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any other territory or possession of the United 
States, or any political subdivision thereof. 
SEC. 10. EFFECT ON OTHER LAWS. 
(a) VACCINE INJURY.—
(1) To the extent that title XXI of the Public 
Health Service Act establishes a Federal rule of law 
applicable to a civil action brought for a vaccine-re-
lated injury or death—
(A) this Act does not affect the application 
of the rule of law to such an action; and 
(B) any rule of law prescribed by this Act 
in conflict with a rule of law of such title XXI 
shall not apply to such action. 
(2) If there is an aspect of a civil action 
brought for a vaccine-related injury or death to 
which a Federal rule of law under title XXI of the 
Public Health Service Act does not apply, then this 
Act or otherwise applicable law (as determined 
under this Act) will apply to such aspect of such ac-
tion. 
(b) OTHER FEDERAL LAW.—Except as provided in 
this section, nothing in this Act shall be deemed to affect 
any defense available to a defendant in a health care law-
suit or action under any other provision of Federal law.
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SEC. 11. STATE FLEXIBILITY AND PROTECTION OF STATES’ 
RIGHTS. 
(a) HEALTH CARE LAWSUITS.—The provisions gov-
erning health care lawsuits set forth in this Act preempt, 
subject to subsections (b) and (c), State law to the extent 
that State law prevents the application of any provisions 
of law established by or under this Act. The provisions 
governing health care lawsuits set forth in this Act super-
sede chapter 171 of title 28, United States Code, to the 
extent that such chapter—
(1) provides for a greater amount of damages 
or contingent fees, a longer period in which a health 
care lawsuit may be commenced, or a reduced appli-
cability or scope of periodic payment of future dam-
ages, than provided in this Act; or 
(2) prohibits the introduction of evidence re-
garding collateral source benefits, or mandates or 
permits subrogation or a lien on collateral source 
benefits. 
(b) PROTECTION OF STATES’ RIGHTS AND OTHER 
LAWS.—(1) Any issue that is not governed by any provi-
sion of law established by or under this Act (including 
State standards of negligence) shall be governed by other-
wise applicable State or Federal law. 
(2) This Act shall not preempt or supersede any State 
or Federal law that imposes greater procedural or sub-
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stantive protections for health care providers and health 
care organizations from liability, loss, or damages than 
those provided by this Act or create a cause of action. 
(c) STATE FLEXIBILITY.—No provision of this Act 
shall be construed to preempt—
(1) any State law (whether effective before, on, 
or after the date of the enactment of this Act) that 
specifies a particular monetary amount of compen-
satory or punitive damages (or the total amount of 
damages) that may be awarded in a health care law-
suit, regardless of whether such monetary amount is 
greater or lesser than is provided for under this Act, 
notwithstanding section 4(a); or 
(2) any defense available to a party in a health 
care lawsuit under any other provision of State or 
Federal law. 
SEC. 12. APPLICABILITY; EFFECTIVE DATE. 
This Act shall apply to any health care lawsuit 
brought in a Federal or State court, or subject to an alter-
native dispute resolution system, that is initiated on or 
after the date of the enactment of this Act, except that 
any health care lawsuit arising from an injury occurring 
prior to the date of the enactment of this Act shall be 
governed by the applicable statute of limitations provisions 
in effect at the time the injury occurred.
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SEC. 13. SENSE OF CONGRESS. 
It is the sense of Congress that a health insurer 
should be liable for damages for harm caused when it 
makes a decision as to what care is medically necessary 
and appropriate.
Passed the House of Representatives July 28, 2005. 
Attest: 
JEFF TRANDAHL, 
Clerk.