[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5 Engrossed in House (EH)]

112th CONGRESS
  2d Session
                                 H. R. 5

_______________________________________________________________________

                                 AN ACT


 
To improve patient access to health care services and provide improved 
  medical care by reducing the excessive burden the liability system 
               places on the health care delivery system.

    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 ``Protecting Access to Healthcare 
Act''.

                          TITLE I--HEALTH ACT

SEC. 101. SHORT TITLE.

    This title may be cited as the ``Help Efficient, Accessible, Low-
cost, Timely Healthcare (HEALTH) Act of 2012''.

SEC. 102. PURPOSE.

    It is the purpose of this title to implement reasonable, 
comprehensive, and effective health care liability reforms designed 
to--
            (1) improve the availability of health care services in 
        cases in which health care liability actions have been shown to 
        be a factor in the decreased availability of services;
            (2) reduce the incidence of ``defensive medicine'' and 
        lower the cost of health care liability insurance, all of which 
        contribute to the escalation of health care costs;
            (3) ensure that persons with meritorious health care injury 
        claims receive fair and adequate compensation, including 
        reasonable noneconomic damages;
            (4) improve the fairness and cost-effectiveness 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; and
            (5) provide an increased sharing of information in the 
        health care system which will reduce unintended injury and 
        improve patient care.

SEC. 103. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS.

    The time for the commencement of a health care lawsuit shall be 3 
years after the date of manifestation 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 manifestation of injury unless tolled for any of the 
following--
            (1) upon proof of fraud;
            (2) intentional concealment; or
            (3) the presence of a foreign body, which has no 
        therapeutic or diagnostic purpose or effect, in the person of 
        the injured person.
Actions by a minor shall be commenced within 3 years from the date of 
the alleged manifestation of injury except that actions by a minor 
under the full age of 6 years shall be commenced within 3 years of 
manifestation of injury or prior to the minor's 8th birthday, whichever 
provides a longer period. Such time limitation shall be tolled for 
minors for any period during which a parent or guardian and a health 
care provider or health care organization have committed fraud or 
collusion in the failure to bring an action on behalf of the injured 
minor.

SEC. 104. COMPENSATING PATIENT INJURY.

    (a) Unlimited Amount of Damages for Actual Economic Losses in 
Health Care Lawsuits.--In any health care lawsuit, nothing in this 
title shall limit a claimant's recovery of the full amount of the 
available economic damages, notwithstanding the limitation in 
subsection (b).
    (b) Additional Noneconomic Damages.--In any health care lawsuit, 
the amount of noneconomic damages, if available, may be as much as 
$250,000, regardless of the number of parties against whom the action 
is brought or the number of separate claims or actions brought with 
respect to the same injury.
    (c) 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.
    (d) 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.

SEC. 105. MAXIMIZING PATIENT RECOVERY.

    (a) Court Supervision of Share of Damages Actually Paid to 
Claimants.--In any health care lawsuit, 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 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 have the power to restrict the payment of a claimant's damage 
recovery to such attorney, and to redirect such damages to the claimant 
based upon the interests of justice and principles of equity. In no 
event shall the total of all contingent fees for representing all 
claimants in a health care lawsuit exceed the following limits:
            (1) Forty percent of the first $50,000 recovered by the 
        claimant(s).
            (2) Thirty-three and one-third percent of the next $50,000 
        recovered by the claimant(s).
            (3) Twenty-five percent of the next $500,000 recovered by 
        the claimant(s).
            (4) Fifteen percent of any amount by which the recovery by 
        the claimant(s) is in excess of $600,000.
    (b) Applicability.--The limitations in 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 to authorize or approve a fee that is less than 
the maximum permitted under this section. The requirement for court 
supervision in the first two sentences of subsection (a) applies only 
in civil actions.

SEC. 106. PUNITIVE DAMAGES.

