Federally Supported Health Centers Assistance Act of 1992
PL 102-501 (H.R.6183), enacted 10/24/1992

106 STAT. 3268 
PUBLIC LAW 102-501—OCT. 24, 1992 
Public Law 102-501 
102d Congress 
An Act 
Oct. 24, 1992 
To amend the Public Health Service Act to provide protections from legal liability 
[H.R. 6183] 
for certain health care professionals providing services pursuant to such Act. 
Be it enacted by the Senate and House of Representatives of 
Federally 
the United States of 
America in Congress assembled, 
Supported 
^ 
^ 
Health Centers 
SECTION 1. SHORT TITLE. 
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This Act may be cited as the "Federally Supported Health 
42 use 201 note. Centers Assistance Act of 1992". 
SEC. 2. LIABILITY PROTECTIONS FOR CERTAIN HEALTH CARE 
PROFESSIONALS. 
(a) IN GENERAL.—Section 224 of the Public Health Service 
Act (42 U.S.C. 233) is amended by adding at the end the following 
new subsection: 
"(gXD For purposes of this section, an entity described in 
paragraph (4) and any officer, employee, or contractor (subject to 
paragraph (5)) of such an entity who is a physician or other licensed 
or certified health care practitioner shall 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 of the full amount 
estimated under subsection (kXl)(A) was made under subsection 
(k)(3) (subject to paragraph (3)). The remedy against the United 
States for an entity described in paragraph (4) and any officer, 
employee, or contractor (subject to paragraph (5)) of such an entity 
who is deemed to be an employee of the Public Health Service 
pursuant to this paragraph shall be exclusive of any other civil 
action or proceeding to tne same extent as the remedy against 
the United States is exclusive pursuant to subsection (a). 
"(2) If, with respect to an entity or person deemed to be an 
employee for purposes of paragraph (1), a cause of action is 
instituted against the United States pursuant to this section, any 
claim of the entity or person for benents under an insurance policy 
with respect to medical malpractice relating to such cause of action 
shall be subrogated to the United States. 
"(3) This subsection shall apply with respect to a cause of 
action arising from an act or omission which occurs on or after 
January 1, 1993. This subsection shall not apply with respect to 
a cause of action arising from an act or omission which occurs 
on or after January 1,1996. 
"(4) An entity described in this paragraph is a public or non-
profit private entity receiving Federal funds under any of the follow-
ing grant programs: 
"(A) Section 329 (relating to grants for migrant health 
centers). 
"(B) Section 330 (relating to grants for community health 
centers). 
"(C) Section 340 (relating to grants for health services 
for the homeless). 
PUBLIC LAW 102-501—OCT. 24, 1992 
106 STAT. 3269 
"(D) Section 340A (relating to grants for health services 
for residents of public housing). 
"(5) For purposes of paragraph (1), an individual may be consid-
ered a contractor of an entity described in paragraph (4) only 
if— 
"(A) the individual normally performs on average at least 
32V2 hours of service per week tor the entity for the period 
of the contract; or 
"(B) in the case of an individual who normally performs 
on average less than 32V2 hours of services per week for the 
entity for the period of the contract and is a licensed or certified 
provider of obstetrical services— 
"(i) the indiviidual's medical malpractice Uability insur-
ance coverage does not extend to services performed by 
the individual for the entity under the contract, or 
"(ii) the Secretary finds that patients to whom the 
entity furnishes services will be deprived of obstetrical 
services if such individual is not considered a contractor 
of the entity for purposes of paragraph (1).". 
