1.Short
title; table of contents
(a)This Act may be cited
as the Sequestration Prevention Act of
2012
.
(b)The table of contents for this Act is as follows:
Sec. 1. Short title; table of
contents.
TITLE I—Fully repeal the sequestration provision of round 2 of
the Budget Control Act
Sec. 101. Repeal.
TITLE II—Repeal of health care law
Sec. 201. Short title.
Sec. 202. Repeal of the job-killing health care law and health
care-related provisions in the Health Care and Education Reconciliation Act of
2010.
Sec. 203. Budgetary effects of this Act.
TITLE III—Nutrition Assistance Block Grant Program
Sec. 301. Nutrition assistance block grant program.
Sec. 302. Funding.
Sec. 303. Repeals.
Sec. 304. Baseline.
TITLE IV—Block Grant the Medicaid Program
Sec. 401. Medical assistance block grant program.
Sec. 402. Funding.
Sec. 403. Termination of mandatory funding.
Sec. 404. Miscellaneous.
Sec. 405. Baseline.
Sec. 406. Definitions.
TITLE V—Reduction of Federal workforce
Sec. 501. Reduction in the number of Federal
employees.
TITLE VI—Prohibition on Climate Change and Global Warming
Funding
Sec. 601. No funding for climate change or global
warming.
TITLE VII—Protecting access to health care
Sec. 700. Short title.
Subtitle A—HEALTH Act
Sec. 701. Short title.
Sec. 702. Purpose.
Sec. 703. Encouraging speedy resolution of claims.
Sec. 704. Compensating patient injury.
Sec. 705. Maximizing patient recovery.
Sec. 706. Punitive damages.
Sec. 707. Authorization of payment of future damages to
claimants in health care lawsuits.
Sec. 708. Definitions.
Sec. 709. Effect on other laws.
Sec. 710. State flexibility and protection of States’
rights.
Sec. 711. Applicability; effective date.
Subtitle B—Health care safety net enhancement
Sec. 721. Short title.
Sec. 722. Protection for emergency and related services
furnished pursuant to EMTALA.
Sec. 723. Constitutional authority.
Subtitle C—Restoring the application of antitrust laws to
health sector insurers
Sec. 731. Short title.
Sec. 732. Application of the antitrust laws to the business of
health insurance.
Subtitle D—Protections for good samaritan health
professionals
Sec. 741. Short title.
Sec. 742. Limitation on liability for volunteer health care
professionals.
TITLE VIII—Budget Control Act spending cap
adjustments
Sec. 801. Budget Control Act spending cap
adjustments.
<enum>I</enum><header>Fully repeal the
sequestration provision of round 2 of the Budget Control Act</header>
<section id="id039E726B2C01402A9E4EDCDF7112FE63"><enum>101.</enum><header>Repeal</header><text display-inline="no-display-inline">Section 251A of the Balanced Budget and
Emergency Deficit Control Act of 1985 is repealed.</text>
</section><enum>II</enum><header>Repeal of health
care law</header>
<section id="id546B8E6F14874FD29A6E2AEB64EF6082"><enum>201.</enum><header>Short
title</header><text display-inline="no-display-inline">This title may be cited
as the <quote><short-title>Repealing the Job-Killing
Health Care Law Act</short-title></quote>.</text>
</section><section id="H2FBAA5A48E564FB88746E5D3CE52CB25"><enum>202.</enum><header>Repeal of the
job-killing health care law and health care-related provisions in the Health
Care and Education Reconciliation Act of 2010</header>
<subsection id="H37DAFA719C1A4866B80055DE03DA79E0"><enum>(a)</enum><header>Job-Killing
health care law</header><text>Effective as of the enactment of Public Law
111–148, such Act is repealed, and the provisions of law amended or repealed by
such Act are restored or revived as if such Act had not been enacted.</text>
</subsection><subsection id="H52B259EDD0214B12B44374B4B62CC36A"><enum>(b)</enum><header>Health
care-Related provisions in the Health Care and Education Reconciliation Act of
2010</header><text>Effective as of the enactment of the Health Care and
Education Reconciliation Act of 2010 (Public Law 111–152), title I and subtitle
B of title II of such Act are repealed, and the provisions of law amended or
repealed by such title or subtitle, respectively, are restored or revived as if
such title and subtitle had not been enacted.</text>
</subsection></section><section display-inline="no-display-inline" id="H826AF063C0204F149AE5D7ACE577D9E1" section-type="subsequent-section"><enum>203.</enum><header>Budgetary effects of
this Act</header><text display-inline="no-display-inline">The budgetary effects
of this title, for the purpose of complying with the Statutory Pay-As-You-Go
Act of 2010, shall be determined by reference to the latest statement titled
<quote>Budgetary Effects of PAYGO Legislation</quote> for this title, submitted
for printing in the Congressional Record by the Chairman of the Committee on
the Budget of the House of Representatives, as long as such statement has been
submitted prior to the vote on passage of this Act.</text>
</section><enum>III</enum><header>Nutrition
Assistance Block Grant Program</header>
<section id="id3846D132AFFC46D98C84E9F7FBD72DCF"><enum>301.</enum><header>Nutrition
assistance block grant program</header>
<subsection id="id66E1D1BEC6B849D8B4309FA1780C2E43"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">For each of fiscal
years 2014 through 2022, the Secretary shall establish a nutrition assistance
block grant program under which the Secretary shall make annual grants to each
participating State that establishes a nutrition assistance program in the
State and submits to the Secretary annual reports under subsection (d).</text>
</subsection><subsection id="idA15C6329B2184DF89B8930C6DB08B10A"><enum>(b)</enum><header>Requirements</header><text>As
a requirement of receiving grants under this section, the Governor of each
participating State shall certify that the State nutrition assistance program
includes—</text>
<paragraph id="id577F67D42021471EAE4BC7501153603D"><enum>(1)</enum><text>work
requirements;</text>
</paragraph><paragraph id="id0397DE48470B4E1FAFEF36F4B53B11B1"><enum>(2)</enum><text>mandatory drug
testing; and</text>
</paragraph><paragraph id="idB4EBE1903DD64554BAE788506CE6C7E2"><enum>(3)</enum><text>limitations on
the eligible uses of benefits that are at least as restrictive as the
limitations in place for the supplemental nutrition assistance program
established under the <act-name parsable-cite="FSA77">Food and Nutrition Act of
2008</act-name> (7 U.S.C. 2011 et seq.) as of May 31, 2012.</text>
</paragraph></subsection><subsection id="id9120067DFA8E4F418C9D47F2E94E3DCC"><enum>(c)</enum><header>Amount of
grant</header><text display-inline="yes-display-inline">For each fiscal year,
the Secretary shall make a grant to each participating State in an amount equal
to the product of—</text>
<paragraph id="id82A8DBCB015746129C24D43ECBB9116B"><enum>(1)</enum><text display-inline="yes-display-inline">the amount made available under section 302
for the applicable fiscal year; and</text>
</paragraph><paragraph id="id9656BC8359FF4A7C9B4346A718886DF3"><enum>(2)</enum><text>the proportion
that—</text>
<subparagraph id="id3A11FB77104047AD87F94148B29A684A"><enum>(A)</enum><text>the number of
legal residents in the State whose income does not exceed 100 percent of the
poverty line (as defined in section 673(2) of the Community Services Block
Grant Act (42 U.S.C. 9902(2), including any revision required by such section))
applicable to a family of the size involved; bears to</text>
</subparagraph><subparagraph id="idD9CCFCA755C0414F9DC4C6BF2A5CFF3D"><enum>(B)</enum><text>the number of
such individuals in all participating States for the applicable fiscal year,
based on data for the most recent fiscal year for which data is
available.</text>
</subparagraph></paragraph></subsection><subsection id="id566B65EEE15D4DA3BDD8F383877AAA5B"><enum>(d)</enum><header>Annual report
requirements</header>
<paragraph id="id0BA51A867EB9492EAD158C4B0603E710"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than
January 1 of each year, each State that receives a grant under this section
shall submit to the Secretary a report that shall include, for the year covered
by the report—</text>
<subparagraph id="id914badfa1af648a38ad9135e1ec474a3"><enum>(A)</enum><text>a description of
the structure and design of the nutrition assistance program of the State,
including the manner in which residents of the State qualify for the
program;</text>
</subparagraph><subparagraph id="id3CD48CE24120444F9D2A3B470CEF0EA7"><enum>(B)</enum><text>the cost the
State incurs to administer the program;</text>
</subparagraph><subparagraph id="id6E3CFE02E4F74552AA3CD1E54CB2075C"><enum>(C)</enum><text>whether the State
has established a rainy day fund for the nutrition assistance program of the
State; and</text>
</subparagraph><subparagraph id="idC2B14D7B82E84FE8BFD38E310E950974"><enum>(D)</enum><text>general
statistics about participation in the nutrition assistance program.</text>
</subparagraph></paragraph><paragraph id="id47AC0CB16A4C4E2892D9F824D840A25E"><enum>(2)</enum><header>Audit</header><text>Each
year, the Comptroller General of the United States shall—</text>
<subparagraph id="id6903ED424C4445E4BAE8444DCC8AA0D2"><enum>(A)</enum><text>conduct an audit
on the effectiveness of the nutritional assistance block grant program and the
manner in which each participating State is implementing the program;
and</text>