    (a) In General.--Punitive damages may, if otherwise permitted by 
applicable State or Federal law, be awarded against any person in a 
health care lawsuit only if it is proven by clear and convincing 
evidence that such person acted with malicious intent to injure the 
claimant, or that such person deliberately failed to avoid unnecessary 
injury that such person knew the claimant was substantially certain to 
suffer. In any health care lawsuit where no judgment for compensatory 
damages is rendered against such person, no punitive damages may be 
awarded with respect to the claim in such lawsuit. No demand for 
punitive damages shall be included in a health care lawsuit as 
initially filed. A court may allow a claimant to file an amended 
pleading for punitive damages only upon a motion by the claimant and 
after a finding by the court, upon review of supporting and opposing 
affidavits or after a hearing, after weighing the evidence, that the 
claimant has established by a substantial probability that the claimant 
will prevail on the claim for punitive damages. At the request of any 
party in a health care lawsuit, the trier of fact shall consider in a 
separate proceeding--
            (1) whether punitive damages are to be awarded and the 
        amount of such award; and
            (2) the amount of punitive damages following a 
        determination of punitive liability.
If a separate proceeding is requested, evidence relevant only to the 
claim for punitive damages, as determined by applicable State law, 
shall be inadmissible in any proceeding to determine whether 
compensatory damages are to be awarded.
    (b) Determining Amount of Punitive Damages.--
            (1) Factors considered.--In determining the amount of 
        punitive damages, if awarded, in a health care lawsuit, the 
        trier of fact shall consider only the following--
                    (A) the severity of the harm caused by the conduct 
                of such party;
                    (B) the duration of the conduct or any concealment 
                of it by such party;
                    (C) the profitability of the conduct to such party;
                    (D) the number of products sold or medical 
                procedures rendered for compensation, as the case may 
                be, by such party, of the kind causing the harm 
                complained of by the claimant;
                    (E) any criminal penalties imposed on such party, 
                as a result of the conduct complained of by the 
                claimant; and
                    (F) the amount of any civil fines assessed against 
                such party as a result of the conduct complained of by 
                the claimant.
            (2) Maximum award.--The amount of punitive damages, if 
        awarded, in a health care lawsuit may be as much as $250,000 or 
        as much as two times the amount of economic damages awarded, 
        whichever is greater. The jury shall not be informed of this 
        limitation.
    (c) No Punitive Damages for Products That Comply With FDA 
Standards.--
            (1) In general.--
                    (A) No punitive damages may be awarded against the 
                manufacturer or distributor of a medical product, or a 
                supplier of any component or raw material of such 
                medical product, based on a claim that such product 
                caused the claimant's harm where--
                            (i)(I) such medical product was subject to 
                        premarket approval, clearance, or licensure by 
                        the Food and Drug Administration with respect 
                        to the safety of the formulation or performance 
                        of the aspect of such medical product which 
                        caused the claimant's harm or the adequacy of 
                        the packaging or labeling of such medical 
                        product; and
                            (II) such medical product was so approved, 
                        cleared, or licensed; or
                            (ii) such medical product is generally 
                        recognized among qualified experts as safe and 
                        effective pursuant to conditions established by 
                        the Food and Drug Administration and applicable 
                        Food and Drug Administration regulations, 
                        including without limitation those related to 
                        packaging and labeling, unless the Food and 
                        Drug Administration has determined that such 
                        medical product was not manufactured or 
                        distributed in substantial compliance with 
                        applicable Food and Drug Administration 
                        statutes and regulations.
                    (B) Rule of construction.--Subparagraph (A) may not 
                be construed as establishing the obligation of the Food 
                and Drug Administration to demonstrate affirmatively 
                that a manufacturer, distributor, or supplier referred 
                to in such subparagraph meets any of the conditions 
                described in such subparagraph.
            (2) Liability of health care providers.--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. Nothing in this paragraph prevents a court from 
        consolidating cases involving health care providers and cases 
        involving products liability claims against the manufacturer, 
        distributor, or product seller of such medical product.
            (3) Packaging.--In a health care lawsuit for harm which is 
        alleged to relate to the adequacy of the packaging or labeling 
        of a drug which is required to have tamper-resistant packaging 
        under regulations of the Secretary of Health and Human Services 
        (including labeling regulations related to such packaging), the 
        manufacturer or product seller of the drug shall not be held 
        liable for punitive damages unless such packaging or labeling 
        is found by the trier of fact by clear and convincing evidence 
        to be substantially out of compliance with such regulations.
            (4) Exception.--Paragraph (1) shall not apply in any health 
        care lawsuit in which--
                    (A) a person, before or after premarket approval, 
                clearance, or licensure of such medical product, 
                knowingly misrepresented to or withheld from the Food 
                and Drug Administration information that is required to 
                be submitted under the Federal Food, Drug, and Cosmetic 
                Act (21 U.S.C. 301 et seq.) or section 351 of the 
                Public Health Service Act (42 U.S.C. 262) that is 
                material and is causally related to the harm which the 
                claimant allegedly suffered;
                    (B) a person made an illegal payment to an official 
                of the Food and Drug Administration for the purpose of 
                either securing or maintaining approval, clearance, or 
                licensure of such medical product; or
                    (C) the defendant caused the medical product which 
                caused the claimant's harm to be misbranded or 
                adulterated (as such terms are used in chapter V of the 
                Federal Food, Drug, and Cosmetic Act (21 U.S.C. 351 et 
                seq.)).

