173 
after a response to the health care liability action is 
filed, 3 members have not been selected by the par-
ties, the court shall appoint any remaining members. 
(6) COMPENSATION OF MEMBERS.—The costs 
of compensation to the members of the independent 
medical review panel shall be shared between the 
parties equally, unless otherwise agreed to by the 
parties. 
(c) TERMS OF REVIEW.—A review by an independent 
medical review panel under this section shall comply with 
the following: 
(1) STANDARD OF CONDUCT.—The mandatory 
independent medical review panel that is charged 
with the responsibility of making a preliminary find-
ing as to liability of the defendant applicable eligible 
professional shall deem the prescribed clinical prac-
tice guidelines as the standard of conduct, care, and 
skill expected of members of the medical profession 
engaged in the defendant’s field of practice under 
the same or similar circumstances, subject to the 
provisions of subsection (b)(4). 
(2) RECORD
FOR
REVIEW.—The independent 
medical review panel shall make a preliminary find-
ing based solely upon the pre-discovery evidence sub-
mitted to it pursuant to Rule 26 of the Federal 
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174 
Rules of Civil Procedure, any medical records that 
would be discoverable if the lawsuit advances to 
trial, and the applicable prescribed clinical practice 
guidelines. 
(3) LIMITATION.—The independent medical re-
view panel shall not make a finding of negligence 
from the mere fact that a treatment or procedure 
was unsuccessful or failed to bring the best result, 
or that the patient died. 
(4) USE AT TRIAL OF WORK PRODUCT OF RE-
VIEW PANEL.—No preliminary finding by the inde-
pendent medical review panel that the defendant ap-
plicable eligible professional breached the standard 
of care as set forth under the prescribed clinical 
practice guidelines shall constitute negligence per se 
or conclusive evidence of liability, but findings, opin-
ions, and conclusions of the review panel shall be ad-
missible as evidence in any and all subsequent pro-
ceedings before the court, including for purposes of 
motions for summary judgment and at trial. 
(d) RESULTS OF REVIEW.— 
(1) IN GENERAL.—Not later than 60 days after 
all members of the independent medical review panel 
have been selected, the panel shall complete a review 
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175 
of the record of the liability action and shall make 
a finding under this subsection. 
(2) FINDING DESCRIBED.—A finding under this 
subsection shall include the following: 
(A) A determination of whether there are 
any applicable clinical practice guidelines to the 
health care liability action that substantively 
pertains to the injury suffered by the claimant. 
(B) Whether the applicable eligible profes-
sional has alleged adherence to any such guide-
line. 
(C) Whether the applicable eligible profes-
sional adhered to any such guideline. 
(D) Whether there is a reasonable prob-
ability that— 
(i) the applicable eligible professional 
violated the applicable clinical practice 
guideline; 
(ii) that violation proximately caused 
the claimant’s alleged injury; and 
(iii) the claimant suffered damages as 
a result of the injury. 
(3) USE
AT
TRIAL.—The finding under this 
subsection may be received into evidence by the 
court. If the independent medical review panel made 
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176 
any finding under paragraph (2)(D) that there was 
no reasonable probability of the matters described in 
clauses (i) through (iii), the court may issue a sum-
mary judgment in favor of the applicable eligible 
professional unless the claimant is able to show oth-
erwise by clear and convincing evidence. If the panel 
made a finding under subparagraphs (A) through 
(C) of paragraph (2) that there was an applicable 
clinical practice guideline that the defendant adhered 
to, the court shall issue summary judgment in favor 
of the applicable eligible professional unless the 
claimant is able to show otherwise by clear and con-
vincing evidence. Any preliminary finding that the 
defendant applicable eligible professional did not 
breach the standard of care as set forth under the 
prescribed medical practice guidelines or that the de-
fendant applicable eligible professional’s nonadher-
ence to the applicable standard was neither the 
cause in fact nor the proximate cause of the plain-
tiff’s injury or that the plaintiff did not incur any 
damages as a result shall be given deference by the 
court and shall entitle the defendant applicable eligi-
ble professional to summary judgment unless the 
plaintiff is able to show by clear and convincing evi-
dence that the independent medical review panel was 
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177 
in error and that there is a genuine issue as to a 
material fact in the case. 
SEC. 509. DEFINITIONS. 
In this Act: 
(1) APPLICABLE
ELIGIBLE
PROFESSIONAL.— 
The term ‘‘applicable eligible professional’’ means a 
physician practicing within clinical practice guide-
lines submitted by an eligible professional organiza-
tion and includes employees and agents of a physi-
cian. 
(2) APPROPRIATE
USE
CRITERIA.—The term 
‘‘appropriate use criteria’’ means established evi-
dence-based guidelines developed or endorsed by an 
eligible professional organization that specify when 
the health benefits of a procedure or service exceed 
the expected health risks by a significantly wide 
margin. 
(3) CLINICAL PRACTICE GUIDELINE.—The term 
‘‘clinical practice guideline’’ means systematically de-
veloped statements based on the review of clinical 
evidence for assisting a health care provider to de-
termine the appropriate health care in specific clin-
ical circumstances. 
(4) ELIGIBLE PROFESSIONAL ORGANIZATION.— 
The term ‘‘eligible professional organization’’ means 
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178 
a national or State medical society or medical spe-
cialty society. 
(5) FEDERAL
PAYOR.—The term ‘‘Federal 
payor’’ includes reimbursements made under the 
Medicare program under title XVIII of the Social 
Security Act or the Medicaid program under title 
XIX of the Social Security Act, or medical 
screenings, treatments, or transfer services provided 
pursuant to section 1867 of the Social Security Act 
is not made by the individual or any non-Federal 
third party on behalf of the individual. 
(6) 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. 
