I 
109TH CONGRESS 
1ST SESSION H. R. 3378 
To provide comprehensive reform regarding medical malpractice. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 21, 2005 
Mr. BAIRD (for himself, Mr. MORAN of Virginia, Mr. RUPPERSBERGER, and 
Mr. LIPINSKI) introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committee 
on the Judiciary, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To provide comprehensive reform regarding medical 
malpractice. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Comprehensive Medical Malpractice Reform Act of 
2005’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents.
TITLE I—HEALTH CARE MALPRACTICE LIABILITY REFORM 
Sec. 101. Cap on non-economic damages. 
Sec. 102. Sanctions for meritless actions and pleadings. 
Sec. 103. Performance standards applicable to State medical boards. 
Sec. 104. Interstate patient reporting and physician tracking database. 
Sec. 105. Definitions. 
TITLE II—HEALTH CARE MALPRACTICE LIABILITY MEDIATION 
PROGRAMS 
Sec. 201. Grants to States and health care entities for mediation programs. 
Sec. 202. Training and assistance for mediation programs. 
Sec. 203. Authorization of appropriations. 
TITLE III—VOLUNTARY REPORTING OF MEDICAL SAFETY 
INCIDENTS 
Subtitle A—Reporting by Individuals Involved in the Provision of Health 
Care 
Sec. 301. Amendments to Public Health Service Act. 
Subtitle B—Liability Protection in Good-Faith Reporting 
Sec. 311. Liability protection for health care providers in good-faith reporting 
to State medical boards. 
TITLE IV—INSURANCE REFORM 
Sec. 401. Uniform state requirements regarding proposed rate increases. 
Sec. 402. Reduction in premiums paid by physicians for medical malpractice in-
surance coverage. 
Sec. 403. Effective date. 
TITLE V—EXCLUSION OF PHARMACEUTICALS AND DEVICES 
FROM LIABILITY REFORMS 
Sec. 501. Exclusion of pharmaceuticals and devices. 
TITLE I—HEALTH CARE MAL-
PRACTICE 
LIABILITY 
RE-
FORM 
SEC. 101. CAP ON NON-ECONOMIC DAMAGES. 
(a) IN GENERAL.—When an individual is injured or 
dies as the result of health care malpractice, a person enti-
tled to recover non-economic damages from a health care 
provider responsible for that malpractice may not recover
such damages, in the aggregate from all such providers, 
in an amount more than $250,000, adjusted for inflation 
from 1975 as provided in subsection (b). This limitation 
applies separately to each person entitled to recover such 
damages. 
(b) ADJUSTMENT FOR INFLATION FROM 1975.— 
(1) PUBLICATION BY SECRETARY OF LABOR.— 
On or about December 1 of each year, the Secretary 
of Labor shall publish in the Federal Register a dol-
lar amount determined by adjusting the dollar 
amount specified in subsection (a) according to the 
adjustments in the Consumer Price Index of the Bu-
reau of Labor Statistics of the Department of Labor 
for the period beginning on or about October 1, 
1975, and ending on or about October 1 of that 
year. 
(2) APPLICABILITY.—For purposes of sub-
section (a), the dollar amount that applies to a cal-
endar year is the dollar amount published on or 
about December 1 of the preceding year. 
(3) ESTIMATION.—Congress estimates that the 
dollar amount that would apply to calendar year 
2005 would be approximately $878,000, though the 
dollar amount published under paragraph (1), rather
than the estimation in this paragraph, is to be ap-
plied. 
(c) APPLICABILITY.— 
(1) IN GENERAL.—Subject to paragraph (2), 
this section applies whenever the amount of a recov-
ery is made final in a calendar year after the date 
of the enactment of this Act. In applying the dollar 
amount to a recovery, all recoveries made final 
(whether before or after the date of the enactment 
of this Act) are included in the aggregate. 
(2) NOT APPLICABLE WHEN STATE BOARD NOT 
IN COMPLIANCE.—During a period in which a State 
medical board is not in compliance with the vol-
untary performance standards developed under sec-
tion 103 or is failing to submit the information de-
scribed in paragraphs (2) and (3)(A) of section 
104(b) (as determined by the Secretary under sec-
tion 103 or 104, respectively), the limitation in sub-
section (a) does not apply to liability arising under 
the law of that State. 
