Prohibits any individual from bringing a medical malpractice liability action unless it is accompanied by the affidavit of a qualified specialist attesting to the reasonableness of the filing. Requires the attorney of a person filing such an action, or the individual if there is no attorney, to sign a certificate of merit attesting to the justified nature of the action.
Directs courts to impose sanctions for violations of the provisions pertaining to the certificate of merit, including to issue fines for multiple offenders.
Requires mediation, to be made available by the State, before a trial for any medical malpractice liability action.
Prohibits punitive damages from being awarded in a medical malpractice action except upon proof of gross negligence, reckless indifference to life, or one of various types of intentional acts.
Requires medical malpractice liability insurance companies to implement a plan to dedicate at least 50 percent of the annual savings from carrying out this section to reducing malpractice premiums. Imposes a civil penalty on medical malpractice liability insurance companies that violate this section.
Amends the Public Health Service Act to permit the Secretary, acting through the Administrator of the Health Resources and Services Administration, to award grants or contracts to geographic areas that have shortages of one or more types of health providers due to the cost of maintaining malpractice insurance.
Establishes the Independent Advisory Commission on Medical Malpractice Insurance, which shall investigate the recent dramatic increases in medical malpractice insurance premiums and formulate proposals to reduce such premiums.
[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1219 Introduced in House (IH)]
108th CONGRESS
1st Session
H. R. 1219
To limit frivolous medical malpractice lawsuits, to reform the medical
malpractice insurance business in order to reduce the cost of medical
malpractice insurance, to enhance patient access to medical care, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 12, 2003
Mr. Conyers (for himself and Mr. Dingell) introduced the following
bill; which was referred to the Committee on the Judiciary, and in
addition to the Committee on Energy and Commerce, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To limit frivolous medical malpractice lawsuits, to reform the medical
malpractice insurance business in order to reduce the cost of medical
malpractice insurance, to enhance patient access to medical care, and
for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Medical
Malpractice and Insurance Reform Act of 2003''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--LIMITING FRIVOLOUS MEDICAL MALPRACTICE LAWSUITS
Sec. 101. Statute of limitations.
Sec. 102. Health care specialist affidavit.
Sec. 103. Sanctions for frivolous actions and pleadings.
Sec. 104. Mandatory mediation.
Sec. 105. Limitation on punitive damages.
Sec. 106. Reduction in premiums paid by physicians for medical
malpractice insurance coverage.
Sec. 107. Definitions.
Sec. 108. Applicability.
TITLE II--MEDICAL MALPRACTICE INSURANCE REFORM
Sec. 201. Prohibition on anticompetitive activities by medical
malpractice insurers.
Sec. 202. Medical malpractice insurance price comparison.
TITLE III--ENHANCING PATIENT ACCESS TO CARE THROUGH DIRECT ASSISTANCE
Sec. 301. Grants and contracts regarding health provider shortages.
Sec. 302. Health professional assignments to trauma centers through
national health service corps.
TITLE IV--INDEPENDENT ADVISORY COMMISSION ON MEDICAL MALPRACTICE
INSURANCE
Sec. 401. Establishment.
Sec. 402. Duties.
Sec. 403. Report.
Sec. 404. Membership.
Sec. 405. Director and staff; experts and consultants.
Sec. 406. Powers.
Sec. 407. Authorization of appropriations.
TITLE I--LIMITING FRIVOLOUS MEDICAL MALPRACTICE LAWSUITS
SEC. 101. STATUTE OF LIMITATIONS.
(a) In General.--A medical malpractice action shall be barred
unless the complaint is filed within 3 years after the right of action
accrues.
(b) Accrual.--A right of action referred to in subsection (a)
accrues upon the last to occur of the following dates:
(1) The date of the injury.
(2) The date on which the claimant discovers, or through
the use of reasonable diligence should have discovered, the
injury.
(3) The date on which the claimant becomes 18 years of age.
(c) Applicability.--This section shall apply to any injury
occurring after the date of the enactment of this Act.
SEC. 102. HEALTH CARE SPECIALIST AFFIDAVIT.
