[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 1370 Introduced in Senate (IS)]







107th CONGRESS
  1st Session
                                S. 1370

              To reform the health care liability system.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 3, 2001

 Mr. McConnell introduced the following bill; which was read twice and 
               referred to the Committee on the Judiciary

_______________________________________________________________________

                                 A BILL


 
              To reform the health care liability system.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Common Sense 
Medical Malpractice Reform Act of 2001''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings and purpose.
Sec. 3. Definitions.
Sec. 4. Applicability.
Sec. 5. Statute of limitations.
Sec. 6. Limitation on non-economic damages.
Sec. 7. Reform of punitive damages.
Sec. 8. Periodic payments.
Sec. 9. Scope of liability.
Sec. 10. Mandatory offsets for damages paid by a collateral source.
Sec. 11. Treatment of attorneys' fees and other costs.
Sec. 12. State-based alternative dispute resolution mechanisms.
Sec. 13. Applicability.
Sec. 14. Severability.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress finds the following:
            (1) Effect on health care access and costs.--The civil 
        justice system of the United States is a costly and inefficient 
        mechanism for resolving claims of health care liability and 
        compensating injured patients and that the problems associated 
        with the current system are having an adverse impact on the 
        availability of, and access to, health care services and the 
        cost of health care in the United States.
            (2) Effect on interstate commerce.--The health care and 
        insurance industries are industries affecting interstate 
        commerce and the health care liability litigation systems 
        existing throughout the United States affect interstate 
        commerce by contributing to the high cost of health care and 
        premiums for health care liability insurance purchased by 
        participants in the health care system.
            (3) Effect on federal spending.--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--
                    (A) the large number of individuals who receive 
                health care benefits under programs operated or 
                financed by the Federal Government;
                    (B) 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
                    (C) the large number of health care providers who 
                provide items or services for which the Federal 
                Government makes payments.
    (b) Purpose.--It is the purpose of this Act to implement 
reasonable, comprehensive, and effective health care liability reform 
that is designed to--
            (1) ensure that individuals with meritorious health care 
        injury claims receive fair and adequate compensation;
            (2) improve the availability of health care service in 
        cases in which health care liability actions have been shown to 
        be a factor in the decreased availability of services; and
            (3) improve the fairness and cost-effectiveness of our 
        current health care liability system of the United States to 
        resolve disputes over, and provide compensation for, health 
        care liability by reducing uncertainty and unpredictability in 
        the amount of compensation provided to injured individuals.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Alternative dispute resolution (adr).--The term 
        ``alternative dispute resolution'' or ``adr'' means a system 
        that provides for the resolution of health care liability 
        claims or actions in a manner other than through a civil action 
        brought in a Federal or State court.
            (2) Attorney.--The term ``attorney'' means any natural 
        person, professional association, corporation, or partnership 
        authorized under applicable law to practice law.
            (3) Attorney services.--The term ``attorney services'' 
        means the professional advice or counseling of or 
        representation by an attorney. Such term shall not include out-
        of-pocket expenses in connection with providing attorney 
        services, such as travel expenses, witness fees, copying, 
        messengers, postage, phone, or preparation by a person other 
        than the attorney of any study, analysis, report, or test.
            (4) Claimant.--The term ``claimant'' means any person who 
        commences a health care liability action, and any person on 
        whose behalf such an action is commenced, including the 
        decedent in the case of an action brought through or on behalf 
        of an estate.
            (5) Clear and convincing evidence.--The term ``clear and 
        convincing evidence'' means that measure or degree of proof 
        that will produce in the mind of the trier of fact a firm 
        belief or conviction as to the truth of the allegations sought 
        to be established, except that such measure or degree of proof 
        is more than that required under preponderance of the evidence, 
        but less than that required for proof beyond a reasonable 
        doubt.
            (6) Collateral source benefit.--The term ``collateral 
        source benefit'' means a rule, either established in statute or 
