H.R. 1215 — what changed
Protecting Access to Care Act of 2017
From Introduced in House to Reported in House. 9 sections amended and 2 removed between Introduced in House and Reported in House.
Sec. 2 Encouraging speedy resolution of claims
added
Statute of limitations— The time for the commencement of a health care lawsuit shall be 3 years after the date of injury or 1 year after the claimant discovers, or through the use of reasonable diligence should have discovered, the injury, whichever occurs first. In no event shall the time for commencement of a health care lawsuit exceed 3 years after the date of injury unless tolled for any of the following—
added
upon proof of fraud;
removed
Findings—
removed
Effect on health care access and costs— Congress finds that the current civil justice system is adversely affecting patient access to health care services, better patient care, and cost-efficient health care, in that the health care liability system without reform is a costly and inefficient mechanism for resolving claims of health care liability and compensating injured patients, and is a deterrent to the sharing of information among health care professionals which impedes efforts to improve patient safety and quality of care.
removed
Effect on Federal spending—
removed
Congress finds that the health care liability litigation systems existing throughout the United States have a significant effect on the amount, distribution, and use of Federal funds because of—
removed
the large number of individuals who receive health care benefits under programs operated or financed by the Federal Government;
removed
the large number of individuals who benefit because of the exclusion from Federal taxes of the amounts spent to provide them with health insurance benefits; and
removed
the large number of health care providers who provide items or services for which the Federal Government makes payments.
removed
Congress finds that the Federal deficit would be reduced by $62 billion over the next decade if Federal health care liability reforms were enacted, as verified by the Congressional Budget Office.
changed
Effect on interstate commerce— Congress finds that the health care and insurance industries are industries affecting interstate commerce and the health care liability litigation systems existing throughout the United States are activities that affect interstate commerce by contributing to the high costs of health care and premiums for health care liability insurance purchased by health care system providers.intentional concealment; or
added
the presence of a foreign body, which has no therapeutic or diagnostic purpose or effect, in the person of the injured person.
changed
Purpose—State flexibility— It is the purpose No provision of this Act subsection (a) shall be construed to implement reasonable, comprehensive, and preempt any state law (whether effective health care liability reforms designed to—before, on, or after the date of the enactment of this Act) that—
changed
improve specifies a time period of less than 3 years after the availability date of health care services in cases in which health care liability actions injury or less than 1 year after the claimant discovers, or through the use of reasonable diligence should have been shown to be a factor in discovered, the decreased availability injury, for the filing of services;a health care lawsuit;
changed
reduce the incidence of “defensive medicine” and lower the cost of health care liability insurance, all of which contribute to that specifies a different time period for the escalation filing of health care costs;lawsuits by a minor;
changed
ensure that persons with meritorious health care injury claims receive fair and adequate compensation, including reasonable noneconomic damages;triggers the time period based on the date of the alleged negligence; or
changed
improve establishes a statute of repose for the fairness and cost-effectiveness filing of our current health care liability system to resolve disputes over, and provide compensation for, health care liability by reducing uncertainty in the amount of compensation provided to injured individuals; andlawsuit.
removed
provide an increased sharing of information in the health care system which will reduce unintended injury and improve patient care.
Sec. 3 Compensating patient injury
changed
Statute Unlimited amount of limitations—damages for actual economic losses in health care lawsuits— The time for the commencement of a In any health care lawsuit lawsuit, nothing in this Act shall be 3 years after the date of injury or 1 year after the claimant discovers, or through the use limit a claimant’s recovery of reasonable diligence should have discovered, the injury, whichever occurs first. In no event shall the time for commencement full amount of a health care lawsuit exceed 3 years after the date of injury unless tolled for any of available economic damages, notwithstanding the following—limitation in subsection (b).
removed
upon proof of fraud;
removed
intentional concealment; or
removed
the presence of a foreign body, which has no therapeutic or diagnostic purpose or effect, in the person of the injured person.
changed
State flexibility—Additional noneconomic damages— No provision In any health care lawsuit, the amount of subsection (a) noneconomic damages, if available, shall be construed to preempt any State law (whether effective before, on, or after not exceed $250,000, regardless of the date number of parties against whom the enactment action is brought or the number of this Act) that—separate claims or actions brought with respect to the same injury.