SEC. 107. AUTHORIZATION OF PAYMENT OF FUTURE DAMAGES TO CLAIMANTS IN 
              HEALTH CARE LAWSUITS.

    (a) 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.
    (b) Applicability.--This section applies to all actions which have 
not been first set for trial or retrial before the effective date of 
this title.

SEC. 108. DEFINITIONS.

    In this title:
            (1) Alternative dispute resolution system; adr.--The term 
        ``alternative dispute resolution system'' or ``ADR'' means a 
        system that provides for the resolution of health care lawsuits 
        in a manner other than through a civil action brought in a 
        State or Federal court.
            (2) Claimant.--The term ``claimant'' means any person who 
        brings a health care lawsuit, including a person who asserts or 
        claims a right to legal or equitable contribution, indemnity, 
        or subrogation, arising out of a health care liability claim or 
        action, and any person on whose behalf such a claim is asserted 
        or such an action is brought, whether deceased, incompetent, or 
        a minor.
            (3) Compensatory damages.--The term ``compensatory 
        damages'' means objectively verifiable monetary losses incurred 
        as a result of the provision of, use of, or payment for (or 
        failure to provide, use, or pay for) 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, 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. The 
        term ``compensatory damages'' includes economic damages and 
        noneconomic damages, as such terms are defined in this section.
            (4) 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.
            (5) Economic damages.--The term ``economic damages'' means 
        objectively verifiable monetary losses incurred as a result of 
        the provision of, use of, or payment for (or failure to 
        provide, use, or pay for) 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.
            (6) Health care lawsuit.--The term ``health care lawsuit'' 
        means any health care liability claim concerning the provision 
        of health care goods or services or any medical product 
        affecting interstate commerce, or any health care liability 
        action concerning the provision of health care goods or 
        services or any medical product affecting interstate commerce, 
        brought in a State or Federal court or pursuant to an 
        alternative dispute resolution system, against a health care 
        provider, a health care organization, or the manufacturer, 
        distributor, supplier, marketer, promoter, or seller of a 
        medical product, 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.
            (7) 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, a health care 
        organization, or the manufacturer, distributor, supplier, 
        marketer, promoter, or seller of a medical product, 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.
            (8) 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, health care 
        organization, or the manufacturer, distributor, supplier, 
        marketer, promoter, or seller of a medical product, including, 
        but not limited to, third-party claims, cross-claims, counter-
        claims, or contribution claims, which are based upon the 
        provision of, use of, or payment for (or the failure to 
        provide, use, or pay for) 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.
            (9) Health care organization.--The term ``health care 
        organization'' means any person or entity which is obligated to 
        provide or pay for health benefits under any health plan, 
        including any person or entity acting under a contract or 
        arrangement with a health care organization to provide or 
        administer any health benefit.
            (10) 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.
            (11) Health care goods or services.--The term ``health care 
        goods or services'' means any goods or services provided by a 
        health care organization, 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.
            (12) Malicious intent to injure.--The term ``malicious 
        intent to injure'' means intentionally causing or attempting to 
        cause physical injury other than providing health care goods or 
        services.
            (13) 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.
            (14) 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.
            (15) Punitive damages.--The term ``punitive damages'' means 
        damages awarded, for the purpose of punishment or deterrence, 
        and not solely for compensatory purposes, against a health care 
        provider, health care organization, or a manufacturer, 
        distributor, or supplier of a medical product. Punitive damages 
        are neither economic nor noneconomic damages.
            (16) 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.
            (17) 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. 109. EFFECT ON OTHER LAWS.

