instruction:
In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ottawa National Wildlife Refuge 
Complex Expansion and Detroit River International Wildlife Refuge 
Expansion Act''.

SEC. 2. FINDINGS.

    Congress finds that--
            (1) the western basin of Lake Erie, as part of the Great 
        Lakes ecosystem--
                    (A) is the largest freshwater ecosystem in the 
                world; and
                    (B) is vitally important to the economic and 
                environmental future of the United States;
            (2) over the 30-year period preceding the date of enactment 
        of this Act, the citizens and governmental institutions of the 
        United States and Canada have devoted increasing attention and 
        resources to the restoration of the water quality and fisheries 
        of the Great Lakes, including the western basin;
            (3) that increased awareness has been accompanied by a 
        gradual shift toward a holistic ecosystem approach that 
        highlights a growing recognition that shoreline areas, commonly 
        referred to as nearshore terrestrial ecosystems, are an 
        integral part of the western basin and the Great Lakes 
        ecosystem;
            (4) the Great Lakes account for more than 90 percent of the 
        surface freshwater in the United States;
            (5) the western basin of Lake Erie receives approximately 
        90 percent of its flow from the Detroit River and only 
        approximately 10 percent from tributaries;
            (6) the western basin is an important ecosystem that 
        includes a number of distinct islands, channels, rivers, and 
        shoals that support dense populations of fish, wildlife, and 
        aquatic plants;
            (7) coastal wetland of Lake Erie supports the largest 
        diversity of plant and wildlife species in the Great Lakes;
            (8) because Lake Erie is located at a more southern 
        latitude than other Great Lakes, the moderate climate of Lake 
        Erie is appropriate for many species that are not found in or 
        along the northern Great Lakes;
            (9) more than 300 species of plants, including 37 
        significant species, have been identified in the aquatic and 
        wetland habitats of the western basin;
            (10) the shallow western basin of Lake Erie, extending from 
        the Lower Detroit River to Sandusky Bay, is home to the 
        greatest concentration of marshes in Lake Erie, including--
                    (A) Mouille, Metzger, and Magee marshes;
                    (B) the Maumee Bay wetland complex;
                    (C) the wetland complexes flanking Locust Point; 
                and
                    (D) the wetland in Sandusky Bay;
            (11) the larger islands of the United States in western 
        Lake Erie have wetland in small embayments;
            (12) the wetland in the western basin comprises some of the 
        most important waterfowl habitat in the Great Lakes;
            (13) waterfowl, wading birds, shore birds, gulls and terns, 
        raptors, and perching birds use the wetland in the western 
        basin for migration, nesting, and feeding;
            (14) hundreds of thousands of diving ducks stop to rest in 
        the Lake Erie area during autumn migration from Canada to 
        points east and south;
            (15) the wetland of the western basin provides a major 
        stopover for sea ducks, such as migrating common goldeneye, 
        common mergansers, and ruddy duck;
            (16) the international importance of Lake Erie is indicated 
        in the United States by congressional designation of the Ottawa 
        and Cedar Point National Wildlife Refuges;
            (17)(A) Lake Erie has an international reputation for 
        walleye, perch, and bass fishing, recreational boating, 
        birding, photography, and duck hunting; and
            (B) on an economic basis, tourism in the Lake Erie area 
        accounts for an estimated $1,500,000,000 in retail sales and 
        more than 50,000 jobs;
            (18)(A) many of the 417,000 boats that are registered in 
        the State of Ohio are used in the western basin, in part to 
        fish for the estimated 10,000,000 walleye that migrate from the 
        lake to spawn; and
            (B) that internationally renowned walleye fishery drives 
        much of the $2,000,000,000 sport fishing industry in the State 
        of Ohio;
            (19) coastal wetland in the western basin has been 
        subjected to intense pressure for 150 years;
            (20) prior to 1850, the western basin was part of an 
        extensive coastal marsh and swamp system consisting of 
        approximately 122,000 hectares that comprised a portion of the 
        Great Black Swamp;
            (21) by 1951, only 12,407 wetland hectares remained in the 
        western basin;
            (22) 50 percent of that acreage was destroyed between 1972 
        and 1987, leaving only approximately 5,000 hectares in 
        existence today;
            (23) along the Michigan shoreline, coastal wetland was 
        reduced by 62 percent between 1916 and the early 1970s;
            (24) the development of the city of Monroe, Michigan, has 
        had a particularly significant impact on the coastal wetland at 
        the mouth of the Raisin River;
            (25) only approximately 100 hectares remain physically 
        unaltered today in an area in which, 70 years ago, marshes were 
        10 times more extensive;
            (26) in addition to the actual loss of coastal wetland 
        acreage along the shores of Lake Erie, the quality of much 
        remaining dike wetland has been degraded by numerous stressors, 
        especially excessive loadings of sediments and nutrients, 
        contaminants, shoreline modification, exotic species, and the 
        diking of wetland; and
            (27) protective peninsula beach systems, such as the former 
        Bay Point and Woodtick, at the border of Ohio and Michigan near 
        the mouth of the Ottawa River and Maumee Bay, have been eroded 
        over the years, exacerbating erosion along the shorelines and 
        negatively affecting breeding and spawning grounds.