(a) Requiring Submission With Complaint.--No medical malpractice
action may be brought by any individual unless, at the time the
individual brings the action (except as provided in subsection (b)(1)),
it is accompanied by the affidavit of a qualified specialist that
includes the specialist's statement of belief that, based on a review
of the available medical record and other relevant material, there is a
reasonable and meritorious cause for the filing of the action against
the defendant.
(b) Extension in Certain Instances.--
(1) In general.--Subject to paragraph (2), subsection (a)
shall not apply with respect to an individual who brings a
medical malpractice action without submitting an affidavit
described in such subsection if, as of the time the individual
brings the action, the individual has been unable to obtain
adequate medical records or other information necessary to
prepare the affidavit.
(2) Deadline for submission where extension applies.--In
the case of an individual who brings an action for which
paragraph (1) applies, the action shall be dismissed unless the
individual (or the individual's attorney) submits the affidavit
described in subsection (a) not later than 90 days after
obtaining the information described in such paragraph.
(c) Qualified Specialist Defined.--In subsection (a), a ``qualified
specialist'' means, with respect to a medical malpractice action, a
health care professional who is reasonably believed by the individual
bringing the action (or the individual's attorney)--
(1) to be knowledgeable in the relevant issues involved in
the action;
(2) to practice (or to have practiced) or to teach (or to
have taught) in the same area of health care or medicine that
is at issue in the action; and
(3) in the case of an action against a physician, to be
board certified in a specialty relating to that area of
medicine.
(d) Confidentiality of Specialist.--Upon a showing of good cause by
a defendant, the court may ascertain the identity of a specialist
referred to in subsection (a) while preserving confidentiality.
SEC. 103. SANCTIONS FOR FRIVOLOUS ACTIONS AND PLEADINGS.
(a) Signature Required.--Every pleading, written motion, and other
paper in any medical malpractice action shall be signed by at least 1
attorney of record in the attorney's individual name, or, if the party
is not represented by an attorney, shall be signed by the party. Each
paper shall state the signer's address and telephone number, if any. An
unsigned paper shall be stricken unless omission of the signature is
corrected promptly after being called to the attention of the attorney
or party.
(b) Certificate of Merit.--(1) A medical malpractice action shall
be dismissed unless the attorney or unrepresented party presenting the
complaint certifies that, to the best of the person's knowledge,
information, and belief, formed after an inquiry reasonable under the
circumstances--
(A) it is not being presented for any improper purpose,
such as to harass or to cause unnecessary delay or needless
increase in the cost of litigation;
(B) the claims and other legal contentions therein are
warranted by existing law or by a nonfrivolous argument for the
extension, modification, or reversal of existing law or the
establishment of new law; and
(C) the allegations and other factual contentions have
evidentiary support or, if specifically so identified, are
likely to have evidentiary support after a reasonable
opportunity for further investigation and discovery.
(2) By presenting to the court (whether by signing, filing,
submitting, or later advocating) a pleading, written motion, or other
paper, an attorney or unrepresented party is certifying that to the
best of the person's knowledge, information and belief, formed after an
inquiry reasonable under the circumstances--
(A) it is not being presented for any improper purpose,
such as to harass or to cause unnecessary delay or needless
increase in the cost of litigation;
(B) the claims, defenses, and other legal contentions
therein are warranted by existing law or by a nonfrivolous
argument for the extension, modification, or reversal of
existing law or the establishment of new law; and
(C) the allegations and other factual contentions have
evidentiary support or, if specifically so identified, are
reasonable based on a lack of information or belief.
(c) Mandatory Sanctions.--
(1) First violation.--If, after notice and a reasonable
opportunity to respond, a court, upon motion or upon its own
initiative, determines that subsection (b) has been violated,
the court shall find each attorney or party in violation in
contempt of court and shall require the payment of costs and
attorneys fees. The court may also impose additional
appropriate sanctions, such as striking the pleadings,
dismissing the suit, and sanctions plus interest, upon the
person in violation, or upon both such person and such person's
attorney or client (as the case may be).
