[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1116 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 1116

 To reform the medical malpractice insurance business, to provide for 
    Federal alternative medical malpractice insurance, and to limit 
                          frivolous lawsuits.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 6, 2003

   Mr. Conyers (for himself, Ms. Berkley, Mr. Baird, Mr. Berman, Mr. 
    Wexler, Mr. Delahunt, Mr. Nadler, Ms. Norton, and Mr. Pascrell) 
 introduced the following bill; which was referred to the Committee on 
the Judiciary, and in addition to the Committee on Energy and Commerce, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of 
                        the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To reform the medical malpractice insurance business, to provide for 
    Federal alternative medical malpractice insurance, and to limit 
                          frivolous lawsuits.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medical Malpractice Insurance and 
Litigation Reform Act''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
             TITLE I--MEDICAL MALPRACTICE INSURANCE REFORM

Sec. 101. Prohibition on anticompetitive activities by medical 
                            malpractice insurers.
Sec. 102. Medical malpractice insurance price comparison.
Sec. 103. Procedural requirements for medical malpractice insurers' 
                            proposed rate increases.
      TITLE II--FEDERAL MEDICAL MALPRACTICE INSURANCE ASSOCIATION

Sec. 201. Establishment; purpose.
Sec. 202. Board of directors.
Sec. 203. Administration.
Sec. 204. Rates.
Sec. 205. Investment policy.
Sec. 206. Medical malpractice risk management program.
Sec. 207. Seed money to be funded by Treasury Department loan.
Sec. 208. Disclosure of data by medical malpractice insurers.
Sec. 209. Annual report by Chairperson.
Sec. 210. Financial matters.
Sec. 211. Definitions.
        TITLE III--LIMITING FRIVOLOUS MEDICAL MALPRACTICE SUITS

Sec. 301. Health care specialist affidavit.
Sec. 302. Sanctions for frivolous actions and pleadings.
Sec. 303. Mandatory mediation.
Sec. 304. Applicability.
Sec. 305. Definitions.

             TITLE I--MEDICAL MALPRACTICE INSURANCE REFORM

SEC. 101. PROHIBITION ON ANTICOMPETITIVE ACTIVITIES BY MEDICAL 
              MALPRACTICE INSURERS.

    Notwithstanding any other provision of law, nothing in the Act of 
March 9, 1945 (15 U.S.C. 1011 et seq., commonly known as the 
``McCarran-Ferguson Act'') shall be construed to permit commercial 
insurers to engage in any form of price fixing, bid rigging, or market 
allocations in connection with the conduct of the business of providing 
medical malpractice insurance. This section does not apply to the 
information-gathering and rate-setting activities of any State 
commissions of insurance, or any other State regulatory body with 
authority to set insurance rates.

SEC. 102. MEDICAL MALPRACTICE INSURANCE PRICE COMPARISON.

