HR 5 RDS
judgment, and such reduction shall be made before ac-
counting for any other reduction in damages required by 
law. If separate awards are rendered for past and future 
noneconomic damages and the combined awards exceed 
$250,000, the future noneconomic damages shall be re-
duced first. 
(d) FAIR SHARE RULE.—In any health care lawsuit, 
each party shall be liable for that party’s several share 
of any damages only and not for the share of any other 
person. Each party shall be liable only for the amount of 
damages allocated to such party in direct proportion to 
such party’s percentage of responsibility. Whenever a 
judgment of liability is rendered as to any party, a sepa-
rate judgment shall be rendered against each such party 
for the amount allocated to such party. For purposes of 
this section, the trier of fact shall determine the propor-
tion of responsibility of each party for the claimant’s 
harm. 
SEC. 105. MAXIMIZING PATIENT RECOVERY. 
(a) COURT SUPERVISION OF SHARE OF DAMAGES 
ACTUALLY PAID TO CLAIMANTS.—In any health care law-
suit, the court shall supervise the arrangements for pay-
ment of damages to protect against conflicts of interest 
that may have the effect of reducing the amount of dam-
ages awarded that are actually paid to claimants. In par-
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
ticular, in any health care lawsuit in which the attorney 
for a party claims a financial stake in the outcome by vir-
tue of a contingent fee, the court shall have the power 
to restrict the payment of a claimant’s damage recovery 
to such attorney, and to redirect such damages to the 
claimant based upon the interests of justice and principles 
of equity. In no event shall the total of all contingent fees 
for representing all claimants in a health care lawsuit ex-
ceed the following limits: 
(1) Forty percent of the first $50,000 recovered 
by the claimant(s). 
(2) Thirty-three and one-third percent of the 
next $50,000 recovered by the claimant(s). 
(3) Twenty-five percent of the next $500,000 
recovered by the claimant(s). 
(4) Fifteen percent of any amount by which the 
recovery by the claimant(s) is in excess of $600,000. 
(b) APPLICABILITY.—The limitations in this section 
shall apply whether the recovery is by judgment, settle-
ment, mediation, arbitration, or any other form of alter-
native dispute resolution. In a health care lawsuit involv-
ing a minor or incompetent person, a court retains the 
authority to authorize or approve a fee that is less than 
the maximum permitted under this section. The require-
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
ment for court supervision in the first two sentences of 
subsection (a) applies only in civil actions. 
SEC. 106. PUNITIVE DAMAGES. 
(a) IN GENERAL.—Punitive damages may, if other-
wise permitted by applicable State or Federal law, be 
awarded against any person in a health care lawsuit only 
if it is proven by clear and convincing evidence that such 
person acted with malicious intent to injure the claimant, 
or that such person deliberately failed to avoid unneces-
sary injury that such person knew the claimant was sub-
stantially certain to suffer. In any health care lawsuit 
where no judgment for compensatory damages is rendered 
against such person, no punitive damages may be awarded 
with respect to the claim in such lawsuit. No demand for 
punitive damages shall be included in a health care lawsuit 
as initially filed. A court may allow a claimant to file an 
amended pleading for punitive damages only upon a mo-
tion by the claimant and after a finding by the court, upon 
review of supporting and opposing affidavits or after a 
hearing, after weighing the evidence, that the claimant has 
established by a substantial probability that the claimant 
will prevail on the claim for punitive damages. At the re-
quest of any party in a health care lawsuit, the trier of 
fact shall consider in a separate proceeding— 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
(1) whether punitive damages are to be award-
ed and the amount of such award; and 
(2) the amount of punitive damages following a 
determination of punitive liability. 
If a separate proceeding is requested, evidence relevant 
only to the claim for punitive damages, as determined by 
applicable State law, shall be inadmissible in any pro-
ceeding to determine whether compensatory damages are 
to be awarded. 
(b) DETERMINING AMOUNT
OF PUNITIVE DAM-
AGES.— 
(1) FACTORS
CONSIDERED.—In determining 
the amount of punitive damages, if awarded, in a 
health care lawsuit, the trier of fact shall consider 
only the following— 
(A) the severity of the harm caused by the 
conduct of such party; 
(B) the duration of the conduct or any 
concealment of it by such party; 
(C) the profitability of the conduct to such 
party; 
(D) the number of products sold or med-
ical procedures rendered for compensation, as 
the case may be, by such party, of the kind 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
causing the harm complained of by the claim-
ant; 
(E) any criminal penalties imposed on such 
party, as a result of the conduct complained of 
by the claimant; and 
(F) the amount of any civil fines assessed 
against such party as a result of the conduct 
complained of by the claimant. 