SEC. 3. PURPOSE.

    The purpose of this Act is to establish a national wildlife refuge 
complex in the State of Ohio--
            (1)(A) to protect the remaining high-quality fish and 
        wildlife habitats of the western basin before those habitats 
        are lost to further development; and
            (B) to restore and enhance degraded wildlife habitats 
        associated with the western basin;
            (2) in partnership with nongovernmental and private 
        organizations and private individuals dedicated to habitat 
        enhancement, to conserve, enhance, and restore the native 
        aquatic and terrestrial community characteristics of the 
        western basin (including associated fish, wildlife, and plant 
        species);
            (3) to facilitate partnerships among the United States Fish 
        and Wildlife Service, Canadian national and provincial 
        authorities, State and local governments, local communities in 
        the United States and Canada, conservation organizations, and 
        other non-Federal entities to promote public awareness of the 
        resources of the western basin; and
            (4) to advance the collective goals and priorities that--
                    (A) were established in the report entitled ``Great 
                Lakes Strategy 2002--A Plan for the New Millennium'', 
                developed by the United States Policy Committee, 
                comprised of Federal agencies (including the United 
                States Fish and Wildlife Service, the National Oceanic 
                and Atmospheric Administration, the United States 
                Geological Survey, the Forest Service, and the Great 
                Lakes Fishery Commission) and State governments and 
                tribal governments in the Great Lakes basin; and
                    (B) include the goals of cooperating to protect and 
                restore the chemical, physical, and biological 
                integrity of the Great Lakes basin ecosystem.

SEC. 4. DEFINITIONS.

    In this Act:
            (1) Cedar point refuge.--The term ``Cedar Point Refuge'' 
        means the Cedar Point National Wildlife Refuge established by 
        the Secretary in accordance with the Migratory Bird 
        Conservation Act (16 U.S.C. 715 et seq.).
            (2) International refuge.--The term ``International 
        Refuge'' means the Detroit River International Wildlife Refuge 
        established by section 5(a) of the Detroit River International 
        Wildlife Refuge Establishment Act (16 U.S.C. 668dd note; 115 
        Stat. 894).
            (3) Ottawa refuge.--The term ``Ottawa Refuge'' means the 
        Ottawa National Wildlife Refuge, established by the Secretary 
        in accordance with the Migratory Bird Conservation Act (16 
        U.S.C. 715 et seq.).
            (4) Refuge complex.--The term ``Refuge Complex'' means the 
        national wildlife refuge complex established by section 5(a).
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of the Interior.
            (6) Western basin.--
                    (A) In general.--The term ``western basin'' means 
                the western basin of Lake Erie, consisting of the land 
                and water in the watersheds of Lake Erie extending from 
                the watershed of the Lower Detroit River in the State 
                of Michigan to and including Sandusky Bay and the 
                watershed of Sandusky Bay in the State of Ohio.
                    (B) Inclusion.--The term `western basin' includes 
                the Bass Island archipelago in the State of Ohio.
            (7) West sister island refuge.--The term ``West Sister 
        Island Refuge'' means the West Sister Island National Wildlife 
        Refuge established by Executive Order 7937, dated August 2, 
        1937.