    (a) Internet Site.--Not later than 90 days after the date of the 
enactment of this Act, and after consultation with the medical 
malpractice insurance industry, the Secretary of Health and Human 
Services shall establish an interactive internet site which shall 
enable any health care provider licensed in the United States to obtain 
a quote from each medical malpractice insurer licensed to write the 
type of coverage sought by the provider.
    (b) Online Forms.--
            (1) In general.--The internet site shall enable health care 
        providers to complete an online form that shall capture a 
        comprehensive set of information sufficient to generate a quote 
        for each insurer. The Secretary shall develop transmission 
        software components which allow such information to be 
        formatted for delivery to each medical malpractice insurer 
        based on the requirements of the computer system of the 
        insurer.
            (2) Protection of confidentiality of information 
        disclosed.--All information provided by a health care provider 
        for purposes of generating a quote through the internet site 
        shall be used only for that purpose.
    (c) Integration of Rating Criteria.--The Secretary shall integrate 
the rating criteria of each insurer into its online form after 
consultation with each insurer. The Secretary shall integrate such 
criteria using one of the following methods:
            (1) Developing a customized interface with the insurer's 
        own rating engine.
            (2) Accessing a third-party rating engine of the insurer's 
        choice.
            (3) Loading the carrier's rating information into a rating 
        engine operated by the Secretary.
            (4) Any other method agreed on between the Secretary and 
        the insurer.
    (d) Presentation of Quotes.--After a health care provider has 
answered all the questions appearing on the online form, such provider 
will be presented with quotes from each medical malpractice insurer 
licensed to write the coverage requested by the provider.
    (e) Accuracy of Quotes.--Quotes provided at the internet site shall 
at all times be accurate. Whenever any insurer changes its rates, such 
rate changes shall be implemented at the internet site by the 
Secretary, in consultation with the insurer, as soon as practicable, 
but in no event later than 10 days after such changes take effect. 
During any period during which an insurer has changed its rates but the 
Secretary has not yet implemented such changed rates on the internet 
site, quotes for that insurer shall not be obtainable at the internet 
site.
    (f) User-Friendly Features.--The Secretary shall design the 
internet site to incorporate user-friendly formats and self-help 
guidance materials, and shall develop a user-friendly internet user-
interface.
    (g) Contact Information.--The internet site shall also provide 
contact information, including address and telephone number, for each 
medical malpractice insurer for which a provider obtains a quote at the 
site.
    (h) Report.--Not later than December 31, 2004, the Secretary shall 
submit a report to the Congress on the development, implementation and 
effects of the internet site. Such report shall be based on--
            (1) the Secretary's consultation with health care 
        providers, medical malpractice insurers, State insurance 
        commissioners, and other interested parties; and
            (2) the Secretary's analysis of other information available 
        to the Secretary.
The report shall describe the Secretary's views concerning the extent 
to which this section has contributed to increasing the availability of 
medical malpractice insurance, and the effect this section has had on 
the cost of medical malpractice insurance.

SEC. 103. PROCEDURAL REQUIREMENTS FOR MEDICAL MALPRACTICE INSURERS' 
              PROPOSED RATE INCREASES.

    (a) In General.--Each State shall have in effect a policy under 
which--
            (1) any health care professional (as defined in title III 
        of this Act) licensed by the State has standing in any State 
        administrative proceeding to challenge a proposed rate increase 
        in medical malpractice insurance; and
            (2) a provider of medical malpractice insurance in the 
        State may not implement a rate increase in such insurance 
        unless the provider, at minimum, first submits to the 
        appropriate State agency a description of the rate increase and 
        a substantial justification for the rate increase.
    (b) Rulemaking.--The Attorney General shall promulgate rules to 
carry out this section.
    (c) Effective Date.--The requirements of this section shall take 
effect 1 year after the date of the enactment of this Act.

      TITLE II--FEDERAL MEDICAL MALPRACTICE INSURANCE ASSOCIATION

SEC. 201. ESTABLISHMENT; PURPOSE.

    (a) Establishment.--There is established a body corporate to be 
known as the Federal Medical Malpractice Insurance Association, which 
shall be in the Department of Health and Human Services.
    (b) Offices.--The Association shall maintain its principal office 
in the District of Columbia and shall be deemed, for purposes of venue 
in civil actions, to be a resident thereof. Agencies or offices may be 
established by the Association in such other place or places as it may 
deem necessary or appropriate in the conduct of its operations.
    (c) Purpose.--The purpose of the Association shall be to provide 
medical malpractice insurance based on customary coverage terms and 
liability amounts in states where such insurance is unavailable or is 
unavailable at reasonable and customary terms, as determined by the 
Association.

SEC. 202. BOARD OF DIRECTORS.

    (a) Appointment of Board.--
            (1) In general.--There is hereby established a board of 
        directors for the Association, consisting of 5 members 
        appointed by the President, with the advice and consent of the 
        Senate.
            (2) Initial appointments.--The first 5 members shall be 
        appointed not later than 90 days after the date of the 
        enactment of this Act. Of the first 5 members appointed, each 
        shall serve a term ending on July 1 of one of the following 
        years: 2004, 2005, 2006, 2007, and 2008, as determined by lot 
        amongst themselves.
            (3) Subsequent members; vacancies.--Each member appointed 
        after the first 5 members shall be appointed to a term of 5 
        years. In the case of a vacancy, the member appointed to fill 
        the vacancy shall serve the remainder of the uncompleted term 
        to which the vacancy relates.
    (b) Eligibility.--Any person may be a director who--
            (1) does not have any interest as a stockholder, employee, 
        attorney, agent, broker, or contractor of an insurance entity 
        who writes medical malpractice insurance or whose affiliates 
        write medical malpractice insurance; and
            (2) is of good moral character and who has never pleaded 
        guilty to, or been found guilty of, a felony.
    (c) Chairperson.--The board shall annually elect a chairperson and 
any other officers it deems necessary for the performance of its 
duties. Board committees and subcommittees may also be formed.
    (d) Authority.--The board is vested with full power, authority, and 
jurisdiction over the Association. The board may perform all acts 
necessary or convenient in the administration of the Association or in 
connection with the insurance business to be carried on by the 
Association. In this regard, the board is empowered to function in all 
aspects as a governing body of a private insurance carrier.