(7) HEALTH
CARE
LIABILITY
ACTION.—The 
term ‘‘health care liability action’’ means a civil ac-
tion against an applicable eligible professional, a 
health care provider, or a health care organization, 
regardless of the theory of liability on which the 
claim is based, or the number of plaintiffs, defend-
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180 
istered, or certified, or exempted from such require-
ment by other statute or regulation. 
(11) 
SECRETARY.—The 
term 
‘‘Secretary’’ 
means the Secretary of Health and Human Services. 
TITLE VI—OTHER PROVISIONS 
SEC. 601. RESPECTING HUMAN LIFE. 
(a) PROHIBITION ON ABORTION MANDATES.—Noth-
ing in this Act (or any amendment made by this Act) shall 
be construed to require any health plan (including any 
high-risk pool) to provide coverage of, or access to, abor-
tion services or to allow the Secretary of the Treasury, 
the Secretary of Labor, the Secretary of Health and 
Human Services, or any other Federal or non-Federal per-
son or entity in implementing this Act (or an amendment 
made by this Act) to require coverage of, or access to, 
abortion services. 
(b) PROHIBITION ON CERTAIN RESEARCH FUND-
ING.— 
(1) IN GENERAL.—No funds authorized or ap-
propriated by this Act (or an amendment made by 
this Act) may be used to conduct or support re-
search that includes embryo-destructive stem cell re-
search and human cloning. 
(2) HUMAN CLONING DEFINED.—In this sub-
section, the term ‘‘human cloning’’ means human 
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181 
asexual reproduction accomplished by introducing 
the nuclear material from a human diploid cell into 
an oocyte to produce a living organism at any stage 
of development with a human or predominantly 
human genetic constitution. 
(3) CONSTRUCTION.—Nothing in this sub-
section may be construed to prohibit conducting or 
supporting research that does not include embryo- 
destructive stem cell research or human cloning, in-
cluding research involving nuclear transfer or other 
cloning techniques to produce molecules, DNA, cells 
other than human embryos, tissues, or animals other 
than humans. 
(c) LIMITATION ON ABORTION FUNDING.— 
(1) IN GENERAL.—No funds authorized or ap-
propriated by this Act (or an amendment made by 
this Act) may be used to pay for any abortion or to 
cover any part of the costs of any health plan that 
includes coverage of abortion (including a high-risk 
pool described in section 2745 of the Public Health 
Service Act (42 U.S.C. 300gg–45), as amended by 
section 311 of this Act), except— 
(A) if the pregnancy is the result of an act 
of rape or incest; or 
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182 
(B) in the case where a pregnant female 
suffers from a physical disorder, physical in-
jury, or physical illness that would, as certified 
by a physician, place the female in danger of 
death unless an abortion is performed, includ-
ing a life-endangering physical condition caused 
by or arising from the pregnancy itself. 
(2) OPTION
TO
PURCHASE
SEPARATE
COV-
ERAGE OR PLAN.—Nothing in this subsection shall 
be construed as prohibiting any non-Federal entity 
(including an individual or a State or local govern-
ment) from purchasing separate coverage for abor-
tions for which funding is prohibited under this sub-
section, or a health plan that includes such abor-
tions, so long as such coverage or plan is paid for 
entirely using only funds not authorized or appro-
priated by this Act. 
(3) OPTION TO OFFER COVERAGE OR PLAN.— 
Nothing in this subsection shall restrict any non- 
Federal health insurance issuer offering a health 
plan from offering separate coverage for abortions 
for which funding is prohibited under this sub-
section, or a health plan that includes such abor-
tions, so long as— 
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183 
(A) premiums for such separate coverage 
or plan are paid for entirely with funds not au-
thorized or appropriated by this Act; and 
(B) administrative costs and all services 
offered through such coverage or plan are paid 
for using only premiums collected for such cov-
erage or plan. 
(4) ADMINISTRATIVE
EXPENSES.—No funds 
authorized or appropriated by this Act shall be avail-
able to pay for administrative expenses in connection 
with any health plan (including an association health 
plan that has entered into trusteeship) which pro-
vides any benefits or coverage for abortions except 
where the life of the mother would be endangered if 
the fetus were carried to term, or the pregnancy is 
the result of an act of rape or incest. 
(d) NO PREEMPTION OF STATE LAWS.—Nothing in 
this Act (or an amendment made by this Act) shall be 
construed to preempt or otherwise have any effect on 
State laws— 
(1) protecting conscience rights or restricting or 
prohibiting abortion or coverage or funding of abor-
tion, as in effect on the date of the enactment of this 
Act; or 
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184 
(2) establishing procedural requirements on 
abortions, including parental notification or consent 
for the performance of an abortion on a minor. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘association health plan’’ has the 
meaning given to such term in section 801 of the 
Employee Retirement Income Security Act of 1974, 
as added by section 451 of this Act. 
(2) The term ‘‘high-risk pool’’ means a high- 
risk pool described in section 2745 of the Public 
Health Service Act (42 U.S.C. 300gg–45), as 
amended by section 311 of this Act. 
SEC. 602. OFFSETS. 
Section 251(c) of the Balanced Budget and Emer-
gency Deficit Control Act of 1985 (2 U.S.C. 901) is 
amended as follows: 
(1) In paragraph (5)(B), by striking the dollar 
amount and inserting ‘‘$507,300,000,000’’. 
(2) In paragraph (6)(B), by striking the dollar 
amount and inserting ‘‘$523,700,000,000’’. 
(3) In paragraph (7)(B), by striking the dollar 
amount and inserting ‘‘$534,900,000,000’’. 
(4) In paragraph (8)(B), by striking the dollar 
amount and inserting ‘‘$546,700,000,000’’. 
Æ 
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