added
No discount of award for noneconomic damages— For purposes of applying the limitation in subsection (b), future noneconomic damages shall not be discounted to present value. The jury shall not be informed about the maximum award for noneconomic damages. An award for noneconomic damages in excess of $250,000 shall be reduced either before the entry of judgment, or by amendment of the judgment after entry of judgment, and such reduction shall be made before accounting for any other reduction in damages required by law. If separate awards are rendered for past and future noneconomic damages and the combined awards exceed $250,000, the future noneconomic damages shall be reduced first.
added
Fair share rule— In any health care lawsuit, each party shall be liable for that party’s several share of any damages only and not for the share of any other person. Each party shall be liable only for the amount of damages allocated to such party in direct proportion to such party’s percentage of responsibility. Whenever a judgment of liability is rendered as to any party, a separate judgment shall be rendered against each such party for the amount allocated to such party. For purposes of this section, the trier of fact shall determine the proportion of responsibility of each party for the claimant’s harm.
added
State flexibility— No provision of this section shall be construed to preempt any State law (whether effective before, on, or after the date of the enactment of this Act) that specifies a particular monetary amount of economic or noneconomic damages (or the total amount of damages) that may be awarded in a health care lawsuit, regardless of whether such monetary amount is greater or lesser than is provided for under this section.
removed
specifies a time period of less than 3 years after the date of injury or less than 1 year after the claimant discovers, or through the use of reasonable diligence should have discovered, the injury, for the filing of a health care lawsuit;
removed
that specifies a different time period for the filing of lawsuits by a minor;
removed
that triggers the time period based on the date of the alleged negligence; or
removed
establishes a statute of repose for the filing of health care lawsuit.
Sec. 4 Maximizing patient recovery
changed
Unlimited amount Court supervision of share of damages for actual economic losses in health care lawsuits—actually paid to claimants— In any health care lawsuit, nothing the court shall supervise the arrangements for payment of damages to protect against conflicts of interest that may have the effect of reducing the amount of damages awarded that are actually paid to claimants. In particular, in this Act any health care lawsuit in which the attorney for a party claims a financial stake in the outcome by virtue of a contingent fee, the court shall limit have the power to restrict the payment of a claimant’s damage recovery of to such attorney, and to redirect such damages to the full amount of claimant based upon the available economic damages, notwithstanding interests of justice and principles of equity. In no event shall the limitation total of all contingent fees for representing all claimants in subsection (b).a health care lawsuit exceed the following limits:
added
Forty percent of the first $50,000 recovered by the claimant(s).
added
Thirty-three and one-third percent of the next $50,000 recovered by the claimant(s).
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Twenty-five percent of the next $500,000 recovered by the claimant(s).
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Fifteen percent of any amount by which the recovery by the claimant(s) is in excess of $600,000.
changed
Additional noneconomic damages—Applicability— In any health care lawsuit, the amount of noneconomic damages, if available, The limitations in this section shall not exceed $250,000, regardless of the number of parties against whom apply whether the action recovery is brought by judgment, settlement, mediation, arbitration, or the number any other form of separate claims alternative dispute resolution. In a health care lawsuit involving a minor or actions brought with respect incompetent person, a court retains the authority to authorize or approve a fee that is less than the same injury.maximum permitted under this section. The requirement for court supervision in the first two sentences of subsection (a) applies only in civil actions.
changed
No discount of award for noneconomic damages—State flexibility— For purposes No provision of applying the limitation in subsection (b), future noneconomic damages this section shall not be discounted construed to present value. The jury shall not be informed about preempt any State law (whether effective before, on, or after the maximum award for noneconomic damages. An award for noneconomic damages in excess date of $250,000 shall be reduced either before the entry enactment of judgment, this Act) that specifies a lesser percentage or by amendment of the judgment after entry lesser total value of judgment, and such reduction shall be made before accounting for any other reduction in damages required by law. If separate awards are rendered for past and future noneconomic damages and the combined awards exceed $250,000, the future noneconomic damages shall which may be reduced first.claimed by an attorney representing a claimant in a health care lawsuit.
