S 1481 ISCommentsClose CommentsPermalink

To restore fairness and reliability to the medical justice system and promote patient safety by fostering alternatives to current medical tort litigation, and for other purposes.CommentsClose CommentsPermalink

May 24, 2007

Mr. BAUCUS (for himself and Mr. ENZI) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and PensionsCommentsClose CommentsPermalink

To restore fairness and reliability to the medical justice system and promote patient safety by fostering alternatives to current medical tort litigation, and for other purposes.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the `Fair and Reliable Medical Justice Act'.CommentsClose CommentsPermalink

SEC. 2. PURPOSES.

The purposes of this Act are--CommentsClose CommentsPermalink





(1) to restore fairness and reliability to the medical justice system by fostering alternatives to current medical tort litigation that promote early disclosure of health care errors and provide prompt, fair, and reasonable compensation to patients who are injured by health care errors;CommentsClose CommentsPermalink





(2) to promote patient safety through disclosure of health care errors; andCommentsClose CommentsPermalink





(3) to support and assist States in developing such alternatives.CommentsClose CommentsPermalink

SEC. 3. STATE DEMONSTRATION PROGRAMS TO EVALUATE ALTERNATIVES TO CURRENT MEDICAL TORT LITIGATION.

Part P of title III of the Public Health Service Act (42 U.S.C. 280g et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

`SEC. 399R. STATE DEMONSTRATION PROGRAMS TO EVALUATE ALTERNATIVES TO CURRENT MEDICAL TORT LITIGATION.

`(a) In General- The Secretary is authorized to award demonstration grants to States for the development, implementation, and evaluation of alternatives to current tort litigation for resolving disputes over injuries allegedly caused by health care providers or health care organizations. In awarding such grants, the Secretary shall ensure the diversity of the alternatives so funded.CommentsClose CommentsPermalink





`(b) Duration- The Secretary may award up to 10 grants under subsection (a) and each grant awarded under such subsection may not exceed a period of 5 years.CommentsClose CommentsPermalink





`(c) Conditions for Demonstration Grants-CommentsClose CommentsPermalink





`(1) REQUIREMENTS- Each State desiring a grant under subsection (a) shall--CommentsClose CommentsPermalink





`(A) develop an alternative to current tort litigation for resolving disputes over injuries allegedly caused by health care providers or health care organizations; andCommentsClose CommentsPermalink





`(B) promote a reduction of health care errors by allowing for patient safety data related to disputes resolved under subparagraph (A) to be collected and analyzed by organizations that engage in efforts to improve patient safety and the quality of health care.CommentsClose CommentsPermalink





`(2) ALTERNATIVE TO CURRENT TORT LITIGATION- Each State desiring a grant under subsection (a) shall demonstrate how the proposed alternative described in paragraph (1)(A)--CommentsClose CommentsPermalink





`(A) makes the medical liability system more reliable through prompt and fair resolution of disputes;CommentsClose CommentsPermalink





`(B) encourages the disclosure of health care errors;CommentsClose CommentsPermalink





`(C) enhances patient safety by detecting, analyzing, and reducing medical errors and adverse events;CommentsClose CommentsPermalink





`(D) maintains access to liability insurance; andCommentsClose CommentsPermalink





`(E) provides patients the opportunity to opt out of or voluntarily withdraw from participating in the alternative.CommentsClose CommentsPermalink





`(3) SOURCES OF COMPENSATION- Each State desiring a grant under subsection (a) shall identify the sources from and methods by which compensation would be paid for claims resolved under the proposed alternative to current tort litigation, which may include public or private funding sources, or a combination of such sources. Funding methods shall to the extent practicable provide financial incentives for activities that improve patient safety.CommentsClose CommentsPermalink





`(4) SCOPE-CommentsClose CommentsPermalink





`(A) IN GENERAL- Each State desiring a grant under subsection (a) may establish a scope of jurisdiction (such as a designated geographic region, a designated area of health care practice, or a designated group of health care providers or health care organizations) for the proposed alternative to current tort litigation that is sufficient to evaluate the effects of the alternative.CommentsClose CommentsPermalink





`(B) NOTIFICATION OF PATIENTS- A State proposing a scope of jurisdiction under subparagraph (A) shall demonstrate how patients would be notified that they are receiving health care services that fall within such scope, and that they may opt out of or voluntarily withdraw from participating in the alternative.CommentsClose CommentsPermalink