SEC. 5. NATIONAL WILDLIFE REFUGE COMPLEX.

    (a) Establishment.--There is established a national wildlife refuge 
complex in the State of Ohio, consisting of--
            (1) the Ottawa Refuge, as modified by subsection (b);
            (2) the West Sister Island Refuge; and
            (3) the Cedar Point Refuge.
    (b) Expansion of Ottawa National Wildlife Refuge.--
            (1) In general.--The Secretary shall expand the boundaries 
        of the Ottawa Refuge to include surrounding land and water in 
        the State of Ohio extending from the eastern boundary of the 
        Maumee Bay State Park to the eastern boundary of the Darby Unit 
        (including the Bass Island archipelago) as depicted on the map 
        entitled ``Ottawa National Wildlife Refuge Complex Expansion 
        and Detroit River International Wildlife Refuge Expansion 
        Act'', dated September 6, 2002.
            (2) Availability of map.--The map referred to in paragraph 
        (1) shall be available for inspection in appropriate offices of 
        the United States Fish and Wildlife Service.
    (c) Boundary Revisions.--The Secretary may make such revisions of 
the boundaries of the Refuge Complex as the Secretary determines to be 
appropriate--
            (1) to facilitate the acquisition of property within the 
        Refuge Complex; or
            (2) to carry out this Act.
    (d) Acquisition.--
            (1) In general.--Subject to paragraph (2), the Secretary 
        may acquire by donation, purchase with donated or appropriated 
        funds, or exchange the land and water, and interests in land 
        and water (including conservation easements), within the 
        boundaries of the Refuge Complex.
            (2) Consent.--No land, water, or interest in land or water 
        described in paragraph (1) may be acquired by the Secretary 
        without the consent of the owner of the land, water, or 
        interest.
    (e) Transfers From Other Agencies.--Administrative jurisdiction 
over any Federal property that is located within the boundaries of the 
Refuge Complex and under the administrative jurisdiction of an agency 
of the United States other than the Department of the Interior may, 
with the concurrence of the head of the administering agency, be 
transferred without consideration to the Secretary for the purpose of 
this Act.
    (f) Study of Associated Area.--
            (1) In general.--The Secretary, acting through the Director 
        of the United States Fish and Wildlife Service, shall conduct a 
        study of fish and wildlife habitat and aquatic and terrestrial 
        communities in and around the 2 dredge spoil disposal sites 
        that are--
                    (A) referred to by the Toledo-Lucas County Port 
                Authority as ``Port Authority Facility Number Three'' 
                and ``Grassy Island'', respectively; and
                    (B) located within Toledo Harbor near the mouth of 
                the Maumee River.
            (2) Report.--Not later than 18 months after the date of 
        enactment of the Act, the Secretary shall--
                    (A) complete the study under paragraph (1); and
                    (B) submit to Congress a report on the results of 
                the study.

SEC. 6. EXPANSION OF INTERNATIONAL REFUGE BOUNDARIES.

    The Secretary shall expand the southern boundary of the 
International Refuge to include additional land and water in the State 
of Michigan located east of Interstate Route 75, extending from the 
southern boundary of Sterling State Park to the Ohio State line, as 
depicted on the map referred to in section 5(b)(1).

SEC. 7. ADMINISTRATION.