removed
Fair share rule— In any health care lawsuit, each party shall be liable for that party’s several share of any damages only and not for the share of any other person. Each party shall be liable only for the amount of damages allocated to such party in direct proportion to such party’s percentage of responsibility. Whenever a judgment of liability is rendered as to any party, a separate judgment shall be rendered against each such party for the amount allocated to such party. For purposes of this section, the trier of fact shall determine the proportion of responsibility of each party for the claimant’s harm.
removed
State flexibility— No provision of this section shall be construed to preempt any State law (whether effective before, on, or after the date of the enactment of this Act) that specifies a particular monetary amount of economic or noneconomic damages (or the total amount of damages) that may be awarded in a health care lawsuit, regardless of whether such monetary amount is greater or lesser than is provided for under this section.
Sec. 5 Authorization of payment of future damages to claimants in health care lawsuits
changed
Court supervision of share of damages actually paid to claimants—In general— In any health care lawsuit, the court shall supervise the arrangements for payment if an award of damages future damages, without reduction to protect present value, equaling or exceeding $50,000 is made against conflicts of interest that may have the effect of reducing the amount of damages awarded that are actually paid to claimants. In particular, in any health care lawsuit in which the attorney for a party claims with sufficient insurance or other assets to fund a financial stake in the outcome by virtue periodic payment of such a contingent fee, judgment, the court shall have the power to restrict shall, at the payment request of any party, enter a claimant’s damage recovery to such attorney, and to redirect such damages to judgment ordering that the claimant based upon future damages be paid by periodic payments, in accordance with the interests of justice and principles Uniform Periodic Payment of equity. In no event shall Judgments Act promulgated by the total National Conference of all contingent fees for representing all claimants in a health care lawsuit exceed the following limits:Commissioners on Uniform State Laws.
removed
Forty percent of the first $50,000 recovered by the claimant(s).
removed
Thirty-three and one-third percent of the next $50,000 recovered by the claimant(s).
removed
Twenty-five percent of the next $500,000 recovered by the claimant(s).
removed
Fifteen percent of any amount by which the recovery by the claimant(s) is in excess of $600,000.
changed
Applicability— The limitations in this This section shall apply whether the recovery is by judgment, settlement, mediation, arbitration, or any other form of alternative dispute resolution. In a health care lawsuit involving a minor or incompetent person, a court retains the authority applies to authorize or approve a fee that is less than the maximum permitted under this section. The requirement all actions which have not been first set for court supervision in trial or retrial before the first two sentences effective date of subsection (a) applies only in civil actions.this Act.
changed
State flexibility—Flexibility— No provision of this section shall be construed to preempt any State law (whether effective before, on, or after the date of the enactment of this Act) that specifies a lesser percentage periodic payments for future damages at any amount other than $50,000 or lesser total value that mandates such payments absent the request of damages which may be claimed by an attorney representing a claimant in a health care lawsuit.either party.
Sec. 6 Product liability for health care providers
added A health care provider who prescribes, or who dispenses pursuant to a prescription, a medical product approved, licensed, or cleared by the Food and Drug Administration shall not be named as a party to a product liability lawsuit involving such product and shall not be liable to a claimant in a class action lawsuit against the manufacturer, distributor, or seller of such product.
removed
Collateral source benefits— In any health care lawsuit involving injury or wrongful death, any party may introduce evidence of collateral source benefits. If a party elects to introduce such evidence, any opposing party may introduce evidence of any amount paid or contributed or reasonably likely to be paid or contributed in the future by or on behalf of the opposing party to secure the right to such collateral source benefits.
removed
Subrogation— No provider of collateral source benefits shall recover any amount against the claimant or receive any lien or credit against the claimant’s recovery or be equitably or legally subrogated to the right of the claimant in a health care lawsuit involving injury or wrongful death.
removed
Applicability— This section shall apply to any health care lawsuit that is settled as well as a health care lawsuit that is resolved by a fact finder. This section shall not apply to section 1862(b) (42 U.S.C. 1395y(b)) or section 1902(a)(25) (42 U.S.C. 1396a(a)(25)) of the Social Security Act.
removed
State flexibility— No provision of subsection (a) shall be construed to preempt any State law (whether effective before, on, or after the date of the enactment of this Act) that specifies a mandatory offset of collateral source benefits against an award in a health care liability lawsuit.