(2) Second violation.--If, after notice and a reasonable
opportunity to respond, a court, upon motion or upon its own
initiative, determines that subsection (b) has been violated
and that the attorney or party with respect to which the
determination was made has committed one previous violation of
subsection (b) before this or any other court, the court shall
find each such attorney or party in contempt of court and shall
require the payment of costs and attorneys fees, and require
such person in violation (or both such person and such person's
attorney or client (as the case may be)) to pay a monetary
fine. The court may also impose additional appropriate
sanctions, such as striking the pleadings, dismissing the suit
and sanctions plus interest, upon such person in violation, or
upon both such person and such person's attorney or client (as
the case may be).
(3) Third violation.--If, after notice and a reasonable
opportunity to respond, a court, upon motion or upon its own
initiative, determines that subsection (b) has been violated
and that the attorney or party with respect to which the
determination was made has committed more than one previous
violation of subsection (b) before this or any other court, the
court shall find each such attorney or party in contempt of
court, refer each such attorney to one or more appropriate
State bar associations for disciplinary proceedings, require
the payment of costs and attorneys fees, and require such
person in violation (or both such person and such person's
attorney or client (as the case may be)) to pay a monetary
fine. The court may also impose additional appropriate
sanctions, such as striking the pleadings, dismissing the suit,
and sanctions plus interest, upon such person in violation, or
upon both such person and such person's attorney or client (as
the case may be).
SEC. 104. MANDATORY MEDIATION.
(a) In General.--In any medical malpractice action, before such
action comes to trial, mediation shall be required. Such mediation
shall be conducted by one or more mediators who are selected by
agreement of the parties or, if the parties do not agree, who are
qualified under applicable State law and selected by the court.
(b) Requirements.--Mediation under subsection (a) shall be made
available by a State subject to the following requirements:
(1) Participation in such mediation shall be in lieu of any
alternative dispute resolution method required by any other law
or by any contractual arrangement made by or on behalf of the
parties before the commencement of the action.
(2) Each State shall disclose to residents of the State the
availability and procedures for resolution of consumer
grievances regarding the provision of (or failure to provide)
health care services, including such mediation.
(3) Each State shall provide that such mediation may begin
before or after, at the option of the claimant, the
commencement of a medical malpractice action.
(4) The Attorney General, in consultation with the
Secretary of Health and Human Services, shall, by regulation,
develop requirements with respect to such mediation to ensure
that it is carried out in a manner that--
(A) is affordable for the parties involved;
(B) encourages timely resolution of claims;
(C) encourages the consistent and fair resolution
of claims; and
(D) provides for reasonably convenient access to
dispute resolution.
(c) Further Redress and Admissibility.--Any party dissatisfied with
a determination reached with respect to a medical malpractice claim as
a result of an alternative dispute resolution method applied under this
section shall not be bound by such determination. The results of any
alternative dispute resolution method applied under this section, and
all statements, offers, and communications made during the application
of such method, shall be inadmissible for purposes of adjudicating the
claim.
SEC. 105. LIMITATION ON PUNITIVE DAMAGES.
(a) In General.--Punitive damages may not be awarded in a medical
malpractice action, except upon proof of--
(1) gross negligence;
(2) reckless indifference to life; or
(3) an intentional act, such as voluntary intoxication or
impairment by a physician, sexual abuse or misconduct, assault
and battery, or falsification of records.
(b) Allocation.--In such a case, the award of punitive damages
shall be allocated 50 percent to the claimant and 50 percent to a
trustee appointed by the court, to be used by such trustee in the
manner specified in subsection (d). The court shall appoint the
Secretary of Health and Human Services as such trustee.
(c) Exception.--This section shall not apply with respect to an
action if the applicable State law provides (or has been construed to
provide) for damages in such an action that are only punitive or
exemplary in nature.
(d) Trust Fund.--
(1) In general.--This subsection applies to amounts
allocated to the Secretary of Health and Human Services as
trustee under subsection (b).
(2) Availability.--Such amounts shall be available for use
by the Secretary of Health and Human Services under paragraph
(3) and shall remain so available until expended.