SEC. 203. ADMINISTRATION.

    (a) Administrator.--The board shall appoint, and fix the pay of, an 
administrator, who shall serve at the pleasure of the board. The 
administrator shall be appointed from among individuals with proven 
successful experience as an executive at the general management level 
in the insurance industry. The administrator shall act as the 
Association's chief executive officer, in charge of the day-to-day 
operations and management of the Association. The first administrator 
shall be appointed not later than 90 days after the date of the 
enactment of this Act.
    (b) Commencement of Operations.--The board shall ensure that the 
Association is fully operational not later than 180 days after the date 
of the enactment of this Act.

SEC. 204. RATES.

    The board shall have full power and authority to establish rates to 
be charged by the Association for insurance. The board shall contract 
for the services of or hire an independent actuary, a member in good 
standing with the American Academy of Actuaries, to develop and 
recommend actuarially sound rates. Rates shall be set at amounts 
sufficient, when invested, to carry all claims to maturity, meet the 
reasonable expenses of conducting the business of the Association and 
maintain a reasonable surplus. The Association shall conduct a medical 
malpractice insurance program that shall be neither more nor less than 
self-supporting. The Association is authorized to purchase reinsurance 
related to its underlying insurance obligations.

SEC. 205. INVESTMENT POLICY.

    The board shall formulate and adopt an investment policy and 
supervise the investment activities of the Association. The 
administrator may invest and reinvest the surplus or reserves of the 
Association subject to any limitations imposed on domestic insurance 
companies by applicable laws. The Association may retain an independent 
investment counsel. The board shall periodically review and appraise 
the investment strategy being followed and the effectiveness of such 
services. Any investment counsel retained or hired shall periodically 
report to the board on investment results and related matters.

SEC. 206. MEDICAL MALPRACTICE RISK MANAGEMENT PROGRAM.

    The administrator shall formulate, implement, and monitor a medical 
malpractice risk management program for all policyholders. To the 
extent practicable, the administrator shall obtain input from the 
National Association of Insurance Commissioners in developing such 
program. The administrator or board may refuse to insure, or may 
terminate the insurance of, any insured who disregards the medical 
malpractice risk management plan. In determining the premium payable by 
an insured, the Association shall consider the compliance of the 
insured with the Association's medical malpractice risk management.

SEC. 207. SEED MONEY TO BE FUNDED BY TREASURY DEPARTMENT LOAN.

    (a) No Appropriation.--The Association shall not receive any 
appropriation, directly or indirectly, except as provided in subsection 
(b).
    (b) Initial Loans.--During the first year of the Association's 
operations, the Secretary of the Treasury shall make 1 or more loans to 
the Association in such amounts as may be necessary for start-up 
funding and initial capitalization of the Association. The board of the 
Association shall make application to the Department of the Treasury 
for the loans, stating the amount to be loaned to the Association. The 
loans shall be for a term of 5 years and, at the time the application 
for such loans is approved, shall bear interest at an annual rate 
determined by the Secretary of the Treasury. Thereafter, the 
Association may seek such additional loans or funding as may be 
authorized by law.

SEC. 208. DISCLOSURE OF DATA BY MEDICAL MALPRACTICE INSURERS.