(b) REQUIREMENT OF APPROPRIATE POUCIES AND PROCEDURES 
REGARDING HEALTH CARE: PROFESSIONALS.—Section 224 of the Pub-
lic Health Service Act, as amended by subsection (a), is further 
amended by adding at the end the following new subsection: 
"(h) Notwithstanding subsection (gXD, the Secretary, in con-
sultation with the Attorney Greneral, may not deem an entity 
described in subsection (g)(4) to be an employee of the Public 
Health Service Act for purposes of this section unless the entity— 
''(I) has implemented appropriate policies and procedures 
to reduce the risk of malpractice and the risk of lawsuits 
arising out of any health or health-related functions performed 
by the, entity; 
"(2) has reviewed and verified the professional credentials, 
references, claims history, fitness, professional review organiza-
tion findings, and license stetiis of its physicians and other 
licensed or certified health care practitioners, and, where nec-
essary, has obtoined the permission from these individuals 
to gain access to this information; 
"(3) has no history of claims having been filed against 
the United Stetes as a result of the application of this section 
to the entity or its officers, employees, or contractors as pro-
vided for under this section, or, if such a history exists, has 
fully cooperated with the Attorney General in defending against 
any such claims and either has taken, or will teke, any nec-
essary corrective steps to assure against such claims m the 
future; and 
"(4) has fully cooperated with the Attorney General in 
providing information relating to an estimate described under 
subsection (k).". 
(c) AUTHORIZATION FOR THE ATTORNEY GENERAL TO EXCLUDE 
CERTAIN HEALTH CARE PROFESSIONALS FROM COVERAGE.—Section 
224 of the Public Health Service Act, as amended by subsections 
(a) and (b), is further amended by adding at the end the following 
new subsection: 
"(iXD Notwithstanding subsection (gXD, the Attorney General, 
in consultation with the Secretary, may determine, after notice 
and opportunity for a hearing, that an individual physician or 
other licensed or certified health care practitioner who is an officer. 
106 STAT. 3270 
PUBLIC LAW 102-501—OCT. 24, 1992 
employee, or contractor of an entity described in subsection (gX4) 
shall not be deemed to be an employee of the Public Health Service 
for purposes of this section, if treating such individual as such 
an employee would expose the Government to an unreasonably 
high degree of risk of loss because such individual— 
"(A) does not comply with the policies and procedures that 
the entity has implemented pursuant to subsection (hXD; 
"(B) has a history of claims filed against him or her as 
{>rovided for under this section that is outside the norm for 
icensed or certified health care practitioners within the same 
specialty; 
"(C) refused to reasonably cooperate with the Attorney 
General in defending against any sucn claim; 
"(D) provided false information relevant to the individual's 
performance of his or her duties to the Secretary, the Attorney 
Greneral, or an applicant for or recipient of funds under this 
Act; or 
"(E) was the subject of disciplinary action taken by a State 
medical licensing authority or a State or national professional 
society. 
"(2) A final determination by the Attorney General under this 
subsection that an individual physician or other licensed or certified 
health care professional shall not be deemed to be an employee 
of the Public Health Service shall be effective upon receipt by 
the entity employing such individual of notice of such determination, 
and shall apply only to acts or omissions occurring after the date 
such notice is received.". 
SEC. 3. HOSPITAL ADMimNG PRIVILEGES FOR CERTAIN HEALTH 
CARE PROVIDERS. 
Section 224 of the Public Health Service Act, as amended 
by section 2, is further amended by adding at the end the following 
new subsection: 
"(j) In the case of a health care provider who is an officer, 
employee, or contractor of an entity described in subsection (g)(4), 
section 335(e) shall apply with respect to the provider to the same 
extent and in the same manner as such section applies to any 
member of the National Health Service Corps.". 
SEC. 4. PAYMENT OF JUDGMENTS. 
Section 224 of the Public Health Service Act, as amended 
by sections 2 and 3, is further amended by adding at the end 
the following new subsection: 
"(kXlXA) For each of the fiscal years 1993, 1994, and 1995, 
the Attorney General, in consultation with the Secretary, shall 
estimate by the beginning of the year (except that an estimate 
shall be made for fiscal year 1993 bv December 31, 1992, subject 
to an adjustment within 90 days thereafter) the amount of all 
claims which are expected to arise under this section (together 
with related fees and expenses of witnesses) for which pajmient 
is expected to be made in accordance with section 1346 and chapter 
171 of title 28, United States Code, from the acts or omissions, 
during the calendar year that begins during that fiscal year, of 
entities described in subsection (g)(4) and of officers, employees, 
or contractors (subject to subsection (g)(5)) of such entities. 