    (a) Refuge Complex.--
            (1) In general.--The Secretary shall administer all 
        federally owned land, water, and interests in land and water 
        that are located within the boundaries of the Refuge Complex in 
        accordance with--
                    (A) the National Wildlife Refuge System 
                Administration Act of 1966 (16 U.S.C. 668dd et seq.); 
                and
                    (B) this Act.
            (2) Additional authority.--The Secretary may use such 
        additional statutory authority available to the Secretary for 
        the conservation of fish and wildlife, and the provision of 
        opportunities for fish- and wildlife-dependent recreation, as 
        the Secretary determines to be appropriate to carry out this 
        Act.
    (b) Priority Uses.--In providing opportunities for compatible fish- 
and wildlife-dependent recreation, the Secretary, in accordance with 
paragraphs (3) and (4) of section 4(a) of the National Wildlife Refuge 
System Administration Act of 1966 (16 U.S.C. 668dd(a)), shall ensure, 
to the maximum extent practicable, that hunting, trapping, fishing, 
wildlife observation and photography, and environmental education and 
interpretation are the priority public uses of the Refuge Complex.
    (c) Cooperative Agreements Regarding Non-Federal Land.--To promote 
public awareness of the resources of the western basin and encourage 
public participation in the conservation of those resources, the 
Secretary may enter into cooperative agreements with the State of Ohio 
or Michigan, any political subdivision of the State, or any person for 
the management, in a manner consistent with this Act, of land that--
            (1) is owned by the State, political subdivision, or 
        person; and
            (2) is located within the boundaries of the Refuge Complex.
    (d) Use of Existing Greenway Authority.--The Secretary shall 
encourage the State of Ohio to use authority under the recreational 
trails program under section 206 of title 23, United States Code, to 
provide funding for acquisition and development of trails within the 
boundaries of the Refuge Complex.

SEC. 8. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated such sums as are 
necessary--
            (1) to acquire land and water within the Refuge Complex 
        under section 5(d);
            (2) to carry out the study under section 5(f); and
            (3) to develop, operate, and maintain the Refuge Complex.
answer:
Ottawa National Wildlife Refuge Complex Expansion and Detroit River International Wildlife Refuge Expansion Act - Establishes a national wildlife refuge complex in Ohio, consisting of the Ottawa, West Sister Island, and Cedar Point National Wildlife Refuges.Requires the Secretary of the Interior to expand the Ottawa Refuge to include specified land and water in Ohio. Permits the Secretary to acquire by donation, purchase, or exchange the land and water and interests in land and water within the boundaries of the Complex.Directs the Secretary, acting through the Director of the United States Fish and Wildlife Service, to study and report to Congress on fish and wildlife habitat and aquatic and terrestrial communities in and around two specified dredge spoil disposal sites in Toledo Harbor.Requires the Secretary to expand the southern boundary of the Detroit River International Wildlife Refuge (the Refuge) to include additional land and water located in the State of Michigan east of Interstate Route 75.Prescribes requirements for administration of the Complex.Directs the Secretary to ensure that hunting, trapping, fishing, wildlife observation and photography, and environmental education and interpretation shall be the priority public uses of the Complex.Requires the Secretary to encourage the State of Ohio to use authority under the Federal recreational trails program to provide funding for the acquisition and development of trails within the boundaries of the Complex.


question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care OverUse Reform Today Act 
(HealthCOURT Act) of 2009''.

SEC. 2. ESTABLISHMENT OF PERFORMANCE-BASED QUALITY MEASURES.

    Not later than January 1, 2010, the Secretary of Health and Human 
Services shall submit to Congress a proposal for a formalized process 
for the development of performance-based quality measures that could be 
applied to physicians' services under the Medicare program under title 
XVIII of the Social Security Act. Such proposal shall be in concert and 
agreement with the Physician Consortium for Performance Improvement and 
shall only utilize measures agreed upon by each physician specialty 
organization.

SEC. 3. AFFIRMATIVE DEFENSE BASED ON COMPLIANCE WITH BEST PRACTICE 
              GUIDELINES.