</subparagraph><subparagraph id="id97506F1E2B204BD0A38BFE3525DCD8D5"><enum>(B)</enum><text>not later than
June 30, submit to the appropriate committees of Congress a report
describing—</text>
<clause id="id273847837EDC489C9B6840F1653FBE15"><enum>(i)</enum><text>the
results of the audit; and</text>
</clause><clause id="idEF77DDC2282C47BF8790B1B3F20E7CBD"><enum>(ii)</enum><text display-inline="yes-display-inline">the manner in which the State will carry
out the supplemental nutrition assistance program in the State, including
eligibility and fraud prevention requirements.</text>
</clause></subparagraph></paragraph></subsection><subsection id="idC2DEB34DDD3044D6B610FD4D6833DF5A"><enum>(e)</enum><header>Use of
funds</header>
<paragraph id="id543AC8FEA5EA4BAD8426AF8CD1D3C4D4"><enum>(1)</enum><header>In
general</header><text>A State that receives a grant under this section may use
the grant in any manner determined to be appropriate by the State to provide
nutrition assistance to the legal residents of the State.</text>
</paragraph><paragraph id="idB687AA27A3ED47B89A05817C31F0A8DD"><enum>(2)</enum><header>Availability of
funds</header><text>Grant funds made available to a State under this section
shall—</text>
<subparagraph id="idB9DE8899E28B46468100F183A6E0113A"><enum>(A)</enum><text>remain available
to the State for a period of 5 years; and</text>
</subparagraph><subparagraph id="id15A9C723982746828D269AD9FB4849EF"><enum>(B)</enum><text>after that
period, shall—</text>
<clause id="idA3B1F49F5081489788B14C3A7E2D1C9A"><enum>(i)</enum><text>revert to the
Federal Government to be deposited in the Treasury and used for Federal budget
deficit reduction; or</text>
</clause><clause id="id39F7BA25E144422E8FD0CAD1DFBC5E6E"><enum>(ii)</enum><text>if
there is no Federal budget deficit, be used to reduce the Federal debt in such
manner as the Secretary of the Treasury considers appropriate.</text>
</clause></subparagraph></paragraph></subsection></section><section id="id0306C6AE99734CE7A89A898FBB176C3C"><enum>302.</enum><header>Funding</header><text display-inline="no-display-inline">There is authorized to be appropriated to
carry out this title—</text>
<paragraph id="idb0e67b93f8f4478389e671b8bd61aa01"><enum>(1)</enum><text>for fiscal year
2014, $44,400,000,000;</text>
</paragraph><paragraph id="id867b4904e4524c4eb4b376f4e59d234c"><enum>(2)</enum><text>for fiscal year
2015, $45,500,000,000;</text>
</paragraph><paragraph id="id42109f7b05c642bea1f507bbc8149417"><enum>(3)</enum><text>for fiscal year
2016, $46,600,000,000;</text>
</paragraph><paragraph id="ida8244658657c4c87af6117af1046042b"><enum>(4)</enum><text>for fiscal year
2017, $47,800,000,000;</text>
</paragraph><paragraph id="id4bee23edcb964712b526254775226f09"><enum>(5)</enum><text>for fiscal year
2018, $49,000,000,000;</text>
</paragraph><paragraph id="idf2df56c1d37a47fe88601a912642e4df"><enum>(6)</enum><text>for fiscal year
2019, $50,200,000,000;</text>
</paragraph><paragraph id="id9a7c2dd861c24bb3bc4bfb2b1daa14b0"><enum>(7)</enum><text>for fiscal year
2020, $51,500,000,000;</text>
</paragraph><paragraph id="ida1bbc1a5204c41909d7f4fdc0778c2f8"><enum>(8)</enum><text>for fiscal year
2021, $52,800,000,000; and</text>
</paragraph><paragraph id="id1B796FE5961048D4977F351A44AFDE88"><enum>(9)</enum><text>for fiscal year
2022, $54,100,000,000.</text>
</paragraph></section><section id="idFBF7E36B995B4660B0E69F3128BB3699"><enum>303.</enum><header>Repeals</header>
<subsection id="id25DC7C0F0CF645A08BEC6FDCBE0FC278"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Effective September
30, 2013, the <act-name parsable-cite="FSA77">Food and Nutrition Act of 2008
</act-name>(7 U.S.C. 2011 et seq.) is repealed.</text>
</subsection><subsection id="idB82AF823F2344A94A637460198BFCF2E"><enum>(b)</enum><header>Repeal of
mandatory funding</header>
<paragraph id="id7AAE08DF86974B778308D8AF44E96442"><enum>(1)</enum><header>In
general</header><text>Notwithstanding any other provision of law, effective
September 30, 2013, the supplemental nutrition assistance program established
under the <act-name parsable-cite="FSA77">Food and Nutrition Act of
2008</act-name> (7 U.S.C. 2011 et seq.) (as in effect prior to that date) shall
cease to be a program funded through direct spending (as defined in section
250(c) of the Balanced Budget and Emergency Deficit Control Act of 1985 (2
U.S.C. 900(c)) prior to the amendment made by paragraph (2)).</text>
</paragraph><paragraph id="id711B0C49F3724EE9B10A12D2A449D0DE"><enum>(2)</enum><header>Direct
spending</header><text display-inline="yes-display-inline">Effective September
30, 2013, section 250(c)(8) of the Balanced Budget and Emergency Deficit
Control Act of 1985 (2 U.S.C. 900(c)(8)) is amended—</text>
<subparagraph id="id923588BE01E2406DB6067C31C56140F3"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A), by adding
<quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="id1909CCFBC1594C3E8176E05C026FA650"><enum>(B)</enum><text>in subparagraph
(B), by striking <quote>; and</quote> at the end and inserting a period;
and</text>
</subparagraph><subparagraph id="id6338D53474B341AEABDE96EB4D1B4339"><enum>(C)</enum><text>by striking
subparagraph (C).</text>
</subparagraph></paragraph><paragraph id="id48BA7D2A1237447A8B313777C7577607"><enum>(3)</enum><header>Entitlement
authority</header><text>Effective September 30, 2013, section 3(9) of the
Congressional Budget and Impoundment Control Act of 1974 (2 U.S.C. 622(9)) is
amended—</text>
<subparagraph id="idD8B36B6E972A4BEAB6AA6F9973E6A29E"><enum>(A)</enum><text>by striking
<quote>means—</quote> and all that follows through <quote>the authority to
make</quote> and inserting <quote>means the authority to make</quote>;</text>
</subparagraph><subparagraph id="id7C3FBB01A89A4229AAA3722B20432BBC"><enum>(B)</enum><text>by striking
<quote>; and</quote> and inserting a period; and</text>
</subparagraph><subparagraph id="id6D6FB802B25C44058C74407FD5397027"><enum>(C)</enum><text>by striking
subparagraph (B).</text>
</subparagraph></paragraph><paragraph id="id051615F582A94411B54A77B7A5BF0036"><enum>(4)</enum><header>Other direct
spending</header><text display-inline="yes-display-inline">Effective September
30, 2013, section 1026(5) of the Congressional Budget and Impoundment Control
Act of 1974 (2 U.S.C. 691e(5)) is amended—</text>
<subparagraph id="id4C01046AA4F24F6F9D97D4BFEAB5EF83"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (A), by adding
<quote>and</quote> at the end;</text>
</subparagraph><subparagraph id="id0E78CDC48862402B84F6C4776BC0BE60"><enum>(B)</enum><text>in subparagraph
(B), by striking <quote>; and</quote> at the end and inserting a period;
and</text>
</subparagraph><subparagraph id="id1C7E4F5AF23E4A8B9FF3F48244E188D1"><enum>(C)</enum><text>by striking
subparagraph (C).</text>
</subparagraph></paragraph></subsection><subsection id="id792FE2701313498A9858892026BD1BC6"><enum>(c)</enum><header>Relationship to
other law</header><text>Any reference in this title, an amendment made by this
title, or any other law to the supplemental nutrition assistance program shall
be considered to be a reference to the nutrition assistance block grant program
under this title.</text>
</subsection></section><section id="id174C06BC12C94BA6AC31E87669D1EF2E"><enum>304.</enum><header>Baseline</header><text display-inline="no-display-inline">Notwithstanding section 257 of the Balanced
Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 907), the baseline
shall assume that, on and after September 30, 2013, no benefits shall be
provided under the supplemental nutrition assistance program established under
the <act-name parsable-cite="FSA77">Food and Nutrition Act of 2008</act-name>
(7 U.S.C. 2011 et seq.) (as in effect prior to that date).</text>
</section><enum>IV</enum><header>Block Grant the
Medicaid Program</header>
<section id="idFA9AB267C5314A81B4B76C0A69452BF3"><enum>401.</enum><header>Medical
assistance block grant program</header>
<subsection id="id91C9CB2227FE49D49D1F679B4C1F9E2E"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">For each of fiscal
years 2014 through 2022, the Secretary shall establish a Medicaid block grant
program under which the Secretary shall make annual grants to each
participating State that establishes a medical assistance program for
individuals in the State and submits to the Secretary annual reports under
subsection (d).</text>
</subsection><subsection id="idd34a79d09e9b464f8ad6625e9034b7be"><enum>(b)</enum><header>Amount of
grant</header><text>For each fiscal year, the Secretary shall make a grant to
each participating State in an amount equal to the product of—</text>
<paragraph id="id7b989ce892d74bb799ac69b74030bcf9"><enum>(1)</enum><text>the amount made
available under section 402 for the applicable fiscal year; and</text>
</paragraph><paragraph id="idd26c482306e54f4eae699597436098be"><enum>(2)</enum><text>the proportion
that—</text>
<subparagraph id="id26af15f3009f49de8c6a741ea2e87af0"><enum>(A)</enum><text>the number of
legal residents in the State whose income does not exceed 185 percent of the
poverty line (as defined in section 673(2) of the Community Services Block
Grant Act (42 U.S.C. 9902(2), including any revision required by such section))
applicable to a family of the size involved; bears to</text>
