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.
(12) 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.
(13) 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.
SEC. 104. EFFECTIVE DATE.
(a) IN GENERAL.—Except as provided in subsection
(b) and section 207, this Act shall apply with respect to
claims accruing or actions brought on or after the expira-
tion of the 3-year period that begins on the date of the
enactment of this Act.
(b) EXCEPTION FOR STATES REQUESTING EARLIER
IMPLEMENTATION OF REFORMS.—
(1) APPLICATION.—A State may submit an ap-
plication to the Secretary requesting the early imple-
mentation of this Act with respect to claims or ac-
tions brought in the State.
(2) DECISION BY SECRETARY.—The Secretary
shall issue a response to a State’s application under
paragraph (1) not later than 90 days after receiving
the application. If the Secretary determines that the
State meets the requirements of this Act at the time
of submitting its application, the Secretary shall ap-
prove the State’s application, and this Act shall
apply with respect to actions brought in the State on
or after the expiration of the 90-day period that be-
gins on the date the Secretary issues the response.
If the Secretary denies the State’s application, the
Secretary shall provide the State with a written ex-
planation of the grounds for the decision.
TITLE II—HEALTH CARE
LIABILITY REFORM
Subtitle A—Reform Described
SEC. 201. REQUIREMENT FOR INITIAL RESOLUTION OF AC-
TION THROUGH ALTERNATIVE DISPUTE RES-
OLUTION.
(a) IN GENERAL.—
(1) STATE CASES.—A health care liability ac-
tion may not be brought in any State court during
a calendar year unless the health care liability claim
that is the subject of the action has been initially re-
solved under an alternative dispute resolution system
certified for the year by the Secretary under section
212(a), or, in the case of a State in which such a
system is not in effect for the year, under the alter-
native Federal system established under section
212(b).
(2) FEDERAL
DIVERSITY
ACTIONS.—A health
care liability action may not be brought in any Fed-
eral court under section 1332 of title 28, United
States Code, during a calendar year unless the
health care liability claim that is the subject of the
action has been initially resolved under the alter-
native dispute resolution system referred to in para-
graph (1) that applied in the State whose law ap-
plies in such action.
(3) CLAIMS AGAINST UNITED STATES.—
(A) ESTABLISHMENT
OF
PROCESS
FOR
CLAIMS.—The Attorney General shall establish
an alternative dispute resolution process for the
resolution of tort claims consisting of health
care liability claims brought against the United
States under chapter 171 of title 28, United
States Code. Under such process, the resolution
of a claim shall occur after the completion of
the administrative claim process applicable to
the claim under section 2675 of such title.
(B) REQUIREMENT FOR INITIAL RESOLU-
TION UNDER PROCESS.—A health care liability
action based on a health care liability claim de-
scribed in subparagraph (A) may not be
brought in any Federal court unless the claim
has been initially resolved under the alternative
dispute resolution process established by the At-
torney General under such subparagraph.
(b) INITIAL
RESOLUTION
OF
CLAIMS
UNDER
ADR.—For purposes of subsection (a), an action is ‘‘ini-
tially resolved’’ under an alternative dispute resolution
system if—
(A) the ADR reaches a decision on wheth-
er the defendant is liable to the plaintiff for
damages; and
(B) if the ADR determines that the de-
fendant is liable, the ADR reaches a decision on
the amount of damages assessed against the de-
fendant.
(c) PROCEDURES FOR FILING ACTIONS.—
(1) NOTICE
OF
INTENT
TO
CONTEST
DECI-
SION.—Not later than 60 days after a decision is is-
sued with respect to a health care liability claim
under an alternative dispute resolution system, each
party affected by the decision shall submit a sealed
statement to a court of competent jurisdiction indi-
cating whether or not the party intends to contest
the decision.
(2) DEADLINE FOR FILING ACTION.—A health
care liability action may not be brought by a party
unless—
(A) the party has filed the notice of intent
required by paragraph (1); and
(B) the party files the action in a court of
competent jurisdiction not later than 90 days
after the decision resolving the health care li-
ability claim that is the subject of the action is