    (a) Selection and Issuance of Best Practices Guidelines.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary'') shall 
        provide for the selection and issuance of best practice 
        guidelines (each in this subsection referred to as a 
        ``guideline'') in accordance with paragraphs (2) and (3).
            (2) Development process.--Not later than 90 days after the 
        date of the enactment of this Act, the Secretary shall enter 
        into a contract with a qualified physician consensus-building 
        organization (such as the Physician Consortium for Performance 
        Improvement), in concert and agreement with physician specialty 
        organizations, to develop guidelines for treatment of medical 
        conditions for application under subsection (b). Under the 
        contract, the organization shall take into consideration any 
        endorsed performance-based quality measures described in 
        section 2. Under the contract and not later than 18 months 
        after the date of the enactment of this Act, the organization 
        shall submit best practice guidelines for issuance as 
        guidelines under paragraph (3).
            (3) Issuance.--
                    (A) In general.--Not later than 2 years after the 
                date of the enactment of this Act, the Secretary shall 
                issue, by regulation, after notice and opportunity for 
                public comment, guidelines that have been recommended 
                under paragraph (2) for application under subsection 
                (b).
                    (B) Limitation.--The Secretary may not issue 
                guidelines unless they have been approved or endorsed 
                by qualified physician consensus-building organization 
                involved and physician specialty organizations.
                    (C) Dissemination.--The Secretary shall broadly 
                disseminate the guidelines so issued.
    (b) Limitation on Damages.--
            (1) Limitation on noneconomic damages.--In any health care 
        lawsuit, no noneconomic damages may awarded with respect to 
        treatment that is within a guideline issued under subsection 
        (a).
            (2) Limitation on punitive damages.--In any health care 
        lawsuit, no punitive damages may be awarded against a health 
        care practitioner based on a claim that such treatment caused 
        the claimant harm if--
                    (A) such treatment was subject to the quality 
                review by a qualified physician consensus-building 
                organization;
                    (B) such treatment was approved in a guideline that 
                underwent full review by such organization, public 
                comment, approval by the Secretary, and dissemination 
                as described in subparagraph (a); and
                    (C) such medical treatment is generally recognized 
                among qualified experts (including medical providers 
                and relevant physician specialty organizations) as 
                safe, effective, and appropriate.
    (c) Use.--
            (1) Introduction as evidence.--Guidelines under subsection 
        (a) may not be introduced as evidence of negligence or 
        deviation in the standard of care in any civil action unless 
        they have previously been introduced by the defendant.
            (2) No presumption of negligence.--There would be no 
        presumption of negligence if a participating physician does not 
        adhere to such guidelines.
    (d) Construction.--Nothing in this section shall be construed as 
preventing a State from--
            (1) replacing their current medical malpractice rules with 
        rules that rely, as a defense, upon a health care provider's 
        compliance with a guideline issued under subsection (a); or
            (2) applying additional guidelines or safe-harbors that are 
        in addition to, but not in lieu of, the guidelines issued under 
        subsection (a).

SEC. 4. STATE GRANTS TO CREATE ADMINISTRATIVE HEALTH CARE TRIBUNALS.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following:

``SEC. 399T. STATE GRANTS TO CREATE ADMINISTRATIVE HEALTH CARE 
              TRIBUNALS.

