IB 
Union Calendar No. 431
107TH CONGRESS 
2D SESSION 
H. R. 4600
[Report No. 107–693, Parts I and II] 
To improve patient access to health care services and provide improved 
medical care by reducing the excessive burden the liability system places 
on the health care delivery system. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 25, 2002
Mr. GREENWOOD (for himself, Mr. COX, Mr. MURTHA, Mr. TOOMEY, Mr. 
MORAN of Virginia, Mr. PETERSON of Minnesota, Mr. STENHOLM, Mr. 
LUCAS of Kentucky, Mr. PICKERING, and Mr. WELDON of Florida) intro-
duced the following bill; which was referred to the Committee on the Ju-
diciary, and in addition to the Committee on Energy and Commerce, for 
a period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
SEPTEMBER 25, 2002
Additional sponsors: Mrs. CAPITO, Mr. SESSIONS, Mr. PITTS, Mr. WAMP, Mr. 
FLETCHER, Mr. HOLDEN, Mr. BARTON of Texas, Mr. GANSKE, Mr. 
WHITFIELD, Mr. GEKAS, Mr. KIRK, Mr. SUNUNU, Mr. HOBSON, Mr. 
BURR of North Carolina, Mr. MCHUGH, Mr. WICKER, Mrs. BIGGERT, 
Mrs. ROUKEMA, Mr. UPTON, Mr. ROGERS of Michigan, Mr. SHAW, Mr. 
SCHAFFER, Mr. STEARNS, Mr. CRANE, Mr. LATOURETTE, Mr. 
HAYWORTH, Mr. SHAYS, Mr. STUMP, Mr. OTTER, Mr. PLATTS, Mr. 
CRENSHAW, Mr. LOBIONDO, Mr. HAYES, Mr. CANNON, Mr. BARR of 
Georgia, Mr. EVERETT, Mr. CUNNINGHAM, Mr. NEY, Mr. PENCE, Mr. 
BARTLETT of Maryland, Mr. SHUSTER, Mr. LATHAM, Mr. TIBERI, Mr. 
BROWN of South Carolina, Mr. WELLER, Mr. TANCREDO, Mr. KING-
STON, Ms. HART, Mr. TOM DAVIS of Virginia, Mr. FORBES, Mr. DAN 
MILLER of Florida, Mr. SIMPSON, Ms. DUNN, Mr. SCHROCK, Mr. BOEH-
LERT, Mr. OSBORNE, Mr. GOODE, Mr. CANTOR, Mr. CHABOT, Mr. 
GRAVES, Mr. ISAKSON, Mr. JEFF MILLER of Florida, Mr. BASS, Mr. 
GALLEGLY, Mr. DEAL of Georgia, Mrs. JO ANN DAVIS of Virginia, Mr. 
GOODLATTE, Mr. HULSHOF, Mr. BILIRAKIS, Mr. PETERSON of Pennsyl-
vania, Mr. TAYLOR of Mississippi, Mr. TAUZIN, Mr. KENNEDY of Min-
nesota, Mr. SAXTON, Mr. NORWOOD, Mr. LEWIS of Kentucky, Mr. REG-
ULA, Mr. KOLBE, Mr. SENSENBRENNER, Mrs. NORTHUP, Mr. WALSH, 
Mr. LAHOOD, Mrs. EMERSON, Mrs. JOHNSON of Connecticut, Mr. ROG-
ERS of Kentucky, Mrs. KELLY, Mrs. CUBIN, Mr. LEWIS of California, 
Mr. WOLF, Mrs. BONO, Mr. MICA, Mr. PORTMAN, Mr. SHADEGG, Mr. 
CALVERT, Mr. RYAN of Wisconsin, Mr. COLLINS, Mr. KNOLLENBERG, 
Mr. LEACH, Ms. GRANGER, Mr. HYDE, Mr. THUNE, Mr. VITTER, Mr. 