</subparagraph><subparagraph id="id8d3d5be8976b41888723ccc4d84cfdd2"><enum>(B)</enum><text>the number of
such individuals in all participating States for the applicable fiscal year,
based on data for the most recent fiscal year for which data is
available.</text>
</subparagraph></paragraph></subsection><subsection id="id592A7E18188F4CE4B0C53A7DB8DE9DE0"><enum>(c)</enum><header>Use of
funds</header>
<paragraph id="id61EDBE5CFB1E4CAAAF72482C781EE255"><enum>(1)</enum><header>In
general</header><text>A State that receives a grant under this section may use
the grant in any manner determined to be appropriate by the State to provide
medical assistance to legal residents of the State.</text>
</paragraph><paragraph id="id3194604c8a1a4126a8821490f51aba02"><enum>(2)</enum><header>Availability of
funds</header><text>Grant funds made available to a State under this section
shall—</text>
<subparagraph id="idb8efc9f50b054714a99ccadc98a4f876"><enum>(A)</enum><text>remain available
to the State for a period of 5 years; and</text>
</subparagraph><subparagraph id="id3c4b1341f6814bd0bac22b317ef2d71c"><enum>(B)</enum><text>after that
period, shall—</text>
<clause id="id159881a992924612b765ac2caa940a0d"><enum>(i)</enum><text>revert to the
Federal Government to be deposited in the Treasury and used for Federal budget
deficit reduction; or</text>
</clause><clause id="id154d5797690f427a827c1504b72eaf5d"><enum>(ii)</enum><text>if
there is no Federal budget deficit, be used to reduce the Federal debt in such
manner as the Secretary of the Treasury considers appropriate.</text>
</clause></subparagraph></paragraph></subsection><subsection id="idefd46c494cfe4edb97d4228fc4aed64b"><enum>(d)</enum><header>Annual report
requirements</header>
<paragraph id="ided500c4ae95e4f91b7f77398114a0ac6"><enum>(1)</enum><header>In
general</header><text>Not later than January 1 of each year, each State that
receives a grant under this section shall submit to the Secretary a report that
shall include, for the year covered by the report—</text>
<subparagraph id="id7c06e2b241bb4e7fba1f69f3e9e3601c"><enum>(A)</enum><text>a description of
the structure and design of the Medicaid program of the State, including the
manner in which residents of the State qualify for the program;</text>
</subparagraph><subparagraph id="id32b67e8ef28248e8801fe98553425587"><enum>(B)</enum><text>the cost the
State incurs to administer the program;</text>
</subparagraph><subparagraph id="id660b727668c74411aed7325c2a7a3eed"><enum>(C)</enum><text>whether the State
has established a rainy day fund for the Medicaid program of the State;
and</text>
</subparagraph><subparagraph id="id1dcee32429b846ea83d1b9d719120bca"><enum>(D)</enum><text>general
statistics about participation in Medicaid program.</text>
</subparagraph></paragraph><paragraph id="idce6e9e47ae874873b30573244edfd086"><enum>(2)</enum><header>Audit</header><text>Each
year, the Comptroller General of the United States shall—</text>
<subparagraph id="id0ac01f23940948cc972daa188ceb81a0"><enum>(A)</enum><text>conduct an audit
on the effectiveness of the Medicaid block grant program and the manner in
which each participating State is implementing the program; and</text>
</subparagraph><subparagraph id="id7ce98a2771dc4625b2257df2fe76c65f"><enum>(B)</enum><text>not later than
June 30, submit to the appropriate committees of Congress a report
describing—</text>
<clause id="id3771a1e9affe4a87b6f49591c6b74589"><enum>(i)</enum><text>the
results of the audit; and</text>
</clause><clause id="id08d6d2fcbee54843bfb6ded526c13a0f"><enum>(ii)</enum><text>the manner in
which the State will carry out the Medicaid program in the State, including
eligibility and fraud prevention requirements.</text>
</clause></subparagraph></paragraph></subsection></section><section id="id08F9C8BBCD6347FA882413C47B582BD3"><enum>402.</enum><header>Funding</header><text display-inline="no-display-inline">There is authorized to be appropriated to
carry out this title—</text>
<paragraph id="id65443778eb10475fb309c57b2a3ea73d"><enum>(1)</enum><text>for fiscal year
2014, $304,000,000,000;</text>
</paragraph><paragraph id="id3b44d0c6674e4602aaab515722f00279"><enum>(2)</enum><text>for fiscal year
2015, $311,000,000,000;</text>
</paragraph><paragraph id="id4109b38644c6445b8ce8b2e31c3c4487"><enum>(3)</enum><text>for fiscal year
2016, $317,000,000,000;</text>
</paragraph><paragraph id="id97da5dc187ec4f86ae7fbfde7498b6c6"><enum>(4)</enum><text>for fiscal year
2017, $334,000,000,000;</text>
</paragraph><paragraph id="ida027b8818d8746f286e6f9636eb3dd67"><enum>(5)</enum><text>for fiscal year
2018, $345,000,000,000;</text>
</paragraph><paragraph id="id23fb86bcb9284275ae6d808f09ff4c0a"><enum>(6)</enum><text>for fiscal year
2019, $355,000,000,000;</text>
</paragraph><paragraph id="id390fee4392f545b6843efde0e2030be7"><enum>(7)</enum><text>for fiscal year
2020, $370,000,000,000;</text>
</paragraph><paragraph id="idaba801370d2f488b96ca532d82c05f4b"><enum>(8)</enum><text>for fiscal year
2021, $382,000,000,000; and</text>
</paragraph><paragraph id="id4752caec4e1e41cc9c2859ef5f084a47"><enum>(9)</enum><text>for fiscal year
2022, $402,000,000,000.</text>
</paragraph></section><section id="id9052D194F15441CE81E9D87A4018FE9D"><enum>403.</enum><header>Termination of
mandatory funding</header>
<subsection id="idc4fecbfa9592461ca3349f1c27a6f129"><enum>(a)</enum><header>In
general</header><text>Effective October 1, 2013, title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) and subsections (f) and (g) of section
1108 of the Social Security Act (42 U.S.C. 1308) are repealed.</text>
</subsection><subsection id="ide7eb7c0235cd4861b47daa2ddf49da2c"><enum>(b)</enum><header>Elimination of
mandatory funding</header><text>Notwithstanding any other provision of law,
effective October 1, 2013, the Medicaid program established under title XIX of
the Social Security Act (42 U.S.C. 1396 et seq.) shall cease to be a program
funded through direct spending (as defined in section 250(c) of the Balanced
Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 900(c)).</text>
</subsection></section><section id="idFB5C0A0BD48B4A39AA04B20AE185600A"><enum>404.</enum><header>Miscellaneous</header>
<subsection id="id97304d9f0be44c24b3fe4811fae43a1f"><enum>(a)</enum><header>Relationship to
other law</header><text>Any reference in this Act, an amendment made by this
Act, or any other Act to the Medicaid program or to title XIX of the Social
Security Act shall be considered to be a reference to the Medicaid block grant
program established under this title.</text>
</subsection><subsection commented="no" id="id14C7C4F5217642A48C565F6B66C818B8"><enum>(b)</enum><header>Nonentitlement</header><text>Nothing
in this title shall be construed as providing—</text>
<paragraph commented="no" id="id6D54AA5CF1824BCAA7DDB98605D03447"><enum>(1)</enum><text>an individual
with an entitlement to medical assistance provided under a grant made under
this title; or</text>
</paragraph><paragraph commented="no" id="idFB13A311FE8E46DA964E09B5DA4618D5"><enum>(2)</enum><text>as an obligation
of the Federal Government to provide payments to States to carry out this title
other than to the extent funds are made available for that purpose through an
appropriations Act.</text>
</paragraph></subsection><subsection commented="no" id="idDE9B82301AA340CDBE3CF765AAB60DBA"><enum>(c)</enum><header>Waivers</header>
<paragraph commented="no" id="id6E0D701F45FD4D0D8F7CCEA3D8BC81B0"><enum>(1)</enum><header>In
general</header><text>In the case of a State conducting an experimental, pilot,
or demonstration project under section 1115 of the Social Security Act (42
U.S.C. 1315) or other authority relating to the Medicaid program under title
XIX of the Social Security Act that is in effect on the date of enactment of
this Act, the waiver shall terminate on September 30, 2013, unless the State
submits a request, not later than July 1, 2013, to the Secretary to continue
the project. The Secretary may approve the request of a State to continue with
such a project only if the total amount of Federal funds paid to the State to
conduct the project will not exceed the amount of Federal funds that would be
paid to the State under this title if the project were not continued.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="idF0C1124D22E74664A6400FF77EAE5363"><enum>(2)</enum><header>No waiver
authority</header><text>The Secretary may not waive any provision of this title
under section 1115 of the Social Security Act (42 U.S.C. 1315).</text>
</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id8E4D687A9EE4417888EA1E59BF715974"><enum>(d)</enum><header>Hold harmless
provisions</header>
<paragraph commented="no" display-inline="no-display-inline" id="id9377000F290C4277B8E1F4005F92F040"><enum>(1)</enum><header>CHIP</header><text>The
State children's health insurance program established under title XXI of the
Social Security Act (42 U.S.C. 1397aa et seq.) shall continue to be operated in
accordance with the provisions of that title.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id43A2B99854B94BCFB931ECEA7FE2ED7D"><enum>(2)</enum><header>Child support
and foster care payments</header><text>The Federal medical assistance
percentage, as defined in section 1905(b) of the Social Security Act (42 U.S.C.