    ``(a) In General.--The Secretary may award grants to States for the 
development, implementation, and evaluation of administrative health 
care tribunals that comply with this section, for the resolution of 
disputes concerning injuries allegedly caused by health care providers.
    ``(b) Conditions for Demonstration Grants.--To be eligible to 
receive a grant under this section, a State shall submit to the 
Secretary an application at such time, in such manner, and containing 
such information as may be required by the Secretary. A grant shall be 
awarded under this section on such terms and conditions as the 
Secretary determines appropriate.
    ``(c) Representation by Counsel.--A State that receives a grant 
under this section may not preclude any party to a dispute before an 
administrative health care tribunal operated under such grant from 
obtaining legal representation during any review by the expert panel 
under subsection (d), the administrative health care tribunal under 
subsection (e), or a State court under subsection (f).
    ``(d) Expert Panel Review and Early Offer Guidelines.--
            ``(1) In general.--Prior to the submission of any dispute 
        concerning injuries allegedly caused by health care providers 
        to an administrative health care tribunal under this section, 
        such allegations shall first be reviewed by an expert panel.
            ``(2) Composition.--
                    ``(A) In general.--The members of each expert panel 
                under this subsection shall be appointed by the head of 
                the State agency responsible for health. Each expert 
                panel shall be composed of no fewer than 3 members and 
                not more than 7 members. At least one-half of such 
                members shall be medical experts (either physicians or 
                health care professionals).
                    ``(B) Licensure and expertise.--Each physician or 
                health care professional appointed to an expert panel 
                under subparagraph (A) shall--
                            ``(i) be appropriately credentialed or 
                        licensed in 1 or more States to deliver health 
                        care services; and
                            ``(ii) typically treat the condition, make 
                        the diagnosis, or provide the type of treatment 
                        that is under review.
                    ``(C) Independence.--
                            ``(i) In general.--Subject to clause (ii), 
                        each individual appointed to an expert panel 
                        under this paragraph shall--
                                    ``(I) not have a material familial, 
                                financial, or professional relationship 
                                with a party involved in the dispute 
                                reviewed by the panel; and
                                    ``(II) not otherwise have a 
                                conflict of interest with such a party.
                            ``(ii) Exception.--Nothing in clause (i) 
                        shall be construed to prohibit an individual 
                        who has staff privileges at an institution 
                        where the treatment involved in the dispute was 
                        provided from serving as a member of an expert 
                        panel merely on the basis of such affiliation, 
                        if the affiliation is disclosed to the parties 
                        and neither party objects.
                    ``(D) Practicing health care professional in same 
                field.--
                            ``(i) In general.--In a dispute before an 
                        expert panel that involves treatment, or the 
                        provision of items or services--
                                    ``(I) by a physician, the medical 
                                experts on the expert panel shall be 
                                practicing physicians (allopathic or 
                                osteopathic) of the same or similar 
                                specialty as a physician who typically 
                                treats the condition, makes the 
                                diagnosis, or provides the type of 
                                treatment under review; or
                                    ``(II) by a health care 
                                professional other than a physician, at 
                                least two medical experts on the expert 
                                panel shall be practicing physicians 
                                (allopathic or osteopathic) of the same 
                                or similar specialty as the health care 
                                professional who typically treats the 
                                condition, makes the diagnosis, or 
                                provides the type of treatment under 
                                review, and, if determined appropriate 
                                by the State agency, an additional 
                                medical expert shall be a practicing 
                                health care professional (other than 
                                such a physician) of such a same or 
                                similar specialty.
                            ``(ii) Practicing defined.--In this 
                        paragraph, the term `practicing' means, with 
                        respect to an individual who is a physician or 
                        other health care professional, that the 
                        individual provides health care services to 
                        individual patients on average at least 2 days 
                        a week.
                    ``(E) Pediatric expertise.--In the case of dispute 
                relating to a child, at least 1 medical expert on the 
                expert panel shall have expertise described in 
                subparagraph (D)(i) in pediatrics.
            ``(3) Determination.--After a review under paragraph (1), 
        an expert panel shall make a determination as to the liability 
        of the parties involved and compensation.
            ``(4) Acceptance.--If the parties to a dispute before an 
        expert panel under this subsection accept the determination of 
        the expert panel concerning liability and compensation, such 
        compensation shall be paid to the claimant and the claimant 
        shall agree to forgo any further action against the health care 
        providers involved.
            ``(5) Failure to accept.--If any party decides not to 
        accept the expert panel's determination, the matter shall be 
        referred to an administrative health care tribunal created 
        pursuant to this section.
    ``(e) Administrative Health Care Tribunals.--
            ``(1) In general.--Upon the failure of any party to accept 
        the determination of an expert panel under subsection (d), the 
        parties shall have the right to request a hearing concerning 
        the liability or compensation involved by an administrative 
        health care tribunal established by the State involved.
            ``(2) Requirements.--In establishing an administrative 
        health care tribunal under this section, a State shall--
                    ``(A) ensure that such tribunals are presided over 
                by special judges with health care expertise;
                    ``(B) provide authority to such judges to make 
                binding rulings, rendered in written decisions, on 
                standards of care, causation, compensation, and related 
                issues with reliance on independent expert witnesses 
                commissioned by the tribunal;
                    ``(C) establish gross negligence as the legal 
                standard for the tribunal;
                    ``(D) allow the admission into evidence of the 
                recommendation made by the expert panel under 
                subsection (d); and
                    ``(E) provide for an appeals process to allow for 
                review of decisions by State courts.
    ``(f) Review by State Court After Exhaustion of Administrative 
Remedies.--
            ``(1) Right to file.--If any party to a dispute before a 
        health care tribunal under subsection (e) is not satisfied with 
        the determinations of the tribunal, the party shall have the 
        right to file their claim in a State court of competent 
        jurisdiction.
            ``(2) Forfeit of awards.--Any party filing an action in a 
        State court in accordance with paragraph (1) shall forfeit any 
        compensation award made under subsection (e).
            ``(3) Admissibility.--The determinations of the expert 
        panel and the administrative health care tribunal pursuant to 
        subsections (d) and (e) with respect to a State court 
        proceeding under paragraph (1) shall be admissible into 
        evidence in any such State court proceeding.
    ``(g) Definition.--In this section, the term `health care provider' 
has the meaning given such term for purposes of part A of title VII.
    ``(h) Authorization of Appropriations.--There are authorized to be 
appropriated for any fiscal year such sums as may be necessary for 
purposes of making grants to States under this section.''.