        established at common law, that prevents the introduction of 
        evidence regarding collateral source benefits or that prohibits 
        the deduction of collateral source benefits from an award of 
        damages in a health care liability action.
            (7) Economic losses.--The term ``economic losses'' means 
        objectively verifiable monetary losses incurred as a result of 
        the provision of (or failure to provide or pay for) health care 
        services or the use of a medical product, including past and 
        future medical expenses, loss of past and future earnings, 
cost of obtaining replacement services in the home (including child 
care, transportation, food preparation, and household care), cost of 
making reasonable accommodations to a personal residence, loss of 
employment, and loss of business or employment opportunities. Economic 
losses are neither non-economic losses nor punitive damages.
            (8) Health care liability action.--The term ``health care 
        liability action'' means a civil action brought in a State or 
        Federal court pursuant to ADR against a health care provider, 
        health care professional, or other defendant, including a right 
        to legal or equitable contribution, indemnity, subrogation, 
        third-party claims, cross claims, or counter-claims, in which 
        the claimant alleges injury related to--
                    (A) the provision of health care services or 
                medical products; or
                    (B) the failure to provide for health care services 
                or medical products;
        regardless of the theory of liability on which the action is 
        based. Such term does not include a product liability action, 
        except where such an action is brought as part of a broader 
        health care liability action.
            (9) Health care professional.--The term ``health care 
        professional'' means any individual who provides health care 
        services in a State and who is required by Federal or State 
        laws or regulations to be licensed, registered or certified to 
        provide such services or who is certified to provide health 
        care services pursuant to a program of education, training and 
        examination by an accredited institution, professional board, 
        or professional organization.
            (10) Health care provider.--The term ``health care 
        provider'' means any organization or institution that is 
        engaged in the delivery of health care items or services in a 
        State and that is required by Federal or State laws or 
        regulations to be licensed, registered or certified to engage 
        in the delivery of such items or services.
            (11) Health plan.--The term ``health plan'' means an 
        employee welfare benefit plan (as defined in section 3(1) of 
        the Employee Retirement Income Security Act of 1974 (29 U.S.C. 
        1002(1))) to the extent that the plan provides medical care 
        (including items and services paid for as medical care) to 
        employees or their dependents (as defined under the terms of 
        the plan) directly or through insurance, reimbursement, or 
        otherwise.
            (12) Health care services.--The term ``health care 
        services'' means any services provided by a health care 
        professional or health care provider, or any individual working 
        under the supervision of a health care professional, that 
        relate to the diagnosis, prevention, or treatment of any 
        disease or impairment, or the assessment of the health of human 
        beings.
            (13) Injury.--The term ``injury'' means any illness, 
        disease, or other harm that is the subject of a health care 
        liability action.
            (14) Noneconomic losses.--The term ``noneconomic losses'' 
        means losses for physical and emotional pain, suffering, 
        inconvenience, physical impairment, mental anguish, 
        disfigurement, loss of enjoyment of life, loss of consortium, 
        loss of society or companionship (other than loss of domestic 
        services), and other non-pecuniary losses incurred by an 
        individual with respect to which a health care liability action 
        is brought. Noneconomic losses are neither economic losses nor 
        punitive damages.
            (15) Punitive damages.--The term ``punitive damages'' means 
        damages awarded, for the purpose of punishment or deterrence, 
        and not for compensatory purposes, against a health care 
        provider, health care professional, or other defendant in a 
        health care liability action. Punitive damages are neither 
        economic nor noneconomic damages.
            (16) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (17) State.--The term ``State'' means each of the several 
        States of the United States, the District of Columbia, and the 
        Commonwealth of Puerto Rico, a territory of possession of the 
        United States, an agency or instrumentality of a State, and a 
        multi-State, regional, or interstate entity having governmental 
        duties and powers.
            (18) State law.--The term ``State law'' includes all 
        constitutional provisions, statutes, laws, judicial decisions, 
        rules regulations, or other State action having the effect of 
        law of, or any State.

SEC. 4. APPLICABILITY.