(2) MAXIMUM AWARD.—The amount of punitive 
damages, if awarded, in a health care lawsuit may 
be as much as $250,000 or as much as two times 
the amount of economic damages awarded, which-
ever is greater. The jury shall not be informed of 
this limitation. 
(c) NO PUNITIVE DAMAGES FOR PRODUCTS THAT 
COMPLY WITH FDA STANDARDS.— 
(1) IN GENERAL.— 
(A) No punitive damages may be awarded 
against the manufacturer or distributor of a 
medical product, or a supplier of any compo-
nent or raw material of such medical product, 
based on a claim that such product caused the 
claimant’s harm where— 
(i)(I) such medical product was sub-
ject to premarket approval, clearance, or li-
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
censure by the Food and Drug Administra-
tion with respect to the safety of the for-
mulation or performance of the aspect of 
such medical product which caused the 
claimant’s harm or the adequacy of the 
packaging or labeling of such medical 
product; and 
(II) such medical product was so ap-
proved, cleared, or licensed; or 
(ii) such medical product is generally 
recognized among qualified experts as safe 
and effective pursuant to conditions estab-
lished by the Food and Drug Administra-
tion and applicable Food and Drug Admin-
istration regulations, including without 
limitation those related to packaging and 
labeling, unless the Food and Drug Admin-
istration has determined that such medical 
product was not manufactured or distrib-
uted in substantial compliance with appli-
cable Food and Drug Administration stat-
utes and regulations. 
(B) RULE OF CONSTRUCTION.—Subpara-
graph (A) may not be construed as establishing 
the obligation of the Food and Drug Adminis-
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
ages unless such packaging or labeling is found by 
the trier of fact by clear and convincing evidence to 
be substantially out of compliance with such regula-
tions. 
(4) EXCEPTION.—Paragraph (1) shall not 
apply in any health care lawsuit in which— 
(A) a person, before or after premarket ap-
proval, clearance, or licensure of such medical 
product, knowingly misrepresented to or with-
held from the Food and Drug Administration 
information that is required to be submitted 
under the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 301 et seq.) or section 351 of 
the Public Health Service Act (42 U.S.C. 262) 
that is material and is causally related to the 
harm which the claimant allegedly suffered; 
(B) a person made an illegal payment to 
an official of the Food and Drug Administra-
tion for the purpose of either securing or main-
taining approval, clearance, or licensure of such 
medical product; or 
(C) the defendant caused the medical prod-
uct which caused the claimant’s harm to be 
misbranded or adulterated (as such terms are 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
used in chapter V of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 351 et seq.)). 
SEC. 107. AUTHORIZATION OF PAYMENT OF FUTURE DAM-
AGES TO CLAIMANTS IN HEALTH CARE LAW-
SUITS. 
(a) IN GENERAL.—In any health care lawsuit, if an 
award of future damages, without reduction to present 
value, equaling or exceeding $50,000 is made against a 
party with sufficient insurance or other assets to fund a 
periodic payment of such a judgment, the court shall, at 
the request of any party, enter a judgment ordering that 
the future damages be paid by periodic payments, in ac-
cordance with the Uniform Periodic Payment of Judg-
ments Act promulgated by the National Conference of 
Commissioners on Uniform State Laws. 
(b) APPLICABILITY.—This section applies to all ac-
tions which have not been first set for trial or retrial be-
fore the effective date of this title. 
SEC. 108. DEFINITIONS. 
In this title: 
(1) ALTERNATIVE DISPUTE RESOLUTION SYS-
TEM; ADR.—The term ‘‘alternative dispute resolution 
system’’ or ‘‘ADR’’ means a system that provides 
for the resolution of health care lawsuits in a man-
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
ner 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, includ-
ing a person who asserts or claims a right to legal 
or equitable contribution, indemnity, or subrogation, 
arising out of a health care liability claim or action, 
and any person on whose behalf such a claim is as-
serted or such an action is brought, whether de-
ceased, incompetent, or a minor. 
(3) 
COMPENSATORY
DAMAGES.—The 
term 
‘‘compensatory 
damages’’ 
means 
objectively 
verifiable monetary losses incurred as a result of the 
provision of, use of, or payment for (or failure to 
provide, use, or pay for) health care services or med-
ical products, such as past and future medical ex-
penses, loss of past and future earnings, cost of ob-
taining domestic services, loss of employment, and 
loss of business or employment opportunities, dam-
ages for physical and emotional pain, suffering, in-
convenience, physical impairment, mental anguish, 
disfigurement, loss of enjoyment of life, loss of soci-
ety and companionship, loss of consortium (other 
than loss of domestic service), hedonic damages, in-
jury to reputation, and all other nonpecuniary losses 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
of any kind or nature. The term ‘‘compensatory 
damages’’ includes economic damages and non-
economic damages, as such terms are defined in this 
section. 