1396d(b)), (as in effect on September 30, 2013) shall continue to apply to
payments to States under parts D and E of title IV of the Social Security Act
(42 U.S.C. 651 et seq.; 670 et seq.). Notwithstanding the repeal of title XIX
of the Social Security Act under section 403(a), the Secretary shall annually
determine and promulgate the Federal medical assistance percentage for each
State in accordance with the provisions of section 1101(a)(8)(B) of the Social
Security Act (42 U.S.C. 1301(a)(8)(B)).</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1E1197296E214DDBA1D4BFBF658167FD"><enum>(3)</enum><header>Vaccines for
children program</header><text>The program for the distribution of pediatric
vaccines established under section 1928 of the Social Security Act (42 U.S.C.
1396s) shall continue to be operated in accordance with the provisions of that
section (as in effect on September 30, 2013).</text>
</paragraph></subsection><subsection commented="no" id="id138A48AED6184C608F1C1A78DF0BFFE9"><enum>(e)</enum><header>Technical
assistance</header><text>The Secretary shall provide technical assistance and
guidance to States to coordinate the transition to the Medicaid block grant
program established under this title.</text>
</subsection></section><section id="id47B90C8ED5A74B5D8B8DD5F4FC0B6ACF"><enum>405.</enum><header>Baseline</header><text display-inline="no-display-inline">Notwithstanding section 257 of the Balanced
Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 907), the baseline
shall assume that after September 30, 2013, no payments shall be provided under
section 1903 of title XIX of the Social Security Act (42 U.S.C. 1396b).</text>
</section><section id="idC3C618B8971F4AE79B9440718D955187"><enum>406.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text>
<paragraph id="idA004883F95F742D397478F7376562463"><enum>(1)</enum><header>Medical
assistance</header><text>The term <term>medical assistance</term> means payment
for part or all of the cost of providing, or arranging for the provision of
(including through the purchase of health insurance coverage), health
benefits.</text>
</paragraph><paragraph id="idF2F37014A9AC4E41B8E92812A1517022"><enum>(2)</enum><header>Secretary</header><text>The
term <term>Secretary</term> means the Secretary of Health and Human
Services.</text>
</paragraph><paragraph id="idFFF523A3C8D7477885F23956CA3EECD3"><enum>(3)</enum><header>State</header><text>The
term <term>State</term> means each of the 50 States, the District of Columbia,
Puerto Rico, the United States Virgin Islands, Guam, the Northern Mariana
Islands, and American Samoa.</text>
</paragraph></section><enum>V</enum><header>Reduction of
Federal workforce</header>
<section id="HD759B43BE8B946A1BB8C7DDC9F79F2B9" section-type="subsequent-section"><enum>501.</enum><header>Reduction in the
number of Federal employees</header>
<subsection id="HCB9F730AB06E4FC1BA6D85F153CACFA6"><enum>(a)</enum><header>Definition</header><text>In
this section, the term <term>agency</term> has the meaning given the term
<term>Executive agency</term> under section 105 of title 5, United States
Code.</text>
</subsection><subsection id="H45DBF370234C4720985D85ED72AB82A3"><enum>(b)</enum><header>Determination of
number of employees</header><text display-inline="yes-display-inline">Not later
than 60 days after the date of enactment of this Act, the Director of the
Office of Management and Budget shall determine the number of full-time
employees employed in each agency. The head of each agency shall cooperate with
the Director of the Office of Management and Budget in making the
determinations.</text>
</subsection><subsection id="HAED4193051F248FFBD7624757AB651E9"><enum>(c)</enum><header>Replacement hire
rate</header>
<paragraph id="H669C21B6912F41BF9B53AB0E489B2D85"><enum>(1)</enum><header>In
general</header><text>During the period described under paragraph (2), the head
of each agency may hire no more than 2 employees in that agency for every 3
employees who leave employment in that agency.</text>
</paragraph><paragraph id="H765E4E8BBA5344F9886412F4FB65C08F"><enum>(2)</enum><header>Period of
replacement hire rate</header><text>Paragraph (1) shall apply to each agency
during the period beginning 60 days after the date of enactment of this Act
through the date on which the Director of the Office of Management and Budget
makes a determination that the number of full-time employees employed in that
agency is 10 percent less than the number of full-time employees employed in
that agency determined under subsection (a).</text>
</paragraph></subsection><subsection id="HB85A72DCA5E5486889BE61A4F52CC0AB"><enum>(d)</enum><header>Waivers</header><text>This
section may be waived upon a determination by the President that—</text>
<paragraph id="H0A3FBC42DAE942B49F1F60890B20CB13"><enum>(1)</enum><text>the existence of a
state of war or other national security concern so requires; or</text>
</paragraph><paragraph id="H22857A8676BD4AAA9C13D3E4ABAC65EC"><enum>(2)</enum><text>the existence of
an extraordinary emergency threatening life, health, public safety, property,
or the environment so requires.</text>
</paragraph></subsection></section><enum>VI</enum><header>Prohibition on
Climate Change and Global Warming Funding</header>
<section id="id8f09666641c1410897c435265c95447b" section-type="subsequent-section"><enum>601.</enum><header>No funding for
climate change or global warming</header><text display-inline="no-display-inline">On and after the date of enactment of this
Act, no Federal funds may be expended for any activity relating to climate
change or global warming.</text>
</section><enum>VII</enum><header>Protecting
access to health care</header>
<section id="idD23679F67201438FAE3FC310E5293FB0"><enum>700.</enum><header>Short
title</header><text display-inline="no-display-inline">This title may be cited
as the <quote><short-title>Protecting Access to Health
Care Act</short-title></quote>.</text>
</section><subtitle id="id9EA7E5F487054C2583469C3EE1E5F8A7"><enum>A</enum><header>HEALTH
Act</header>
<section id="HF6A53BA63DAB4252816BD2030186074E" section-type="subsequent-section"><enum>701.</enum><header>Short
title</header><text display-inline="no-display-inline">This subtitle may be
cited as the <quote><short-title>Help Efficient,
Accessible, Low-cost, Timely Healthcare (HEALTH) Act of
2012</short-title></quote>.</text>
</section><section id="H40B146F8450F44D7B4C51AD8C4BDCC37"><enum>702.</enum><header>Purpose</header><text display-inline="no-display-inline">It is the purpose of this subtitle to
implement reasonable, comprehensive, and effective health care liability
reforms designed to—</text>
<paragraph id="HAF2F537194EF4FBDAF73991C4CDADD9F"><enum>(1)</enum><text>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;</text>
</paragraph><paragraph id="H75B2350A335D4CC89568B3BD44689A44"><enum>(2)</enum><text>reduce the
incidence of <quote>defensive medicine</quote> and lower the cost of health
care liability insurance, all of which contribute to the escalation of health
care costs;</text>
</paragraph><paragraph id="H5A75972834BE4743A0D6884930AE44DD"><enum>(3)</enum><text>ensure that
persons with meritorious health care injury claims receive fair and adequate
compensation, including reasonable noneconomic damages;</text>
</paragraph><paragraph id="H827D112272744AD5AFBB867FA7AAA34E"><enum>(4)</enum><text>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</text>
</paragraph><paragraph id="H1425BC40F7E84CA38B516E7628C406C1"><enum>(5)</enum><text>provide an
increased sharing of information in the health care system which will reduce
unintended injury and improve patient care.</text>
</paragraph></section><section id="H10B5074E4D7047A8953EE4952AA8E8B8"><enum>703.</enum><header>Encouraging
speedy resolution of claims</header><text display-inline="no-display-inline">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—</text>
<paragraph id="H486CD81D49B64A54ACDCB7E9B7C636E6"><enum>(1)</enum><text>upon proof of
fraud;</text>
</paragraph><paragraph id="H5F68674C9E1C4A28B957CB220942B03F"><enum>(2)</enum><text>intentional
concealment; or</text>
</paragraph><paragraph id="HCC2C38F547B44883AA49C4DAEFBC34A0"><enum>(3)</enum><text>the presence of a
foreign body, which has no therapeutic or diagnostic purpose or effect, in the
person of the injured person.</text>
</paragraph><continuation-text continuation-text-level="section">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.</continuation-text></section><section id="H2BFB79C6758448CE95C356736C9DE48C"><enum>704.</enum><header>Compensating
patient injury</header>
<subsection id="H21020A0A4E3043F988BDD5E17587FB98"><enum>(a)</enum><header>Unlimited Amount
of Damages for Actual Economic Losses in Health Care Lawsuits</header><text>In
any health care lawsuit, nothing in this subtitle shall limit a claimant’s
recovery of the full amount of the available economic damages, notwithstanding
the limitation in
<internal-xref idref="HBD3DE0C8F3214EFFB8BAC507D2DDD625" legis-path="4.(b)">subsection (b)</internal-xref>.</text>
</subsection><subsection id="HBD3DE0C8F3214EFFB8BAC507D2DDD625"><enum>(b)</enum><header>Additional
Noneconomic Damages</header><text>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.</text>
</subsection><subsection id="H7F48EF93B2A94C339B2D32AAEB03F6F3"><enum>(c)</enum><header>No Discount of