    (a) In General.--Except as provided in subsections (c) and (d), 
this Act shall apply with respect to any health care liability action 
brought in any Federal or State court, and any claim brought pursuant 
to an alternative dispute resolution, except that this Act shall not 
apply to an 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 action.
    (b) Preemption.--
            (1) In general.--The provisions of this Act shall preempt 
        any State law in effect on, or enacted after, the date of 
        enactment of this Act to the extent that such law is 
        inconsistent with the limitations contained in such provisions. 
        The provisions of this Act shall not preempt any State law to 
        the extent that such law--
                    (A) places greater restrictions on the amount of or 
                standards for awarding economic or punitive damages 
                than those provided for in this Act;
                    (B) places greater limitations on the awarding of 
                attorneys fees for awards in excess of $150,000 than 
                those provided for in this Act;
                    (C) permits a lower threshold for the periodic 
                payment of future damages than that provided for in 
                this Act;
                    (D) establishes a shorter period during which a 
                health care liability action may be initiated or a more 
                restrictive rule with respect to the time at which the 
                period of limitations begins to run than that provided 
                for in this Act; or
                    (E) either permits the introduction of evidence of 
                collateral source benefits or provides for the 
                mandatory offset of collateral source benefits from 
                damage awards.
            (2) Rule of construction.--The provisions of this Act shall 
        not be construed to preempt any State law that--
                    (A) permits State officials to commence health care 
                liability actions as a representative of an individual;
                    (B) permits provider-based alternative dispute 
                resolution;
                    (C) places a maximum limit on the total damages in 
                a health care liability action;
                    (D) places a maximum limit on the time in which a 
                health care liability action may be initiated; or
                    (E) provides for defenses in addition to those 
                contained in this Act.
    (c) State Option.--
            (1) In general.--With respect to a provision of this Act, 
        such provision shall not apply to a health care liability 
        action involving parties that are residents of the same State 
        if the action is brought in a court of that State and the State 
        has enacted a law--
                    (A) specifically citing the authority of this 
                subsection; and
                    (B)(i) proclaiming that the State has determined 
                that such provision shall not apply to such actions; or
                    (ii) establishing provisions that specifically 
                contradict the provisions of this Act.
            (2) Multiple state.--With respect to a health care 
        liability action involving parties that are residents of more 
        than one State, if each such State has enacted a law described 
        in paragraph (1), the choice-of-law rules of each such State 
        shall govern the rules and procedures applicable in the action.
            (3) Corporate entity.--For purposes of this subsection, a 
        corporate entity shall be deemed to be a resident of the State 
        in which such entity is incorporated and the State in which the 
        principal place of business of the entity is located.
            (4) Rule of construction.--Nothing in this subsection shall 
        be construed as requiring a State to reenact any provision of 
        State law if such law existed on the date of enactment of this 
        Act and such law is not otherwise preempted under the 
        provisions of subsection (b).
    (d) Effect on Sovereign Immunity and Choice of Law or Venue.--
Nothing in this Act 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 
        actions brought by a foreign nation or a citizen of a foreign 
        nation;
            (5) affect the right of any court to transfer venue or to 
        apply the law of a foreign nation or to dismiss an action of a 
        foreign nation or of a citizen of a foreign nation on the 
        ground of inconvenient forum; or
            (6) supersede any provision of Federal law.
    (e) 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 health 
care liability actions on the basis of sections 1331 or 1337 of title 
28, United States Code.

SEC. 5. STATUTE OF LIMITATIONS.

    A health care liability action that is subject to this Act may not 
be initiated unless a complaint with respect to such action is filed 
within the 2-year period beginning on the date on which the claimant 
discovered or, in the exercise of reasonable care, should have 
discovered the injury and its cause, except that such an action 
relating to a claimant under legal disability may be filed within 2 
years after the date on which the disability ceases. If the 
commencement of a health care liability action is stayed or enjoined, 
the running of the statute of limitations under this section shall be 
suspended for the period of the stay or injunction.

SEC. 6. LIMITATION ON NON-ECONOMIC DAMAGES.