(d) RELATIONSHIP TO STATE LAW.—This section op-
erates on a case-by-case basis to provide a maximum re-
covery and to prevent State law from providing a recovery 
above that maximum. It does not prevent State law from 
providing a recovery below that maximum.
SEC. 102. SANCTIONS FOR MERITLESS ACTIONS AND 
PLEADINGS. 
(a) SIGNATURE REQUIRED.—Every pleading, written 
motion, and other paper in any medical malpractice action 
shall be signed by at least 1 attorney of record in the at-
torney’s individual name, or, if the party is not rep-
resented by an attorney, shall be signed by the party. Each 
paper shall state the signer’s address and telephone num-
ber, if any. An unsigned paper shall be stricken unless 
omission of the signature is corrected promptly after being 
called to the attention of the attorney or party. 
(b) CERTIFICATE OF MERIT.— 
(1) IN GENERAL.—A medical malpractice action 
shall be dismissed unless the attorney or unrepre-
sented party presenting the complaint certifies that, 
to the best of the person’s knowledge, information, 
and belief, formed after an inquiry reasonable under 
the circumstances— 
(A) it is not being presented for any im-
proper purpose, such as to harass or to cause 
unnecessary delay or needless increase in the 
cost of litigation; 
(B) the claims and other legal contentions 
therein are warranted by existing law or by a 
nonfrivolous argument for the extension, modi-
fication, or reversal of existing law or the estab-
lishment of new law; and 
(C) the allegations and other factual con-
tentions have evidentiary support or, if specifi-
cally so identified, are likely to have evidentiary 
support after a reasonable opportunity for fur-
ther investigation and discovery. 
(2) PAPER
CONSIDERED
TO
BE
A
CERTIFI-
CATION.—By presenting to the court (whether by 
signing, filing, submitting, or later advocating) a 
pleading, written motion, or other paper, an attorney 
or unrepresented party is certifying that to the best 
of the person’s knowledge, information and belief, 
formed after an inquiry reasonable under the cir-
cumstances— 
(A) it is not being presented for any im-
proper purpose, such as to harass or to cause 
unnecessary delay or needless increase in the 
cost of litigation; 
(B) the claims, defenses, and other legal 
contentions therein are warranted by existing 
law or by a nonfrivolous argument for the ex-
tension, modification, or reversal of existing law 
or the establishment of new law; and
(C) the allegations and other factual con-
tentions have evidentiary support or, if specifi-
cally so identified, are reasonable based on a 
lack of information or belief. 
(c) MANDATORY SANCTIONS.— 
(1) FIRST VIOLATION.—If, after notice and a 
reasonable opportunity to respond, a court, upon 
motion or upon its own initiative, determines that 
subsection (b) has been violated, the court shall find 
each attorney or party in violation in contempt of 
court and shall require the payment of costs and at-
torneys fees. The court may also impose additional 
appropriate sanctions, such as striking the plead-
ings, dismissing the suit, and sanctions plus interest, 
upon the person in violation, or upon both such per-
son and such person’s attorney or client (as the case 
may be). 
(2) SECOND VIOLATION.—If, after notice and a 
reasonable opportunity to respond, a court, upon 
motion or upon its own initiative, determines that 
subsection (b) has been violated and that the attor-
ney or party with respect to which the determination 
was made has committed one previous violation of 
subsection (b) before this or any other court, the 
court shall find each such attorney or party in con-
tempt of court and shall require the payment of 
costs and attorneys fees, and require such person in 
violation (or both such person and such person’s at-
torney or client (as the case may be)) to pay a mon-
etary fine. The court may also impose additional ap-
propriate sanctions, such as striking the pleadings, 
dismissing the suit and sanctions plus interest, upon 
such person in violation, or upon both such person 
and such person’s attorney or client (as the case 
may be). 