THOMAS, Mr. POMEROY, Mr. THORNBERRY, Mr. PUTNAM, Mr. GILLMOR, 
Mr. RILEY, Mr. FOSSELLA, Mr. FRELINGHUYSEN, Mr. BRADY of Texas, 
and Mr. MCINNIS 
Deleted sponsors: Mr. SIMMONS (added June 5, 2002; deleted July 10, 2002), 
and Mr. FATTAH (added July 10, 2002; deleted July 11, 2002) 
SEPTEMBER 25, 2002 
Reported from the Committee on the Judiciary with an amendment 
[Strike out all after the enacting clause and insert the part printed in italic] 
SEPTEMBER 25, 2002 
Reported from the Committee on Energy and Commerce with an amendment; 
committed to the Committee of the Whole House on the State of the 
Union and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in boldface roman] 
[For text of introduced bill, see copy of bill as introduced on April 25, 2002] 
A BILL 
To improve patient access to health care services and provide 
improved medical care by reducing the excessive burden 
the liability system places on the health care delivery 
system.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Help Efficient, Acces-
sible, Low-cost, Timely Healthcare (HEALTH) Act of 
2002’’.
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—
(1) EFFECT
ON
HEALTH
CARE
ACCESS
AND 
COSTS.—Congress finds that our current civil justice 
system is adversely affecting patient access to health 
care services, better patient care, and cost-efficient 
health care, in that the health care liability system is 
a costly and ineffective mechanism for resolving 
claims of health care liability and compensating in-
jured patients, and is a deterrent to the sharing of in-
formation among health care professionals which im-
pedes efforts to improve patient safety and quality of 
care. 
(2) EFFECT ON INTERSTATE COMMERCE.—Con-
gress finds that the health care and insurance indus-
tries are industries affecting interstate commerce and 
the health care liability litigation systems existing 
throughout the United States are activities that affect 
interstate commerce by contributing to the high costs 
of health care and premiums for health care liability 
insurance purchased by health care system providers. 
(3) EFFECT ON FEDERAL SPENDING.—Congress 
finds that the health care liability litigation systems 
existing throughout the United States have a signifi-
cant effect on the amount, distribution, and use of 
Federal funds because of—
(A) the large number of individuals who re-
ceive health care benefits under programs oper-
ated or financed by the Federal Government; 
(B) the large number of individuals who 
benefit because of the exclusion from Federal 
taxes of the amounts spent to provide them with 
health insurance benefits; and 
(C) the large number of health care pro-
viders who provide items or services for which 
the Federal Government makes payments. 
(b) PURPOSE.—It is the purpose of this Act to imple-
ment reasonable, comprehensive, and effective health care 
liability reforms designed to—
(1) improve the availability of health care serv-
ices in cases in which health care liability actions 
have been shown to be a factor in the decreased avail-
ability of services; 
(2) reduce the incidence of ‘‘defensive medicine’’ 
and lower the cost of health care liability insurance, 
all of which contribute to the escalation of health care 
costs; 
(3) ensure that persons with meritorious health 
care injury claims receive fair and adequate com-
pensation, including reasonable noneconomic dam-
ages;
(4) improve the fairness and cost-effectiveness of 
our current health care liability system to resolve dis-
putes over, and provide compensation for, health care 
liability by reducing uncertainty in the amount of 
compensation provided to injured individuals; and 
(5) provide an increased sharing of information 
in the health care system which will reduce unin-
tended injury and improve patient care. 
SEC. 3. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS. 
A health care lawsuit may be commenced no later than 
3 years after the date of injury or 1 year after the claimant 
discovers, or through the use of reasonable diligence should 
have discovered, the injury, whichever occurs first. In no 
event shall the time for commencement of a health care law-
suit exceed 3 years, except that in the case of an alleged 
injury sustained by a minor before the age of 6, a health 
care lawsuit may be commenced by or on behalf of the 
minor until the later of 3 years from the date of injury, 
or the date on which the minor attains the age of 8.
SEC. 4. COMPENSATING PATIENT INJURY. 
(a) UNLIMITED AMOUNT OF DAMAGES FOR ACTUAL 
ECONOMIC LOSSES IN HEALTH CARE LAWSUITS.—In any 
health care lawsuit, the full amount of a claimant’s eco-
nomic loss may be fully recovered without limitation.
