203 
allowable for a cause of action exemption from 
preemption under paragraph (1) shall not ex-
ceed 1⁄3 of the total amount of the plaintiff’s re-
covery (not including the reimbursement of ac-
tual out-of-pocket expenses of the attorney). 
‘‘(B) DETERMINATION
BY
COURT.—The 
last court in which the action was pending upon 
the final disposition, including all appeals, of 
the action may review the attorney’s fee to en-
sure that the fee is a reasonable one. 
‘‘(C) NO PREEMPTION OF STATE LAW.— 
Subparagraph (A) shall not apply with respect 
to a cause of action that is brought in a State 
that has a law or framework of laws with re-
spect to the amount of an attorney’s contin-
gency fee that may be incurred for the rep-
resentation of a participant or beneficiary (or 
the estate of such participant or beneficiary) 
who brings such a cause of action. 
‘‘(e) RULES
OF
CONSTRUCTION
RELATING
TO 
HEALTH CARE.—Nothing in this title shall be construed 
as— 
‘‘(1) affecting any State law relating to the 
practice of medicine or the provision of, or the fail-
ure to provide, medical care, or affecting any action
204 
(whether the liability is direct or vicarious) based 
upon such a State law, 
‘‘(2) superseding any State law permitted under 
section 152(b)(1)(A) of the Patients’ Bill of Rights 
Act of 2005, or 
‘‘(3) affecting any applicable State law with re-
spect to limitations on monetary damages. 
‘‘(f) NO RIGHT OF ACTION FOR RECOVERY, INDEM-
NITY, OR CONTRIBUTION BY ISSUERS AGAINST TREATING 
HEALTH CARE PROFESSIONALS
AND TREATING HOS-
PITALS.—In the case of any care provided, or any treat-
ment decision made, by the treating health care profes-
sional or the treating hospital of a participant or bene-
ficiary under a group health plan which consists of medical 
care provided under such plan, any cause of action under 
State law against the treating health care professional or 
the treating hospital by the plan or a health insurance 
issuer providing health insurance coverage in connection 
with the plan for recovery, indemnity, or contribution in 
connection with such care (or any medically reviewable de-
cision made in connection with such care) or such treat-
ment decision is superseded.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to acts and omissions (from which
205 
a cause of action arises) occurring on or after the applica-
ble effective date under section 601. 
SEC. 403. COOPERATION BETWEEN FEDERAL AND STATE 
AUTHORITIES. 
(a) IN GENERAL.—Subpart C of part 7 of subtitle 
B of title I of the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1191 et seq.) is amended by add-
ing at the end the following new section: 
‘‘SEC. 735. COOPERATION BETWEEN FEDERAL AND STATE 
AUTHORITIES. 
‘‘(a) AGREEMENT WITH STATES.—A State may 
enter into an agreement with the Secretary for the delega-
tion to the State of some or all of the Secretary’s authority 
under this title to enforce the requirements applicable 
under title I of the Patients’ Bill of Rights Act of 2005 
with respect to health insurance coverage offered by a 
health insurance issuer and with respect to a group health 
plan that is a non-Federal governmental plan. 
‘‘(b) DELEGATIONS.—Any department, agency, or in-
strumentality of a State to which authority is delegated 
pursuant to an agreement entered into under this section 
may, if authorized under State law and to the extent con-
sistent with such agreement, exercise the powers of the 
Secretary under this title which relate to such authority.’’.
206 
(b) CLERICAL AMENDMENT.—The table of contents 
of such Act is amended by inserting after the item relating 
to section 734 the following new item: 
‘‘Sec. 735. Cooperation between Federal and State authorities.’’. 
TITLE V—AMENDMENTS TO THE 
INTERNAL 
REVENUE 
CODE 
OF 1986 
Subtitle A—Application of Patient 
Protection Provisions 
SEC. 501. APPLICATION TO GROUP HEALTH PLANS UNDER 
THE INTERNAL REVENUE CODE OF 1986. 
Subchapter B of chapter 100 of the Internal Revenue 
Code of 1986 is amended— 
(1) in the table of sections, by inserting after 
the item relating to section 9812 the following new 
item: 
‘‘Sec. 9813. Standard relating to patients’ bill of rights.’’ 
; and 
(2) by inserting after section 9812 the fol-
lowing: 
‘‘SEC. 9813. STANDARD RELATING TO PATIENTS’ BILL OF 
RIGHTS. 
‘‘A group health plan shall comply with the require-
ments of title I of the Patients’ Bill of Rights Act of 2005 
(as in effect as of the date of the enactment of such Act),