(4) CONTINGENT FEE.—The term ‘‘contingent 
fee’’ includes all compensation to any person or per-
sons which is payable only if a recovery is effected 
on behalf of one or more claimants. 
(5) ECONOMIC DAMAGES.—The term ‘‘economic 
damages’’ means objectively verifiable monetary 
losses incurred 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 services, 
loss of employment, and loss of business or employ-
ment opportunities. 
(6) 
HEALTH
CARE
LAWSUIT.—The 
term 
‘‘health care lawsuit’’ means any health care liability 
claim concerning the provision of health care goods 
or services or any medical product affecting inter-
state commerce, or any health care liability action 
concerning the provision of health care goods or 
services or any medical product affecting interstate 
commerce, brought in a State or Federal court or 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
pursuant to an alternative dispute resolution system, 
against a health care provider, a health care organi-
zation, or the manufacturer, distributor, 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 claimants, plain-
tiffs, defendants, or other parties, or the number of 
claims or causes of action, in which the claimant al-
leges a health care liability claim. Such term does 
not include 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. 
(7) 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, a health care organization, or 
the manufacturer, distributor, 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, defendants, or other par-
ties, or the number of causes of action, in which the 
claimant alleges a health care liability claim. 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
(8) 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 organiza-
tion, or the manufacturer, distributor, supplier, mar-
keter, promoter, or seller of a medical product, in-
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. 
(9) 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. 
(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 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
care services, and being either so licensed, reg-
istered, or certified, or exempted from such require-
ment by other statute or regulation. 
(11) 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. 
(12) 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. 
(13) 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(g)(1) and (h)) and section 351(a) of the 
Public Health Service Act (42 U.S.C. 262(a)), re-
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
spectively, including any component or raw material 
used therein, but excluding health care services. 
(14) 
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. 
(15) 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. 
(16) 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 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
overhead costs or charges for legal services are not 
deductible disbursements or costs for such purpose. 
(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. 
SEC. 109. 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 title does not affect the application 
of the rule of law to such an action; and 
(B) any rule of law prescribed by this title 
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 
title or otherwise applicable law (as determined 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
under this title) will apply to such aspect of such ac-
tion. 
(b) OTHER FEDERAL LAW.—Except as provided in 
this section, nothing in this title 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. 
110. 
STATE 
FLEXIBILITY 
AND 
PROTECTION 
OF 
STATES’ RIGHTS. 
(a) HEALTH CARE LAWSUITS.—The provisions gov-
erning health care lawsuits set forth in this title 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 title. The provisions 
governing health care lawsuits set forth in this title 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 title; or 
(2) prohibits the introduction of evidence re-
garding collateral source benefits, or mandates or 
permits subrogation or a lien on collateral source 
benefits. 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
(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 title (including 
State standards of negligence) shall be governed by other-
wise applicable State or Federal law. 
(2) This title shall not preempt or supersede any 
State or Federal law that imposes greater procedural or 
substantive protections for health care providers and 
health care organizations from liability, loss, or damages 
than those provided by this title or create a cause of ac-
tion. 
(c) STATE FLEXIBILITY.—No provision of this title 
shall be construed to preempt— 
(1) any State law (whether effective before, on, 
or after the date of the enactment of this title) 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 title, 
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. 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
SEC. 111. APPLICABILITY; EFFECTIVE DATE. 
This title 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 title, except that 
any health care lawsuit arising from an injury occurring 
prior to the date of the enactment of this title shall be 
governed by the applicable statute of limitations provisions 
in effect at the time the injury occurred. 
TITLE 
II—REPEAL 
OF 
INDE-
PENDENT 
PAYMENT 
ADVI-
SORY BOARD 
SEC. 201. SHORT TITLE. 
This title may be cited as the ‘‘Medicare Decisions 
Accountability Act of 2012’’. 
SEC. 202. REPEAL OF THE INDEPENDENT PAYMENT ADVI-
SORY BOARD. 
Effective as of the enactment of the Patient Protec-
tion and Affordable Care Act (Public Law 111–148), sec-
tions 3403 and 10320 of such Act (including the amend-
ments made by such sections, but excluding subsection (d) 
of section 1899A of the Social Security Act, as added and 
amended by such sections) are repealed, and any provision 
of law amended by such sections is hereby restored as if 
such sections had not been enacted into law. 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00023
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
TITLE III—HEALTH CARE 
SAFETY NET ENHANCEMENT 
SEC. 301. SHORT TITLE. 
This title may be cited as the ‘‘Health Care Safety 
Net Enhancement Act of 2012’’. 
SEC. 302. PROTECTION FOR EMERGENCY AND RELATED 
SERVICES 
FURNISHED 
PURSUANT 
TO 
EMTALA. 
