Medical Care Access Protection Act of 2011 or the MCAP Act - Sets forth provisions regulating lawsuits for health care liability claims related to the provision of health care services.
Sets a statute of limitations of three years after the date of manifestation of injury or one year after the claimant discovers the injury, with certain exceptions.
Requires a court to impose sanctions for the filing of frivolous lawsuits.
Limits noneconomic damages to $250,000 from the provider or health care institution, but no more than $500,000 from multiple health care institutions. Makes each party liable only for the amount of damages directly proportional to such party's percentage of responsibility.
Allows the court to restrict the payment of attorney contingency fees. Limits the fees to a decreasing percentage based on the increasing value of the amount awarded.
Prescribes qualifications for expert witnesses.
Requires the court to reduce damages received by the amount of collateral source benefits to which a claimant is entitled, unless the payor of such benefits has the right to reimbursement or subrogation under federal or state law.
Authorizes the award of punitive damages only where: (1) it is proven by clear and convincing evidence that a person acted with malicious intent to injure the claimant or deliberately failed to avoid unnecessary injury the claimant was substantially certain to suffer, and (2) compensatory damages are awarded. Limits punitive damages to the greater of two times the amount of economic damages or $250,000.
Prohibits a health care provider from being named as a party in a product liability or class action lawsuit for prescribing or dispensing a Food and Drug Administration (FDA)-approved prescription drug, biological product, or medical device for an approved indication.
Provides for periodic payments of future damage awards.
[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 197 Introduced in Senate (IS)]
112th CONGRESS
1st Session
S. 197
To improve patient access to health care services and provide improved
medical care by reducing the excessive burden the liability system
places on the health care delivery system.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 26, 2011
Mr. Ensign (for himself, Mr. Inhofe, Mr. Vitter, Mr. Burr, Mr. Cornyn,
and Mr. Alexander) introduced the following bill; which was read twice
and referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To improve patient access to health care services and provide improved
medical care by reducing the excessive burden the liability system
places on the health care delivery system.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medical Care Access Protection Act
of 2011'' or the ``MCAP Act''.
SEC. 2. FINDINGS AND PURPOSE.
(a) Findings.--
(1) Effect on health care access and costs.--Congress finds
that our current civil justice system is adversely affecting
patient access to health care services, better patient care,
and cost-efficient health care, in that the health care
liability system is a costly and ineffective mechanism for
resolving claims of health care liability and compensating
injured patients, and is a deterrent to the sharing of
information among health care professionals which impedes
efforts to improve patient safety and quality of care.
(2) Effect on interstate commerce.--Congress finds that the
health care and insurance industries are industries affecting
interstate commerce and the health care liability litigation
systems existing throughout the United States are activities
that affect interstate commerce by contributing to the high
costs of health care and premiums for health care liability
insurance purchased by health care system providers.
(3) Effect on federal spending.--Congress finds that the
health care liability litigation systems existing throughout
the United States have a significant effect on the amount,
distribution, and use of Federal funds because of--
(A) the large number of individuals who receive
health care benefits under programs operated or
financed by the Federal Government;
(B) the large number of individuals who benefit
because of the exclusion from Federal taxes of the
amounts spent to provide them with health insurance
benefits; and
(C) the large number of health care providers who
provide items or services for which the Federal
Government makes payments.
(b) Purpose.--It is the purpose of this Act to implement
reasonable, comprehensive, and effective health care liability reforms
designed to--
(1) improve the availability of health care services in
cases in which health care liability actions have been shown to
be a factor in the decreased availability of services;
(2) reduce the incidence of ``defensive medicine'' and
lower the cost of health care liability insurance, all of which
contribute to the escalation of health care costs;
(3) ensure that persons with meritorious health care injury
claims receive fair and adequate compensation, including
reasonable noneconomic damages;
(4) improve the fairness and cost-effectiveness of our
current health care liability system to resolve disputes over,
and provide compensation for, health care liability by reducing
uncertainty in the amount of compensation provided to injured
individuals; and
(5) provide an increased sharing of information in the
health care system which will reduce unintended injury and
improve patient care.