Sec. 7 Definitions
added In this Act:
removed
In general— In any health care lawsuit, if an award of future damages, without reduction to present value, equaling or exceeding $50,000 is made against a party with sufficient insurance or other assets to fund a periodic payment of such a judgment, the court shall, at the request of any party, enter a judgment ordering that the future damages be paid by periodic payments, in accordance with the Uniform Periodic Payment of Judgments Act promulgated by the National Conference of Commissioners on Uniform State Laws.
changed
Applicability—Alternative dispute resolution system; ADR— This section applies to all actions which have not been first set for trial The term “alternative dispute resolution system” or retrial before “ADR” means a system that provides for the effective date resolution of this Act.health care lawsuits in a manner other than through a civil action brought in a State or Federal court.
changed
State Flexibility—Claimant— No provision of this section shall be construed to preempt The term “claimant” means any State law (whether effective before, on, person who brings a health care lawsuit, including a person who asserts or after the date of the enactment claims a right to legal or equitable contribution, indemnity, or subrogation, arising out of this Act) that specifies periodic payments for future damages at a health care liability claim or action, and any amount other than $50,000 person on whose behalf such a claim is asserted or that mandates such payments absent the request of either party.an action is brought, whether deceased, incompetent, or a minor.
added
Collateral source benefits— The term “collateral source benefits” means any amount paid or reasonably likely to be paid in the future to or on behalf of the claimant, or any service, product, or other benefit provided or reasonably likely to be provided in the future to or on behalf of the claimant, as a result of the injury or wrongful death, pursuant to—
added
any State or Federal health, sickness, income-disability, accident, or workers’ compensation law;
added
any health, sickness, income-disability, or accident insurance that provides health benefits or income-disability coverage;
added
any contract or agreement of any group, organization, partnership, or corporation to provide, pay for, or reimburse the cost of medical, hospital, dental, or income-disability benefits; and
added
any other publicly or privately funded program.
added
Contingent fee— The term “contingent fee” includes all compensation to any person or persons which is payable only if a recovery is effected on behalf of one or more claimants.
added
Economic damages— The term “economic damages” means objectively verifiable monetary losses incurred as a result of the provision or use of (or failure to provide or use) health care services or medical products, such as past and future medical expenses, loss of past and future earnings, cost of obtaining domestic services, loss of employment, and loss of business or employment opportunities, unless otherwise defined under applicable state law. In no circumstances shall damages for health care services or medical products exceed the amount actually paid or incurred by or on behalf of the claimant.
added
Future damages— The term “future damages” means any damages that are incurred after the date of judgment, settlement, or other resolution (including mediation, or any other form of alternative dispute resolution).
added
Health care lawsuit— The term “health care lawsuit” means any health care liability claim concerning the provision of goods or services for which coverage was provided in whole or in part via a Federal program, subsidy or tax benefit, or any health care liability action concerning the provision of goods or services for which coverage was provided in whole or in part via a Federal program, subsidy or tax benefit, brought in a State or Federal court or pursuant to an alternative dispute resolution system, against a health care provider regardless of the theory of liability on which the claim is based, or the number of claimants, plaintiffs, defendants, or other parties, or the number of claims or causes of action, in which the claimant alleges a health care liability claim. Such term does not include a claim or action which is based on criminal liability; which seeks civil fines or penalties paid to Federal, State, or local government; or which is grounded in antitrust.
added
Health care liability action— The term “health care liability action” means a civil action brought in a State or Federal court or pursuant to an alternative dispute resolution system, against a health care provider regardless of the theory of liability on which the claim is based, or the number of plaintiffs, defendants, or other parties, or the number of causes of action, in which the claimant alleges a health care liability claim.