    (a) Vaccine Injury.--
            (1) 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--
                    (A) this title does not affect the application of 
                the rule of law to such an action; and
                    (B) any rule of law prescribed by this title in 
                conflict with a rule of law of such title XXI shall not 
                apply to such action.
            (2) 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 title or otherwise applicable law (as 
        determined under this title) will apply to such aspect of such 
        action.
    (b) Other Federal Law.--Except as provided in this section, nothing 
in this title 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. 110. STATE FLEXIBILITY AND PROTECTION OF STATES' RIGHTS.

    (a) Health Care Lawsuits.--The provisions governing health care 
lawsuits set forth in this title 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 
title. The provisions governing health care lawsuits set forth in this 
title supersede chapter 171 of title 28, United States Code, to the 
extent that such chapter--
            (1) 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 title; or
            (2) prohibits the introduction of evidence regarding 
        collateral source benefits, or mandates or permits subrogation 
        or a lien on collateral source benefits.
    (b) Protection of States' Rights and Other Laws.--(1) Any issue 
that is not governed by any provision of law established by or under 
this title (including State standards of negligence) shall be governed 
by otherwise applicable State or Federal law.
    (2) This title shall not preempt or supersede any State or Federal 
law that imposes greater procedural or substantive protections for 
health care providers and health care organizations from liability, 
loss, or damages than those provided by this title or create a cause of 
action.
    (c) State Flexibility.--No provision of this title shall be 
construed to preempt--
            (1) any State law (whether effective before, on, or after 
        the date of the enactment of this title) that specifies a 
        particular monetary amount of compensatory or punitive 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 title, 
        notwithstanding section 4(a); or
            (2) any defense available to a party in a health care 
        lawsuit under any other provision of State or Federal law.

SEC. 111. APPLICABILITY; EFFECTIVE DATE.

    This title 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 
title, except that any health care lawsuit arising from an injury 
occurring prior to the date of the enactment of this title shall be 
governed by the applicable statute of limitations provisions in effect 
at the time the injury occurred.

         TITLE II--REPEAL OF INDEPENDENT PAYMENT ADVISORY BOARD

SEC. 201. SHORT TITLE.

    This title may be cited as the ``Medicare Decisions Accountability 
Act of 2012''.

SEC. 202. REPEAL OF THE INDEPENDENT PAYMENT ADVISORY BOARD.

    Effective as of the enactment of the Patient Protection and 
Affordable Care Act (Public Law 111-148), sections 3403 and 10320 of 
such Act (including the amendments made by such sections, but excluding 
subsection (d) of section 1899A of the Social Security Act, as added 
and amended by such sections) are repealed, and any provision of law 
amended by such sections is hereby restored as if such sections had not 
been enacted into law.

             TITLE III--HEALTH CARE SAFETY NET ENHANCEMENT

SEC. 301. SHORT TITLE.

    This title may be cited as the ``Health Care Safety Net Enhancement 
Act of 2012''.

SEC. 302. PROTECTION FOR EMERGENCY AND RELATED SERVICES FURNISHED 
              PURSUANT TO EMTALA.