(b) ADDITIONAL NONECONOMIC DAMAGES.—In any 
health care lawsuit, the amount of noneconomic damages 
recovered may be as much as $250,000, regardless of the 
number of parties against whom the action is brought or 
the number of separate claims or actions brought with re-
spect to the same occurrence. 
(c) NO DISCOUNT OF AWARD FOR NONECONOMIC DAM-
AGES.—In any health care lawsuit, an award for future 
noneconomic damages shall not be discounted to present 
value. The jury shall not be informed about the maximum 
award for noneconomic damages. An award for non-
economic damages in excess of $250,000 shall be reduced 
either before the entry of judgment, or by amendment of 
the judgment after entry of judgment, and such reduction 
shall be made before accounting 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 reduced 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. A separate 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 proportion of responsibility of each 
party for the claimant’s harm. 
SEC. 5. MAXIMIZING PATIENT RECOVERY. 
(a) COURT SUPERVISION OF SHARE OF DAMAGES AC-
TUALLY PAID TO CLAIMANTS.—In any health care lawsuit, 
the court shall supervise the arrangements for payment of 
damages to protect against conflicts of interest that may 
have the effect of reducing the amount of damages awarded 
that are actually paid to claimants. In particular, in any 
health care lawsuit in which the attorney for a party claims 
a financial stake in the outcome by virtue 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 inter-
ests 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 exceed the following limits: 
(1) 40 percent of the first $50,000 recovered by 
the claimant(s). 
(2) 331⁄3 percent of the next $50,000 recovered by 
the claimant(s). 
(3) 25 percent of the next $500,000 recovered by 
the claimant(s).
(4) 15 percent of any amount by which the re-
covery 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, settlement, 
mediation, arbitration, or any other form of alternative dis-
pute resolution. In a health care lawsuit involving a minor 
or incompetent person, a court retains the authority to au-
thorize or approve a fee that is less than the maximum per-
mitted under this section. 
SEC. 6. ADDITIONAL HEALTH BENEFITS. 
In any health care lawsuit, any party may introduce 
evidence of collateral source benefits. If a party elects to in-
troduce such evidence, any opposing party may introduce 
evidence of any amount paid or contributed or reasonably 
likely to be paid or contributed in the future by or on behalf 
of the opposing party to secure the right to such collateral 
source benefits. No provider of collateral source benefits 
shall recover any amount against the claimant or receive 
any lien or credit against the claimant’s recovery or be eq-
uitably or legally subrogated to the right of the claimant 
in a health care lawsuit. This section shall apply to any 
health care lawsuit that is settled as well as a health care 
lawsuit that is resolved by a fact finder.
SEC. 7. 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 unnecessary 
injury that such person knew the claimant was substan-
tially 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 puni-
tive 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—
(1) whether punitive damages are to be awarded 
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 appli-
cable State law, shall be inadmissible in any proceeding 
to determine whether compensatory damages are to be 
awarded. 
(b) DETERMINING AMOUNT OF PUNITIVE DAMAGES.—
(1) FACTORS CONSIDERED.—In determining the 
amount of punitive damages, 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 con-
cealment of it by such party; 
(C) the profitability of the conduct to such 
party; 
(D) the number of products sold or medical 
procedures rendered for compensation, as the 
case may be, by such party, of the kind causing 
the harm complained of by the claimant;
(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 awarded in a health care lawsuit may be up 
to as much as two times the amount of economic 
damages awarded or $250,000, whichever is greater. 
The jury shall not be informed of this limitation. 
(c) NO CIVIL MONETARY PENALTIES FOR PRODUCTS 
THAT COMPLY WITH FDA STANDARDS.—
(1) IN GENERAL.—No punitive damages may be 
awarded against the manufacturer or distributor of a 
medical product based on a claim that such product 
caused the claimant’s harm where—
(A)(i) such medical product was subject to 
premarket approval or clearance by the Food 
and Drug Administration with respect to the 
safety of the formulation or performance of the 
aspect of such medical product which caused the 
claimant’s harm or the adequacy of the pack-
aging or labeling of such medical product; and 
(ii) such medical product was so approved 
or cleared; or 
(B) such medical product is generally recog-
nized among qualified experts as safe and effec-
tive pursuant to conditions established by the 
Food and Drug Administration and applicable 
Food and Drug Administration regulations, in-
cluding without limitation those related to pack-
aging and labeling. 
