or causes of action, in which the claimant alleges a 
health care liability claim. Such term does not in-
clude a claim or action which is based on criminal 
liability; which seeks civil fines or penalties paid to 
Federal, State, or local government; or which is 
grounded in antitrust. 
(8) HEALTH
CARE
LIABILITY
ACTION.—The 
term ‘‘health care liability action’’ means a civil ac-
tion brought in a State or Federal court or pursuant 
to an alternative dispute resolution system, against 
a health care provider regardless of the theory of li-
ability on which the claim is based, or the number 
of plaintiffs, defendants, or other parties, or the 
number of causes of action, in which the claimant al-
leges a health care liability claim. 
(9) HEALTH
CARE
LIABILITY
CLAIM.—The 
term ‘‘health care liability claim’’ means a demand 
by any person, whether or not pursuant to ADR, 
against a health care provider, including, but not 
limited to, third-party claims, cross-claims, counter- 
claims, or contribution claims, which are based upon 
the provision or use of (or the failure to provide or 
use) health care services or medical products, re-
gardless of the theory of liability on which the claim 
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is based, or the number of plaintiffs, defendants, or 
other parties, or the number of causes of action. 
(10) 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, as well as any 
other individual or entity defined as a health care 
provider, health care professional, or health care in-
stitution under State law. 
(11) HEALTH
CARE
SERVICES.—The term 
‘‘health care services’’ means the provision of any 
goods or services by a health care 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. 
(12) 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) 
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of the Federal Food, Drug, and Cosmetic Act (21 
U.S.C. 321(g)(1) and (h)) and section 351(a) of the 
Public Health Service Act (42 U.S.C. 262(a)), re-
spectively, including any component or raw material 
used therein, but excluding health care services. 
(13) 
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 incurred as a result of the provision or use 
of (or failure to provide or use) health care services 
or medical products, unless otherwise defined under 
applicable State law. 
(14) 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. 
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(15) RELATIVE.—The term ‘‘relative’’ means a 
victim’s spouse, parent, grandparent, stepfather, 
stepmother, child, grandchild, brother, sister, half 
brother, half sister, or spouse’s parents. The term 
includes said relationships that are created as a re-
sult of adoption. 
(16) REPRESENTATIVE.—The term ‘‘represent-
ative’’ means a legal guardian, attorney, person des-
ignated to make decisions on behalf of a patient 
under a medical power of attorney, or any person 
recognized in law or custom as a patient’s agent. 
(17) 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. 
(18) UNANTICIPATED
OUTCOME.—The term 
‘‘unanticipated outcome’’ means the outcome of a 
medical treatment or procedure that differs from an 
expected result. 
SEC. 14. EFFECT ON OTHER LAWS. 
(a) VACCINE INJURY.— 
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(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. 15. RULES OF CONSTRUCTION. 
(a) HEALTH CARE LAWSUITS.—Unless otherwise 
specified in this Act, the provisions governing health care 
lawsuits set forth in this Act preempt, subject to sub-
sections (b) and (c), State law to the extent that State 
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law prevents the application of any provisions of law estab-
lished by or under this Act. The provisions governing 
health care lawsuits set forth in this Act supersede 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.—Any issue that is not governed by any provision 
of law established by or under this Act (including State 
standards of negligence) shall be governed by otherwise 
applicable State or Federal law. 
(c) STATE FLEXIBILITY.—No provision of this Act 
shall be construed to preempt any defense available to a 
party in a health care lawsuit under any other provision 
of State or Federal law. 
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SEC. 16. 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 cause of action accrued. 
Æ 
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