    (a) In General.--In any health care liability action that is 
subject to this Act, the amount of noneconomic damages shall not exceed 
$250,000 regardless of the number of parties against whom the action is 
brought or the number of claims or actions brought with respect to the 
injury that is the subject of the action.
    (b) Calculation of Award.--For purposes of this section, an award 
for future noneconomic damages in a health care liability action shall 
not be discounted to present value. A jury shall not be informed about 
the limitation on noneconomic damages in such an action. Any award for 
noneconomic damages that is in excess of $250,000 shall be reduced 
prior to the entry of judgment or by an amendment of the judgment after 
such entry. Any award of damages for noneconomic losses that is in 
excess of $250,000, shall be reduced to $250,000 before accounting for 
any other reduction in damages required by law. If separate awards of 
damages for past and future noneconomic damages are rendered and the 
combined awards exceed $250,000, the award of damages for future 
noneconomic losses shall be reduced first.

SEC. 7. REFORM OF PUNITIVE DAMAGES.

    (a) Limitation.--With respect to a health care liability action, an 
award for punitive damages may only be made, if otherwise permitted by 
applicable law, if it is proven by clear and convincing evidence that 
the defendant--
            (1) intended to injure the claimant for a reason unrelated 
        to the provision of health care services;
            (2) understood the claimant was substantially certain to 
        suffer unnecessary injury, and in providing or failing to 
        provide health care services, the defendant deliberately failed 
        to avoid such injury; or
            (3) acted with a conscious disregard of a substantial and 
        unjustifiable risk of unnecessary injury which the defendant 
        failed to avoid in a manner which constitutes a gross deviation 
        from the normal standard of conduct in such circumstances.
    (b) Punitive Damages Not Permitted.--Notwithstanding the provisions 
of subsection (a), punitive damages may not be awarded against a 
defendant with respect to any health care liability action if no 
judgment for compensatory damages, including nominal damages (under 
$500), is rendered against the defendant.
    (c) Requirements for Pleading of Punitive Damages.--
            (1) In general.--No demand for punitive damages shall be 
        included in a health care liability action as initially filed.
            (2) Amended pleading.--A court may allow a claimant to file 
        an amended complaint or pleading for punitive damages in a 
        health care liability action if--
                    (A) the claimant submits a motion to amend the 
                complaint or pleading within the earlier of--
                            (i) 2 years after the complaint or initial 
                        pleading is filed, or
                            (ii) 9 months before the date the matter is 
                        first set for trial; and
                    (B) after a finding by a court upon review of 
                supporting and opposing affidavits or after a hearing, 
                that after weighing the evidence the claimant has 
                established by a substantial probability that the 
                claimant will prevail on the claim for punitive 
                damages.
    (d) Separate Proceeding.--
            (1) In general.--At the request of any defendant in a 
        health care liability action, the trier of fact shall consider 
        in a separate proceeding--
                    (A) whether punitive damages are to be awarded and 
                the amount of such award, or
                    (B) the amount of punitive damages following a 
                determination of punitive liability.
            (2) Only relevant evidence admissible.--If a defendant 
        requests a separate proceeding under paragraph (1), evidence 
        relevant only to the claim of punitive damages in a health care 
        liability action, as determined by applicable State law, shall 
        be inadmissible in any proceeding to determine whether 
        compensatory damages are to be awarded.
    (e) Determining Amount of Punitive Damages.--In determining the 
amount of punitive damages in a health care liability action, the trier 
of fact shall consider only the following:
            (1) The severity of the harm caused by the conduct of the 
        defendant.
            (2) The duration of the conduct or any concealment of it by 
        the defendant.
            (3) The profitability of the conduct of the defendant.
            (4) The number of products sold or medical procedures 
        rendered for compensation, as the case may be, by the defendant 
        of the kind causing the harm complained of by the claimant.
            (5) Awards of punitive or exemplary damages to persons 
        similarly situated to the claimant, when offered by the 
        defendant.
            (6) Prospective awards of compensatory damages to persons 
        similarly situated to the claimant.
            (7) Any criminal penalties imposed on the defendant as a 
        result of the conduct complained of by the claimant, when 
        offered by the defendant.
            (8) The amount of any civil fines assessed against the 
        defendant as a result of the conduct complained of by the 
        claimant, when offered by the defendant.
    (f) Limitation Amount.--The amount of damages that may be awarded 
as punitive damages in any health care liability action shall not 
exceed 3 times the amount awarded to the claimant for the economic 
injury on which such claim is based, or $250,000, whichever is greater. 
This subsection shall be applied by the court and shall not be 
disclosed to the jury.
    (g) Restrictions Permitted.--Nothing in this section shall be 
construed to imply a right to seek punitive damages where none exists 
under Federal or State law.