SEC. 3. DEFINITIONS.
In this Act:
(1) Alternative dispute resolution system; adr.--The term
``alternative dispute resolution system'' or ``ADR'' means a
system that provides for the resolution of health care lawsuits
in a manner other than through a civil action brought in a
State or Federal court.
(2) Claimant.--The term ``claimant'' means any person who
brings a health care lawsuit, including a person who asserts or
claims a right to legal or equitable contribution, indemnity or
subrogation, arising out of a health care liability claim or
action, and any person on whose behalf such a claim is asserted
or such an action is brought, whether deceased, incompetent, or
a minor.
(3) Collateral source benefits.--The term ``collateral
source benefits'' means any amount paid or reasonably likely to
be paid in the future to or on behalf of the claimant, or any
service, product or other benefit provided or reasonably likely
to be provided in the future to or on behalf of the claimant,
as a result of the injury or wrongful death, pursuant to--
(A) any State or Federal health, sickness, income-
disability, accident, or workers' compensation law;
(B) any health, sickness, income-disability, or
accident insurance that provides health benefits or
income-disability coverage;
(C) any contract or agreement of any group,
organization, partnership, or corporation to provide,
pay for, or reimburse the cost of medical, hospital,
dental, or income disability benefits; and
(D) any other publicly or privately funded program.
(4) Compensatory damages.--The term ``compensatory
damages'' means objectively verifiable monetary losses incurred
as a result of the provision of, use of, or payment for (or
failure to provide, use, or pay for) health care services or
medical products, such as past and future medical expenses,
loss of past and future earnings, cost of obtaining domestic
services, loss of employment, and loss of business or
employment opportunities, damages for physical and emotional
pain, suffering, inconvenience, physical impairment, mental
anguish, disfigurement, loss of enjoyment of life, loss of
society and companionship, loss of consortium (other than loss
of domestic service), hedonic damages, injury to reputation,
and all other nonpecuniary losses of any kind or nature. Such
term includes economic damages and noneconomic damages, as such
terms are defined in this section.
(5) Contingent fee.--The term ``contingent fee'' includes
all compensation to any person or persons which is payable only
if a recovery is effected on behalf of one or more claimants.
(6) Economic damages.--The term ``economic damages'' means
objectively verifiable monetary losses incurred as a result of
the provision of, use of, or payment for (or failure to
provide, use, or pay for) health care services or medical
products, such as past and future medical expenses, loss of
past and future earnings, cost of obtaining domestic services,
loss of employment, and loss of business or employment
opportunities.
(7) Health care goods or services.--The term ``health care
goods or services'' means any goods or services provided by a
health care institution, provider, or by any individual working
under the supervision of a health care provider, that relates
to the diagnosis, prevention, care, or treatment of any human
disease or impairment, or the assessment of the health of human
beings.
(8) Health care institution.--The term ``health care
institution'' means any entity licensed under Federal or State
law to provide health care services (including but not limited
to ambulatory surgical centers, assisted living facilities,
emergency medical services providers, hospices, hospitals and
hospital systems, nursing homes, or other entities licensed to
provide such services).
(9) Health care lawsuit.--The term ``health care lawsuit''
means any health care liability claim concerning the provision
of health care goods or services affecting interstate commerce,
or any health care liability action concerning the provision of
(or the failure to provide) health care goods or services
affecting interstate commerce, brought in a State or Federal
court or pursuant to an alternative dispute resolution system,
against a health care provider or a health care institution
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.
(10) Health care liability action.--The term ``health care
liability action'' means a civil action brought in a State or
Federal Court or pursuant to an alternative dispute resolution
system, against a health care provider or a health care
institution 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.
(11) Health care liability claim.--The term ``health care
liability claim'' means a demand by any person, whether or not
pursuant to ADR, against a health care provider or health care
institution, including 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, 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.
