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

    This Act may be cited as the ``End-User Protection Act of 2014''.

SEC. 2. DEFINITIONS.

    (a) In General.--Section 1a of the Commodity Exchange Act (7 U.S.C. 
1a) is amended--
            (1) by redesignating paragraphs (8) through (51) as 
        paragraphs (9) through (52), respectively;
            (2) by inserting after paragraph (7) the following:
            ``(8) Commercial market participant.--The term `commercial 
        market participant' means any producer, processor, merchant, or 
        commercial user of an exempt or agricultural commodity, or the 
        products or by-products of an exempt or agricultural 
        commodity.'';
            (3) in subparagraph (B) of paragraph (48) (as so 
        redesignated), by striking clause (ii) and inserting the 
        following:
                            ``(ii) any purchase or sale of a 
                        nonfinancial commodity or security for deferred 
                        shipment or delivery, so long as the 
                        transaction is intended to be physically 
                        settled, including any stand-alone or embedded 
                        option for which exercise would result in a 
                        physical delivery obligation;''; and
            (4) in paragraph (50) (as redesignated by paragraph (1)), 
        by striking subparagraph (D) and inserting the following:
                    ``(D) De minimis exception.--
                            ``(i) In general.--The Commission shall 
                        exempt from designation as a swap dealer an 
                        entity that engages in a de minimis quantity of 
                        swap dealing (which shall not be less than 
                        $8,000,000,000) in connection with transactions 
                        with or on behalf of its customers.
                            ``(ii) Regulations.--The Commission shall 
                        promulgate regulations to establish the factors 
                        to be used in a determination under clause (i) 
                        to exempt, including any monetary or other 
                        levels established by the Commission, and those 
                        levels shall only be amended or changed through 
                        an affirmative action of the Commission 
                        undertaken by rule or regulation.''.
    (b) Financial Entity.--Section 2(h)(7)(C) of the Commodity Exchange 
Act (7 U.S.C. 2(h)(7)(C)) is amended--
            (1) in clause (iii)--
                    (A) by striking ``an entity whose'' and inserting 
                the following: ``an entity--
                                    ``(I) whose'';
                    (B) by striking the period at the end and inserting 
                a semicolon; and
                    (C) by adding at the end the following:
                                    ``(II) that is--
                                            ``(aa) a commercial market 
                                        participant;
                                            ``(bb) included in clause 
                                        (i)(VIII); and
                                            ``(cc) not supervised by a 
                                        prudential regulator; or
                                    ``(III) that is included in clause 
                                (i)(VIII) because--
                                            ``(aa) the entity regularly 
                                        enters into foreign exchange or 
                                        derivatives transactions on 
                                        behalf of, or to hedge or 
                                        mitigate, whether directly or 
                                        indirectly, the commercial risk 
                                        of 1 or more entities within 
                                        the same commercial enterprise 
                                        as the entity; or
                                            ``(bb) of the making of 
                                        loans to 1 or more entities 
                                        within the same commercial 
                                        enterprise as the entity.''; 
                                        and
            (2) by adding at the end the following:
                            ``(iv) Same commercial enterprise.--For 
                        purposes of clause (iii)(III), an entity shall 
                        be considered to be within the same commercial 
                        enterprise as another entity if--
                                    ``(I) 1 of the entities owns, 
                                directly or indirectly, at least a 
                                majority ownership interest in the 
                                other entity and reports its financial 
                                statements on a consolidated basis and 
                                the consolidated financial statements 
                                include the financial results of both 
                                entities; or
                                    ``(II) a third party owns at least 
                                a majority ownership interest in both 
                                entities and reports its financial 
                                statements on a consolidated basis and 
                                the financial statements of the third 
                                party include the financial results of 
                                both entities.
                            ``(v) Predominantly engaged.--
                                    ``(I) In general.--Not later than 
                                90 days after the date of enactment of 
                                this clause, the Commission shall 
                                promulgate regulations defining the 
                                term `predominantly engaged' for 
                                purposes of clause (i)(VIII).
                                    ``(II) Minimum revenues.--The 
                                regulations shall provide that an 
                                entity shall not be considered to be 
                                predominantly engaged in activities 
                                that are in the business of banking or 
                                financial in nature if the consolidated 
                                revenues of the entity derived from the 
                                activities constitute less than a 
                                percentage (as specified by the 
                                Commission in the regulations) of the 
                                total consolidated revenues of the 
                                entity.
                                    ``(III) Revenues from banking or 
                                financial activities.--In determining 
                                the percentage of the revenues of an 
                                entity that are derived from activities 
                                that are in the business of banking or 
                                financial in nature, the regulations 
                                shall exclude all revenues that are or 
                                result from foreign exchange or 
                                derivatives transactions used to hedge 
                                or mitigate commercial risk (as defined 
                                by the Commission in the 
                                regulations).''.

