[Congressional Record Volume 141, Number 197 (Tuesday, December 12, 1995)]
[Senate]
[Pages S18443-S18444]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

       By Mr. HATCH (for himself and Mr. Kennedy):

  S. 1471. A bill to make permanent the program of malpractice coverage 
for health centers under the Federal Tort Claims Act, and for other 
purposes; to the Committee on the Judiciary.


  THE FEDERAL TORT CLAIMS ACT MALPRACTICE COVERAGE FOR HEALTH CENTERS 
                         EXTENSION ACT OF 1995

  Mr. HATCH. Mr. President, today Senator Kennedy and I are pleased to 
introduce S. 1471, the Federal Tort Claims Act Malpractice Coverage for 
Health Centers Extension Act of 1995. Our bill will make permanent an 
exemption in current law that provides medical malpractice coverage 
under the Federal Tort Claims Act [FTCA] to federally funded community 
health center personnel.
  The current law is due to expire on December 31, necessitating speedy 
consideration of this legislation in the Congress.
  I am pleased to announce that the House passed this afternoon a 
similar bill, H.R. 1747, authored by my good friend from Connecticut, 
Representative Nancy Johnson and I am hopeful the Senate can take up 
the Johnson bill forthwith.
  A brief recitation of the legislative history on this issue may be 
useful to my colleagues at this point.
  In 1992, Senator Kennedy and I worked with our colleagues in the 
House to treat community health center [CHC] physicians, nurses, and 
other personnel as Federal employees under the FTCA for the purpose of 
defending against malpractice claims.
  Substituting the FTCA remedy for private lawsuits relieves CHC's from 
devoting their limited program funds to purchase costly private 
malpractice insurance. Purchase of such insurance had proven an 
extremely costly burden to the centers, which, I believe, have been 
doing a marvelous job in providing excellent care in underserved areas 
on what amounts to a shoestring budget.
  The Federal Tort Claims Act, which falls under the jurisdiction of 
the Judiciary Committee, stipulates strict procedural requirements for 
the consideration of claims. For example, it does not provide for jury 
trials or the award of punitive damages. These streamlined procedures 
act to reduce the number of, and costs associated with, tort claims.
  By reducing insurance costs, the more than 500 community and migrant 
health centers can provide more direct medical services to the 5 
million Americans who rely on these centers for their primary health 
care needs.
  In the initial 3 years of our experience under the FTCA, it is 
encouraging to find that all experience suggests that health centers 
have a lower incidence of malpractice claims than comparable private 
insurance providers.
  Through fiscal year 1995, it has been estimated that only 15 claims 
have been filed nationwide against the 119 participating health 
centers. Thus far, no funds have been required to be paid out under the 
statute to satisfy claims. In fact, the Department of Health and Human 
Services estimates that the 1992 law has saved over $14.3 million to 
date. This is consistent with the 1992 House Judiciary Committee report 
on this topic which noted that the savings from the law would far 
exceed the costs of coverage.
  I want to take a moment to discuss the history of this legislation in 
the 104th Congress.
  As I noted earlier, the House passed a similar bill today under 
suspension of the rules.
  The version reported from the House Commerce Committee on September 
27 was very similar to the approach that Senator Kennedy and I were 
developing. However, that bill recommended a 3-year extension whereas 
we believed a permanent extension was warranted.
  Ultimately, through discussions with our House colleagues, we were 
able to reach an agreement and the bill that passed the House today 
makes the FTCA coverage for CHC's permanent.
  The bill that passed the House today also differs from our approach 
in two other areas.
  First, I understand that the House bill makes explicit that centers 
are not required to operate under the FTCA aegis. In other words, 
centers are free to purchase insurance on their own if they so desire. 
I believe this is appropriate, and have no objection to this provision. 
It clearly was our intent in drafting S. 1471.
  Second, in order to address concerns that our claims experience may 
be too limited in the first 3 years of operation to predict the 
adequacy of future reserves, we have provided for a General Accounting 
Office study of the medical liability risk exposure of centers. If--as 
seems unlikely based on the past experience and future expectations--
unforeseen problems develop in this program, this issue can be 
revisited.
  The House bill contains a GAO study provision which is much more 
detailed 

[[Page S18444]]
than that embodied in the bill we introduce today. Again, I have no 
objection to the House alternative.
  Mr. President, in closing, I note that the administration is 
supportive of this legislation and of making the program permanent. 
According to a recent administration report in support of extending 
FTCA coverage: ``Our experience to date * * * is sufficiently positive 
that we believe that it is advisable to adopt FTCA coverage without a 
time limitation, rather than to continue to insert sunset provisions.''
  The legislation that Senator Kennedy and I are introducing today will 
result in the delivery of more public health services to underserved 
areas throughout the country, whether these areas are urban or rural. 
It is no secret to my colleagues that I am a tremendous fan of the work 
that CHC's are doing, especially in Utah, and I think it behooves the 
Congress to give them this added tool to help improve health care 
services in areas in which access has traditionally suffered.
  At the bottom line, the 1992 legislation achieved more public health 
bang-for-the-buck and should be made permanent.
  It is important that a bill be acted upon in the near future to 
extend coverage so that centers will know whether or not they have to 
purchase private coverage for 1996. Therefore, I urge my colleagues to 
support a permanent extension of the legislation authorizing Federal 
Tort Claims Act coverage of community health centers.

                          ____________________