(3) Use.--
(A) Subject to subparagraph (B), the Secretary of
Health and Human Services, acting through the Director
of the Agency for Healthcare Research and Quality,
shall use the amounts to which this subsection applies
for activities to reduce medical errors and improve
patient safety.
(B) The Secretary of Health and Human Services may
not use any part of such amounts to establish or
maintain any system that requires mandatory reporting
of medical errors.
(C) The Secretary of Health and Human Services
shall promulgate regulations to establish programs and
procedures for carrying out this paragraph.
(4) Investment.--
(A) The Secretary of Health and Human Services
shall invest the amounts to which this subsection
applies in such amounts as such Secretary determines
are not required to meet current withdrawals. Such
investments may be made only in interest-bearing
obligations of the United States. For such purpose,
such obligations may be acquired on original issue at
the issue price, or by purchase of outstanding
obligations at the market price.
(B) Any obligation acquired by the Secretary in
such Secretary's capacity as trustee of such amounts
may be sold by the Secretary at the market price.
SEC. 106. REDUCTION IN PREMIUMS PAID BY PHYSICIANS FOR MEDICAL
MALPRACTICE INSURANCE COVERAGE.
(a) In General.--Not later than 180 days after the date of the
enactment of this Act, each medical malpractice liability insurance
company shall--
(1) develop a reasonable estimate of the annual amount of
financial savings that will be achieved by the company as a
result of this title;
(2) develop and implement a plan to annually dedicate at
least 50 percent of such annual savings to reduce the amount of
premiums that the company charges physicians for medical
malpractice liability coverage; and
(3) submit to the Secretary of Health and Human Services
(hereinafter referred to in this section as the ``Secretary'')
a written certification that the company has complied with
paragraphs (1) and (2).
(b) Reports.--Not later than one year after the date of the
enactment of this Act and annually thereafter, each medical malpractice
liability insurance company shall submit to the Secretary a report that
identifies the percentage by which the company has reduced medical
malpractice coverage premiums relative to the date of the enactment of
this Act.
(c) Enforcement.--A medical malpractice liability insurance company
that violates a provision of this section is liable to the United
States for a civil penalty in an amount assessed by the Secretary, not
to exceed $11,000 for each such violation. The provisions of paragraphs
(3) through (5) of section 303(g) of the Federal Food, Drug, and
Cosmetic Act apply to such a civil penalty to the same extent and in
the same manner as such paragraphs apply to a civil penalty under such
section.
(d) Definition.--For purposes of this section, the term ``medical
malpractice liability insurance company'' means an entity in the
business of providing an insurance policy under which the entity makes
payment in settlement (or partial settlement) of, or in satisfaction of
a judgment in, a medical malpractice action or claim.
SEC. 107. DEFINITIONS.
In this title, the following definitions apply:
(1) Alternative dispute resolution method.--The term
``alternative dispute resolution method'' means a method that
provides for the resolution of medical malpractice claims in a
manner other than through medical malpractice actions.
(2) Claimant.--The term ``claimant'' means any person who
alleges a medical malpractice claim, and any person on whose
behalf such a claim is alleged, including the decedent in the
case of an action brought through or on behalf of an estate.
(3) Health care professional.--The term ``health care
professional'' means any individual who provides health care
services in a State and who is required by the laws or
regulations of the State to be licensed or certified by the
State to provide such services in the State.
(4) Health care provider.--The term ``health care
provider'' means any organization or institution that is
engaged in the delivery of health care services in a State and
that is required by the laws or regulations of the State to be
licensed or certified by the State to engage in the delivery of
such services in the State.
(5) Injury.--The term ``injury'' means any illness,
disease, or other harm that is the subject of a medical
malpractice action or a medical malpractice claim.
(6) Mandatory.--The term ``mandatory'' means required to be
used by the parties to attempt to resolve a medical malpractice
claim notwithstanding any other provision of an agreement,
State law, or Federal law.
(7) Mediation.--The term ``mediation'' means a settlement
process coordinated by a neutral third party and without the
ultimate rendering of a formal opinion as to factual or legal
findings.