SEC. 3. REPORTING OF ILLIQUID SWAPS SO AS TO NOT DISADVANTAGE CERTAIN 
              NON-FINANCIAL END USERS.

    Section 2(a)(13) of the Commodity Exchange Act (7 U.S.C. 2(a)(13)) 
is amended--
            (1) in subparagraph (C), by striking ``The Commission'' and 
        inserting ``Except as provided in subparagraph (D), the 
        Commission'';
            (2) by redesignating subparagraphs (D) through (G) as 
        subparagraphs (E) through (H), respectively; and
            (3) by inserting after subparagraph (C) the following:
                    ``(D) Requirements for swap transactions in 
                illiquid markets.--
                            ``(i) Definition of illiquid markets.--In 
                        this subparagraph, the term `illiquid markets' 
                        means any market in which the volume and 
                        frequency of trading in swaps is at such a 
                        level as to allow identification of individual 
                        market participants.
                            ``(ii) Requirements.--Notwithstanding 
                        subparagraph (C), the Commission shall--
                                    ``(I) provide by rule for the 
                                public reporting of swap transactions, 
                                including price and volume data, in 
                                illiquid markets that are not cleared 
                                and entered into by a nonfinancial 
                                entity that is hedging or mitigating 
                                commercial risk in accordance with 
                                subsection (h)(7)(A); and
                                    ``(II) ensure that the swap 
                                transaction information described in 
                                subclause (I) is available to the 
                                public not sooner than 30 days after 
                                the swap transaction has been executed 
                                or at such later date as the Commission 
                                determines appropriate to protect the 
                                identity of participants and positions 
                                in illiquid markets and to prevent the 
                                elimination or reduction of market 
                                liquidity.''.

SEC. 4. TREATMENT OF AFFILIATES.

    Section 2(h)(7)(D)(i) of the Commodity Exchange Act (7 U.S.C. 
2(h)(7)(D)(i)) is amended--
            (1) by striking ``An affiliate'' and inserting ``A person 
        that is a financial entity and is an affiliate'';
            (2) by striking ``(including affiliate entities 
        predominantly engaged in providing financing for the purchase 
        of the merchandise or manufactured goods of the person)''; and
            (3) by striking ``and as an agent''.

SEC. 5. APPLICABILITY TO BONA FIDE HEDGE TRANSACTIONS OR POSITIONS.

    Section 4a(c) of the Commodity Exchange Act (7 U.S.C. 6a(c)) is 
amended--
            (1) in the second sentence of paragraph (1), by striking 
        ``into the future for which'' and inserting ``in the future, to 
        be determined by the Commission, for which either an 
        appropriate swap is available or''; and
            (2) in paragraph (2)--
                    (A) in the matter preceding subparagraph (A), by 
                striking ``subsection (a)(2)'' and all that follows 
                through ``position that--'' and inserting ``paragraphs 
                (2) and (5) of subsection (a) for swaps, contracts of 
                sale for future delivery, or options on the contracts 
                or commodities, a bona fide hedging transaction or 
                position is a transaction or position that--''; and
                    (B) in subparagraph (A)(ii), by striking ``of 
                risks'' and inserting ``or management of current or 
                anticipated risks''; and
            (3) by adding at the end the following:
            ``(3) Commission definition.--The Commission may further 
        define, by rule or regulation, what constitutes a bona fide 
        hedging transaction or position so long as the rule or 
        regulation is consistent with the requirements of subparagraphs 
        (A) and (B) of paragraph (2).''.