SEC. 5. SENSE OF CONGRESS REGARDING HEALTH INSURER LIABILITY.

    It is the sense of Congress that a health insurance issuer should 
be liable for damages for harm caused when it makes a decision as to 
what care is medically necessary and appropriate.
answer:
Health Care OverUse Reform Today Act (HealthCOURT Act) of 2009 - Directs the Secretary of Health and Human Services (HHS) to propose to Congress a formalized process for the development of performance-based quality measures that could be applied to physicians' services under title XVIII (Medicare) of the Social Security Act. Requires the proposal: (1) to be in concert and agreement with the Physician Consortium for Performance Improvement; and (2) utilize only measures agreed upon by each physician specialty organization.

Directs the Secretary to: (1) provide for the selection and issuance of best practice guidelines for treatment of medical conditions; and (2) contract with a qualified physician consensus-building organization (such as the Physician Consortium for Performance Improvement), in concert and agreement with physician specialty organizations, to develop such guidelines.

Prohibits the award of any noneconomic damages in any health care lawsuit with respect to treatment that is within an issued guideline.

Prohibits the award of punitive damages against a health care practitioner in such a lawsuit based on a claim that medical treatment caused the claimant harm if the treatment: (1) was subject to quality review by a qualified physician consensus-building organization; (2) was approved in a guideline that underwent full review by such organization, public comment, the Secretary's approval, and dissemination; and (3) is generally recognized among qualified experts as safe, effective, and appropriate.

Amends the Public Health Service Act to authorize the Secretary to award grants to states for the development, implementation, and evaluation of administrative health care tribunals for the resolution of disputes concerning injuries allegedly caused by health care providers.

Expresses the sense of Congress that a health insurance issuer should be liable for damages for a harm caused when it makes a decision as to what care is medically necessary and appropriate.


question:
SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Family Health Care Accessibility Act 
of 2015''.

SEC. 2. LIABILITY PROTECTIONS FOR HEALTH PROFESSIONAL VOLUNTEERS AT 
              COMMUNITY HEALTH CENTERS.

