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SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medical Malpractice Reform Act of
1994''.

SEC. 2. CALCULATION AND PAYMENT OF DAMAGES IN MEDICAL MALPRACTICE
CLAIMS AND ACTIONS.

(a) Limitation on Noneconomic Damages.--The total amount of
noneconomic damages that may be awarded to a claimant and the members
of the claimant's family for losses resulting from the injury which is
the subject of a medical malpractice liability claim or action may not
exceed $250,000, regardless of the number of parties against whom the
claim or action is brought or the number of actions brought with
respect to the injury.
(b) Mandatory Offsets for Damages Paid by a Collateral Source.--
(1) In general.--With respect to a medical malpractice
liability claim or action, the total amount of damages received
by an individual under such claim or action shall be reduced,
in accordance with paragraph (2), by any other payment that has
been, or will be, made to an individual to compensate such
individual for the injury that was the subject of such claim or
action.
(2) Amount of reduction.--The amount by which an award of
damages to an individual for an injury shall be reduced under
paragraph (1) shall be--
(A) the total amount of any payments (other than
such award) that have been made or that will be made to
such individual to pay costs of or compensate such
individual for the injury that was the subject of the
claim or action; minus
(B) the amount paid by such individual (or by the
spouse, parent, or legal guardian of such individual)
to secure the payments described in subparagraph (A).
(c) Periodic Payments for Future Losses.--
(1) General rule.--In any medical malpractice liability
claim or action in which future economic damages exceed
$100,000, a defendant may not be required to pay such damages
in a single, lump-sum payment, but shall be permitted to make
such payments periodically based on when the damages are found
likely to occur, as such payments are determined by the court.
(2) Waiver.--A court may waive the application of paragraph
(1) with respect to a defendant if the court determines that it
is not in the best interests of the plaintiff to receive
payments for damages on such a periodic basis.

SEC. 3. LIMITATION ON ATTORNEYS' CONTINGENCY FEES AND OTHER COSTS UNDER
MEDICAL MALPRACTICE CLAIMS.

(a) In General.--An attorney who represents, on a contingency fee
basis, a claimant in a medical malpractice liability claim may not
charge, demand, receive, or collect for services rendered in connection
with such claim in excess of the following amount recovered by judgment
or settlement under such claim:
(1) 25 percent of the first $150,000 (or portion thereof)
recovered, plus
(2) 10 percent of any amount in excess of $150,000
recovered.
(b) Calculation of Periodic Payments.--In the event that a judgment
or settlement includes periodic or future payments of damages, the
amount recovered for purposes of computing the limitation on the
contingency fee under subsection (a) shall be based on the cost of the
annuity or trust established to make the payments. In any case in which
an annuity or trust is not established to make such payments, such
amount shall be based on the present value of the payments.

SEC. 4. APPLICABILITY; EFFECT ON STATE LAW.

(a) Applicability.--This Act shall apply with respect to any
medical malpractice liability claim and to any medical malpractice
liability action brought in any State or Federal court, except that
this subtitle shall not apply to a claim or action for damages arising
from a vaccine-related injury or death to the extent that title XXI of
the Public Health Service Act applies to the claim or action.
(b) Preemption.--The provisions of this Act shall preempt any State
law to the extent such law is inconsistent with such provisions, except
that such provisions shall not preempt any State law that places
greater limitations on the amount of damages that may be awarded or the
amount of attorneys' fees that may be collected with respect to medical
malpractice liability claims.
(c) Effect on Sovereign Immunity and Choice of Law or Venue.--
Nothing in subsection (b) shall be construed to--
(1) waive or affect any defense of sovereign immunity
asserted by any State under any provision of law;
(2) waive or affect any defense of sovereign immunity
asserted by the United States;
(3) affect the applicability of any provision of the
Foreign Sovereign Immunities Act of 1976;
(4) preempt State choice-of-law rules with respect to
claims brought by a foreign nation or a citizen of a foreign
nation; or
(5) affect the right of any court to transfer venue or to
apply the law of a foreign nation or to dismiss a claim of a
foreign nation or of a citizen of a foreign nation on the
ground of inconvenient forum.
(d) Federal Court Jurisdiction Not Established on Federal Question
Grounds.--Nothing in this Act shall be construed to establish any
jurisdiction in the district courts of the United States over medical
malpractice liability actions on the basis of section 1331 or 1337 of
title 28, United States Code.

SEC. 5. DEFINITIONS.