SEC. 6. REPORTING AND RECORDKEEPING.

    Section 4g(f) of the Commodity Exchange Act (7 U.S.C. 6g(f)) is 
amended--
            (1) by striking ``(f) Nothing contained in this section'' 
        and inserting the following:
    ``(f) Authority of Commission To Make Separate Determinations 
Unimpaired.--
            ``(1) In general.--Except as provided in paragraph (2), 
        nothing in this section''; and
            (2) by adding at the end the following:
            ``(2) Exception.--If the Commission imposes any requirement 
        under this section on any person that is not registered, or 
        required to be registered, with the Commission in any capacity, 
        that person shall satisfy the requirements of any rule, order, 
        or regulation under this section by maintaining a written 
        record of each cash or forward transaction related to a 
        reportable or hedging commodity interest transaction, futures 
        contract, option on a futures contract, or swap.
            ``(3) Sufficiency.--A written record described in paragraph 
        (2) shall be sufficient if the written record--
                    ``(A) memorializes the final agreement between the 
                parties, including the material economic terms of the 
                transaction; and
                    ``(B) is identifiable and searchable by 
                transaction.''.

SEC. 7. MARGIN REQUIREMENTS.

    (a) Commodity Exchange Act Amendment.--Section 4s(e) of the 
Commodity Exchange Act (7 U.S.C. 6s(e)) is amended by adding at the end 
the following:
            ``(4) Applicability with respect to counterparties.--The 
        requirements of paragraphs (2)(A)(ii) and (2)(B)(ii), including 
        the initial and variation margin requirements imposed by rules 
        adopted pursuant to paragraphs (2)(A)(ii) and (2)(B)(ii), shall 
        not apply to a swap in which a counterparty qualifies for an 
        exception under section 2(h)(7)(A) or 2(h)(7)(D), or an 
        exemption issued under section 4(c)(1) from the requirements of 
        section 2(h)(1)(A) for cooperative entities as defined in that 
        exemption.''.
    (b) Securities Exchange Act Amendment.--Section 15F(e) of the 
Securities Exchange Act of 1934 (15 U.S.C. 78o-10(e)) is amended by 
adding at the end the following:
            ``(4) Applicability with respect to counterparties.--The 
        requirements of paragraphs (2)(A)(ii) and (2)(B)(ii) shall not 
        apply to a security-based swap in which a counterparty 
        qualifies for an exception under section 3C(g)(1) or satisfies 
        the criteria in section 3C(g)(4).''.
    (c) Implementation.--The amendments made by this section to the 
Commodity Exchange Act (7 U.S.C. 1 et seq.) shall be implemented--
            (1) without regard to--
                    (A) chapter 35 of title 44, United States Code; and
                    (B) the notice and comment provisions of section 
                553 of title 5, United States Code;
            (2) through the promulgation of an interim final rule, 
        pursuant to which public comment is sought before a final rule 
        is issued; and
            (3) such that paragraph (1) shall apply solely to changes 
        to rules and regulations, or proposed rules and regulations, 
        that are limited to and directly a consequence of the 
        amendments.

SEC. 8. ANALYSIS BY THE COMMODITY FUTURES TRADING COMMISSION OF THE 
              COSTS AND BENEFITS OF REGULATIONS AND ORDERS.