Award for Noneconomic Damages</header><text>For purposes of applying the
limitation in
<internal-xref idref="HBD3DE0C8F3214EFFB8BAC507D2DDD625" legis-path="4.(b)">subsection (b)</internal-xref>, 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.</text>
</subsection><subsection id="HCABC7545EDEB46BDB53C790541119124"><enum>(d)</enum><header>Fair Share
Rule</header><text>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.</text>
</subsection></section><section id="H8556D8CFBE7C47BC845F9F269D240D0E"><enum>705.</enum><header>Maximizing
patient recovery</header>
<subsection id="H49E75058B01B417AA1B52802D4DCD6B6"><enum>(a)</enum><header>Court
Supervision of Share of Damages Actually Paid to Claimants</header><text>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:</text>
<paragraph id="H67698D4D6A404D21B810A061544B1C67"><enum>(1)</enum><text>Forty percent of
the first $50,000 recovered by the claimant(s).</text>
</paragraph><paragraph id="HE4052D94F9E344A78D322AA552FA5BF9"><enum>(2)</enum><text>Thirty-three and
one-third percent of the next $50,000 recovered by the claimant(s).</text>
</paragraph><paragraph id="HAC011592C5D841559BB4DE0B6A42809D"><enum>(3)</enum><text>Twenty-five
percent of the next $500,000 recovered by the claimant(s).</text>
</paragraph><paragraph id="HE2ABFB9830C04E21BA882F1A7FDDA164"><enum>(4)</enum><text>Fifteen percent of
any amount by which the recovery by the claimant(s) is in excess of
$600,000.</text>
</paragraph></subsection><subsection id="HAC4015BAE7644F459BC337EA887BDE0E"><enum>(b)</enum><header>Applicability</header><text>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
<internal-xref idref="H49E75058B01B417AA1B52802D4DCD6B6" legis-path="5.(a)">subsection (a)</internal-xref> applies only in civil
actions.</text>
</subsection></section><section id="HF4D0C33790F8467C8457A85DD187D6C7"><enum>706.</enum><header>Punitive
damages</header>
<subsection id="H20B8BB913320482980C94F043E24E3A4"><enum>(a)</enum><header>In
General</header><text>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—</text>
<paragraph id="H6C90F46455124AD990BD41B1A621CD6C"><enum>(1)</enum><text>whether punitive
damages are to be awarded and the amount of such award; and</text>
</paragraph><paragraph id="H7399654232E44EBE91931D8A2FF92DCF"><enum>(2)</enum><text>the amount of
punitive damages following a determination of punitive liability.</text>
</paragraph><continuation-text continuation-text-level="subsection">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.</continuation-text></subsection><subsection id="H0D753C3B03484400AC81B3BA33BD8AE5"><enum>(b)</enum><header>Determining
Amount of Punitive Damages</header>
<paragraph id="H3D3333C217924249A1692CBAF77ED831"><enum>(1)</enum><header>Factors
considered</header><text>In determining the amount of punitive damages, if
awarded, in a health care lawsuit, the trier of fact shall consider only the
following—</text>
<subparagraph id="H47CA13A765B6447EA48881586A6CB055"><enum>(A)</enum><text>the severity of
the harm caused by the conduct of such party;</text>
</subparagraph><subparagraph id="H733F1896EA1B49FEA780396BA6DE4C03"><enum>(B)</enum><text>the duration of
the conduct or any concealment of it by such party;</text>
</subparagraph><subparagraph id="H93F626C3C16241119E5AB06CA70A5BEA"><enum>(C)</enum><text>the profitability
of the conduct to such party;</text>
</subparagraph><subparagraph id="HDDC296C5B2354AC4B0064CC2148AEFEF"><enum>(D)</enum><text>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;</text>
</subparagraph><subparagraph id="H2FC4D910874D4A6CB40784B452F08312"><enum>(E)</enum><text>any criminal
penalties imposed on such party, as a result of the conduct complained of by
the claimant; and</text>
</subparagraph><subparagraph id="H28459CDAB1FB4AEA95806B03752C1D08"><enum>(F)</enum><text>the amount of any
civil fines assessed against such party as a result of the conduct complained
of by the claimant.</text>
</subparagraph></paragraph><paragraph id="H911F043F35A44AF49A9EF63C978D6F17"><enum>(2)</enum><header>Maximum
award</header><text>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.</text>
</paragraph></subsection><subsection id="HCBD31F875F2148108C2932DEB72A01D4"><enum>(c)</enum><header>No Punitive
Damages for Products That Comply With FDA Standards</header>
<paragraph id="HB7199B1EEADF496690435FB4CBC992F8"><enum>(1)</enum><header>In
general</header>
<subparagraph id="H3AF2914DCBF649C6BE8311E8FC5E8D2F"><enum>(A)</enum><text>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—</text>
<clause id="HD30C7810B1F14E44AD55F9D1C1CED507"><enum>(i)</enum><subclause commented="no" display-inline="yes-display-inline" id="H03C5F18352A94424A2508CBEF1A94D8A"><enum>(I)</enum><text>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</text>
</subclause><subclause id="H9F092FBBD53A4DAAA5CC7005FEE064C5" indent="up1"><enum>(II)</enum><text>such medical product was so approved,
cleared, or licensed; or</text>
</subclause></clause><clause id="H30CF539A523147BF8D04E0C90DCEDAC0"><enum>(ii)</enum><text>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.</text>
</clause></subparagraph><subparagraph id="H7363F9C70DB445A6B4ADACFFE4BB4D01"><enum>(B)</enum><header>Rule of
construction</header><text><internal-xref idref="H3AF2914DCBF649C6BE8311E8FC5E8D2F" legis-path="7.(c)(1)(A)">Subparagraph
(A)</internal-xref> 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.</text>
</subparagraph></paragraph><paragraph id="HC4C92FD3F38144D99DCA49E7570CA787"><enum>(2)</enum><header>Liability of
health care providers</header><text>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.</text>
</paragraph><paragraph id="HBDC8A951EEBA4DF8BDBCA7A914E85131"><enum>(3)</enum><header>Packaging</header><text>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.</text>
</paragraph><paragraph id="H4D3C99D32F8F4D5CB54B26A0215886D0"><enum>(4)</enum><header>Exception</header><text><internal-xref idref="HB7199B1EEADF496690435FB4CBC992F8" legis-path="7.(c)(1)">Paragraph
(1)</internal-xref> shall not apply in any health care lawsuit in which—</text>
<subparagraph id="H48B8E9057B284F12BE56B18541759CB0"><enum>(A)</enum><text>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
<act-name parsable-cite="FFDCA">Federal Food, Drug, and Cosmetic Act</act-name>
(21 U.S.C. 301 et seq.) or section 351 of the <act-name parsable-cite="PHSA">Public Health Service Act</act-name> (42 U.S.C. 262) that
is material and is causally related to the harm which the claimant allegedly
suffered;</text>
</subparagraph><subparagraph id="H2199269E962A4C5E9928E7264DE9DF2B"><enum>(B)</enum><text>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</text>
</subparagraph><subparagraph id="HBE68481F137B4A6C8D346A3B5A2D463C"><enum>(C)</enum><text>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.)).</text>
</subparagraph></paragraph></subsection></section><section id="H83A5EB5835A540DFB566AC23443C8A76"><enum>707.</enum><header>Authorization
of payment of future damages to claimants in health care lawsuits</header>
<subsection id="HDA4B0A1A24AE4D42B8B852AADC23C39B"><enum>(a)</enum><header>In
General</header><text>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.</text>
</subsection><subsection id="HB2190A1B28BD4D838303C158A09207C0"><enum>(b)</enum><header>Applicability</header><text>This
section applies to all actions which have not been first set for trial or
retrial before the effective date of this subtitle.</text>
</subsection></section><section id="H2F0661E334D74A28A0993B85DDAFD02F"><enum>708.</enum><header>Definitions</header><text display-inline="no-display-inline">In this subtitle:</text>
<paragraph id="H6782622526734E68847E95E45E07AF00"><enum>(1)</enum><header>Alternative
dispute resolution system; ADR</header><text>The term <term>alternative dispute
resolution system</term> or <term>ADR</term> 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.</text>
</paragraph><paragraph id="H6AE6B0B834EC4889AFE9AEF0CDE341AD"><enum>(2)</enum><header>Claimant</header><text>The
term <term>claimant</term> 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.</text>
</paragraph><paragraph id="H8C9184319B4D4B64946040AAB40BD2C4"><enum>(3)</enum><header>Compensatory
damages</header><text>The term <term>compensatory damages</term> 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 <term>compensatory damages</term> includes economic
damages and noneconomic damages, as such terms are defined in this
section.</text>
</paragraph><paragraph id="H06687484616D452F8EBB514ED0352472"><enum>(4)</enum><header>Contingent
fee</header><text>The term <term>contingent fee</term> includes all
compensation to any person or persons which is payable only if a recovery is
effected on behalf of one or more claimants.</text>
</paragraph><paragraph id="H0E7FB976CD934D7090EA80B178AFCC82"><enum>(5)</enum><header>Economic
damages</header><text>The term <term>economic damages</term> 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.</text>
</paragraph><paragraph id="H76C93C209FE94AD3A60B5CA6F5F2BAB0"><enum>(6)</enum><header>Health care
lawsuit</header><text>The term <term>health care lawsuit</term> 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.</text>
</paragraph><paragraph id="H9F903A6703B54CECB6FA0D0DA7D6A7DC"><enum>(7)</enum><header>Health care
liability action</header><text>The term <term>health care liability
action</term> 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.</text>