added
Health care liability claim— The term “health care liability claim” means a demand by any person, whether or not pursuant to ADR, against a health care provider, including, but not limited to, third-party claims, cross-claims, counter-claims, or contribution claims, which are based upon the provision or use of (or the failure to provide or use) health care services or medical products, regardless of the theory of liability on which the claim is based, or the number of plaintiffs, defendants, or other parties, or the number of causes of action.
added
Health care provider— The term “health care provider” means any person or entity required by State or Federal laws or regulations to be licensed, registered, or certified to provide health care services, and being either so licensed, registered, or certified, or exempted from such requirement by other statute or regulation, as well as any other individual or entity defined as a health care provider, health care professional, or health care institution under state law.
added
Health care services— The term “health care services” means the provision of any goods or services by a health care provider, or by any individual working under the supervision of a health care provider, that relates to the diagnosis, prevention, or treatment of any human disease or impairment, or the assessment or care of the health of human beings.
added
Medical product— The term “medical product” means a drug, device, or biological product intended for humans, and the terms “drug”, “device”, and “biological product” have the meanings given such terms in sections 201(g)(1) and 201(h) of the Federal Food, Drug and Cosmetic Act (21 U.S.C. 321(g)(1) and (h)) and section 351(a) of the Public Health Service Act (42 U.S.C. 262(a)), respectively, including any component or raw material used therein, but excluding health care services.
added
Noneconomic damages— The term “noneconomic damages” means damages for physical and emotional pain, suffering, inconvenience, physical impairment, mental anguish, disfigurement, loss of enjoyment of life, loss of society and companionship, loss of consortium (other than loss of domestic service), hedonic damages, injury to reputation, and all other nonpecuniary losses of any kind or nature incurred as a result of the provision or use of (or failure to provide or use) health care services or medical products, unless otherwise defined under applicable state law.
added
Recovery— The term “recovery” means the net sum recovered after deducting any disbursements or costs incurred in connection with prosecution or settlement of the claim, including all costs paid or advanced by any person. Costs of health care incurred by the plaintiff and the attorneys’ office overhead costs or charges for legal services are not deductible disbursements or costs for such purpose.
added
Representative— The term “representative” means a legal guardian, attorney, person designated to make decisions on behalf of a patient under a medical power of attorney, or any person recognized in law or custom as a patient’s agent.
added
State— The term “State” means each of the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, the Northern Mariana Islands, the Trust Territory of the Pacific Islands, and any other territory or possession of the United States, or any political subdivision thereof.
Sec. 8 Effect on other laws
added
Vaccine injury—
added
To the extent that title XXI of the Public Health Service Act establishes a Federal rule of law applicable to a civil action brought for a vaccine-related injury or death—
added
this Act does not affect the application of the rule of law to such an action; and
added
any rule of law prescribed by this Act in conflict with a rule of law of such title XXI shall not apply to such action.
added
If there is an aspect of a civil action brought for a vaccine-related injury or death to which a Federal rule of law under title XXI of the Public Health Service Act does not apply, then this Act or otherwise applicable law (as determined under this Act) will apply to such aspect of such action.
added
Other Federal law— Except as provided in this section, nothing in this Act shall be deemed to affect any defense available to a defendant in a health care lawsuit or action under any other provision of Federal law.
removed
A health care provider who prescribes, or who dispenses pursuant to a prescription, a medical product approved, licensed, or cleared by the Food and Drug Administration shall not be named as a party to a product liability lawsuit involving such product and shall not be liable to a claimant in a class action lawsuit against the manufacturer, distributor, or seller of such product.