    Section 15(a) of the Commodity Exchange Act (7 U.S.C. 19(a)) is 
amended by striking paragraphs (1) and (2) and inserting the following:
            ``(1) In general.--Before promulgating a regulation under 
        this Act or issuing an order (except as provided in paragraph 
        (3)), the Commission, acting through the Office of the Chief 
        Economist, shall--
                    ``(A) state a justification for the regulation or 
                order;
                    ``(B) state the baseline for the cost-benefit 
                analysis and explain how the regulation or order 
                measures costs against the baseline;
                    ``(C) assess the costs and benefits, both 
                qualitative and quantitative, of the intended 
                regulation or order;
                    ``(D) measure, and seek to improve, the actual 
                results of regulatory requirements; and
                    ``(E) propose or adopt a regulation or order only 
                on a reasoned determination that the benefits of the 
                intended regulation or order justify the costs of the 
                intended regulation or order (recognizing that some 
                benefits and costs are difficult to quantify).
            ``(2) Considerations.--In making a reasoned determination 
        of costs and benefits under paragraph (1), the Commission shall 
        consider--
                    ``(A) the protection of market participants and the 
                public;
                    ``(B) the efficiency, competitiveness, and 
                financial integrity of futures and swaps markets;
                    ``(C) the impact on market liquidity in the futures 
                and swaps markets;
                    ``(D) price discovery;
                    ``(E) sound risk management practices;
                    ``(F) the cost of available alternatives to direct 
                regulation;
                    ``(G) the degree and nature of the risks posed by 
                various activities within the scope of the jurisdiction 
                of the Commission;
                    ``(H) whether, consistent with obtaining regulatory 
                objectives, the regulation or order is tailored to 
                impose the least burden on society, including market 
                participants, individuals, businesses of differing 
                sizes, and other entities (including small communities 
                and governmental entities), taking into account, to the 
                extent practicable, the cumulative costs of regulations 
                and orders;
                    ``(I) whether the regulation or order is 
                inconsistent, incompatible, or duplicative of other 
                Federal regulations and orders; and
                    ``(J) whether, in choosing among alternative 
                regulatory approaches, those approaches maximize net 
                benefits (including potential economic, environmental, 
                and other benefits, distributive impacts, and 
                equity).''.

SOLUTION: End-User Protection Act of 2014 - Amends the Commodity Exchange Act with respect to exceptions to the requirement that any swap be cleared by a derivatives clearing organization either registered under that Act, or exempted from registration, if the swap is required to be cleared. Revises the definition of a financial entity subject to such requirement to exclude one that: (1) is a commercial market participant predominantly engaged in activities in the business of banking, or in activities that are financial in nature, but is not supervised by a prudential regulator; or (2) is considered as predominantly engaged in activities in the business of banking or in financial activities because it regularly enters into foreign exchange or derivatives transactions on behalf of, or to hedge or mitigate the commercial risk of, one or more other entities within the entity's same commercial enterprise, or because of making loans to one or more of such other entities. Directs the Commodity Futures Trading Commission (CFTC) to provide by rule for the public reporting of swap transactions, including price and volume data, in illiquid markets that are not cleared and entered into by a nonfinancial entity that is hedging or mitigating commercial risk. Defines &quot;illiquid&quot; as any market in which the volume and frequency of trading in swaps is at such a level as to allow identification of individual market participants. Requires the CFTC to ensure that such swap transaction information is not available to the public until 30 days after the transaction has been executed, or at an appropriate later date, in order to: (1) protect the identity of participants and positions in illiquid markets, and (2) prevent the elimination or reduction of market liquidity. Accords financial entities exempt from swap-clearing requirements the same treatment as exempted affiliates. Revises the exemption of bona fide hedge transactions or positions from certain trading limitations to set criteria for CFTC rules or regulations treating swaps, contracts of sale for future delivery, or options on the contracts or commodities as bona fide hedge transactions or positions also exempt from those limitations. Declares that, if the CFTC imposes any reporting and recordkeeping requirement on any person that is not registered, or required to be registered, with the CFTC, that person shall satisfy the requirements of any pertinent rule, order, or regulation by maintaining a written record of each cash or forward transaction related to a reportable or hedging commodity interest transaction, futures contract, option on a futures contract, or swap. Makes such a written record sufficient if it: (1) memorializes the final agreement between the parties, including the transaction's material economic terms; and (2) is identifiable and searchable by transaction. States that certain requirements for adoption of rules governing capital and margin requirements for swap dealers and major swap participants, including the initial and variation margin requirements imposed by rules adopted according to such requirements, shall not apply to a swap in which a counterparty qualifies for specified exceptions or exemptions. Revises requirements for a CFTC cost-benefit analysis made before an order is issued. Requires the CFTC, acting through the Office of the Chief Economist, among other things to:  state a justification for the regulation or order; state the baseline for the cost-benefit analysis and explain how the regulation or order measures costs against the baseline; assess the costs and benefits, both qualitative and quantitative, of the intended regulation or order; measure, and seek to improve, the actual results of regulatory requirements; and propose or adopt a regulation or order only on a reasoned determination that the benefits of the intended regulation or order justify its costs. 