(12) Health care provider.--
(A) In general.--The term ``health care provider''
means any person (including but not limited to a
physician (as defined by section 1861(r) of the Social
Security Act (42 U.S.C. 1395x(r)), registered nurse,
dentist, podiatrist, pharmacist, chiropractor, or
optometrist) required by State or Federal law 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.
(B) Treatment of certain professional
associations.--For purposes of this Act, a professional
association that is organized under State law by an
individual physician or group of physicians, a
partnership or limited liability partnership formed by
a group of physicians, a nonprofit health corporation
certified under State law, or a company formed by a
group of physicians under State law shall be treated as
a health care provider under subparagraph (A).
(13) Malicious intent to injure.--The term ``malicious
intent to injure'' means intentionally causing or attempting to
cause physical injury other than providing health care goods or
services.
(14) Noneconomic damages.--The term ``noneconomic damages''
means damages for physical and emotional pain, suffering,
inconvenience, physical impairment, mental anguish,
disfigurement, loss of enjoyment of life, loss of society and
companionship, loss of consortium (other than loss of domestic
service), hedonic damages, injury to reputation, and all other
nonpecuniary losses of any kind or nature.
(15) Punitive damages.--The term ``punitive damages'' means
damages awarded, for the purpose of punishment or deterrence,
and not solely for compensatory purposes, against a health care
provider or health care institution. Punitive damages are
neither economic nor noneconomic damages.
(16) Recovery.--The term ``recovery'' means the net sum
recovered after deducting any disbursements or costs incurred
in connection with prosecution or settlement of the claim,
including all costs paid or advanced by any person. Costs of
health care incurred by the plaintiff and the attorneys' office
overhead costs or charges for legal services are not deductible
disbursements or costs for such purpose.
(17) State.--The term ``State'' means each of the several
States, the District of Columbia, the Commonwealth of Puerto
Rico, the Virgin Islands, Guam, American Samoa, the Northern
Mariana Islands, the Trust Territory of the Pacific Islands,
and any other territory or possession of the United States, or
any political subdivision thereof.
SEC. 4. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS.
(a) In General.--Except as otherwise provided for in this section,
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.
(b) General Exception.--The time for the commencement of a health
care lawsuit shall not exceed 3 years after the date of manifestation
of injury unless the tolling of time was delayed as a result of--
(1) fraud;
(2) intentional concealment; or
(3) the presence of a foreign body, which has no
therapeutic or diagnostic purpose or effect, in the person of
the injured person.
(c) Minors.--An action by a minor shall be commenced within 3 years
from the date of the alleged manifestation of injury except that if
such minor is under the full age of 6 years, such action shall be
commenced within 3 years of the manifestation of injury, or prior to
the eighth birthday of the minor, 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
institution have committed fraud or collusion in the failure to bring
an action on behalf of the injured minor.
(d) Rule 11 Sanctions.--Whenever a Federal or State court
determines (whether by motion of the parties or whether on the motion
of the court) that there has been a violation of Rule 11 of the Federal
Rules of Civil Procedure (or a similar violation of applicable State
court rules) in a health care liability action to which this Act
applies, the court shall impose upon the attorneys, law firms, or pro
se litigants that have violated Rule 11 or are responsible for the
violation, an appropriate sanction, which shall include an order to pay
the other party or parties for the reasonable expenses incurred as a
direct result of the filing of the pleading, motion, or other paper
that is the subject of the violation, including a reasonable attorneys'
fee. Such sanction shall be sufficient to deter repetition of such
conduct or comparable conduct by others similarly situated, and to
compensate the party or parties injured by such conduct.
SEC. 5. COMPENSATING PATIENT INJURY.
(a) Unlimited Amount of Damages for Actual Economic Losses in
Health Care Lawsuits.--In any health care lawsuit, nothing in this Act
shall limit the recovery by a claimant of the full amount of the
available economic damages, notwithstanding the limitation contained in
subsection (b).
