 
entities receive fair representation on such 
panel: 
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‘‘(I) Patient advocates. 
‘‘(II) Health care providers and 
health care organizations. 
‘‘(III) Attorneys with expertise in 
representing patients and health care 
providers. 
‘‘(IV) Medical malpractice insur-
ers. 
‘‘(V) State officials. 
‘‘(VI) Patient safety experts. 
‘‘(C) CHAIRPERSON.—The Comptroller Gen-
eral, or an individual within the Government 
Accountability Office designated by the Comp-
troller General, shall be the chairperson of the re-
view panel. 
‘‘(D) AVAILABILITY OF INFORMATION.—The 
Comptroller General shall make available to the 
review panel such information, personnel, and 
administrative services and assistance as the re-
view panel may reasonably require to carry out 
its duties. 
‘‘(E) INFORMATION FROM AGENCIES.—The 
review panel may request directly from any de-
partment or agency of the United States any in-
formation that such panel considers necessary to 
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