PROBLEM: 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.

SOLUTION: 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.

PROBLEM: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``RAFT (Restore Access to Foreign 
Trade) Act''.

SEC. 2. ELIMINATION OF FOREIGN BASE COMPANY SHIPPING INCOME AS FOREIGN 
              BASE COMPANY INCOME.

    (a) Elimination of Foreign Base Company Shipping Income.--Section 
954 of the Internal Revenue Code of 1986 (relating to foreign base 
company income) is amended--
            (1) by striking paragraph (4) of subsection (a) (relating 
        to foreign base company shipping income), and
            (2) by striking subsection (f) (relating to foreign base 
        company shipping income).
    (b) Conforming Amendments.--
            (1) Subparagraph (D) of section 904(d)(2) of such Code 
        (relating to the definition of shipping income for purposes of 
        the foreign tax credit) is amended to read as follows:
                    ``(D) Shipping income.--
                            ``(i) In general.--The term `shipping 
                        income' means income derived from, or in 
                        connection with, the use (or hiring or leasing 
                        for use) of any aircraft or vessel in foreign 
                        commerce, or from, or in connection with, the 
                        performance of services directly related to the 
                        use of any such aircraft, or vessel, or from 
                        the sale, exchange, or other disposition of any 
                        such aircraft or vessel.
                            ``(ii) Special rules.--
                                    ``(I) Such term includes dividends 
                                and interest received from a foreign 
                                corporation in respect of which taxes 
                                are deemed paid under section 902 
                                (other than dividends from a 
                                noncontrolled section 902 corporation 
                                out of earnings and profits accumulated 
                                in taxable years beginning before 
                                January 1, 2003) and gain from the 
                                sale, exchange, or other disposition of 
                                stock or obligations of such a foreign 
                                corporation to the extent that such 
                                dividends, interest, and gains are 
                                attributable to shipping income.
                                    ``(II) Such term includes that 
                                portion of the distributive share of 
                                the income of a partnership 
                                attributable to shipping income.
                                    ``(III) Such term includes any 
                                income derived from a space or ocean 
                                activity (as defined in section 
                                863(d)(2)).
                                    ``(IV) Such term does not include, 
                                except as provided in subclause (I), 
                                any dividend or interest income which 
                                is foreign personal holding company 
                                income as defined in section 954(c).
                                    ``(V) Such term does not include 
                                financial services income.''.
            (2) Section 952(c)(1)(B)(iii) of such Code is amended by 
        striking subclause (I) and redesignating subclauses (II) 
        through (VI) as subclauses (I) through (V), respectively.
            (3) Section 953 of such Code is amended--
                    (A) by striking ``954(i)'' and inserting ``954(h)'' 
                in subsections (b)(3) and (e) each place it appears, 
                and
                    (B) by striking ``954(h)(7)'' and inserting 
                ``954(g)(7)'' in subsection (e)(7)(A).
            (4) Section 954 of such Code is amended--
                    (A) in subsection (a) by inserting ``and'' at the 
                end of paragraph (3) and redesignating paragraph (5) as 
                paragraph (4),
                    (B) in subsection (b)--
                            (i) by striking ``the foreign base shipping 
                        income,'' in paragraph (5),
                            (ii) by striking paragraphs (6) and (7), 
                        and
                            (iii) by redesignating paragraph (8) as 
                        paragraph (6), and
                    (C) by redesignating subsections (g), (h), and (i) 
                as subsections (f), (g), and (h), respectively.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years of foreign corporations beginning after December 
31, 2001, and to taxable years of United States shareholders (within 
the meaning of section 951(b) of the Internal Revenue Code of 1986) 
within which or with which such taxable years of such foreign 
corporations end.

SOLUTION:
RAFT (Restore Access to Foreign Trade) Act - Amends the Internal Revenue Code to eliminate foreign base company shipping income from inclusion as foreign base company income.Revises the definition of "shipping income" with respect to the application of the foreign tax credit.