    Not later than March 1 of each year, each insurer writing medical 
malpractice insurance coverage to a health care provider shall file 
with the Chairperson a copy of the annual statement it files with the 
department of insurance in the State in which it is domiciled. Each 
such insurer shall also file the following information with the 
Chairperson, to the extent it is not disclosed on the insurer's annual 
statement:
            (1) Information on closed claims.
            (2) Information regarding verdicts, payment, and severity 
        of injury in connection with verdicts.
            (3) Information on rate changes.
            (4) Information on premiums and losses by medical 
        specialty.
            (5) Information on premiums and losses by experience of the 
        insured.
            (6) Information on the performance of the investments of 
        the insurer.

SECTION 209. ANNUAL REPORT BY CHAIRPERSON.

    (a) In General.--The Chairperson shall file an annual report with 
the President and the Congress, which shall include--
            (1) a statement of the Association's accounts, funds, and 
        securities;
            (2) copies of any other reports required to be filed by 
        applicable law and by the National Association of Insurance 
        Commissioners;
            (3) any appropriate request for additional loans;
            (4) an assessment of the medical malpractice insurance 
        marketplace; and
            (5) to the extent practicable, an assessment as to why 
        health care providers are unable to obtain malpractice 
        insurance in certain markets, or are unable to obtain 
        malpractice insurance at reasonable and customary terms.
    (b) Obligations of Chairperson.--The Chairperson shall determine 
what data shall be included under section 208 by insurers writing 
medical malpractice insurance coverage to a health care provider.

SEC. 210. FINANCIAL MATTERS.

    (a) Budget.--The administrator shall annually submit to the board 
for its approval an estimated budget of the entire expense of 
administering the Association for the succeeding calendar year having 
due regard to the business interests and contract obligations of the 
Association.
    (b) Determination of Cash Dividend.--The incurred loss experience 
and expense of the Association shall be ascertained each year to 
include but not be limited to estimates of outstanding liabilities for 
claims reported to the Association but not yet paid and liabilities for 
claims arising from injuries which have occurred but have not yet been 
reported to the Association. If there is an excess of assets over 
liabilities, necessary reserves and a reasonable surplus, then a cash 
dividend shall be declared or a credit allowed to any health care 
provider who has complied with the Association's medical malpractice 
risk management program.

SEC. 211. DEFINITIONS.

    In this title, the following definitions apply:
            (1) Association.--The term ``Association'' means the 
        Federal Medical Malpractice Insurance Association established 
        under section 201.
            (2) Medical malpractice insurance.--The term ``medical 
        malpractice insurance'' means insurance against legal liability 
        of the insured, and against loss, damage, or expense incident 
        to a claim of such liability arising out of the death or injury 
        of any person due to medical, dental, podiatric, certified 
        nurse-midwifery, or hospital malpractice by any licensed 
        physician, dentist, podiatrist, certified nurse-midwife, 
        certified registered nurse anesthetist, hospital, or clinical 
        psychologist.
            (3) Hospital.--The term ``hospital'' means any of the 
        following:
                    (A) Any facility defined as a hospital under State 
                law and issued an operating certificate as a hospital 
                or nursing home, and those distinct parts of a facility 
                that are subject to the powers of visitation, 
                examination, inspection, and investigation of the State 
                mental hygiene agency which provide hospital or nursing 
                home service.
                    (B) Any ambulance service which is registered or 
                certified under State law and which is designed and 
                equipped to provide definitive acute medical care 
                pursuant to rules and regulations of the State health 
                agency, which must include, but not be limited to, the 
                provision of advanced life support services.
                    (C) Any community mental health center operated by 
                a State or unit of local government, holding an 
                operating certificate issued by the State mental 
                hygiene agency.
                    (D) Any certified public or voluntary nonprofit 
                home care service agency which possesses a valid 
                certificate of approval issued under State public 
                health law.

        TITLE III--LIMITING FRIVOLOUS MEDICAL MALPRACTICE SUITS

SEC. 301. HEALTH CARE SPECIALIST AFFIDAVIT.