Section 224(g) of the Public Health Service Act (42 
U.S.C. 233(g)) is amended— 
(1) in paragraph (4), by striking ‘‘An entity’’ 
and inserting ‘‘Subject to paragraph (6), an entity’’; 
and 
(2) by adding at the end the following: 
‘‘(6)(A) For purposes of this section— 
‘‘(i) an entity described in subparagraph 
(B) shall be considered to be an entity de-
scribed in paragraph (4); and 
‘‘(ii) the provisions of this section shall 
apply to an entity described in subparagraph 
(B) in the same manner as such provisions 
apply to an entity described in paragraph (4), 
except that— 
‘‘(I) 
notwithstanding 
paragraph 
(1)(B), the deeming of any entity described 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00024
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
in subparagraph (B), or of an officer, gov-
erning board member, employee, con-
tractor, or on-call provider of such an enti-
ty, to be an employee of the Public Health 
Service for purposes of this section shall 
apply only with respect to items and serv-
ices that are furnished to an individual 
pursuant to section 1867 of the Social Se-
curity Act and to post stabilization services 
(as defined in subparagraph (D)) furnished 
to such an individual; 
‘‘(II) nothing in paragraph (1)(D) 
shall be construed as preventing a physi-
cian or physician group described in sub-
paragraph (B)(ii) from making the appli-
cation referred to in such paragraph or as 
conditioning the deeming of a physician or 
physician group that makes such an appli-
cation upon receipt by the Secretary of an 
application from the hospital or emergency 
department that employs or contracts with 
the physician or group, or enlists the phy-
sician or physician group as an on-call pro-
vider; 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00025
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
‘‘(III) notwithstanding paragraph (3), 
this paragraph shall apply only with re-
spect to causes of action arising from acts 
or omissions that occur on or after Janu-
ary 1, 2012; 
‘‘(IV) paragraph (5) shall not apply to 
a physician or physician group described in 
subparagraph (B)(ii); 
‘‘(V) the Attorney General, in con-
sultation with the Secretary, shall make 
separate estimates under subsection (k)(1) 
with respect to entities described in sub-
paragraph (B) and entities described in 
paragraph (4) (other than those described 
in subparagraph (B)), and the Secretary 
shall establish separate funds under sub-
section (k)(2) with respect to such groups 
of entities, and any appropriations under 
this subsection for entities described in 
subparagraph (B) shall be separate from 
the amounts authorized by subsection 
(k)(2); 
‘‘(VI) 
notwithstanding 
subsection 
(k)(2), the amount of the fund established 
by the Secretary under such subsection 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00026
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
with respect to entities described in sub-
paragraph (B) may exceed a total of 
$10,000,000 for a fiscal year; and 
‘‘(VII) subsection (m) shall not apply 
to entities described in subparagraph (B). 
‘‘(B) An entity described in this subparagraph 
is— 
‘‘(i) a hospital or an emergency depart-
ment to which section 1867 of the Social Secu-
rity Act applies; and 
‘‘(ii) a physician or physician group that is 
employed by, is under contract with, or is an 
on-call provider of such hospital or emergency 
department, to furnish items and services to in-
dividuals under such section. 
‘‘(C) For purposes of this paragraph, the term 
‘on-call provider’ means a physician or physician 
group that— 
‘‘(i) has full, temporary, or locum tenens 
staff privileges at a hospital or emergency de-
partment to which section 1867 of the Social 
Security Act applies; and 
‘‘(ii) is not employed by or under contract 
with such hospital or emergency department, 
but agrees to be ready and available to provide 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00027
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS
HR 5 RDS
services pursuant to section 1867 of the Social 
Security Act or post-stabilization services to in-
dividuals being treated in the hospital or emer-
gency department with or without compensation 
from the hospital or emergency department. 
‘‘(D) For purposes of this paragraph, the term 
‘post stabilization services’ means, with respect to an 
individual who has been treated by an entity de-
scribed in subparagraph (B) for purposes of com-
plying with section 1867 of the Social Security Act, 
services that are— 
‘‘(i) related to the condition that was so 
treated; and 
‘‘(ii) provided after the individual is sta-
bilized in order to maintain the stabilized condi-
tion or to improve or resolve the condition of 
the individual. 
‘‘(E)(i) Nothing in this paragraph (or in any 
other provision of this section as such provision ap-
plies to entities described in subparagraph (B) by 
operation of subparagraph (A)) shall be construed as 
authorizing or requiring the Secretary to make pay-
ments to such entities, the budget authority for 
which is not provided in advance by appropriation 
Acts. 
VerDate Mar 15 2010 
23:48 Mar 29, 2012
Jkt 099200
PO 00000
Frm 00028
Fmt 6652
Sfmt 6201
E:\BILLS\H5.RDS
H5
jbell on DSK7SPTVN1PROD with BILLS