SEC. 9. DEFINITIONS. 
In this Act:
(1) ALTERNATIVE
DISPUTE
RESOLUTION 
SYSTEM; ADR.—The term ‘‘alternative dis-
pute resolution system’’ or ‘‘ADR’’ means 
a system that provides for the resolution 
of health care lawsuits in a manner other 
than through a civil action brought in a 
State or Federal court. 
(2) CLAIMANT.—The term ‘‘claimant’’ 
means any person who brings a health 
care lawsuit, including a person who as-
serts or claims a right to legal or equi-
table contribution, indemnity or subroga-
tion, arising out of a health care liability 
claim or action, and any person on whose 
behalf such a claim is asserted or such an 
action is brought, whether deceased, in-
competent, or a minor. 
(3) COLLATERAL
SOURCE
BENEFITS.—
The term ‘‘collateral source benefits’’ 
means any amount paid or reasonably 
likely to be paid in the future to or on be-
half of the claimant, or any service, prod-
uct or other benefit provided or reason-
ably likely to be provided in the future to
or on behalf of the claimant, as a result of 
the injury or wrongful death, pursuant 
to—
(A) any State or Federal health, 
sickness, income-disability, accident, 
or workers’ compensation law; 
(B) any health, sickness, income-
disability, or accident insurance that 
provides health benefits or income-
disability coverage; 
(C) any contract or agreement of 
any group, organization, partnership, 
or corporation to provide, pay for, or 
reimburse the cost of medical, hos-
pital, dental, or income disability ben-
efits; and 
(D) any other publicly or pri-
vately funded program. 
(4) 
COMPENSATORY
DAMAGES.—The 
term ‘‘compensatory damages’’ means ob-
jectively verifiable monetary losses in-
curred as a result of the provision of, use 
of, or payment for (or failure to provide, 
use, or pay for) health care services or 
medical products, such as past and future
medical expenses, loss of past and future 
earnings, cost of obtaining domestic serv-
ices, loss of employment, and loss of busi-
ness or employment opportunities, dam-
ages for physical and emotional pain, suf-
fering, inconvenience, physical impair-
ment, mental anguish, disfigurement, loss 
of enjoyment of life, loss of society and 
companionship, loss of consortium (other 
than loss of domestic service), hedonic 
damages, injury to reputation, and all 
other nonpecuniary losses of any kind or 
nature. The term ‘‘compensatory dam-
ages’’ includes economic damages and 
noneconomic damages, as such terms are 
defined in this section. 
(5) CONTINGENT FEE.—The term ‘‘con-
tingent fee’’ includes all compensation to 
any person or persons which is payable 
only if a recovery is effected on behalf of 
one or more claimants. 
(6) 
ECONOMIC
DAMAGES.—The 
term 
‘‘economic damages’’ means objectively 
verifiable monetary losses incurred as a 
result of the provision of, use of, or pay-
ment for (or failure to provide, use, or 
pay for) health care services or medical 
products, such as past and future medical 
expenses, loss of past and future earn-
ings, cost of obtaining domestic services, 
loss of employment, and loss of business 
or employment opportunities. 
(7) HEALTH CARE LAWSUIT.—The term 
‘‘health care lawsuit’’ means any health 
care liability claim concerning the provi-
sion of health care goods or services af-
fecting 
interstate 
commerce, 
or 
any 
health care liability action concerning 
the provision of health care goods or 
services affecting interstate commerce, 
brought in a State or Federal court or 
pursuant to an alternative dispute resolu-
tion system, against a health care pro-
vider, a health care organization, or the 
manufacturer, distributor, supplier, mar-
keter, promoter, or seller of a medical 
product, regardless of the theory of liabil-
ity on which the claim is based, or the 
number of claimants, plaintiffs, defend-
ants, or other parties, or the number of
claims or causes of action, in which the 
claimant alleges a health care liability 
claim. 
(8) HEALTH
CARE
LIABILITY
ACTION.—
The term ‘‘health care liability action’’ 
means a civil action brought in a State or 
Federal Court or pursuant to an alter-
native dispute resolution system, against 
a health care provider, a health care or-
ganization, or the manufacturer, dis-
tributor, supplier, marketer, promoter, or 
seller of a medical product, regardless of 
the theory of liability on which the claim 
is based, or the number of plaintiffs, de-
fendants, or other parties, or the number 
of causes of action, in which the claimant 
alleges 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, health care organization, or the 
manufacturer, distributor, supplier, mar-
keter, promoter, or seller of a medical 
product, including, 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 the-
ory of liability on which the claim is 
based, or the number of plaintiffs, de-
fendants, or other parties, or the number 
of causes of action. 