    Section 224(g) of the Public Health Service Act (42 U.S.C. 233(g)) 
is amended--
            (1) in paragraph (4), by striking ``An entity'' and 
        inserting ``Subject to paragraph (6), an entity''; and
            (2) by adding at the end the following:
            ``(6)(A) For purposes of this section--
                    ``(i) an entity described in subparagraph (B) shall 
                be considered to be an entity described in paragraph 
                (4); and
                    ``(ii) the provisions of this section shall apply 
                to an entity described in subparagraph (B) in the same 
                manner as such provisions apply to an entity described 
                in paragraph (4), except that--
                            ``(I) notwithstanding paragraph (1)(B), the 
                        deeming of any entity described in subparagraph 
                        (B), or of an officer, governing board member, 
                        employee, contractor, or on-call provider of 
                        such an entity, to be an employee of the Public 
                        Health Service for purposes of this section 
                        shall apply only with respect to items and 
                        services that are furnished to an individual 
                        pursuant to section 1867 of the Social Security 
                        Act and to post stabilization services (as 
                        defined in subparagraph (D)) furnished to such 
                        an individual;
                            ``(II) nothing in paragraph (1)(D) shall be 
                        construed as preventing a physician or 
                        physician group described in subparagraph 
                        (B)(ii) from making the application referred to 
                        in such paragraph or as conditioning the 
                        deeming of a physician or physician group that 
                        makes such an application upon receipt by the 
                        Secretary of an application from the hospital 
                        or emergency department that employs or 
                        contracts with the physician or group, or 
                        enlists the physician or physician group as an 
                        on-call provider;
                            ``(III) notwithstanding paragraph (3), this 
                        paragraph shall apply only with respect to 
                        causes of action arising from acts or omissions 
                        that occur on or after January 1, 2012;
                            ``(IV) paragraph (5) shall not apply to a 
                        physician or physician group described in 
                        subparagraph (B)(ii);
                            ``(V) the Attorney General, in consultation 
                        with the Secretary, shall make separate 
                        estimates under subsection (k)(1) with respect 
                        to entities described in subparagraph (B) and 
                        entities described in paragraph (4) (other than 
                        those described in subparagraph (B)), and the 
                        Secretary shall establish separate funds under 
                        subsection (k)(2) with respect to such groups 
                        of entities, and any appropriations under this 
                        subsection for entities described in 
                        subparagraph (B) shall be separate from the 
                        amounts authorized by subsection (k)(2);
                            ``(VI) notwithstanding subsection (k)(2), 
                        the amount of the fund established by the 
                        Secretary under such subsection with respect to 
                        entities described in subparagraph (B) may 
                        exceed a total of $10,000,000 for a fiscal 
                        year; and
                            ``(VII) subsection (m) shall not apply to 
                        entities described in subparagraph (B).
            ``(B) An entity described in this subparagraph is--
                    ``(i) a hospital or an emergency department to 
                which section 1867 of the Social Security Act applies; 
                and
                    ``(ii) a physician or physician group that is 
                employed by, is under contract with, or is an on-call 
                provider of such hospital or emergency department, to 
                furnish items and services to individuals under such 
                section.
            ``(C) For purposes of this paragraph, the term `on-call 
        provider' means a physician or physician group that--
                    ``(i) has full, temporary, or locum tenens staff 
                privileges at a hospital or emergency department to 
                which section 1867 of the Social Security Act applies; 
                and
                    ``(ii) is not employed by or under contract with 
                such hospital or emergency department, but agrees to be 
                ready and available to provide services pursuant to 
                section 1867 of the Social Security Act or post-
                stabilization services to individuals being treated in 
                the hospital or emergency department with or without 
                compensation from the hospital or emergency department.
            ``(D) For purposes of this paragraph, the term `post 
        stabilization services' means, with respect to an individual 
        who has been treated by an entity described in subparagraph (B) 
        for purposes of complying with section 1867 of the Social 
        Security Act, services that are--
                    ``(i) related to the condition that was so treated; 
                and
                    ``(ii) provided after the individual is stabilized 
                in order to maintain the stabilized condition or to 
                improve or resolve the condition of the individual.
            ``(E)(i) Nothing in this paragraph (or in any other 
        provision of this section as such provision applies to entities 
        described in subparagraph (B) by operation of subparagraph (A)) 
        shall be construed as authorizing or requiring the Secretary to 
        make payments to such entities, the budget authority for which 
        is not provided in advance by appropriation Acts.
            ``(ii) The Secretary shall limit the total amount of 
        payments under this paragraph for a fiscal year to the total 
        amount appropriated in advance by appropriation Acts for such 
        purpose for such fiscal year. If the total amount of payments 
        that would otherwise be made under this paragraph for a fiscal 
        year exceeds such total amount appropriated, the Secretary 
        shall take such steps as may be necessary to ensure that the 
        total amount of payments under this paragraph for such fiscal 
        year does not exceed such total amount appropriated.''.