Sec. 9 Rules of construction
added
Health care lawsuits— Unless otherwise specified in this Act, the provisions governing health care lawsuits set forth in this Act preempt, subject to subsections (b) and (c), State law to the extent that State law prevents the application of any provisions of law established by or under this Act. The provisions governing health care lawsuits set forth in this Act supersede chapter 171 of title 28, United States Code, to the extent that such chapter—
added
provides for a greater amount of damages or contingent fees, a longer period in which a health care lawsuit may be commenced, or a reduced applicability or scope of periodic payment of future damages, than provided in this Act; or
added
prohibits the introduction of evidence regarding collateral source benefits, or mandates or permits subrogation or a lien on collateral source benefits.
removed
In this Act:
changed
Alternative dispute resolution system; ADR—Protection of States’ rights and other laws— The term alternative dispute resolution system or ADR means a system Any issue that provides for the resolution is not governed by any provision of health care lawsuits in a manner other than through a civil action brought in a law established by or under this Act (including State standards of negligence) shall be governed by otherwise applicable State or Federal court.law
changed
Claimant—State Flexibility— The term claimant means No provision of this Act shall be construed to preempt any person who brings a health care lawsuit, including a person who asserts or claims a right defense available to legal or equitable contribution, indemnity, or subrogation, arising out of a party in a health care liability claim or action, and lawsuit under any person on whose behalf such a claim is asserted or such an action is brought, whether deceased, incompetent, other provision of State or a minor.Federal law.
removed
Collateral source benefits— The term collateral source benefits means any amount paid or reasonably likely to be paid in the future to or on behalf of the claimant, or any service, product, or other benefit provided or reasonably likely to be provided in the future to or on behalf of the claimant, as a result of the injury or wrongful death, pursuant to—
removed
any State or Federal health, sickness, income-disability, accident, or workers’ compensation law;
removed
any health, sickness, income-disability, or accident insurance that provides health benefits or income-disability coverage;
removed
any contract or agreement of any group, organization, partnership, or corporation to provide, pay for, or reimburse the cost of medical, hospital, dental, or income-disability benefits; and
removed
any other publicly or privately funded program.
removed
Contingent fee— The term contingent fee includes all compensation to any person or persons which is payable only if a recovery is effected on behalf of one or more claimants.
removed
Economic damages— The term economic damages means objectively verifiable monetary losses incurred as a result of the provision or use of (or failure to provide or use) health care services or medical products, such as past and future medical expenses, loss of past and future earnings, cost of obtaining domestic services, loss of employment, and loss of business or employment opportunities, unless otherwise defined under applicable State law. In no circumstances shall damages for health care services or medical products exceed the amount actually paid or incurred by or on behalf of the claimant.
removed
Future damages— The term future damages means any damages that are incurred after the date of judgment, settlement, or other resolution (including mediation, or any other form of alternative dispute resolution).
removed
Health care lawsuit— The term health care lawsuit means any health care liability claim concerning the provision of goods or services for which coverage was provided in whole or in part via a Federal program, subsidy or tax benefit, or any health care liability action concerning the provision of goods or services for which coverage was provided in whole or in part via a Federal program, subsidy or tax benefit, brought in a State or Federal court or pursuant to an alternative dispute resolution system, against a health care provider regardless of the theory of liability on which the claim is based, or the number of claimants, plaintiffs, defendants, or other parties, or the number of claims or causes of action, in which the claimant alleges a health care liability claim. Such term does not include a claim or action which is based on criminal liability; which seeks civil fines or penalties paid to Federal, State, or local government; or which is grounded in antitrust.
removed
Health care liability action— The term health care liability action means a civil action brought in a State or Federal court or pursuant to an alternative dispute resolution system, against a health care provider regardless of the theory of liability on which the claim is based, or the number of plaintiffs, defendants, or other parties, or the number of causes of action, in which the claimant alleges a health care liability claim.
removed
Health care liability claim— The term health care liability claim means a demand by any person, whether or not pursuant to ADR, against a health care provider, including, but not limited to, third-party claims, cross-claims, counter-claims, or contribution claims, which are based upon the provision or use of (or the failure to provide or use) health care services or medical products, regardless of the theory of liability on which the claim is based, or the number of plaintiffs, defendants, or other parties, or the number of causes of action.
removed
Health care provider— The term health care provider means any person or entity required by State or Federal laws or regulations to be licensed, registered, or certified to provide health care services, and being either so licensed, registered, or certified, or exempted from such requirement by other statute or regulation, as well as any other individual or entity defined as a health care provider, health care professional, or health care institution under State law.