SEC. 8. PERIODIC PAYMENTS.

    With respect to a health care liability action, if the award of 
future damages exceeds $100,000, the adjudicating body shall, at the 
request of either party, enter a judgment ordering that future damages 
be paid on a periodic basis in accordance with the guidelines contained 
in the Uniform Periodic Payments of Judgments Act, as promulgated by 
the National Conference of Commissioners on Uniform State Laws in July 
of 1990. The adjudicating body may waive the requirements of this 
section if such body determines that such a waiver is in the interests 
of justice.

SEC. 9. SCOPE OF LIABILITY.

    (a) In General.--With respect to punitive and noneconomic damages, 
the liability of each defendant in a health care liability action shall 
be several only and may not be joint. Such a defendant shall be liable 
only for the amount of punitive or noneconomic damages allocated to the 
defendant in direct proportion to such defendant's percentage of fault 
or responsibility for the injury suffered by the claimant.
    (b) Determination of Percentage of Liability.--With respect to 
punitive and noneconomic damages, the trier of fact in a health care 
liability action shall determine the extent of each defendant's fault 
or responsibility for injury suffered by the claimant, and shall assign 
a percentage of responsibility for such injury to each such defendant.

SEC. 10. MANDATORY OFFSETS FOR DAMAGES PAID BY A COLLATERAL SOURCE.

    (a) In General.--With respect to a health care liability action, 
the total amount of damages received by an individual under such action 
shall be reduced, in accordance with subsection (b), 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 action.
    (b) Amount of Reduction.--The amount by which an award of damages 
to an individual for an injury shall be reduced under subsection (a) 
shall be--
            (1) 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 action; minus
            (2) the amount paid by such individual (or by the spouse, 
        parent, or legal guardian of such individual) to secure the 
        payments described in paragraph (1).
    (c) Determination of Collateral Source Benefits.--The reductions 
required under subsection (b) shall be determined by the court in a 
pretrial proceeding. At the subsequent trial--
            (1) no evidence shall be admitted as to the amount of any 
        charge, payments, or damage for which a claimant--
                    (A) has received payment from a collateral source 
                or the obligation for which has been assured by a third 
                party; or
                    (B) is, or with reasonable certainty, will be 
                eligible to receive payment from a collateral source of 
                the obligation which will, with reasonable certainty be 
                assumed by a third party; and
            (2) the jury, if any, shall be advised that--
                    (A) except for damages as to which the court 
                permits the introduction of evidence, the claimant's 
                medical expenses and lost income have been or will be 
                paid by a collateral source or third party; and
                    (B) the claimant shall receive no award for any 
                damages that have been or will be paid by a collateral 
                source or third party.

SEC. 11. TREATMENT OF ATTORNEYS' FEES AND OTHER COSTS.

    (a) In General.--No attorney in any health care liability action to 
which this Act applies shall charge, demand, receive, or collect for 
services rendered in connection with such action in excess of 25 
percent of any judgment or settlement recovered under such action.
    (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 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. 12. STATE-BASED ALTERNATIVE DISPUTE RESOLUTION MECHANISMS.