As used in this Act:
(1) Claimant.--The term ''claimant'' means any person who
alleges a medical malpractice liability claim, and any person
on whose behalf such a claim is alleged, including the decedent
in the case of an action brought through or on behalf of an
estate.
(2) Economic damages.--The term ''economic damages'' means
damages paid to compensate an individual for hospital and other
medical expenses, lost wages, lost employment, and other
pecuniary losses.
(3) Health care professional.--The term ''health care
professional'' means any individual who provides health care
services in a State and who is required by the laws or
regulations of the State to be licensed or certified by the
State to provide such services in the State.
(4) Health care provider.--The term ''health care
provider'' means any organization or institution that is
engaged in the delivery of health care services in a State and
that is required by the laws or regulations of the State to be
licensed or certified by the State to engage in the delivery of
such services in the State.
(5) Injury.--The term ''injury'' means any illness,
disease, or other harm that is the subject of a medical
malpractice liability action or a medical malpractice liability
claim.
(6) Medical malpractice liability action.--The term
''medical malpractice liability action'' means a civil action
brought in a State or Federal court against a health care
provider or health care professional in which the plaintiff
alleges a medical malpractice liability claim, but does not
include any action in which the plaintiff's sole allegation is
an allegation of an intentional tort.
(7) Medical malpractice liability claim.--The term
''medical malpractice liability claim'' means a claim in which
the claimant alleges that injury was caused by the provision of
(or the failure to provide) health care services or the use of
a medical product.
(8) Medical product.--
(A) In general.--The term ''medical product''
means, with respect to the allegation of a claimant, a
drug (as defined in section 201(g)(1) of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 321(g)(1)) or a
medical device (as defined in section 201(h) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(h))
if--
(i) such drug or device was subject to
premarket approval under section 505, 507, or
515 of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 355, 357, or 360e) or section 351 of
the Public Health Service Act (42 U.S.C. 262)
with respect to the safety of the formulation
or performance of the aspect of such drug or
device which is the subject of the claimant's
allegation or the adequacy of the packaging or
labeling of such drug or device, and such drug
or device is approved by the Food and Drug
Administration; or
(ii) the drug or device is generally
recognized as safe and effective under
regulations issued by the Secretary of Health
and Human Services under section 201(p) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C.
321(p)).
(B) Exception in case of misrepresentation or
fraud.--Notwithstanding subparagraph (A), the term
''medical product'' shall not include any product
described in such subparagraph if the claimant shows
that the product is approved by the Food and Drug
Administration for marketing as a result of withheld
information, misrepresentation, or an illegal payment
by manufacturer of the product.
(9) Noneconomic damages.--The term ''noneconomic damages''
means damages paid to compensate an individual for physical and
emotional pain, suffering, inconvenience, physical impairment,
mental anguish, disfigurement, loss of enjoyment of life, loss
of consortium, and other nonpecuniary losses, but does not
include punitive damages.
(10) Punitive damages.--The term ''punitive damages'' means
compensation, in addition to compensation for actual harm
suffered, that is awarded for the purpose of punishing a person
for conduct deemed to be malicious, wanton, willful, or
excessively reckless.
(11) State.--The term ''State'' means each of the several
States, the District of Columbia, the Commonwealth of Puerto
Rico, the Virgin Islands, Guam, and American Samoa.

SEC. 6. EFFECTIVE DATE.

This Act shall apply with respect to claims accruing or actions
brought on or after the date of the enactment of this Act.
Output:
Medical Malpractice Reform Act of 1994 - Limits to $250,000 the total amount of noneconomic damages that may be awarded to a claimant and members of the claimant's family for losses resulting from the injury which is the subject of a medical malpractice liability claim or action (claim), regardless of the number of parties against whom the claim is brought or the number of actions brought.
Provides for a reduction of the total amount of damages received by an individual under such claim by any other payment made to compensate for the injury.
Specifies that, in any such claim in which future economic damages exceed $100,000, a defendant shall be permitted to make payments periodically, rather than in a single, lump-sum payment, based on when the damages are found likely to occur. Permits a court to waive such provision if the court determines that it is not in the plaintiff's best interests to receive payments on a periodic basis.
Prohibits an attorney from charging or collecting a contingency fee for services rendered in connection with such a claim in excess of: (1) 25 percent of the first $150,000 (or portion thereof) recovered, plus; (2) ten percent of any amount in excess of $150,000 recovered.
Makes this Act applicable to any such claim brought in State or Federal court, except with respect to a claim for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies.
Sets forth provisions regarding: (1) preemption; and (2) effect on sovereign immunity and choice of law or venue.