I 
114TH CONGRESS 
2D SESSION 
H. R. 4589 
To amend title XVIII of the Social Security Act to repeal the cap on 
the Medicare Advantage star rating bonuses, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 23, 2016 
Mr. MACARTHUR introduced the following bill; which was referred to the Com-
mittee on the Judiciary, and in addition to the Committees on Energy 
and Commerce and Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to repeal 
the cap on the Medicare Advantage star rating bonuses, 
and for other purposes. 
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 ‘‘Excellence in Medicare 
Act’’. 
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TITLE I—MEDICARE ADVANTAGE 
SEC. 101. REPEALING CAP ON MEDICARE ADVANTAGE STAR 
RATING BONUSES. 
(a) IN GENERAL.—Section 1853(n)(4) of the Social 
Security Act (42 U.S.C. 1395w–23(n)(4)) is amended by 
striking ‘‘(determined taking into account subsection (o))’’ 
and inserting ‘‘determined before application of subsection 
(o))’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply beginning with respect to 2017. 
TITLE II—HEALTH ACT 
SEC. 201. SHORT TITLE. 
This title may be cited as the ‘‘Medical Malpractice 
Reform Act of 2015’’. 
SEC. 202. 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 
information among health care professionals which 
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impedes efforts to improve patient safety and quality 
of care. 
(2) EFFECT
ON
INTERSTATE
COMMERCE.— 
Congress finds that the health care liability litigation 
systems existing throughout the United States are 
activities that affect interstate commerce by contrib-
uting 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.—Con-
gress finds that the health care liability 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 individuals who 
receive health care benefits under programs op-
erated 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. 
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(b) PURPOSE.—It is the purpose of this title 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 
availability of services; 
(2) reduce the incidence of ‘‘defensive medi-
cine’’ and lower the cost of health care liability in-
surance, 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 
disputes 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. 
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SEC. 203. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS. 
The time for the commencement of a health care law-
suit shall be 3 years after the date of manifestation 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 lawsuit exceed 3 years 
after the date of manifestation of injury unless tolled for 
any of the following— 
(1) upon proof of fraud; 
(2) intentional concealment; or 
(3) the presence of a foreign body, which has no 
therapeutic or diagnostic purpose or effect, in the 
person of the injured person. 
Actions by a minor shall be commenced within 3 years 
from the date of the alleged manifestation of injury except 
that actions by a minor under the full age of 6 years shall 
be commenced within 3 years of manifestation of injury 
or prior to the minor’s 8th birthday, whichever provides 
a longer period. Such time limitation shall be tolled for 
minors for any period during which a parent or guardian 
and a health care provider or health care organization 
have committed fraud or collusion in the failure to bring 
an action on behalf of the injured minor. 
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