(2) LIABILITY OF HEALTH CARE PROVIDERS.—A 
health care provider who prescribes a drug or device 
(including blood products) approved by the Food and 
Drug Administration shall not be named as a party 
to a product liability lawsuit involving such drug or 
device and shall not be liable to a claimant in a class 
action lawsuit against the manufacturer, distributor, 
or product seller of such drug or device. 
(3) PACKAGING.—In a health care lawsuit for 
harm which is alleged to relate to the adequacy of the 
packaging or labeling of a drug which is required to 
have tamper-resistant packaging under regulations of 
the Secretary of Health and Human Services (includ-
ing labeling regulations related to such packaging), 
the manufacturer or product seller of the drug shall 
not be held liable for punitive damages 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 regulations. 
(4) EXCEPTION.—Paragraph (1) shall not apply 
in any health care lawsuit in which—
(A) a person, before or after premarket ap-
proval or clearance of such medical product,
knowingly misrepresented to or withheld from 
the Food and Drug Administration information 
that is required to be submitted under the Fed-
eral 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 claim-
ant allegedly suffered; or 
(B) a person made an illegal payment to an 
official of the Food and Drug Administration for 
the purpose of either securing or maintaining 
approval or clearance of such medical product. 
SEC. 8. 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 accord-
ance with the Uniform Periodic Payment of Judgments 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 before 
the effective date of this Act. 
SEC. 9. DEFINITIONS. 
In this Act: 
(1) ALTERNATIVE DISPUTE RESOLUTION SYSTEM; 
ADR.—The term ‘‘alternative dispute resolution sys-
tem’’ 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 Fed-
eral 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 deceased, 
incompetent, 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 
behalf of the claimant, or any service, product or 
other benefit provided or reasonably likely to be pro-
vided 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’ com-
pensation law; 
(B) any health, sickness, income-disability, 
or accident insurance that provides health bene-
fits 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 med-
ical, hospital, dental, or income disability bene-
fits; and 
(D) any other publicly or privately funded 
program. 
(4) COMPENSATORY DAMAGES.—The term ‘‘com-
pensatory damages’’ means objectively verifiable mon-
etary 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, damages for physical and emo-
tional pain, suffering, inconvenience, physical im-
pairment, mental anguish, disfigurement, loss of en-
joyment of life, loss of society and companionship, 
loss of consortium (other than loss of domestic serv-
ice), hedonic damages, injury to reputation, and all 
other nonpecuniary losses of any kind or nature. The 
term ‘‘compensatory damages’’ includes economic 
damages and noneconomic damages, as such terms 
are defined in this section. 
(5) 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. 
(6) 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 employment op-
portunities. 
(7) HEALTH CARE LAWSUIT.—The term ‘‘health 
care lawsuit’’ means any health care liability claim 
concerning the provision of health care goods or serv-
ices affecting 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 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 claimants, plaintiffs, defendants, or 
other parties, or the number of claims or causes of ac-
tion, in which the claimant alleges a health care li-
ability 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 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 parties, 
or the number of causes of action, in which the claim-
ant 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, marketer, pro-
moter, 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 theory 
of liability on which the claim is based, or the num-
ber 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 enti-
ty which is obligated to provide or pay for health ben-
efits under any health plan, including any person or 
entity acting under a contract or arrangement with 
a health care organization to provide or administer 
any health benefit. 
(11) 
HEALTH
CARE
PROVIDER.—The 
term 
‘‘health care provider’’ means any person or entity re-
quired by State or Federal laws or regulations to be 
licensed, registered, or certified to provide health care 
services, and being either so licensed, registered, or
certified, or exempted from such requirement 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 organization, 
provider, or by any individual working under the su-
pervision of a health care provider, that relates to the 
diagnosis, prevention, or treatment of any human dis-
ease 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 attempting to cause physical injury other 
than providing health care goods or services. 