    (a) Establishment by States.--Each State is encouraged to establish 
or maintain alternative dispute resolution mechanisms that promote the 
resolution of health care liability claims in a manner that--
            (1) is affordable for the parties involved in the claims;
            (2) provides for the timely resolution of claims; and
            (3) provides the parties with convenient access to the 
        dispute resolution process.
    (b) Guidelines.--The Attorney General, in consultation with the 
Secretary and the Administrative Conference of the United States, shall 
develop guidelines with respect to alternative dispute resolution 
mechanisms that may be established by States for the resolution of 
health care liability claims. Such guidelines shall include procedures 
with respect to the following methods of alternative dispute 
resolution:
            (1) Arbitration.--The use of arbitration, a nonjury 
        adversarial dispute resolution process which may, subject to 
        subsection (d), result in a final decision as to facts, law, 
        liability or damages. The parties may elect binding 
        arbitration.
            (2) Mediation.--The use of mediation, a settlement process 
        coordinated by a neutral third party without the ultimate 
        rendering of a formal opinion as to factual or legal findings.
            (3) Early neutral evaluation.--The use of early neutral 
        evaluation, in which the parties make a presentation to a 
        neutral attorney or other neutral evaluator for an assessment 
        of the merits, to encourage settlement. If the parties do not 
        settle as a result of assessment and proceed to trial, the 
        neutral evaluator's opinion shall be kept confidential.
            (4) Early offer and recovery mechanism.--The use of early 
        offer and recovery mechanisms under which a health care 
        provider, health care organization, or any other alleged 
        responsible defendant may offer to compensate a claimant for 
        his or her reasonable economic damages, including future 
        economic damages, less amounts available from collateral 
        sources.
            (5) Certificate of merit.--The requirement that a claimant 
        in a health care liability action submit to the court before 
        trial a written report by a qualified specialist that includes 
        the specialist's determination that, after a review of the 
        available medical record and other relevant material, there is 
        a reasonable and meritorious cause for the filing of the action 
        against the defendant.
            (6) No-fault.--The use of a no-fault statute under which 
        certain health care liability actions are barred and claimants 
        are compensated for injuries through their health plans or 
        through other appropriate mechanisms.
    (c) Further Redress.--
            (1) In general.--The extent to which any party may seek 
        further redress (subsequent to a decision of an alternative 
        dispute resolution method established by a State under this 
        section) concerning a health care liability claim in a Federal 
        or State court shall be dependent upon the methods of 
        alternative dispute resolution adopted by the State involved.
            (2) Claimant.--With respect to further redress described in 
        paragraph (1), if the party initiating such court action is the 
        claimant and the claimant receives a level of damages that is 
        at least 25 percent less under the decision of the court than 
        under the State alternative dispute resolution method, such 
        party shall bear the reasonable costs, including legal fees, 
        incurred in the court action by the other party or parties to 
        such action.
            (3) Provider or other defendant.--With respect to further 
        redress described in paragraph (1), if the party initiating a 
        court action is the health care professional or health care 
        provider, or other defendant in a health care liability action 
        and the health care professional, health care provider, or 
        other defendant is found liable for a level of damages that is 
        at least 25 percent more under the decision of the court than 
        under the State alternative dispute resolution method, such 
        party shall bear the reasonable costs, including legal fees, 
        incurred in the court action by the other party or parties to 
        such action.
    (d) Technical Assistance and Evaluations.--
            (1) Technical assistance.--The Attorney General may provide 
        States with technical assistance in establishing or maintaining 
        alternative dispute resolution mechanisms under this section.
            (2) Evaluations.--The Attorney General, in consultation 
        with the Secretary and the Administrative Conference of the 
        United States, shall monitor and evaluate the effectiveness of 
        State alternative dispute resolution mechanisms established or 
        maintained under this section.

SEC. 13. APPLICABILITY.

    This Act shall apply to all civil actions covered under this Act 
that are commenced on or after the date of enactment of this Act, 
including any such action with respect to which the harm asserted in 
the action or the conduct that caused the harm occurred before the date 
of enactment of this Act.

SEC. 14. SEVERABILITY.

    If any provision of this Act, an amendment made by this Act, or the 
application of such provision or amendment to any person or 
circumstance is held to be unconstitutional, the remainder of this Act, 
the amendments made by this Act, and the application of the provisions 
of such to any person or circumstance shall not be affected thereby.
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