"(B) The estimate imder subparagraph (A) shall take into 
account— 
PUBLIC LAW 102-501—OCT. 24, 1992 
106 STAT. 3271 
"(i) the value and frequency of all claims for damage for 
personal injury, including death, resulting from the perform-
ance of medical, surgical, dental, or related functions by entities 
described in subsection (gX4) or by officers, employees, or con-
tractors (subject to subsection (gX5)) of such entities who are 
deemed to be employees of the Public Health Service under 
subsection (gXD that, during the preceding 5-year period, are 
filed imder this section or, with respect to years occurring 
before this subsection takes effect, are filed against persons 
other than the United States, 
"(ii) the amounts paid during that 5-year period on all 
claims described in clause (i), regardless of when such claims 
were filed, adjusted to reflect payments which would not be 
permitted under section 1346 and chapter 171 of title 28, United 
States Code, and 
"(iii) amounts in the fund established imder paragraph 
(2) but unspent from prior fiscal years. 
"(2) Subject to appropriations, for each of the fiscal years 1993, 
1994, and 1995, the Secretary shall establish a fund of an amoiint 
equal to the amount estimated under paragraph (1) that is attrib-
utable to entities receiving funds under each of the grant programs 
described in paragraph (4) of subsection (g), but not to exceed 
a total of $30,000,000 for each such fiscal year. 
"(3) In order for payments to be made for judgments against 
the United States (together with related fees and expenses of wit-
nesses) pursuant to this section arising from the acts or omissions 
of entities described in subsection (gX4) and of officers, employees, 
or contractors (subject to subsection (gX5)) of such entities, the 
total amount contained within the fund established by the Secretary 
under paragraph (2) for a fiscal year shall be transferred not later 
than the December 31 that occurs during the fiscal year to the 
appropriate accounts in the Treasury.". 
SEC. 5. REPORT ON RISK EXPOSURE OF COVERED ENTITIES. 
42 USC 233 note. 
(a) IN GENERAL.—Not later than April 1, 1995, the Attorney 
Greneral, in consultation with the Secretary of Health and Human 
Services (hereafter referred to as the "Secretary"), shall submit 
a report to Congress on the medical malpractice liability claims 
experience of entities subject to section 224(g) of the Public Health 
Service Act (as added by section 2(a)) and the risk exposure associ-
ated with such entities. 
(b) EFFECT OF LIABILITY PROTECTIONS ON COSTS INCURRED 
BY COVERED ENTITIES.—The Attorney General's report under sub-
section (a) shall include an analysis by the Secretary comparing— 
(1) the Secreterir's estimate of the aggregate amounts that 
such entities (together with the of^cers, employees, and contrac-
tors of such entities who are subject to section 224(g) of such 
Act) would have directly or indirectly paid to obtain medical 
malpractice liability insurance coverage had section 224(g) of 
the Public Health Service Act not been enacted into law, with 
(2) the aggregate amounts by which the grants received 
106 STAT. 3272 
PUBLIC LAW 102-501—OCT. 24, 1992 
by such entities under the Public Health Service Act were 
reduced as a result of the enactment of section 224(kX2) of 
such Act. 
42 u s e 233 note. 
SEC. 6. EFFECTIVE DATE. 
The amendments made by this Act shall take effect on the 
date of the enactment of this Act. 
Approved October 24, 1992. 
LEGISLATIVE HISTORY—H.R. 6183: 
CONGRESSIONAL RECORD, Vol. 138 (1992): 
Oct. 5, considered and passed House. 
Oct. 8, considered and passed Senate.