(14) MEDICAL
PRODUCT.—The term ‘‘medical 
product’’ means a drug or device intended for hu-
mans, 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 Cosmetic Act 
(21 U.S.C. 321), respectively, including any compo-
nent or raw material used therein, but excluding 
health care services. 
(15) NONECONOMIC DAMAGES.—The term ‘‘non-
economic damages’’ means damages for physical and 
emotional pain, suffering, inconvenience, physical im-
pairment, mental anguish, disfigurement, loss of en-
joyment of life, loss of society and companionship, 
loss of consortium (other than loss of domestic serv-
ice), 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, dis-
tributor, 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 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 de-
ductible disbursements or costs for such purpose. 
(18) STATE.—The term ‘‘State’’ means each of 
the several States, the District of Columbia, the Com-
monwealth 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 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 Fed-
eral 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 action. 
(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 gov-
erning 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 applica-
bility or scope of periodic payment of future damages, 
than provided in this Act; or 
(2) prohibits the introduction of evidence regard-
ing collateral source benefits, 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 (including State standards of negligence) 
shall be governed by otherwise applicable State or Federal 
law. This Act does not preempt or supersede any law that 
imposes greater protections (such as a shorter statute of lim-
itations) for health care providers and health care organiza-
tions 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 dam-
ages (or the total amount of damages) that may be 
awarded in a health care lawsuit, whether or not such 
State limit permits the recovery of a specific dollar 
amount of damages that 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.
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Help Effi-
cient, Accessible, Low Cost, Timely Health 
Care (HEALTH) Act of 2002’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—
(1) EFFECT
ON
HEALTH
CARE
ACCESS 
AND COSTS.—Congress finds that our cur-
rent civil justice system is adversely af-
fecting patient access to health care serv-
ices, better patient care, and cost-effi-
cient health care, in that the health care 
liability system is a costly and ineffective 
mechanism for resolving claims of health 
care liability and compensating injured 
patients, and is a deterrent to the sharing 
of information among health care profes-
sionals which impedes efforts to improve 
patient safety and quality of care. 
(2) 
EFFECT
ON
INTERSTATE
COM-
MERCE.—Congress finds that the health 
care and insurance industries are indus-
tries affecting interstate commerce and 
the health care liability litigation systems 
existing throughout the United States are 
activities that affect interstate commerce
by contributing to the high costs of 
health care and premiums for health care 
liability insurance purchased by health 
care system providers. 
(3) EFFECT
ON
FEDERAL
SPENDING.—
Congress finds that the health care liabil-
ity litigation systems existing throughout 
the United States have a significant effect 
on the amount, distribution, and use of 
Federal funds because of—
(A) the large number of individ-
uals who receive health care benefits 
under programs operated or financed 
by the Federal Government; 
(B) the large number of individ-
uals who benefit because of the exclu-
sion 
from 
Federal 
taxes 
of 
the 
amounts spent to provide them with 
health insurance benefits; and 
(C) the large number of health 
care providers who provide items or 
services for which the Federal Gov-
ernment makes payments. 
(b) PURPOSE.—It is the purpose of this Act 
to implement reasonable, comprehensive, and
equitably or legally subrogated to the right of 
the claimant in a health care lawsuit. This 
section shall apply to any health care lawsuit 
that is settled as well as a health care lawsuit 
that is resolved by a fact finder. 
SEC. 7. PUNITIVE DAMAGES. 
(a) IN GENERAL.—Punitive damages may, if 
otherwise 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 per-
son acted with malicious intent to injure the 
claimant, or that such person deliberately 
failed to avoid unnecessary injury that such 
person knew the claimant was substantially 
certain to suffer. In any health care lawsuit 
where no judgment for compensatory dam-
ages is rendered against such person, no puni-
tive damages may be awarded with respect to 
the claim in such lawsuit. No demand for pu-
nitive 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 motion by 
the claimant and after a finding by the court,