    (a) Requiring Submission With Complaint.--No medical malpractice 
liability action may be brought by any individual unless, at the time 
the individual brings the action (except as provided in subsection 
(b)(1)), it is accompanied by the affidavit of a qualified specialist 
that includes the specialist's statement of belief that, based on 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.
    (b) Extension in Certain Instances.--
            (1) In general.--Subject to paragraph (2), subsection (a) 
        shall not apply with respect to an individual who brings a 
        medical malpractice liability action without submitting an 
        affidavit described in such subsection if, as of the time the 
        individual brings the action, the individual has been unable to 
        obtain adequate medical records or other information necessary 
        to prepare the affidavit.
            (2) Deadline for submission where extension applies.--In 
        the case of an individual who brings an action for which 
        paragraph (1) applies, the action shall be dismissed unless the 
        individual (or the individual's attorney) submits the affidavit 
        described in subsection (a) not later than 90 days after 
        obtaining the information described in such subparagraph.
    (c) Qualified Specialist Defined.--In subsection (a), a ``qualified 
specialist'' means, with respect to a medical malpractice liability 
action, a health care professional who is reasonably believed by the 
individual bringing the action (or the individual's attorney)--
            (1) to be knowledgeable in the relevant issues involved in 
        the action,
            (2) to practice (or to have practiced) or to teach (or to 
        have taught) in the same area of health care or medicine that 
        is at issue in the action, and
            (3) in the case of an action against a physician, to be 
        board certified in a specialty relating to that area of 
        medicine.
    (d) Confidentiality of Specialist.--Upon a showing of good cause by 
a defendant, the court may ascertain the identity of a specialist 
referred to in subsection (a) while preserving confidentiality.

SEC. 302. SANCTIONS FOR FRIVOLOUS ACTIONS AND PLEADINGS.

    (a) Signature Required.--Every pleading, written motion, and other 
paper in any medical malpractice liability action shall be signed by at 
least 1 attorney of record in the attorney's individual name, or, if 
the party is not represented by an attorney, shall be signed by the 
party. Each paper shall state the signer's address and telephone 
number, if any. An unsigned paper shall be stricken unless omission of 
the signature is corrected promptly after being called to the attention 
of the attorney or party.
    (b) Certificate of Merit.--By presenting to the court (whether by 
signing, filing, submitting, or later advocating) a pleading, written 
motion, or other paper, an attorney or unrepresented party is 
certifying that to the best of the person's knowledge, information and 
belief, formed after an inquiry reasonable under the circumstances--
            (1) it is not being presented for any improper purpose, 
        such as to harass or to cause unnecessary delay or needless 
        increase in the cost of litigation;
            (2) the claims, defenses, and other legal contentions 
        therein are warranted by existing law or by a nonfrivolous 
        argument for the extension, modification, or reversal of 
        existing law or the establishment of new law; and
            (3) the allegations and other factual contentions have 
        evidentiary support or, if specifically so identified, are 
        reasonable based on a lack of information or belief.
    (c) Mandatory Sanctions.--
            (1) First violation.--If, after notice and a reasonable 
        opportunity to respond, a court, upon motion or upon its own 
        initiative, determines that subsection (b) has been violated, 
        the court shall find each attorney or party in violation in 
        contempt of court and shall require the payment of costs and 
        attorneys fees. The court may also impose additional 
        appropriate sanctions, such as striking the pleadings, 
        dismissing the suit, and sanctions plus interest, upon the 
        person in violation, or upon both such person and such person's 
        attorney or client (as the case may be).
            (2) Second violation.--If, after notice and a reasonable 
        opportunity to respond, a court, upon motion or upon its own 
        initiative, determines that subsection (b) has been violated 
        and that the attorney or party with respect to which the 
        determination was made has committed one previous violation of 
        subsection (b) before this or any other court, the court shall 
        find each such attorney or party in contempt of court and shall 
        require the payment of costs and attorneys fees, and require 
        such person in violation (or both such person and such person's 
        attorney or client (as the case may be)) to pay a monetary 
        fine. The court may also impose additional appropriate 
        sanctions, such as striking the pleadings, dismissing the suit 
        and sanctions plus interest, upon such person in violation, or 
        upon both such person and such person's attorney or client (as 
        the case may be).
            (3) Third violation.--If, after notice and a reasonable 
        opportunity to respond, a court, upon motion or upon its own 
        initiative, determines that subsection (b) has been violated 
        and that the attorney or party with respect to which the 
        determination was made has committed more than one previous 
        violation of subsection (b) before this or any other court, the 
        court shall find each such attorney or party in contempt of 
        court, refer each such attorney to one or more appropriate 
        State bar associations for disciplinary proceedings, require 
        the payment of costs and attorneys fees, and require such 
        person in violation (or both such person and such person's 
        attorney or client (as the case may be)) to pay a monetary 
        fine. The court may also impose additional appropriate 
        sanctions, such as striking the pleadings, dismissing the suit, 
        and sanctions plus interest, upon such person in violation, or 
        upon both such person and such person's attorney or client (as 
        the case may be).