</paragraph><paragraph id="H7B86E1E6524F4ACB9E8625B4DAE1312C"><enum>(8)</enum><header>Health care
liability claim</header><text>The term <term>health care liability claim</term>
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.</text>
</paragraph><paragraph id="H3000E70BB52B4F7D9EDA71A17EB9B13A"><enum>(9)</enum><header>Health care
organization</header><text>The term <term>health care organization</term> 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.</text>
</paragraph><paragraph id="HACF4D08BF06B4B0B818BDE3148DE6A2B"><enum>(10)</enum><header>Health care
provider</header><text>The term <term>health care provider</term> 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.</text>
</paragraph><paragraph id="H27B80BFB5ED74841A8EE2765DD021023"><enum>(11)</enum><header>Health care
goods or services</header><text>The term <term>health care goods or
services</term> 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.</text>
</paragraph><paragraph id="HF587117ADCB84F62A88F84F94D664771"><enum>(12)</enum><header>Malicious
intent to injure</header><text>The term <term>malicious intent to injure</term>
means intentionally causing or attempting to cause physical injury other than
providing health care goods or services.</text>
</paragraph><paragraph id="H1EFBE76B908142BEAF41BF50FB8FEC1A"><enum>(13)</enum><header>Medical
product</header><text>The term <term>medical product</term> means a drug,
device, or biological product intended for humans, and the terms
<term>drug</term>, <term>device</term>, and <term>biological product</term>
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 <act-name parsable-cite="PHSA">Public Health Service
Act</act-name> (42 U.S.C. 262(a)), respectively, including any component or raw
material used therein, but excluding health care services.</text>
</paragraph><paragraph id="H62442A1BF2EE4C97951284C176413296"><enum>(14)</enum><header>Noneconomic
damages</header><text>The term <term>noneconomic damages</term> 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.</text>
</paragraph><paragraph id="HFE7970D09E47477386A19420AD2480C5"><enum>(15)</enum><header>Punitive
damages</header><text>The term <term>punitive damages</term> 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.</text>
</paragraph><paragraph id="HA77F68E508E146DF9B1AC5EC24DA0C41"><enum>(16)</enum><header>Recovery</header><text>The
term <term>recovery</term> 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.</text>
</paragraph><paragraph id="H590ACAF3D9ED461C874408E0270481E0"><enum>(17)</enum><header>State</header><text>The
term <term>State</term> 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.</text>
</paragraph></section><section id="H68DDA6270E8F488193D92183EC48D7AB"><enum>709.</enum><header>Effect on other
laws</header>
<subsection id="H291CFA5232264C07B9C804689CE7EECC"><enum>(a)</enum><header>Vaccine
Injury</header>
<paragraph id="H6E9396FEBF2C42BE80FC63CBAB03EB1D"><enum>(1)</enum><text>To the extent that
title XXI of the <act-name parsable-cite="PHSA">Public Health Service
Act</act-name> establishes a Federal rule of law applicable to a civil action
brought for a vaccine-related injury or death—</text>
<subparagraph id="H93AA56D3C12E4BAE9D339414BBB0080A"><enum>(A)</enum><text>this subtitle does
not affect the application of the rule of law to such an action; and</text>
</subparagraph><subparagraph id="HB0D94290612F4E1796CB30E4A6059593"><enum>(B)</enum><text>any rule of law
prescribed by this subtitle in conflict with a rule of law of such title XXI
shall not apply to such action.</text>
</subparagraph></paragraph><paragraph id="HD7C7D840981748F4B87C939AC768AA25"><enum>(2)</enum><text>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 <act-name parsable-cite="PHSA">Public Health Service Act</act-name> does not apply, then
this subtitle or otherwise applicable law (as determined under this subtitle)
will apply to such aspect of such action.</text>
</paragraph></subsection><subsection id="HE996113F28A3408A805EB3EAFEE6CB52"><enum>(b)</enum><header>Other Federal
Law</header><text>Except as provided in this section, nothing in this subtitle
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.</text>
</subsection></section><section id="HB18B1397F5B046C187BD286C20C79F61"><enum>710.</enum><header>State
flexibility and protection of States’ rights</header>
<subsection id="HA8C15C85C944496D85DE3D9598D13D3E"><enum>(a)</enum><header>Health Care
Lawsuits</header><text>The provisions governing health care lawsuits set forth
in this subtitle 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 subtitle. The provisions governing health care
lawsuits set forth in this subtitle supersede chapter 171 of title 28, United
States Code, to the extent that such chapter—</text>
<paragraph id="H633839DD5E2B4B5CA30361E37D8D933A"><enum>(1)</enum><text>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 subtitle; or</text>
</paragraph><paragraph id="H8FEA3A480DFF4F85A9199876DEDD3DED"><enum>(2)</enum><text>prohibits the
introduction of evidence regarding collateral source benefits, or mandates or
permits subrogation or a lien on collateral source benefits.</text>
</paragraph></subsection><subsection id="HBAB4FFB3AC2146DE805F93C1F02F7C0A"><enum>(b)</enum><header>Protection of
States’ Rights and Other Laws</header><paragraph commented="no" display-inline="yes-display-inline" id="H715408EB0FA041B5AB6A4C2F53DE904D"><enum>(1)</enum><text>Any issue that is not
governed by any provision of law established by or under this subtitle
(including State standards of negligence) shall be governed by otherwise
applicable State or Federal law.</text>
</paragraph><paragraph id="HCE7B7CBC83184DE5A2CE289AABDD48B0" indent="up1"><enum>(2)</enum><text>This subtitle 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 subtitle or create
a cause of action.</text>
</paragraph></subsection><subsection id="H2A7FEE2FFFF34C2BBF0960CED9E6F82D"><enum>(c)</enum><header>State
Flexibility</header><text>No provision of this subtitle shall be construed to
preempt—</text>
<paragraph id="H5F26AA36EB954C438A984663CAF7D667"><enum>(1)</enum><text>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 subtitle, notwithstanding
<internal-xref idref="H21020A0A4E3043F988BDD5E17587FB98" legis-path="4.(a)">section 704(a)</internal-xref>; or</text>
</paragraph><paragraph id="HD62C46758CCF4ED3AA242432D0027454"><enum>(2)</enum><text>any defense
available to a party in a health care lawsuit under any other provision of
State or Federal law.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H7DDE7F30578848839643B078A3BC139C" section-type="subsequent-section"><enum>711.</enum><header>Applicability;
effective date</header><text display-inline="no-display-inline">This subtitle
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.</text>
</section></subtitle><subtitle id="idAE786428AB244C29B2BADA0310A024E0"><enum>B</enum><header>Health care
safety net enhancement</header>
<section id="H50E9A8C42D74485D851E284176487323" section-type="subsequent-section"><enum>721.</enum><header>Short
title</header><text display-inline="no-display-inline">This subtitle may be
cited as the <quote><short-title>Health Care Safety Net
Enhancement Act of 2012</short-title></quote>.</text>
</section><section id="HEC151B8C7F4741C2AAAC3811B01BEFC0"><enum>722.</enum><header>Protection for
emergency and related services furnished pursuant to EMTALA</header><text display-inline="no-display-inline">Section 224(g) of the Public Health Service
Act (42 U.S.C. 233(g)) is amended—</text>
<paragraph id="H3D24ADD72A704C3CBB1231C1F52B51CF"><enum>(1)</enum><text>in paragraph (4),
by striking <quote>An entity</quote> and inserting <quote>Subject to paragraph
(6), an entity</quote>; and</text>
</paragraph><paragraph id="H3229E1542AF4407AB3065E8467D05EA2"><enum>(2)</enum><text>by adding at the
end the following:</text>
<quoted-block id="H812ADBBA581D40CD80F49C25852F294D" style="OLC">
<paragraph id="H580A32F0117F4BAE8E0BC86220DD8A98"><enum>(6)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H7E0A5863B2654615B8ADFB5057748BF0"><enum>(A)</enum><text>For purposes of this
section—</text>
<clause id="H4823215423264339AE4741C4A567EBA3" indent="up1"><enum>(i)</enum><text>an entity described in subparagraph
(B) shall be considered to be an entity described in paragraph (4); and</text>
</clause><clause id="H5168A22D91314E94A6AD97F9F5FF8494" indent="up1"><enum>(ii)</enum><text>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—</text>
<subclause id="H01C070F012BA46A99ABFE434E3BC449D"><enum>(I)</enum><text>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;</text>
</subclause><subclause id="H273AE059E644415E9A144788F6754595"><enum>(II)</enum><text>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;</text>
</subclause><subclause id="H47F8B409A86F4A92BD129EB17F8669F3"><enum>(III)</enum><text>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;</text>
</subclause><subclause id="H83FE8489BCE748CC9D8DDB29634C9BF1"><enum>(IV)</enum><text>paragraph (5) shall not apply to a
physician or physician group described in subparagraph (B)(ii);</text>
</subclause><subclause id="H12636E0C9E67451599FF33492E09B87C"><enum>(V)</enum><text>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);</text>
</subclause><subclause id="HBA8C3C151D7240BE80DCC4027B6C3D01"><enum>(VI)</enum><text>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</text>
