cluding, but not limited to, third-party claims, cross-
claims, counter-claims, or contribution claims, which
are based upon the provision of, use of, or payment
for (or the failure to provide, use, or pay for) health
care services or medical products, regardless of the
theory of liability on which the claim is based, or the
number of plaintiffs, defendants, or other parties, or
the number of causes of action.
(10) HEALTH CARE ORGANIZATION.—The term
‘‘health care organization’’ means any person or en-
tity which is obligated to provide or pay for health
benefits under any health plan, including any person
or entity acting under a contract or arrangement
with a health care organization to provide or admin-
ister any health benefit.
(11) HEALTH
CARE
PROVIDER.—The term
‘‘health care provider’’ means any person or entity
required by State or Federal laws or regulations to
be licensed, registered, or certified to provide health
care services, and being either so licensed, reg-
istered, or certified, or exempted from such require-
ment by other statute or regulation.
(12) 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.
(13) MALICIOUS
INTENT
TO
INJURE.—The
term ‘‘malicious intent to injure’’ means inten-
tionally causing or attempting to cause physical in-
jury other than providing health care goods or serv-
ices.
(14) MEDICAL PRODUCT.—The term ‘‘medical
product’’ means a drug, device, or biological product
intended for humans, and the terms ‘‘drug’’, ‘‘de-
vice’’, and ‘‘biological product’’ have the meanings
given such terms in sections 201(g)(1) and 201(h)
of the Federal Food, Drug and Cosmetic Act (21
U.S.C. 321) and section 351(a) of the Public Health
Service Act (42 U.S.C. 262(a)), respectively, includ-
ing any component or raw material used therein, but
excluding health care services.
(15) 
NONECONOMIC
DAMAGES.—The 
term
‘‘noneconomic damages’’ means damages for phys-
ical and emotional pain, suffering, inconvenience,
physical impairment, mental anguish, disfigurement,
loss of enjoyment of life, loss of society and compan-
ionship, loss of consortium (other than loss of do-
mestic service), hedonic damages, injury to reputa-
tion, and all other nonpecuniary losses of any kind
or nature.
(16) PUNITIVE DAMAGES.—The term ‘‘punitive
damages’’ means damages awarded, for the purpose
of punishment or deterrence, and not solely for com-
pensatory purposes, against a health care provider,
health care organization, or a manufacturer, dis-
tributor, or supplier of a medical product. Punitive
damages are neither economic nor noneconomic
damages.
(17) RECOVERY.—The term ‘‘recovery’’ means
the net sum recovered after deducting any disburse-
ments or costs incurred in connection with prosecu-
tion or settlement of the claim, including all costs
paid or advanced by any person. Costs of health care
incurred by the plaintiff and the attorneys’ office
overhead costs or charges for legal services are not
deductible disbursements or costs for such purpose.
(18) STATE.—The term ‘‘State’’ means each of
the several States, the District of Columbia, the
Commonwealth of Puerto Rico, the Virgin Islands,
Guam, American Samoa, the Northern Mariana Is-
lands, the Trust Territory of the Pacific Islands, and
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.
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-
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.