SEC. 303. CONSTITUTIONAL AUTHORITY.

    The constitutional authority upon which this title rests is the 
power of the Congress to provide for the general welfare, to regulate 
commerce, and to make all laws which shall be necessary and proper for 
carrying into execution Federal powers, as enumerated in section 8 of 
article I of the Constitution of the United States.

TITLE IV--RESTORING THE APPLICATION OF ANTITRUST LAWS TO HEALTH SECTOR 
                                INSURERS

SEC. 401. SHORT TITLE.

    This title may be cited as the ``Health Insurance Industry Fair 
Competition Act of 2012''.

SEC. 402. APPLICATION OF THE ANTITRUST LAWS TO THE BUSINESS OF HEALTH 
              INSURANCE.

    (a) Amendment to McCarran-Ferguson Act.--Section 3 of the Act of 
March 9, 1945 (15 U.S.C. 1013), commonly known as the McCarran-Ferguson 
Act, is amended by adding at the end the following:
    ``(c) Nothing contained in this Act shall modify, impair, or 
supersede the operation of any of the antitrust laws with respect to 
the business of health insurance. For purposes of the preceding 
sentence, the term `antitrust laws' has the meaning given it in 
subsection (a) of the first section of the Clayton Act, except that 
such term includes section 5 of the Federal Trade Commission Act to the 
extent that such section 5 applies to unfair methods of competition. 
For the purposes of this subsection, the term `business of health 
insurance' shall--
            ``(1) mean `health insurance coverage' offered by a `health 
        insurance issuer' as those terms are defined in section 9001 of 
        the Patient Protection and Affordable Care Act, which 
        incorporates by reference and utilizes the definitions included 
        in section 9832 of the Internal Revenue Code (26 U.S.C. 9832); 
        and
            ``(2) not include--
                    ``(A) life insurance and annuities;
                    ``(B) property or casualty insurance, including but 
                not limited to, automobile, medical malpractice or 
                workers' compensation insurance; or
                    ``(C) any insurance or benefits defined as 
                `excepted benefits' under section 9832(c) of the 
                Internal Revenue Code (26 U.S.C. 9832(c)), whether 
                offered separately or in combination with products 
                described in subparagraph (A).''.
    (b) Related Provision.--For purposes of section 5 of the Federal 
Trade Commission Act (15 U.S.C. 45) to the extent such section applies 
to unfair methods of competition, section 3(c) of the McCarran-Ferguson 
Act shall apply with respect to the business of health insurance 
without regard to whether such business is carried on for profit, 
notwithstanding the definition of ``Corporation'' contained in section 
4 of the Federal Trade Commission Act.
    (c) Limitation on Class Actions.--
            (1) Limitation.--No class action may be heard in a Federal 
        or State court on a claim against a person engaged in the 
        business of health insurance for a violation of any of the 
        antitrust laws (as defined in section 3(c) of the Act of March 
        9, 1945 (15 U.S.C. 1013), commonly known as the McCarran-
        Ferguson Act).
            (2) Exemption.--Paragraph (1) shall not apply with respect 
        to any action commenced--
                    (A) by the United States or any State; or
                    (B) by a named claimant for an injury only to 
                itself.

      TITLE V--PROTECTIONS FOR GOOD SAMARITAN HEALTH PROFESSIONALS

SEC. 501. SHORT TITLE.

    This title may be cited as the ``Good Samaritan Health 
Professionals Act of 2012''.

SEC. 502. LIMITATION ON LIABILITY FOR VOLUNTEER HEALTH CARE 
              PROFESSIONALS.

    (a) In General.--Title II of the Public Health Service Act (42 
U.S.C. 202 et seq.) is amended by inserting after section 224 the 
following:

``SEC. 224A. LIMITATION ON LIABILITY FOR VOLUNTEER HEALTH CARE 
              PROFESSIONALS.