`(5) PREFERENCE IN AWARDING DEMONSTRATION GRANTS- In awarding grants under subsection (a), the Secretary shall give preference to States--CommentsClose CommentsPermalink





`(A) that have developed the proposed alternative through substantive consultation with relevant stakeholders, including patient advocates, health care providers and health care organizations, attorneys with expertise in representing patients and health care providers, medical malpractice insurers, and patient safety experts;CommentsClose CommentsPermalink





`(B) that make proposals that are likely to enhance patient safety by detecting, analyzing, and reducing medical errors and adverse events; andCommentsClose CommentsPermalink





`(C) in which State law at the time of the application would not prohibit the adoption of an alternative to current tort litigation.CommentsClose CommentsPermalink





`(d) Application-CommentsClose CommentsPermalink





`(1) IN GENERAL- Each State desiring a grant under subsection (a) shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require.CommentsClose CommentsPermalink





`(2) REVIEW PANEL-CommentsClose CommentsPermalink





`(A) IN GENERAL- In reviewing applications under paragraph (1), the Secretary shall consult with a review panel composed of relevant experts appointed by the Comptroller General.CommentsClose CommentsPermalink





`(B) COMPOSITION-CommentsClose CommentsPermalink





`(i) NOMINATIONS- The Comptroller General shall solicit nominations from the public for individuals to serve on the review panel.CommentsClose CommentsPermalink





`(ii) APPOINTMENT- The Comptroller General shall appoint, at least 14 but not more than 19, highly qualified and knowledgeable individuals to serve on the review panel and shall ensure that the following entities receive fair representation on such panel:CommentsClose CommentsPermalink





`(I) Patient advocates.CommentsClose CommentsPermalink





`(II) Health care providers and health care organizations.CommentsClose CommentsPermalink





`(III) Attorneys with expertise in representing patients and health care providers.CommentsClose CommentsPermalink





`(IV) Medical malpractice insurers.CommentsClose CommentsPermalink





`(V) State officials.CommentsClose CommentsPermalink





`(VI) Patient safety experts.CommentsClose CommentsPermalink





`(C) CHAIRPERSON- The Comptroller General, or an individual within the Government Accountability Office designated by the Comptroller General, shall be the chairperson of the review panel.CommentsClose CommentsPermalink





`(D) AVAILABILITY OF INFORMATION- The Comptroller General shall make available to the review panel such information, personnel, and administrative services and assistance as the review panel may reasonably require to carry out its duties.CommentsClose CommentsPermalink





`(E) INFORMATION FROM AGENCIES- The review panel may request directly from any department or agency of the United States any information that such panel considers necessary to carry out its duties. To the extent consistent with applicable laws and regulations, the head of such department or agency shall furnish the requested information to the review panel.CommentsClose CommentsPermalink





`(e) Reports-CommentsClose CommentsPermalink





`(1) BY STATE- Each State receiving a grant under subsection (a) shall submit to the Secretary an annual report evaluating the effectiveness of activities funded with grants awarded under such subsection.CommentsClose CommentsPermalink





`(2) BY SECRETARY- The Secretary shall submit to Congress an annual compendium of the reports submitted under paragraph (1).CommentsClose CommentsPermalink





`(f) Technical Assistance-CommentsClose CommentsPermalink





`(1) IN GENERAL- The Secretary shall provide technical assistance to the States applying for or awarded grants under subsection (a).CommentsClose CommentsPermalink





`(2) REQUIREMENTS- Technical assistance under paragraph (1) shall include--CommentsClose CommentsPermalink





`(A) guidance on non-economic damages, including the consideration of individual facts and circumstances in determining appropriate payment, guidance on identifying avoidable injuries, and guidance on disclosure to patients of health care errors and adverse events; andCommentsClose CommentsPermalink





`(B) the development, in consultation with States, of common definitions, formats, and data collection infrastructure for States receiving grants under this section to use in reporting to facilitate aggregation and analysis of data both within and between States.CommentsClose CommentsPermalink





`(3) USE OF COMMON DEFINITIONS, FORMATS, AND DATA COLLECTION INFRASTRUCTURE- States not receiving grants under this section may also use the common definitions, formats, and data collection infrastructure developed under paragraph (2)(B).CommentsClose CommentsPermalink





`(g) Evaluation-CommentsClose CommentsPermalink





`(1) IN GENERAL- The Secretary, in consultation with the review panel established under subsection (d)(2), shall enter into a contract with an appropriate research organization to conduct an overall evaluation of the effectiveness of grants awarded under subsection (a) and to annually prepare and submit a report to Congress. Such an evaluation shall begin not later than 18 months following the date of implementation of the first program funded by a grant under subsection (a).CommentsClose CommentsPermalink





