quent civil action brought in a State or Federal 
court) against a health care professional or a health 
care provider in which the claimant alleges a medical 
malpractice claim. 
(10) 
SECRETARY.—The 
term 
‘‘Secretary’’ 
means the Secretary of Health and Human Services. 
(11) STATE.—The term ‘‘State’’ means the 50 
States, the District of Columbia, and any Common-
wealth, territory, or possession of the United States. 
SEC. 3. MEDICAL MALPRACTICE INSURANCE CORPORA-
TIONS. 
(a) ESTABLISHMENT AND PURPOSE.—There are au-
thorized to be established bodies corporate which shall pro-
vide medical malpractice insurance to health care profes-
sionals and health care providers based on customary cov-
erage terms and liability amounts. 
(b) CERTIFICATION.—The Secretary for Health and 
Human Services shall certify as a medical malpractice in-
surance corporation each corporation that satisfies the re-
quirements of subsection (d). 
(c) OPERATION.—Notwithstanding any State law to 
the contrary, a medical malpractice insurance corporation 
certified under subsection (b) may operate and function 
without hindrance or impedance in any or all of the several 
States.
(d) CERTIFICATION REQUIREMENTS.—A corporation 
may be certified as a medical malpractice insurance cor-
poration if— 
(1) it is subject to the fiduciary standards pro-
mulgated by the Secretary for Health and Human 
Services, as required by subsection (e); 
(2) its corporate structure is organized in such 
a way as to require any excess earnings to be used 
to reduce premiums paid by their insureds, con-
sistent with the fiduciary standards promulgated 
under subsection (e); and 
(3) its corporate structure is organized under 
the requirements of section 501(c)(3) of the Internal 
Revenue Code of 1986. 
(e) PROMULGATION OF AND ADHERENCE TO FIDU-
CIARY STANDARDS.—The Secretary shall promulgate ap-
propriate fiduciary standards to which all such medical 
malpractice insurance corporations shall adhere. 
SEC. 4. MEDICAL MALPRACTICE DISPUTE RESOLUTION. 
(a) QUALIFIED EXPERT OPINION.— 
(1) ACCOMPANYING
AFFIDAVIT.—No medical 
malpractice liability action may be brought against 
a health care professional or a health care provider 
by any claimant unless, at the time the claimant 
brings the action (except as provided in subsection
(c)), it is accompanied by the affidavit of a qualified 
specialist or medical expert containing the informa-
tion required by paragraph (2). 
(2) CONTENTS OF AFFIDAVIT.—To satisfy the 
requirements of paragraph (1), the affidavit shall in-
clude the specialist’s or expert’s statement of belief 
that, based on a review of the available medical 
record and other relevant material, there is a reason-
able and meritorious cause for the filing of the ac-
tion. 
(b) QUALIFIED SPECIALIST OR MEDICAL EXPERT.— 
With respect to a medical malpractice liability action, a 
qualified specialist or medical expert is a person who has 
been so recognized by the Secretary or has received proper 
accreditation from the medical licensing board of any 
State, such that such qualified specialist or medical expert 
is recognized— 
(1) to be knowledgeable in the relevant issues 
involved in the action; 
(2) to practice (or to have practiced) or to teach 
(or to have taught) in the same area of health care 
or medicine that is at issue in the action; and 
(3) in the case of an action against a physician, 
to be board certified in a speciality relating to that 
area of medicine.
(c) EXTENSION IN CERTAIN INSTANCES.— 
(1) UNAVAILABILITY
OF
ADEQUATE
MEDICAL 
RECORDS.—Subject to paragraph (2), subsection (a) 
shall not apply with respect to a claimant who 
brings a medical malpractice liability action without 
submitting an affidavit described in such subsection 
if, as of the time the claimant brings the action, the 
claimant certifies that adequate medical records or 
other information necessary to prepare the affidavit 
are unavailable. 
(2) TIME LIMIT.—In the case of an claimant 
who brings an action for which paragraph (1) ap-
plies, the action shall be dismissed unless the claim-
ant submits the affidavit described in subsection (a) 
not later than 120 days after commencement of the 
action. 
(d) MEDICAL
MALPRACTICE
ARBITRATION
PAN-
ELS.— 
(1) ESTABLISHMENT.—The Secretary of Health 
and Human Services shall provide for the establish-
ment of medical malpractice arbitration panels which 
shall hear and render a decision on all medical mal-
practice claims.