removed
Health care services— The term health care services means the provision of any goods or services by a health care provider, or by any individual working under the supervision of a health care provider, that relates to the diagnosis, prevention, or treatment of any human disease or impairment, or the assessment or care of the health of human beings.
removed
Medical product— The term medical product means a drug, device, or biological product intended for humans, and the terms drug, device, and biological product have the meanings given such terms in sections 201(g)(1) and 201(h) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(g)(1) and (h)) and section 351(a) of the Public Health Service Act (42 U.S.C. 262(a)), respectively, including any component or raw material used therein, but excluding health care services.
removed
Noneconomic damages— The term noneconomic damages means damages for physical and emotional pain, suffering, inconvenience, physical impairment, mental anguish, disfigurement, loss of enjoyment of life, loss of society and companionship, loss of consortium (other than loss of domestic service), hedonic damages, injury to reputation, and all other nonpecuniary losses of any kind or nature incurred as a result of the provision or use of (or failure to provide or use) health care services or medical products, unless otherwise defined under applicable State law.
removed
Recovery— The term recovery means the net sum recovered after deducting any disbursements or costs incurred in connection with prosecution or settlement of the claim, including all costs paid or advanced by any person. Costs of health care incurred by the plaintiff and the attorneys’ office overhead costs or charges for legal services are not deductible disbursements or costs for such purpose.
removed
Representative— The term representative means a legal guardian, attorney, person designated to make decisions on behalf of a patient under a medical power of attorney, or any person recognized in law or custom as a patient’s agent.
removed
State— The term State means each of the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, the Northern Mariana Islands, the Trust Territory of the Pacific Islands, and any other territory or possession of the United States, or any political subdivision thereof.
Sec. 10 Effective date
added This Act shall apply to any health care lawsuit brought in a Federal or State court, or subject to an alternative dispute resolution system, that is initiated on or after the date of the enactment of this Act, except that any health care lawsuit arising from an injury occurring prior to the date of the enactment of this Act shall be governed by the applicable statute of limitations provisions in effect at the time the cause of action accrued.
removed
Vaccine injury—
removed
To the extent that title XXI of the Public Health Service Act establishes a Federal rule of law applicable to a civil action brought for a vaccine-related injury or death—
removed
this Act does not affect the application of the rule of law to such an action; and
removed
any rule of law prescribed by this Act in conflict with a rule of law of such title XXI shall not apply to such action.
removed
If there is an aspect of a civil action brought for a vaccine-related injury or death to which a Federal rule of law under title XXI of the Public Health Service Act does not apply, then this Act or otherwise applicable law (as determined under this Act) will apply to such aspect of such action.
removed
Other Federal law— Except as provided in this section, nothing in this Act shall be deemed to affect any defense available to a defendant in a health care lawsuit or action under any other provision of Federal law.
Sec. 11 Rules of construction
removed
removed
Health care lawsuits— Unless otherwise specified in this Act, the provisions governing health care lawsuits set forth in this Act preempt, subject to subsections (b) and (c), State law to the extent that State law prevents the application of any provisions of law established by or under this Act. The provisions governing health care lawsuits set forth in this Act supersede chapter 171 of title 28, United States Code, to the extent that such chapter—
removed
provides for a greater amount of damages or contingent fees, a longer period in which a health care lawsuit may be commenced, or a reduced applicability or scope of periodic payment of future damages, than provided in this Act; or
removed
prohibits the introduction of evidence regarding collateral source benefits, or mandates or permits subrogation or a lien on collateral source benefits.
removed
Protection of States’ rights and other laws— Any issue that is not governed by any provision of law established by or under this Act (including State standards of negligence) shall be governed by otherwise applicable State or Federal law.
removed
State Flexibility— No provision of this Act shall be construed to preempt any defense available to a party in a health care lawsuit under any other provision of State or Federal law.
Sec. 12 Effective date
removed
removed
This Act shall apply to any health care lawsuit brought in a Federal or State court, or subject to an alternative dispute resolution system, that is initiated on or after the date of the enactment of this Act, except that any health care lawsuit arising from an injury occurring prior to the date of the enactment of this Act shall be governed by the applicable statute of limitations provisions in effect at the time the cause of action accrued.