(8) Medical malpractice action.--The term ``medical
malpractice action'' means an action in any State or Federal
court against a physician, or other health professional, who is
licensed in accordance with the requirements of the State involved
that--
(A) arises under the law of the State involved;
(B) alleges the failure of such physician or other
health professional to adhere to the relevant
professional standard of care for the service and
specialty involved;
(C) alleges death or injury proximately caused by
such failure; and
(D) seeks monetary damages, whether compensatory or
punitive, as relief for such death or injury.
(9) Medical malpractice claim.--The term ``medical
malpractice claim'' means a claim forming the basis of a
medical malpractice action.
(10) State.--The term ``State'' means each of the several
States, the District of Columbia, the Commonwealth of Puerto
Rico, American Samoa, Guam, the Commonwealth of the Northern
Mariana Islands, the Virgin Islands, and any other territory or
possession of the United States.
SEC. 108. APPLICABILITY.
(a) In General.--Except as provided in section 104, this title
shall apply with respect to any medical malpractice action brought on
or after the date of the enactment of this Act.
(b) Federal Court Jurisdiction Not Established on Federal Question
Grounds.--Nothing in this title shall be construed to establish any
jurisdiction in the district courts of the United States over medical
malpractice actions on the basis of section 1331 or 1337 of title 28,
United States Code.
TITLE II--MEDICAL MALPRACTICE INSURANCE REFORM
SEC. 201. PROHIBITION ON ANTICOMPETITIVE ACTIVITIES BY MEDICAL
MALPRACTICE INSURERS.
Notwithstanding any other provision of law, nothing in the Act of
March 9, 1945 (15 U.S.C. 1011 et seq., commonly known as the
``McCarran-Ferguson Act'') shall be construed to permit commercial
insurers to engage in any form of price fixing, bid rigging, or market
allocations in connection with the conduct of the business of providing
medical malpractice insurance. This section does not apply to the
information-gathering and rate-setting activities of any State
commissions of insurance, or any other State regulatory body with
authority to set insurance rates.
SEC. 202. MEDICAL MALPRACTICE INSURANCE PRICE COMPARISON.
(a) Internet Site.--Not later than 90 days after the date of the
enactment of this Act, and after consultation with the medical
malpractice insurance industry, the Secretary of Health and Human
Services shall establish an interactive internet site which shall
enable any health care provider licensed in the United States to obtain
a quote from each medical malpractice insurer licensed to write the
type of coverage sought by the provider.
(b) Online Forms.--
(1) In general.--The internet site shall enable health care
providers to complete an online form that shall capture a
comprehensive set of information sufficient to generate a quote
for each insurer. The Secretary shall develop transmission
software components which allow such information to be
formatted for delivery to each medical malpractice insurer
based on the requirements of the computer system of the
insurer.
(2) Protection of confidentiality of information
disclosed.--All information provided by a health care provider
for purposes of generating a quote through the internet site
shall be used only for that purpose.
(c) Integration of Rating Criteria.--The Secretary shall integrate
the rating criteria of each insurer into its online form after
consultation with each insurer. The Secretary shall integrate such
criteria using one of the following methods:
(1) Developing a customized interface with the insurer's
own rating engine.
(2) Accessing a third-party rating engine of the insurer's
choice.
(3) Loading the carrier's rating information into a rating
engine operated by the Secretary.
(4) Any other method agreed on between the Secretary and
the insurer.
(d) Presentation of Quotes.--After a health care provider has
answered all the questions appearing on the online form, such provider
will be presented with quotes from each medical malpractice insurer
licensed to write the coverage requested by the provider.
(e) Accuracy of Quotes.--Quotes provided at the internet site shall
at all times be accurate. Whenever any insurer changes its rates, such
rate changes shall be implemented at the internet site by the
Secretary, in consultation with the insurer, as soon as practicable,
but in no event later than 10 days after such changes take effect.
During any period during which an insurer has changed its rates but the
Secretary has not yet implemented such changed rates on the internet
site, quotes for that insurer shall not be obtainable at the internet
site.