</subclause><subclause id="HB67FBC74D5284BDFB969A9270CAE056D"><enum>(VII)</enum><text>subsection (m) shall not apply to
entities described in subparagraph (B).</text>
</subclause></clause></subparagraph><subparagraph id="HDA05D21A98D34306A701EC58342F53BB" indent="up1"><enum>(B)</enum><text>An entity described in this
subparagraph is—</text>
<clause id="HB2B205E4D1A74691A6B6509103276E33"><enum>(i)</enum><text>a hospital or an emergency
department to which section 1867 of the Social Security Act applies; and</text>
</clause><clause id="H9EE4E52BD5E440669CE2B0146BFBD5F0"><enum>(ii)</enum><text>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.</text>
</clause></subparagraph><subparagraph id="H3668EA45C35B42C09E2CA09E3E1FA8CE" indent="up1"><enum>(C)</enum><text>For purposes of this paragraph, the
term <term>on-call provider</term> means a physician or physician group
that—</text>
<clause id="H0D61EABFCBD84CCEA9D8371A9BF8A1D6"><enum>(i)</enum><text>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</text>
</clause><clause id="H9FA8BE5606B74E29B2F75CA293571E6E"><enum>(ii)</enum><text>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.</text>
</clause></subparagraph><subparagraph id="H818BAE7DA60C4504BC9D059EE16C680A" indent="up1"><enum>(D)</enum><text>For purposes of this paragraph, the
term <term>post stabilization services</term> 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—</text>
<clause id="H41919111C60F47279BC23117D28197DB"><enum>(i)</enum><text>related to the condition that was
so treated; and</text>
</clause><clause id="HBEECE9858120420EBA60DFEAF547A179"><enum>(ii)</enum><text>provided after the individual is
stabilized in order to maintain the stabilized condition or to improve or
resolve the condition of the individual.</text>
</clause></subparagraph><subparagraph id="H7AB57EC2F0FF4C4FAEC35B152319AA0B" indent="up1"><enum>(E)</enum><clause commented="no" display-inline="yes-display-inline" id="HF4F186F2C2CE490C85F52458146951C6"><enum>(i)</enum><text>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.</text>
</clause><clause id="HC64915A7A23A4EC091E304378CFCD7D8" indent="up1"><enum>(ii)</enum><text>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.</text>
</clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section><section commented="no" display-inline="no-display-inline" id="H5402886E661443E3A15CC979FE945399" section-type="subsequent-section"><enum>723.</enum><header>Constitutional
authority</header><text display-inline="no-display-inline">The constitutional
authority upon which this subtitle 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.</text>
</section></subtitle><subtitle id="id1647EFA580364883823587435AD310A2"><enum>C</enum><header>Restoring the
application of antitrust laws to health sector insurers</header>
<section id="H14C836250C2B4EDF8FD64B6BA1D55DF0" section-type="subsequent-section"><enum>731.</enum><header>Short
title</header><text display-inline="no-display-inline">This subtitle may be
cited as the <quote><short-title>Health Insurance Industry
Fair Competition Act</short-title> of 2012</quote>.</text>
</section><section id="H9B77B47131CD4329A97D948662139D10"><enum>732.</enum><header>Application of
the antitrust laws to the business of health insurance</header>
<subsection id="H9CE42ED430F94D5EA48DF3ABD8B5A6E9"><enum>(a)</enum><header>Amendment to
McCarran-Ferguson Act</header><text>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:</text>
<quoted-block id="H1AEF6310906C4688A3CF66B95874BB2C" style="OLC">
<subsection display-inline="no-display-inline" id="H1938C3630A0C408FAAD52A23084A327E"><enum>(c)</enum><text display-inline="yes-display-inline">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 <quote>antitrust laws</quote> 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—</text>
<paragraph id="H3F3488241438406A841298501497A2A6"><enum>(1)</enum><text>mean <quote>health
insurance coverage</quote> offered by a <quote>health insurance issuer</quote>
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</text>
</paragraph><paragraph id="HC7D66BBAF1AD4B79A0A4E05332494154"><enum>(2)</enum><text>not
include—</text>
<subparagraph id="HC9B2A3AA3D89405C97947D8CF8427347"><enum>(A)</enum><text>life insurance and
annuities;</text>
</subparagraph><subparagraph id="HDB9C9D4B8C114F6EA74044D0C8F8310D"><enum>(B)</enum><text>property or
casualty insurance, including but not limited to, automobile, medical
malpractice or workers’ compensation insurance; or</text>
</subparagraph><subparagraph id="H019FF5F357E24D5AB39A0A1247DC0407"><enum>(C)</enum><text>any insurance or
benefits defined as <quote>excepted benefits</quote> 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).</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H2B0C2BD2FA0A43A6ACD3F2F47C5E1DB3"><enum>(b)</enum><header>Related
Provision</header><text>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
<quote>Corporation</quote> contained in section 4 of the Federal Trade
Commission Act.</text>
</subsection><subsection id="H691496588B4E4F9DA001AB76FD0655A7"><enum>(c)</enum><header>Limitation on
class actions</header>
<paragraph id="H8F67824C227E4E4BB66B3A757840C91B"><enum>(1)</enum><header>Limitation</header><text>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).</text>
</paragraph><paragraph id="HDF2C2DF3789543CD87FC66D0A29339B5"><enum>(2)</enum><header>Exemption</header><text display-inline="yes-display-inline">Paragraph (1) shall not apply with respect
to any action commenced—</text>
<subparagraph id="H9D7BE4BEA2D54B7DA14B422BA472063B"><enum>(A)</enum><text>by the United
States or any State; or</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="H1AE16E95052A4DCA9FC967A2C4B95A0B"><enum>(B)</enum><text>by a named
claimant for an injury only to itself.</text>
</subparagraph></paragraph></subsection></section></subtitle><subtitle id="id270A89BAF9DC46B1BCCFF6A699F1DE7D"><enum>D</enum><header>Protections for
good samaritan health professionals</header>
<section commented="no" id="HFF4C53FDDA4D4567B12BF2BD360708DB" section-type="subsequent-section"><enum>741.</enum><header>Short
title</header><text display-inline="no-display-inline">This subtitle may be
cited as the <quote><short-title>Good Samaritan Health
Professionals Act of 2012</short-title></quote>.</text>
</section><section id="HF5B70F32AB604869BCF7673D6E62F88B"><enum>742.</enum><header>Limitation on
liability for volunteer health care professionals</header>
<subsection id="HBC961EDB6F3C4BCB8B25E3D94FC6CB1A"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Title II of the
Public Health Service Act (42 U.S.C. 202 et seq.) is amended by inserting after
section 224 the following:</text>
<quoted-block display-inline="no-display-inline" id="H3BA1C2C8BEA3430BAEB2C7B35BF0CB5F" style="OLC">
<section id="HA4D48FCB4C3C4CAB84BD568DAABA67DB"><enum>224A.</enum><header>Limitation on
liability for volunteer health care professionals</header>
<subsection id="HE3C78AEE5B4542359ECCF9C3011EC90E"><enum>(a)</enum><header>Limitation on
liability</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="H510E761EED8645099A14EC3586D89504"><enum>(1)</enum><text>the professional
is serving as a volunteer for purposes of responding to a disaster; and</text>
</paragraph><paragraph id="HAAD28C7EC798420FA4BCD5A06BB9F81E"><enum>(2)</enum><text>the act or
omission occurs—</text>
<subparagraph commented="no" id="HE3DC9B15839F416686D87D35ED507822"><enum>(A)</enum><text>during the period
of the disaster, as determined under the laws listed in subsection
(e)(1);</text>
</subparagraph><subparagraph id="H07D6DD247B014AEE86037BA6510F8FF7"><enum>(B)</enum><text>in the health care
professional’s capacity as such a volunteer; and</text>
</subparagraph><subparagraph commented="no" id="H0543853EB58C4507A8A20827B7ABD854"><enum>(C)</enum><text display-inline="yes-display-inline">in a good faith belief that the individual
being treated is in need of health care services.</text>
</subparagraph></paragraph></subsection><subsection id="H21AA8044CF4B4783A9ADD86CCE7B1D72"><enum>(b)</enum><header>Exceptions</header><text>Subsection
(a) does not apply if—</text>
<paragraph id="H13715B5E466E4EA0B34A5401D560F18A"><enum>(1)</enum><text>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</text>
</paragraph><paragraph commented="no" id="H0A89C8013DF941E89CFDB50BB76D06D6"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection commented="no" id="H13AB7F3506B04230BEF4AD5A1DD3CEA0"><enum>(c)</enum><header>Standard of
proof</header><text>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.</text>
</subsection><subsection commented="no" id="H9E79BC1B1FDD4F46A711456B1381A623"><enum>(d)</enum><header>Preemption</header>
<paragraph commented="no" id="HDF5E15DF4C4E4B9695975F03B3665D8A"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">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.</text>
</paragraph><paragraph commented="no" id="H98D77216E8D74BAEA226F6432920FF00"><enum>(2)</enum><header>Volunteer
Protection Act</header><text>Protections afforded by this section are in
addition to those provided by the Volunteer Protection Act of 1997.</text>
</paragraph></subsection><subsection id="HD5F64E0F35F54316AAD6617A915E1EA0"><enum>(e)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H9BB2B416BCF1456C9647CD6FCA4A97E0"><enum>(1)</enum><text>The term
<term>disaster</term> means—</text>
