I 
111TH CONGRESS 
1ST SESSION H. R. 4007 
To authorize the Secretary of Health and Human Services to make grants 
to 5 States to establish medical malpractice tribunal pilot programs, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 3, 2009 
Mr. LEE of New York (for himself and Mr. HUNTER) introduced the following 
bill; which was referred to the Committee on the Judiciary 
A BILL 
To authorize the Secretary of Health and Human Services 
to make grants to 5 States to establish medical mal-
practice tribunal pilot programs, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. MEDICAL TRIBUNAL PILOT PROGRAMS. 
(a) AUTHORIZATION.—The Secretary of Health and 
Human Services is authorized to make grants to 5 States 
to establish pilot programs under which each medical mal-
practice case is heard in the first instance by a medical 
tribunal composed of a State trial court judge, a physician, 
and a lawyer. 
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(b) ELIGIBILITY.—The Secretary may only award a 
grant under this section to a State that— 
(1) has an average cost of medical malpractice 
insurance that exceeds the national average of such 
cost; 
(2) has not— 
(A) placed a limit on noneconomic dam-
ages in medical malpractice cases; or 
(B) established or begun to establish a 
medical tribunal program similar to that de-
scribed in subsection (e); and 
(3) submits an application at such time, in such 
form, and accompanied by such information and as-
surances as the Secretary may require. 
(c) DURATION OF GRANT.—A grant under this sec-
tion shall be awarded over 3 fiscal years. 
(d) USE OF FUNDS.—A State that receives a grant 
under this section shall use grant funds to establish and 
administer a medical tribunal pilot program in accordance 
with subsection (e). 
(e) REQUIREMENTS FOR MEDICAL TRIBUNAL PILOT 
PROGRAM.—The medical tribunal pilot program required 
by subsection (d) shall include the following elements: 
(1) HEARING OF CASE IN FIRST INSTANCE.— 
Each medical malpractice case filed in the courts of 
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the State shall be heard in the first instance by a 
medical tribunal. 
(2) DETERMINATION BY MEDICAL TRIBUNAL.— 
The medical tribunal shall hear all evidence that 
would be admissible in the courts of the State and 
determine whether such evidence would be sufficient 
to support a finding for the plaintiff. 
(3) EFFECT OF MEDICAL TRIBUNAL’S DETER-
MINATION.— 
(A) If the medical tribunal determines that 
the evidence would be sufficient to support a 
finding for the plaintiff, the plaintiff may pur-
sue the case through the State’s usual judicial 
process. 
(B) If the medical tribunal determines that 
the evidence would be insufficient to support a 
finding for the plaintiff, the plaintiff may pur-
sue the case through the State’s usual judicial 
process only after filing with the clerk of the 
court in which the case is pending a bond in an 
amount determined to be appropriate by the 
State trial court judge serving on the tribunal. 
(4) COMPOSITION OF MEDICAL TRIBUNAL.— 
(A) IN
GENERAL.—A medical tribunal 
shall be composed of a State trial court judge, 
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a physician licensed to practice medicine in the 
State, and a lawyer licensed to practice law in 
the State. 
(B) SELECTION OF PHYSICIAN AND LAW-
YER.—The State trial court judge who will 
serve on a medical tribunal shall select the phy-
sician from a list provided by the State medical 
society or association and the lawyer from a list 
provided by the State bar association. 
(C) DEFENDANT
OTHER
THAN
PHYSI-
CIAN.—If the defendant in a medical mal-
practice case is a health care provider other 
than a physician, then a practitioner in such 
other field of health care shall serve on the 
medical tribunal instead of a physician. The 
State trial court judge who will serve on the tri-
bunal shall select such practitioner in a manner 
the judge considers appropriate. 
(f) STUDY OF EFFECTIVENESS OF MEDICAL TRIBU-
NALS AND REPORT TO CONGRESS.— 
(1) STUDY.—After the end of the 3rd fiscal 
year in which grant funds are paid under this sec-
tion, the Secretary shall collect from each State that 
received grant funds the following data: 
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bunal that were tried to a judgment, and the 
number of such judgments that were for the 
plaintiff. 
(D) The number of medical malpractice 
cases considered nonmeritorious by the medical 
tribunal that were tried to a judgment, and the 
number of such judgments that were for the 
plaintiff. 
(2) REPORT TO CONGRESS.—Not later than 18 
months after the end of the 3rd fiscal year in which 
grant funds are paid under this section, the Sec-
retary shall submit to Congress a report setting 
forth the data collected under paragraph (1). 
(3) CASES
CONSIDERED
MERITORIOUS.—For 
purposes of paragraph (1), a case is considered mer-
itorious by the medical tribunal if the tribunal found 
that the evidence would be sufficient to support a 
finding for the plaintiff, and a case is considered 
nonmeritorious by the medical tribunal if the tri-
bunal found that the evidence would be insufficient 
to support a finding for the plaintiff. 
(g) MEDICAL MALPRACTICE CASE DEFINED.—In 
this section, the term ‘‘medical malpractice case’’ means 
a civil action against a health care provider in which the 
plaintiff alleges harm arising from an error or breach of 
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the standard of care by the health care provider in treating 
the plaintiff. 
(h) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out this section for fiscal years 2011 
through 2013. 
Æ 
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