(b) Additional Noneconomic Damages.--
(1) Health care providers.--In any health care lawsuit
where final judgment is rendered against a health care
provider, the amount of noneconomic damages recovered from the
provider, if otherwise available under applicable Federal or
State law, may be as much as $250,000, regardless of the number
of parties other than a health care institution against whom
the action is brought or the number of separate claims or
actions brought with respect to the same occurrence.
(2) Health care institutions.--
(A) Single institution.--In any health care lawsuit
where final judgment is rendered against a single
health care institution, the amount of noneconomic
damages recovered from the institution, if otherwise
available under applicable Federal or State law, 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 occurrence.
(B) Multiple institutions.--In any health care
lawsuit where final judgment is rendered against more
than one health care institution, the amount of
noneconomic damages recovered from each institution, if
otherwise available under applicable Federal or State
law, 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 occurrence, except that the total
amount recovered from all such institutions in such
lawsuit shall not exceed $500,000.
(c) No Discount of Award for Noneconomic Damages.--In any health
care lawsuit--
(1) an award for future noneconomic damages shall not be
discounted to present value;
(2) the jury shall not be informed about the maximum award
for noneconomic damages under subsection (b);
(3) an award for noneconomic damages in excess of the
limitations provided for in subsection (b) 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; and
(4) if separate awards are rendered for past and future
noneconomic damages and the combined awards exceed the
limitations described in subsection (b), the future noneconomic
damages shall be reduced first.
(d) Fair Share Rule.--In any health care lawsuit, each party shall
be liable for that party's several share of any damages only and not
for the share of any other person. Each party shall be liable only for
the amount of damages allocated to such party in direct proportion to
such party's percentage of responsibility. A separate judgment shall be
rendered against each such party for the amount allocated to such
party. For purposes of this section, the trier of fact shall determine
the proportion of responsibility of each party for the claimant's harm.
SEC. 6. MAXIMIZING PATIENT RECOVERY.
(a) Court Supervision of Share of Damages Actually Paid to
Claimants.--
(1) In general.--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.
(2) Contingency fees.--
(A) In general.--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.
(B) Limitation.--The total of all contingent fees
for representing all claimants in a health care lawsuit
shall not exceed the following limits:
(i) Forty percent of the first $50,000
recovered by the claimant(s).
(ii) Thirty-three and one-third percent of
the next $50,000 recovered by the claimant(s).
(iii) Twenty-five percent of the next
$500,000 recovered by the claimant(s).
(iv) Fifteen percent of any amount by which
the recovery by the claimant(s) is in excess of
$600,000.
(b) Applicability.--
(1) In general.--The limitations in subsection (a) shall
apply whether the recovery is by judgment, settlement,
mediation, arbitration, or any other form of alternative
dispute resolution.
(2) Minors.--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.
(c) Expert Witnesses.--
(1) Requirement.--No individual shall be qualified to
testify as an expert witness concerning issues of negligence in
any health care lawsuit against a defendant unless such
individual--
(A) except as required under paragraph (2), is a
health care professional who--
(i) is appropriately credentialed or
licensed in 1 or more States to deliver health
care services; and
(ii) typically treats the diagnosis or
condition or provides the type of treatment
under review; and
(B) can demonstrate by competent evidence that, as
a result of training, education, knowledge, and
experience in the evaluation, diagnosis, and treatment
of the disease or injury which is the subject matter of
the lawsuit against the defendant, the individual was
substantially familiar with applicable standards of
care and practice as they relate to the act or omission
which is the subject of the lawsuit on the date of the
incident.
(2) Physician review.--In a health care lawsuit, if the
claim of the plaintiff involved treatment that is recommended
or provided by a physician (allopathic or osteopathic), an
individual shall not be qualified to be an expert witness under
this subsection with respect to issues of negligence concerning
such treatment unless such individual is a physician.