    ``(a) Limitation on Liability.--Except as provided in subsection 
(b), a health care professional shall not be liable under Federal or 
State law for any harm caused by an act or omission of the professional 
if--
            ``(1) the professional is serving as a volunteer for 
        purposes of responding to a disaster; and
            ``(2) the act or omission occurs--
                    ``(A) during the period of the disaster, as 
                determined under the laws listed in subsection (e)(1);
                    ``(B) in the health care professional's capacity as 
                such a volunteer; and
                    ``(C) in a good faith belief that the individual 
                being treated is in need of health care services.
    ``(b) Exceptions.--Subsection (a) does not apply if--
            ``(1) the harm was caused by an act or omission 
        constituting willful or criminal misconduct, gross negligence, 
        reckless misconduct, or a conscious flagrant indifference to 
        the rights or safety of the individual harmed by the health 
        care professional; or
            ``(2) the health care professional rendered the health care 
        services under the influence (as determined pursuant to 
        applicable State law) of intoxicating alcohol or an 
        intoxicating drug.
    ``(c) Standard of Proof.--In any civil action or proceeding against 
a health care professional claiming that the limitation in subsection 
(a) applies, the plaintiff shall have the burden of proving by clear 
and convincing evidence the extent to which limitation does not apply.
    ``(d) Preemption.--
            ``(1) In general.--This section preempts the laws of a 
        State or any political subdivision of a State to the extent 
        that such laws are inconsistent with this section, unless such 
        laws provide greater protection from liability.
            ``(2) Volunteer protection act.--Protections afforded by 
        this section are in addition to those provided by the Volunteer 
        Protection Act of 1997.
    ``(e) Definitions.--In this section:
            ``(1) The term `disaster' means--
                    ``(A) a national emergency declared by the 
                President under the National Emergencies Act;
                    ``(B) an emergency or major disaster declared by 
                the President under the Robert T. Stafford Disaster 
                Relief and Emergency Assistance Act; or
                    ``(C) a public health emergency determined by the 
                Secretary under section 319 of this Act.
            ``(2) The term `harm' includes physical, nonphysical, 
        economic, and noneconomic losses.
            ``(3) The term `health care professional' means an 
        individual who is licensed, certified, or authorized in one or 
        more States to practice a health care profession.
            ``(4) The term `State' includes each of the several States, 
        the District of Columbia, the Commonwealth of Puerto Rico, the 
        Virgin Islands, Guam, American Samoa, the Northern Mariana 
        Islands, and any other territory or possession of the United 
        States.
            ``(5)(A) The term `volunteer' means a health care 
        professional who, with respect to the health care services 
        rendered, does not receive--
                    ``(i) compensation; or
                    ``(ii) any other thing of value in lieu of 
                compensation, in excess of $500 per year.
            ``(B) For purposes of subparagraph (A), the term 
        `compensation'--
                    ``(i) includes payment under any insurance policy 
                or health plan, or under any Federal or State health 
                benefits program; and
                    ``(ii) excludes--
                            ``(I) reasonable reimbursement or allowance 
                        for expenses actually incurred;
                            ``(II) receipt of paid leave; and
                            ``(III) receipt of items to be used 
                        exclusively for rendering the health services 
                        in the health care professional's capacity as a 
                        volunteer described in subsection (a)(1).''.
    (b) Effective Date.--
            (1) In general.--This title and the amendment made by 
        subsection (a) shall take effect 90 days after the date of the 
        enactment of this title.
            (2) Application.--This title applies to any claim for harm 
        caused by an act or omission of a health care professional 
        where the claim is filed on or after the effective date of this 
        title, but only if the harm that is the subject of the claim or 
        the conduct that caused such harm occurred on or after such 
        effective date.

            Passed the House of Representatives March 22, 2012.

            Attest:

                                                                 Clerk.
112th CONGRESS

  2d Session

                                H. R. 5

_______________________________________________________________________

                                 AN ACT

To improve patient access to health care services and provide improved 
  medical care by reducing the excessive burden the liability system 
               places on the health care delivery system.