`(2) CONTENTS- The evaluation under paragraph (1) shall include--CommentsClose CommentsPermalink





`(A) an analysis of the effects of the grants awarded under subsection (a) on the measures described in paragraph (3);CommentsClose CommentsPermalink





`(B) a comparison between and among the alternatives approved under subsection (a) of the measures described in paragraph (3); andCommentsClose CommentsPermalink





`(C) a comparison between and among States receiving grants approved under subsection (a) and similar States not receiving such grants of the measures described in paragraph (3).CommentsClose CommentsPermalink





`(3) MEASURES- The evaluations under paragraph (2) shall analyze and make comparisons on the basis of--CommentsClose CommentsPermalink





`(A) the nature and number of disputes over injuries allegedly caused by health care providers or health care organizations;CommentsClose CommentsPermalink





`(B) the nature and number of claims in which tort litigation was pursued despite the existence of an alternative under subsection (a);CommentsClose CommentsPermalink





`(C) the disposition of disputes and claims described in clauses (i) and (ii), including the length of time and estimated costs to all parties;CommentsClose CommentsPermalink





`(D) the medical liability environment;CommentsClose CommentsPermalink





`(E) health care quality;CommentsClose CommentsPermalink





`(F) patient safety in terms of detecting, analyzing, and reducing medical errors and adverse events; andCommentsClose CommentsPermalink





`(G) patient and health care provider and organization satisfaction with the alternative under subsection (a) and with the medical liability environment.CommentsClose CommentsPermalink





`(4) FUNDING- The Secretary shall reserve 5 percent of the amount appropriated in each fiscal year under subsection (j) to carry out this subsection.CommentsClose CommentsPermalink





`(h) Option to Provide for Initial Planning Grants- Of the funds appropriated pursuant to subsection (j), the Secretary may use a portion not to exceed $500,000 per State to provide planning grants to such States for the development of demonstration project applications meeting the criteria described in subsection (c). In selecting States to receive such planning grants, the Secretary shall give preference to those States in which State law at the time of the application would not prohibit the adoption of an alternative to current tort litigation.CommentsClose CommentsPermalink





`(i) Definitions- In this section:CommentsClose CommentsPermalink





`(1) HEALTH CARE SERVICES- The term `health care services' means any services provided by a health care provider, or by any individual working under the supervision of a health care provider, that relate to--CommentsClose CommentsPermalink





`(A) the diagnosis, prevention, or treatment of any human disease or impairment; orCommentsClose CommentsPermalink





`(B) the assessment of the health of human beings.CommentsClose CommentsPermalink





`(2) HEALTH CARE ORGANIZATION- The term `health care organization' means any individual or entity which is obligated to provide, pay for, or administer health benefits under any health plan.CommentsClose CommentsPermalink





`(3) HEALTH CARE PROVIDER- The term `health care provider' means any individual or entity--CommentsClose CommentsPermalink





`(A) licensed, registered, or certified under Federal or State laws or regulations to provide health care services; orCommentsClose CommentsPermalink





`(B) required to be so licensed, registered, or certified but that is exempted by other statute or regulation.CommentsClose CommentsPermalink





`(4) NET ECONOMIC LOSS- The term `net economic loss' means--CommentsClose CommentsPermalink





`(A) reasonable expenses incurred for products, services, and accommodations needed for health care, training, and other remedial treatment and care of an injured individual;CommentsClose CommentsPermalink





`(B) reasonable and appropriate expenses for rehabilitation treatment and occupational training;CommentsClose CommentsPermalink





`(C) 100 percent of the loss of income from work that an injured individual would have performed if not injured, reduced by any income from substitute work actually performed; andCommentsClose CommentsPermalink





`(D) reasonable expenses incurred in obtaining ordinary and necessary services to replace services an injured individual would have performed for the benefit of the individual or the family of such individual if the individual had not been injured.CommentsClose CommentsPermalink





`(5) NON-ECONOMIC DAMAGES- The term `non-economic damages' means losses 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), injury to reputation, and all other non-pecuniary losses of any kind or nature, to the extent permitted under State law.CommentsClose CommentsPermalink





`(j) Authorization of Appropriations- There are authorized to be appropriated to carry out this section such sums as may be necessary. Amounts appropriated pursuant to this subsection shall remain available until expended.'.CommentsClose CommentsPermalink