(3) Specialties and subspecialties.--With respect to a
lawsuit described in paragraph (1), a court shall not permit an
expert in one medical specialty or subspecialty to testify
against a defendant in another medical specialty or
subspecialty unless, in addition to a showing of substantial
familiarity in accordance with paragraph (1)(B), there is a
showing that the standards of care and practice in the two
specialty or subspecialty fields are similar.
(4) Limitation.--The limitations in this subsection shall
not apply to expert witnesses testifying as to the degree or
permanency of medical or physical impairment.
SEC. 7. ADDITIONAL HEALTH BENEFITS.
(a) In General.--The amount of any damages received by a claimant
in any health care lawsuit shall be reduced by the court by the amount
of any collateral source benefits to which the claimant is entitled,
less any insurance premiums or other payments made by the claimant (or
by the spouse, parent, child, or legal guardian of the claimant) to
obtain or secure such benefits.
(b) Preservation of Current Law.--Where a payor of collateral
source benefits has a right of recovery by reimbursement or subrogation
and such right is permitted under Federal or State law, subsection (a)
shall not apply.
(c) Application of Provision.--This section shall apply to any
health care lawsuit that is settled or resolved by a fact finder.
SEC. 8. PUNITIVE DAMAGES.
(a) Punitive Damages Permitted.--
(1) In general.--Punitive damages may, if otherwise
available under 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.
(2) Filing of 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.
(3) Separate proceeding.--At the request of any party in a
health care lawsuit, the trier of fact shall consider in a
separate proceeding--
(A) whether punitive damages are to be awarded and
the amount of such award; and
(B) the amount of punitive damages following a
determination of punitive liability.
If a separate proceeding is requested, evidence relevant only
to the claim for punitive damages, as determined by applicable
State law, shall be inadmissible in any proceeding to determine
whether compensatory damages are to be awarded.
(4) Limitation where no compensatory damages are awarded.--
In any health care lawsuit where no judgment for compensatory
damages is rendered against a person, no punitive damages may
be awarded with respect to the claim in such lawsuit against
such person.
(b) Determining Amount of Punitive Damages.--
(1) Factors considered.--In determining the amount of
punitive damages under this section, the trier of fact shall
consider only the following:
(A) the severity of the harm caused by the conduct
of such party;
(B) the duration of the conduct or any concealment
of it by such party;
(C) the profitability of the conduct to such party;
(D) the number of products sold or medical
procedures rendered for compensation, as the case may
be, by such party, of the kind causing the harm
complained of by the claimant;
(E) any criminal penalties imposed on such party,
as a result of the conduct complained of by the
claimant; and
(F) the amount of any civil fines assessed against
such party as a result of the conduct complained of by
the claimant.
(2) Maximum award.--The amount of punitive damages awarded
in a health care lawsuit may not exceed an amount equal to two
times the amount of economic damages awarded in the lawsuit or
$250,000, whichever is greater. The jury shall not be informed
of the limitation under the preceding sentence.
(c) Liability of Health Care Providers.--
(1) In general.--A health care provider who prescribes, or
who dispenses pursuant to a prescription, a drug, biological
product, or medical device approved by the Food and Drug
Administration, for an approved indication of the drug,
biological product, or medical device, shall not be named as a
party to a product liability lawsuit invoking such drug,
biological product, or medical device and shall not be liable
to a claimant in a class action lawsuit against the
manufacturer, distributor, or product seller of such drug,
biological product, or medical device.
(2) Medical product.--The term ``medical product'' means a
drug or device intended for humans. The terms ``drug'' and
``device'' 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), respectively, including any component or raw
material used therein, but excluding health care services.
SEC. 9. AUTHORIZATION OF PAYMENT OF FUTURE DAMAGES TO CLAIMANTS IN
HEALTH CARE LAWSUITS.