(10) HEALTH CARE ORGANIZATION.—The 
term ‘‘health care organization’’ means 
any person or entity which is obligated to 
provide or pay for health benefits under 
any health plan, including any person or 
entity acting under a contract or ar-
rangement with a health care organiza-
tion to provide or administer 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 li-
censed, registered, or certified to provide 
health care services, and being either so
licensed, registered, or certified, or ex-
empted from such requirement by other 
statute or regulation. 
(12) HEALTH
CARE
GOODS
OR
SERV-
ICES.—The term ‘‘health care goods or 
services’’ means any goods or services 
provided by a health care organization, 
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 
of the health of human beings. 
(13) MALICIOUS
INTENT
TO
INJURE.—
The term ‘‘malicious intent to injure’’ 
means intentionally causing or attempt-
ing to cause physical injury other than 
providing health care goods or services. 
(14) 
MEDICAL
PRODUCT.—The 
term 
‘‘medical product’’ means a drug or de-
vice intended for humans, and the terms 
‘‘drug’’ and ‘‘device’’ have the meanings 
given such terms in sections 201(g)(1) and 
201(h) of the Federal Food, Drug and Cos-
metic Act (21 U.S.C. 321), respectively, in-
cluding any component or raw material 
used therein, but excluding health care 
services. 
(15) 
NONECONOMIC
DAMAGES.—The 
term 
‘‘noneconomic 
damages’’ 
means 
damages for physical and emotional pain, 
suffering, inconvenience, physical impair-
ment, mental anguish, disfigurement, loss 
of enjoyment of life, loss of society and 
companionship, loss of consortium (other 
than loss of domestic service), hedonic 
damages, injury to reputation, 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 compen-
satory purposes, against a health care 
provider, health care organization, or a 
manufacturer, distributor, or supplier of 
a medical product. Punitive damages are 
neither economic nor noneconomic dam-
ages.
(17) RECOVERY.—The term ‘‘recovery’’ 
means the net sum recovered after de-
ducting any disbursements or costs in-
curred in connection with prosecution 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 over-
head 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 Islands, 
the Trust Territory of the Pacific Islands, 
and any other territory or possession of 
the United States, or any political sub-
division 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-related in-
jury or death—
(A) this Act does not affect the ap-
plication 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 ac-
tion brought for a vaccine-related injury 
or death to which a Federal rule of law 
under title XXI of the Public Health Serv-
ice Act does not apply, then this Act or 
otherwise applicable law (as determined 
under this Act) will apply to such aspect 
of such action. 
(b) OTHER FEDERAL LAW.—Except as pro-
vided in this section, nothing in this Act shall 
be deemed to affect any defense available to 
a defendant in a health care lawsuit or action 
under any other provision of Federal law.
SEC. 11. STATE FLEXIBILITY AND PROTECTION OF STATES’ 
RIGHTS. 
(a) HEALTH CARE LAWSUITS.—The provi-
sions governing 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 pro-
visions 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 pe-
riod in which a health care lawsuit may 
be commenced, or a reduced applicability 
or scope of periodic payment of future 
damages, than provided in this Act; or 
(2) prohibits the introduction of evi-
dence regarding collateral source bene-
fits, or mandates or permits subrogation 
or a lien on collateral source benefits. 
(b) PROTECTION OF STATES’ RIGHTS.—Any 
issue that is not governed by any provision of 
law established by or under this Act (includ-
ing State standards of negligence) shall be
governed by otherwise applicable State or 
Federal law. This Act does not preempt or su-
persede any law that imposes greater protec-
tions (such as a shorter statute of limitations) 
for health care providers and health care or-
ganizations from liability, loss, or damages 
than those provided by this Act. 
(c) STATE FLEXIBILITY.—No provision of 
this Act shall be construed to preempt—
(1) any State statutory limit (whether 
enacted before, on, or after the date of 
the enactment of this Act) on the amount 
of compensatory or punitive damages (or 
the total amount of damages) that may be 
awarded in a health care lawsuit, wheth-
er or not such State limit permits the re-
covery of a specific dollar amount of 
damages that is greater or lesser than is 
provided for under this Act, notwith-
standing 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.