(f) User-Friendly Features.--The Secretary shall design the
internet site to incorporate user-friendly formats and self-help
guidance materials, and shall develop a user-friendly internet user-
interface.
(g) Contact Information.--The internet site shall also provide
contact information, including address and telephone number, for each
medical malpractice insurer for which a provider obtains a quote at the
site.
(h) Report.--Not later than December 31, 2004, the Secretary shall
submit a report to the Congress on the development, implementation and
effects of the internet site. Such report shall be based on--
(1) the Secretary's consultation with health care
providers, medical malpractice insurers, State insurance
commissioners, and other interested parties; and
(2) the Secretary's analysis of other information available
to the Secretary.
The report shall describe the Secretary's views concerning the extent
to which this section has contributed to increasing the availability of
medical malpractice insurance, and the effect this section has had on
the cost of medical malpractice insurance.
TITLE III--ENHANCING PATIENT ACCESS TO CARE THROUGH DIRECT ASSISTANCE
SEC. 301. GRANTS AND CONTRACTS REGARDING HEALTH PROVIDER SHORTAGES.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.) is amended by adding at the end the following
section.
``SEC. 330L. HEALTH PROVIDER SHORTAGES RESULTING FROM COSTS OF MEDICAL
MALPRACTICE INSURANCE.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, may make awards of
grants or contracts in accordance with this section for geographic
areas that, as determined by the Secretary, have a shortage of one or
more types of health providers as a result of the providers making the
decision to cease or curtail providing health services in the
geographic areas because of the costs of maintaining malpractice
insurance.
``(b) Recipients of Awards; Expenditure.--In accordance with such
criteria as the Secretary may establish:
``(1) Awards under subsection (a) may be made to health
providers who agree to provide health services (or to continue
providing health services, as the case may be) in geographic
areas described in such subsection for the period during which
payments under the awards are made to the health providers.
``(2) Health providers who receive such awards may expend
the awards to assist the providers with the costs of
maintaining medical malpractice insurance for providing health
services in the geographic area for which the award is made.
``(c) Definition.--For purposes of this section, the term `health
providers' means physicians and other health professionals, and
organizations that provide health services (including hospitals,
clinics, and group practices), that meet applicable legal requirements
to provide the health services involved.''.
SEC. 302. HEALTH PROFESSIONAL ASSIGNMENTS TO TRAUMA CENTERS THROUGH
NATIONAL HEALTH SERVICE CORPS.
Section 338H of the Public Health Service Act (42 U.S.C. 254q) is
amended by adding at the end the following subsection:
``(d) Trauma Centers; Separate Authorization Regarding Shortages
Resulting From Costs of Medical Malpractice Insurance.--
``(1) In general.--For the purpose of assigning Corps
surgeons, obstetricians/gynecologists, and other health
professionals to trauma centers in health professional shortage
areas described in paragraph (2), there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2003 through 2006. Such authorization is in
addition to any other authorization of appropriations that is
available for such purpose.
``(2) Description of areas.--A health professional shortage
area referred to in paragraph (1) is such an area in which, as
determined by the Secretary, a medical facility in the area has
lost its designation as a trauma center or as a particular
level of trauma center, or is at significant risk of losing
such a designation, as a result of one or more surgeons,
obstetricians/gynecologists, or other health professionals
making the decision to cease or curtail practicing at the
facility because of the costs of maintaining malpractice
insurance. For purposes of paragraph (1), (A) the term `trauma
center' includes such a medical facility; and (B) the Secretary
may adjust the criteria for designation as a health
professional shortage area to the extent necessary to make
funds appropriated under paragraph (1) available with respect
to any medical facility to ensure that the facility does not
lose any such designation as a result of such decisions by
health professionals.''.
TITLE IV--INDEPENDENT ADVISORY COMMISSION ON MEDICAL MALPRACTICE
INSURANCE
SEC. 401. ESTABLISHMENT.
(a) Findings.--The Congress finds as follows:
(1) The sudden rise in medical malpractice premiums in
regions of the United States can threaten patient access to
doctors and other health providers.