    Section 224 of the Public Health Service Act (42 U.S.C. 233) is 
amended by adding at the end the following:
    ``(q)(1) For purposes of this section, a health professional 
volunteer at an entity described in subsection (g)(4) shall, in 
providing a health professional service eligible for funding under 
section 330 to an individual, be deemed to be an employee of the Public 
Health Service for a calendar year that begins during a fiscal year for 
which a transfer was made under paragraph (4)(C). The preceding 
sentence is subject to the provisions of this subsection.
    ``(2) In providing a health service to an individual, a health care 
practitioner shall for purposes of this subsection be considered to be 
a health professional volunteer at an entity described in subsection 
(g)(4) if the following conditions are met:
            ``(A) The service is provided to the individual at the 
        facilities of an entity described in subsection (g)(4), or 
        through offsite programs or events carried out by the entity.
            ``(B) The entity is sponsoring the health care practitioner 
        pursuant to paragraph (3)(B).
            ``(C) The health care practitioner does not receive any 
        compensation for the service from the individual or from any 
        third-party payer (including reimbursement under any insurance 
        policy or health plan, or under any Federal or State health 
        benefits program), except that the health care practitioner may 
        receive repayment from the entity described in subsection 
        (g)(4) for reasonable expenses incurred by the health care 
        practitioner in the provision of the service to the individual.
            ``(D) Before the service is provided, the health care 
        practitioner or the entity described in subsection (g)(4) posts 
        a clear and conspicuous notice at the site where the service is 
        provided of the extent to which the legal liability of the 
        health care practitioner is limited pursuant to this 
        subsection.
            ``(E) At the time the service is provided, the health care 
        practitioner is licensed or certified in accordance with 
        applicable law regarding the provision of the service.
    ``(3) Subsection (g) (other than paragraphs (3) and (5)) and 
subsections (h), (i), and (l) apply to a health care practitioner for 
purposes of this subsection to the same extent and in the same manner 
as such subsections apply to an officer, governing board member, 
employee, or contractor of an entity described in subsection (g)(4), 
subject to paragraph (4) and subject to the following:
            ``(A) The first sentence of paragraph (1) applies in lieu 
        of the first sentence of subsection (g)(1)(A).
            ``(B) With respect to an entity described in subsection 
        (g)(4), a health care practitioner is not a health professional 
        volunteer at such entity unless the entity sponsors the health 
        care practitioner. For purposes of this subsection, the entity 
        shall be considered to be sponsoring the health care 
        practitioner if--
                    ``(i) with respect to the health care practitioner, 
                the entity submits to the Secretary an application 
                meeting the requirements of subsection (g)(1)(D); and
                    ``(ii) the Secretary, pursuant to subsection 
                (g)(1)(E), determines that the health care practitioner 
                is deemed to be an employee of the Public Health 
                Service.
            ``(C) In the case of a health care practitioner who is 
        determined by the Secretary pursuant to subsection (g)(1)(E) to 
        be a health professional volunteer at such entity, this 
        subsection applies to the health care practitioner (with 
        respect to services performed on behalf of the entity 
        sponsoring the health care practitioner pursuant to 
        subparagraph (B)) for any cause of action arising from an act 
        or omission of the health care practitioner occurring on or 
        after the date on which the Secretary makes such determination.
            ``(D) Subsection (g)(1)(F) applies to a health care 
        practitioner for purposes of this subsection only to the extent 
        that, in providing health services to an individual, each of 
        the conditions specified in paragraph (2) is met.
    ``(4)(A) Amounts in the fund established under subsection (k)(2) 
shall be available for transfer under subparagraph (C) for purposes of 
carrying out this subsection.
    ``(B) Not later May 1 of each fiscal year, the Attorney General, in 
consultation with the Secretary, shall submit to the Congress a report 
providing an estimate of the amount of claims (together with related 
fees and expenses of witnesses) that, by reason of the acts or 
omissions of health professional volunteers, will be paid pursuant to 
this section during the calendar year that begins in the following 
fiscal year. Subsection (k)(1)(B) applies to the estimate under the 
preceding sentence regarding health professional volunteers to the same 
extent and in the same manner as such subsection applies to the 
estimate under such subsection regarding officers, governing board 
members, employees, and contractors of entities described in subsection 
(g)(4).
    ``(C) Not later than December 31 of each fiscal year, the Secretary 
shall transfer from the fund under subsection (k)(2) to the appropriate 
accounts in the Treasury an amount equal to the estimate made under 
subparagraph (B) for the calendar year beginning in such fiscal year, 
subject to the extent of amounts in the fund.
    ``(5)(A) This subsection takes effect on October 1, 2017, except as 
provided in subparagraph (B).
    ``(B) Effective on the date of the enactment of this subsection--
            ``(i) the Secretary may issue regulations for carrying out 
        this subsection, and the Secretary may accept and consider 
        applications submitted pursuant to paragraph (3)(B); and
            ``(ii) reports under paragraph (4)(B) may be submitted to 
        the Congress.''.
answer:

Family Health Care Accessibility Act of 2015 This bill amends the Public Health Service Act to deem a health professional volunteer providing primary health care to an individual at a community health center or through programs or events carried out by a center to be an employee of the Public Health Service for purposes of any civil action that may arise from providing services to patients. For a volunteer to be covered by this liability protection, the Department of Health and Human Services must approve the center's application to sponsor the volunteer.