(a) In General.--In any health care lawsuit, if an award of future
damages, without reduction to present value, equaling or exceeding
$50,000 is made against a party with sufficient insurance or other
assets to fund a periodic payment of such a judgment, the court shall,
at the request of any party, enter a judgment ordering that the future
damages be paid by periodic payments in accordance with the Uniform
Periodic Payment of Judgments Act promulgated by the National
Conference of Commissioners on Uniform State Laws.
(b) Applicability.--This section applies to all actions which have
not been first set for trial or retrial before the effective date of
this Act.
SEC. 10. EFFECT ON OTHER LAWS.
(a) General Vaccine Injury.--
(1) In general.--To the extent that title XXI of the Public
Health Service Act establishes a Federal rule of law applicable
to a civil action brought for a vaccine-related injury or
death--
(A) this Act shall not affect the application of
the rule of law to such an action; and
(B) any rule of law prescribed by this Act in
conflict with a rule of law of such title XXI shall not
apply to such action.
(2) Exception.--If there is an aspect of a civil action
brought for a vaccine-related injury or death to which a
Federal rule of law under title XXI of the Public Health
Service Act does not apply, then this Act or otherwise
applicable law (as determined under this Act) will apply to
such aspect of such action.
(b) Smallpox Vaccine Injury.--
(1) In general.--To the extent that part C of title II of
the Public Health Service Act establishes a Federal rule of law
applicable to a civil action brought for a smallpox vaccine-
related injury or death--
(A) this Act shall not affect the application of
the rule of law to such an action; and
(B) any rule of law prescribed by this Act in
conflict with a rule of law of such part C shall not
apply to such action.
(2) Exception.--If there is an aspect of a civil action
brought for a smallpox vaccine-related injury or death to which
a Federal rule of law under part C of title II of the Public
Health Service Act does not apply, then this Act or otherwise
applicable law (as determined under this Act) will apply to
such aspect of such action.
(c) Other Federal Law.--Except as provided in this section, nothing
in this Act shall be deemed to affect any defense available, or any
limitation on liability that applies to, a defendant in a health care
lawsuit or action under any other provision of Federal law.
SEC. 11. STATE FLEXIBILITY AND PROTECTION OF STATES' RIGHTS.
(a) Health Care Lawsuits.--The provisions governing health care
lawsuits set forth in this Act shall 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 Act.
The provisions governing health care lawsuits set forth in this Act
supersede chapter 171 of title 28, United States Code, to the extent
that such chapter--
(1) provides for a greater amount of damages or contingent
fees, a longer period in which a health care lawsuit may be
commenced, or a reduced applicability or scope of periodic
payment of future damages, than provided in this Act; or
(2) prohibits the introduction of evidence regarding
collateral source benefits.
(b) Preemption of Certain State Laws.--No provision of this Act
shall be construed to preempt any State law (whether effective before,
on, or after the date of the enactment of this Act) 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 Act, notwithstanding section 5(a).
(c) Protection of State's Rights and Other Laws.--
(1) In general.--Any issue that is not governed by a
provision of law established by or under this Act (including
the State standards of negligence) shall be governed by
otherwise applicable Federal or State law.
(2) Rule of construction.--Nothing in this Act shall be
construed to--
(A) preempt or supersede any Federal or State law
that imposes greater procedural or substantive
protections (such as a shorter statute of limitations)
for a health care provider or health care institution
from liability, loss, or damages than those provided by
this Act;
(B) preempt or supercede any State law that permits
and provides for the enforcement of any arbitration
agreement related to a health care liability claim
whether enacted prior to or after the date of enactment
of this Act;
(C) create a cause of action that is not otherwise
available under Federal or State law; or
(D) affect the scope of preemption of any other
Federal law.
SEC. 12. APPLICABILITY; EFFECTIVE DATE.
This Act 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
Act, except that any health care lawsuit arising from an injury
occurring prior to the date of enactment of this Act shall be governed
by the applicable statute of limitations provisions in effect at the
time the injury occurred.
<all>
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