<subparagraph id="H1A7452601002457F83493FC288829113"><enum>(A)</enum><text>a national
emergency declared by the President under the National Emergencies Act;</text>
</subparagraph><subparagraph id="H446C959B80AC4263A8108D1BD375F4C6"><enum>(B)</enum><text>an emergency or
major disaster declared by the President under the Robert T. Stafford Disaster
Relief and Emergency Assistance Act; or</text>
</subparagraph><subparagraph id="HE1D7D5989A4F44E1809D91EFDBD7C763"><enum>(C)</enum><text>a public health
emergency determined by the Secretary under section 319 of this Act.</text>
</subparagraph></paragraph><paragraph id="H079FC9AD9A9B453F993C5C8A02AE4DC1"><enum>(2)</enum><text>The term
<term>harm</term> includes physical, nonphysical, economic, and noneconomic
losses.</text>
</paragraph><paragraph id="H9F23E055EFBA4A14A6D64123C1ED8495"><enum>(3)</enum><text>The term
<term>health care professional</term> means an individual who is licensed,
certified, or authorized in one or more States to practice a health care
profession.</text>
</paragraph><paragraph id="H3270A8FFAAC24E6191CD474956E4CC8E"><enum>(4)</enum><text>The term
<term>State</term> 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.</text>
</paragraph><paragraph id="H739F4AAD355B444E84627A3B77A06537"><enum>(5)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="H37D6F2252C314504800037477D0715F7"><enum>(A)</enum><text>The term
<term>volunteer</term> means a health care professional who, with respect to
the health care services rendered, does not receive—</text>
<clause id="H943DD35FA624432FBD920891F683BB1E" indent="up1"><enum>(i)</enum><text>compensation; or</text>
</clause><clause id="HF76B29BC5FA145F391FAC7D23375127A" indent="up1"><enum>(ii)</enum><text display-inline="yes-display-inline">any other thing of value in lieu of
compensation, in excess of $500 per year.</text>
</clause></subparagraph><subparagraph id="H7905119BCE1449EC99229BDA253D5A78" indent="up1"><enum>(B)</enum><text>For purposes of subparagraph (A), the
term <term>compensation</term>—</text>
<clause id="H954A388DA4DD43CC90837D625B45C028"><enum>(i)</enum><text display-inline="yes-display-inline">includes payment under any insurance policy
or health plan, or under any Federal or State health benefits program;
and</text>
</clause><clause commented="no" id="HE6C4785B5AA243F5AAA7B38EAB9B5AE8"><enum>(ii)</enum><text display-inline="yes-display-inline">excludes—</text>
<subclause commented="no" id="HA2376A9D3A2F4482BCBD3605C0790245"><enum>(I)</enum><text>reasonable reimbursement or allowance for
expenses actually incurred;</text>
</subclause><subclause commented="no" id="HF312015B40EA40F4ADF13449643EF8D7"><enum>(II)</enum><text>receipt of paid leave; and</text>
</subclause><subclause commented="no" id="HABC3ECAEE73843E8A1AEF323D249E0EC"><enum>(III)</enum><text>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).</text>
</subclause></clause></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H899FD9F008FA469491D7ED963F2E481D"><enum>(b)</enum><header>Effective
date</header>
<paragraph id="HAADB27EFF9F94569A8713EBB4916153C"><enum>(1)</enum><header>In
general</header><text>This subtitle and the amendment made by subsection (a)
shall take effect 90 days after the date of the enactment of this title.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7AB48E28573E4108A2FF6D34AAD4F66C"><enum>(2)</enum><header>Application</header><text>This
subtitle 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 subtitle, 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.</text>
</paragraph></subsection></section></subtitle><enum>VIII</enum><header>Budget Control
Act spending cap adjustments</header>
<section id="id3E80343A34A54DC69E25256F5DCB9746"><enum>801.</enum><header>Budget Control
Act spending cap adjustments</header>
<subsection id="id16D31A98492A436BA579FD1FC5D883ED"><enum>(a)</enum><header>Reenactment</header><text display-inline="yes-display-inline">Section 251 of the Balanced Budget and
Emergency Deficit Control Act of 1985 is reenacted as in effect on January 15,
2012.</text>
</subsection><subsection id="id90387BDDA2524C0A82CAD22E7C067A4D"><enum>(b)</enum><header>New
caps</header><text display-inline="yes-display-inline">The Balanced Budget and
Emergency Deficit Control Act of 1985 is amended—</text>
<paragraph id="id722C22F43A404957B930D0DACBE65B6A"><enum>(1)</enum><text display-inline="yes-display-inline">in section 250(c)(4), by striking
subparagraph (B) and inserting the following:</text>
<quoted-block display-inline="no-display-inline" id="id0492A6E344B549D9BE8F0D7DAE3E4677" style="OLC">
<paragraph id="id344F0030C8BB402E9387FD2AB235B58E"><enum>(B)</enum><text display-inline="yes-display-inline">The term <term>security category</term>
means discretionary appropriations in budget function
050.</text>
</paragraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</paragraph><paragraph id="idBC8DB7665D2D4C31BCE0FCC75B8F3319"><enum>(2)</enum><text>in section
251(c), by striking paragraphs (2) through (10) and inserting the
following:</text>
<quoted-block display-inline="no-display-inline" id="id3AF45914BE6B4EE99154C6C581EC6C82" style="OLC">
<paragraph id="id301fe3d694bb4273a9045257362826ca"><enum>(2)</enum><text>with respect to
fiscal year 2013—</text>
<subparagraph id="idcb647e1c7f6a485dbb1aaf8057e4b43e"><enum>(A)</enum><text>for the security
category, $546,000,000,000; and</text>
</subparagraph><subparagraph id="id9d29d853b837416898b07aa8e6782028"><enum>(B)</enum><text>for the
nonsecurity category, $430,700,000,000;</text>
</subparagraph></paragraph><paragraph id="id2329b093e903430b86691f389de9489d"><enum>(3)</enum><text>with respect to
fiscal year 2014—</text>
<subparagraph id="idffcb0cd95a33493aa4ad60d12fd13a49"><enum>(A)</enum><text>for the security
category, $566,800,000,000; and</text>
</subparagraph><subparagraph id="id5cb26c15d7df43c8a2a9ebcef666b1a7"><enum>(B)</enum><text>for the
nonsecurity category, $769,100,000,000;</text>
</subparagraph></paragraph><paragraph id="id3ae4047d5d8a4a928ae2cdcc3a08b004"><enum>(4)</enum><text>with respect to
fiscal year 2015—</text>
<subparagraph id="id80fa55aa617d426d8098bdf1b55ab0d9"><enum>(A)</enum><text>for the security
category, $620,400,000,000; and</text>
</subparagraph><subparagraph id="idaebf1c739a9647348339700f0059fa0c"><enum>(B)</enum><text>for the
nonsecurity category, $777,200,000,000;</text>
</subparagraph></paragraph><paragraph id="id1beb2527cb064515a024401b5601ac44"><enum>(5)</enum><text>with respect to
fiscal year 2016—</text>
<subparagraph id="idb4d97c2432764f5786140d2f0d960987"><enum>(A)</enum><text>for the security
category, $657,700,000,000; and</text>
</subparagraph><subparagraph id="id86888460060549db940a40964da0f4b3"><enum>(B)</enum><text>for the
nonsecurity category, $784,300,000,000;</text>
</subparagraph></paragraph><paragraph id="idc5fb4a1817a145c2b8150d2da4b9847f"><enum>(6)</enum><text>with respect to
fiscal year 2017—</text>
<subparagraph id="idac09d8e65ccd49a5833a7a3590e5be33"><enum>(A)</enum><text>for the security
category, $702,000,000,000; and</text>
</subparagraph><subparagraph id="idcc9b27d04d1b4c7caf8fd2da1eb3402e"><enum>(B)</enum><text>for the
nonsecurity category, $802,000,000,000;</text>
</subparagraph></paragraph><paragraph id="id04716376dc5240c4b3882d8322b3d98e"><enum>(7)</enum><text>with respect to
fiscal year 2018—</text>
<subparagraph id="idd579a8f38780448a91d80d71fe795f7e"><enum>(A)</enum><text>for the security
category, $736,800,000,000; and</text>
</subparagraph><subparagraph id="id45899474b7ec47edb4d77dce18c4c326"><enum>(B)</enum><text>for the
nonsecurity category, $824,400,000,000;</text>
</subparagraph></paragraph><paragraph id="idb756964a4d8846e29f36079028c6cc0e"><enum>(8)</enum><text>with respect to
fiscal year 2019—</text>
<subparagraph id="id4fa6d41f63134c229daf67ecde10fc45"><enum>(A)</enum><text>for the security
category, $780,900,000,000; and</text>
</subparagraph><subparagraph id="id3092abdcee254181ac50f9301beef620"><enum>(B)</enum><text>for the
nonsecurity category, $845,700,000,000;</text>
</subparagraph></paragraph><paragraph id="id7b12a2322d8644a282f4c9a0c6b86d4c"><enum>(9)</enum><text>with respect to
fiscal year 2020—</text>
<subparagraph id="ideb95acc717754f60961b8ae10966f10e"><enum>(A)</enum><text>for the security
category, $828,100,000,000; and</text>
</subparagraph><subparagraph id="ida85fda15c5b546949873bfd207c62816"><enum>(B)</enum><text>for the
nonsecurity category, $872,100,000,000;</text>
</subparagraph></paragraph><paragraph id="id0adcc83a560e4e4faf1ca60b6932dc1e"><enum>(10)</enum><text>with respect to
fiscal year 2021—</text>
<subparagraph id="id257cdc1c34e6428b9a65692915bc3066"><enum>(A)</enum><text>for the security
category, $865,300,000,000; and</text>
</subparagraph><subparagraph id="id79e902532d5148838202bd1141b43545"><enum>(B)</enum><text>for the
nonsecurity category, $894,400,000,000; and</text>
</subparagraph></paragraph><paragraph id="id00ca5923700745a2a198f295a8c15416"><enum>(11)</enum><text>with respect to
fiscal year 2022—</text>
<subparagraph id="id22917ec48da940518fab02dbdb6dc418"><enum>(A)</enum><text>for the security
category, $990,800,000,000; and</text>
</subparagraph><subparagraph id="id30bb9d32c33a4c5e9424763664618718"><enum>(B)</enum><text>for the
nonsecurity category:
$925,300,000,000.</text>
</subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection></section>