(3) THIRD AND SUBSEQUENT VIOLATIONS.—If, 
after notice and a reasonable opportunity to re-
spond, a court, upon motion or upon its own initia-
tive, determines that subsection (b) has been vio-
lated and that the attorney or party with respect to 
which the determination was made has committed 
more than one previous violation of subsection (b) 
before this or any other court, the court shall find 
each such attorney or party in contempt of court, 
refer each such attorney to one or more appropriate 
State bar associations for disciplinary proceedings, 
require the payment of costs and attorneys fees, and 
require such person in violation (or both such person 
and such person’s attorney or client (as the case 
may be)) to pay a monetary fine. The court may
also impose additional appropriate sanctions, such as 
striking the pleadings, dismissing the suit, and sanc-
tions plus interest, upon such person in violation, or 
upon both such person and such person’s attorney or 
client (as the case may be). 
(d) CENTRAL TRACKING DATABASE.—The Attorney 
General shall establish and maintain a central tracking 
database reporting system to which courts are to report 
violations of subsection (b). The database shall include all 
identifying information with respect to the attorney or the 
party (if not represented by an attorney). The Attorney 
General shall permit courts to consult the database to de-
termine the extent to which an attorney or party has vio-
lated subsection (b) previously. 
SEC. 103. PERFORMANCE STANDARDS APPLICABLE TO 
STATE MEDICAL BOARDS. 
(a) DEVELOPMENT.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, in consultation with the Federation 
of State Medical Boards, shall develop and make publicly 
available voluntary performance standards applicable to 
State medical boards. 
(b) CONTENTS.—In developing performance stand-
ards under this section, the Secretary shall include stand-
ards to require the following:
(1) Processing patient complaints within a spec-
ified limited period of time. 
(2) Maintaining a website or toll-free telephone 
number to enable a patient submitting a complaint 
to track the status of the complaint. 
(3) Maintaining an adequate level of staff for 
the activities of the State medical board. 
(4) Ensuring that staff are qualified. 
(5) Making the following information available 
to the public for physicians: 
(A) Each physician’s education and train-
ing. 
(B) Each physician’s medical specialties. 
(C) For each physician a description of 
medical malpractice claims paid, hospital dis-
ciplinary actions taken, criminal convictions oc-
curring, and disciplinary actions taken by the 
State medical board, within the previous 10 
years. 
(D) At the option of a State medical 
board, each physician’s professional demo-
graphics (such as business address, insurance 
plan and hospital affiliations, and available 
translation services), professional or community
awards received, and research or other profes-
sional publications. 
(6) Issuing an annual report that includes ag-
gregate disciplinary statistics, including— 
(A) statistics on the number and type of 
complaints received; and 
(B) with respect to physicians, statistics on 
the number and type of complaints received, 
disaggregated by the medical school and grad-
uate medical education program completed by 
the physicians involved. 
(7) Such other issues as the Secretary deter-
mines appropriate. 
(c) DETERMINATION REQUIRED.—For the period be-
ginning 3 years after the date of the enactment of this 
Act, the Secretary shall determine whether the State med-
ical board of each State is in compliance with the vol-
untary performance standards developed under subsection 
(a). 
(d) DETERMINATION OF NONCOMPLIANCE.—Before 
making a determination under subsection (c) that a State 
medical board is not in compliance with the voluntary per-
formance standards developed under subsection (a), the 
Secretary shall— 
(1) propose a determination of noncompliance;
(2) identify the reasons for such noncompliance; 
and 
(3) give the State medical board an opportunity 
to correct such noncompliance. 
(e) REVISION OF DETERMINATIONS.—The Secretary 
shall periodically review and, as necessary, revise deter-
minations of compliance and noncompliance under sub-
section (c). 
(f) REPORT BY SECRETARY.—Not later than 5 years 
after the date of the enactment of this Act, and annually 
thereafter, the Secretary shall submit a report to the Con-
gress on the activities of the Secretary under this section, 
including a listing of the State medical boards determined 
by the Secretary to be in compliance or not in compliance 
with the voluntary standards developed under subsection 
(a). 
SEC. 104. INTERSTATE PATIENT REPORTING AND PHYSI-
CIAN TRACKING DATABASE. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services shall establish and maintain an interstate 
patient reporting and physician tracking database (in this 
section referred to as the ‘‘database’’). 
(b) DATABASE CONTENTS.—