SEC. 303. MANDATORY MEDIATION.

    (a) In General.--In any medical malpractice liability action, 
before such action comes to trial, mediation shall be required. Such 
mediation shall be conducted by one or more mediators who are selected 
by agreement of the parties or, if the parties do not agree, who are 
qualified under applicable State law and selected by the court.
    (b) Requirements.--Mediation under subsection (a) shall be made 
available by a State subject to the following requirements:
            (1) Participation in such mediation shall be in lieu of any 
        alternative dispute resolution method required by any other law 
        or by any contractual arrangement made by or on behalf of the 
        parties before the commencement of the action.
            (2) Each State shall disclose to residents of the State the 
        availability and procedures for resolution of consumer 
        grievances regarding the provision of (or failure to provide) 
        health care services, including such mediation.
            (3) Each State shall provide that such mediation may begin 
        before or after, at the option of the claimant, the 
        commencement of a medical malpractice liability action.
            (4) The Attorney General, in consultation with the 
        Secretary of Health and Human Services, shall, by regulation, 
        develop requirements with respect to such mediation to ensure 
        that it is carried out in a manner that--
                    (A) is affordable for the parties involved;
                    (B) encourages timely resolution of claims;
                    (C) encourages the consistent and fair resolution 
                of claims; and
                    (D) provides for reasonably convenient access to 
                dispute resolution.
    (c) Further Redress and Admissibility.--Any party dissatisfied with 
a determination reached with respect to a medical malpractice claim as 
a result of an alternative dispute resolution method applied under this 
section shall not be bound by such determination. The results of any 
alternative dispute resolution method applied under this section, and 
all statements, offers, and communications made during the application 
of such method, shall be inadmissible for purposes of adjudicating the 
claim.

SEC. 304. APPLICABILITY.

    (a) In General.--Except as provided in section 303, this title 
shall apply with respect to any medical malpractice liability action 
brought on or after the date of the enactment of this Act in any State 
or Federal court, except that this title 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 title shall preempt any 
State law to the extent such law relates to a type of tort reform 
included under this title and is inconsistent with such provisions.
    (c) Effect on Sovereign Immunity and Choice of Law or Venue.--
Nothing in this title 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 title 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. 305. DEFINITIONS.

    In this title, the following definitions apply:
            (1) Alternative dispute resolution method.--The term 
        ``alternative dispute resolution method'' means a method that 
        provides for the resolution of medical malpractice claims in a 
        manner other than through medical malpractice liability 
        actions.
            (2) Claimant.--The term ``claimant'' means any person who 
        alleges a medical malpractice 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.
            (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 claim.
            (6) Mandatory.--The term ``mandatory'' means required to be 
        used by the parties to attempt to resolve a medical malpractice 
        claim notwithstanding any other provision of an agreement, 
        State law, or Federal law.
            (7) Mediation.--The term ``mediation'' means a settlement 
        process coordinated by a neutral third party and without the 
        ultimate rendering of a formal opinion as to factual or legal 
        findings.
            (8) Medical malpractice claim.--The term ``medical 
        malpractice claim'' means a claim against a health care 
        provider, a health care professional, or a blood or tissue bank 
        licensed or registered by the Food and Drug Administration in 
        which a claimant alleges that injury was caused by the 
        provision of (or the failure to provide) health care services, 
        except that such term does not include--
                    (A) any claim based on an allegation of an 
                intentional tort; or
                    (B) any claim based on an allegation that a product 
                is defective or unreasonably dangerous.
            (9) 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, a health care professional, or a blood or tissue bank 
        licensed or registered by the Food and Drug Administration in 
        which the plaintiff alleges a medical malpractice claim.
            (10) State.--The term ``State'' includes the District of 
        Columbia and any commonwealth, territory, or possession of the 
        United States.
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