(2) Improving patient access to doctors and other health
providers is a national priority.
(b) Establishment.--There is established a national commission to
be known as the ``Independent Advisory Commission on Medical
Malpractice Insurance'' (in this title referred to as the
``Commission'').
SEC. 402. DUTIES.
(a) In General.--The Commission shall evaluate the causes and scope
of the recent and dramatic increases in medical malpractice insurance
premiums and formulate additional proposals to reduce such medical
malpractice premiums and make recommendations to avoid any dramatic
increases in medical malpractice premiums in the future, in light of
proposals for tort reform regarding medical malpractice.
(b) Considerations.--In formulating proposals under this section,
the Commission shall, at a minimum, consider the following:
(1) Alternatives to the current medical malpractice tort
system that would ensure adequate compensation for patients,
preserve access to providers, and improve health care safety
and quality.
(2) Modifications of, and alternatives to, the existing
State and Federal regulations and oversight that affect, or
could affect, medical malpractice lines of insurance.
(3) State and Federal reforms that would distribute the
risk of medical malpractice more equitably among health care
providers.
(4) State and Federal reforms that would more evenly
distribute the risk of medical malpractice across various
categories of providers.
(5) The effect of a Federal medical malpractice reinsurance
program administered by the Department of Health and Human
Services.
(6) The effect of a Federal medical malpractice insurance
program, administered by the Department of Health and Human
Services, to provide medical malpractice insurance based on
customary coverage terms and liability amounts in States where
such insurance is unavailable or is unavailable at reasonable
and customary terms.
(7) Programs that would reduce medical errors and increase
patient safety, including new innovations in technology and
management.
(8) The effect of State policies under which--
(A) any health care professional licensed by the
State has standing in any State administrative
proceeding to challenge a proposed rate increase in
medical malpractice insurance; and
(B) a provider of medical malpractice insurance in
the State may not implement a rate increase in such
insurance unless the provider, at minimum, first
submits to the appropriate State agency a description
of the rate increase and a substantial justification
for the rate increase.
SEC. 403. REPORT.
(a) In General.--The Commission shall transmit to Congress--
(1) an initial report not later than 180 days after the
date of the initial meeting of the Commission; and
(2) a report not less than each year thereafter until the
Commission terminates.
(b) Contents.--Each report transmitted under this section shall
contain a detailed statement of the findings and conclusions of the
Commission, including proposals for addressing the current dramatic
increases in medical malpractice insurance rates and recommendations
for avoiding any such dramatic increases in the future.
(c) Voting and Reporting Requirements.--With respect to each
proposal or recommendation contained in the report submitted under
subsection (a), each member of the Commission shall vote on the
proposal or recommendation, and the Commission shall include, by
member, the results of that vote in the report.
SEC. 404. MEMBERSHIP.
(a) Number and Appointment.--The Commission shall be composed of 15
members appointed by the Comptroller General of the United States.
(b) Membership.--
(1) In general.--The membership of the Commission shall
include individuals with national recognition for their
expertise in health finance and economics, actuarial science,
medical malpractice insurance, insurance regulation, health
care law, health care policy, health care access, allopathic
and osteopathic physicians, other providers of health care
services, patient advocacy, and other related fields, who
provide a mix of different professionals, broad geographic
representations, and a balance between urban and rural
representatives.
(2) Inclusion.--The membership of the Commission shall
include the following:
(A) Two individuals with expertise in health
finance and economics, including one with expertise in
consumer protections in the area of health finance and
economics.
(B) Two individuals with expertise in medical
malpractice insurance, representing both commercial
insurance carriers and physician-sponsored insurance
carriers.
(C) An individual with expertise in State insurance
regulation and State insurance markets.
(D) An individual representing physicians.
(E) An individual with expertise in issues
affecting hospitals, nursing homes, nurses, and other
providers.
(F) Two individuals representing patient interests.
(G) Two individuals with expertise in health care
law or health care policy.
(H) An individual with expertise in representing
patients in malpractice lawsuits.
(3) Majority.--The total number of individuals who are
directly involved with the provision or management of
malpractice insurance, representing physicians or other
providers, or representing physicians or other providers in
malpractice lawsuits, shall not constitute a majority of the
membership of the Commission.
(4) Ethical disclosure.--The Comptroller General of the
United States shall establish a system for public disclosure by
members of the Commission of financial or other potential
conflicts of interest relating to such members.
(c) Terms.--
(1) In general.--The terms of the members of the Commission
shall be for 3 years except that the Comptroller General of the
United States shall designate staggered terms for the members
first appointed.
(2) Vacancies.--Any member appointed to fill a vacancy
occurring before the expiration of the term for which the
member's predecessor was appointed shall be appointed only for
the remainder of that term. A member may serve after the
expiration of that member's term until a successor has taken
office. A vacancy in the Commission shall be filled in the
manner in which the original appointment was made.
(3) Compensation.--Members of the Commission shall be
compensated in accordance with section 1805(c)(4) of the Social
Security Act.
(4) Chairman; vice chairman.--The Comptroller General of
the United States shall designate at the time of appointment a
member of the Commission as Chairman and a member as Vice
Chairman. In the case of vacancy of the Chairmanship or Vice
Chairmanship, the Comptroller General may designate another
member for the remainder of that member's term.
(5) Meetings.--
(A) In general.--The Commission shall meet at the
call of the Chairman.
(B) Initial meeting.--The Commission shall hold an
initial meeting not later than the date that is 1 year
after the date of the enactment of this title, or the date that is 3
months after the appointment of all the members of the Commission,
whichever occurs earlier.
SEC. 405. DIRECTOR AND STAFF; EXPERTS AND CONSULTANTS.
Subject to such review as the Comptroller General of the United
States deems necessary to assure the efficient administration of the
Commission, the Commission may--
(1) employ and fix the compensation of an Executive
Director (subject to the approval of the Comptroller General)
and such other personnel as may be necessary to carry out its
duties (without regard to the provisions of title 5, United
States Code, governing appointments in the competitive
service);
(2) seek such assistance and support as may be required in
the performance of its duties from appropriate Federal
departments and agencies;
(3) enter into contracts or make other arrangements, as may
be necessary for the conduct of the work of the Commission
(without regard to section 3709 of the Revised Statutes (41
U.S.C. 5));
(4) make advance, progress, and other payments which relate
to the work of the Commission;
(5) provide transportation and subsistence for persons
serving without compensation; and
(6) prescribe such rules and regulations as it deems
necessary with respect to the internal organization and
operation of the Commission.
SEC. 406. POWERS.
(a) Obtaining Official Data.--The Commission may secure directly
from any department or agency of the United States information
necessary to enable it to carry out this section. Upon request of the
Chairman, the head of that department or agency shall furnish that
information to the Commission on an agreed upon schedule.
(b) Data Collection.--In order to carry out its functions, the
Commission shall--
(1) utilize existing information, both published and
unpublished, where possible, collected and assessed either by
its own staff or under other arrangements made in accordance
with this section;
(2) carry out, or award grants or contracts for, original
research and experimentation, where existing information is
inadequate; and
(3) adopt procedures allowing any interested party to
submit information for the Commission's use in making reports
and recommendations.
(c) Access of General Accounting Office to Information.--The
Comptroller General of the United States shall have unrestricted access
to all deliberations, records, and nonproprietary data of the
Commission, immediately upon request.
(d) Periodic Audit.--The Commission shall be subject to periodic
audit by the Comptroller General of the United States.
SEC. 407. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--There are authorized to be appropriated such sums
as may be necessary to carry out this title for each of fiscal years
2004 through 2008.
(b) Requests for Appropriations.--The Commission shall submit
requests for appropriations in the same manner as the Comptroller
General of the United States submits requests for appropriations, but
amounts appropriated for the Commission shall be separate from amounts
appropriated for the Comptroller General.
<all>
Introduced in House
Introduced in House
Referred to the Committee on the Judiciary, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on the Judiciary, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on the Judiciary, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
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