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H.R. 4600: Help Efficient, Accessible, Low Cost, Timely
Health Care (HEALTH) Act of 2002 (Greenwood)
Medical Malpractice Reform
Proposal before the 107^th Congress

H.R. 4600 Summary (Requires Adobe Acrobat Reader)

Representative James C. Greenwood (R-PA) introduced the "Help Efficient, Accessible, Low Cost, Timely Health Care (HEALTH) Act on April 25, 2002. Representative Greenwood was joined by 9 cosponsors: 5 Democrats and 4 Republicans. To date, the Act has the support of 113 additional cosponsors: 109 Republicans and 4 Democrats.

The bill was referred to the House Committees on the Judiciary and on Energy and Commerce. On May 10, 2002, the Committee on the Judiciary reported the bill with no substantive changes. On September 18, 2002, Representative Greenwood introduced and the Committee passed an amendment in the form of a substitute. The substitute amendment made substantive changes to provisions that would establish a statute of limitations on filing health care claims. The House passed the Health Act with further amendments to the statute of limitations provisions on September 26^th. This document provides an overview of the Health Act as initially introduced and as passed by the House of Representatives.

Senator John Ensign (R-NV) introduced S. 2793, a companion bill to H.R. 4600, on July 25, 2002. The companion bill was referred to the Senate Committee on the Judiciary, which has not held a hearing on the bill. The Senate is not expected to take up the HEALTH Act during the 107^th Congress.

The stated purpose of the HEALTH Act is "to implement reasonable, comprehensive, and effective health care liability reforms." The bill applies to any civil health care action or claim against health care providers or organizations. It addresses procedural rules and burdens of proof for establishing liability. The Act establishes procedures for and limits on awards for noneconomic losses and punitive damages. The bill also regulates and establishes limits on attorneys' contingency fees, and provides additional protections for certain health care providers and services. Among other provisions, the HEALTH Act:

• Applies to all health care lawsuits and claims whether filed in a state or federal court, including those adjudicated through alternative dispute resolution (ADR) systems.
• Defines "health care lawsuits" broadly to include any health care liability claim arising from the provision of health care goods or services by any health care provider or organization.
• Establishes a baseline statute of limitations of three-years for initiating health care claims.
• Establishes a "fair share" rule that prohibits a determination of joint liability, and requires the judge or jury to determine each defendant's proportional responsibility for harm.
• Aggregates all claims and actions for noneconomic damages resulting from the same occurrence, and limits the total amount of recovery to $250,000 regardless of the number of parties against whom the action is brought, or the number of claims or actions for all types of noneconomic damages.
• Establishes procedural requirements and a higher standard of proof (malicious intent to inflict or deliberate failure to avoid unnecessary injury) for a claim for punitive damages, and limits the amount of punitive damages that a court may award to a claimant.
• Authorizes a court to require periodic payment of future damages, but prohibits discounting future damages to present value.
• Limits the amount of an award of attorneys' contingency fees and gives a court discretion to restrict fees for equitable purposes. Specifically authorizes a court to award lower attorneys' contingency fees in cases in which the claimant is a minor or a legally incapacitated person.
• Allows any party to introduce evidence of collateral source benefits, but prohibits recovery of by a provider of these benefits against a successful claimant.
• Provides protection from liability for, and exempts from punitive damages, certain providers of medical services and products.
• Limits jury discretion in awarding noneconomic and punitive damages by prohibiting the jury from being informed
  about limitations of these damages established under the Act.

The HEALTH Act represents a national approach to tort reform. Sponsors find support for federal medical malpractice reform in the impact of the health care and insurance industries and of state health care liability systems on interstate commerce due to the high costs of health care and premiums for health care liability insurance. The Health Act would supercede some, but not all, state liability laws. For example, the Act:

• Preempts state laws to the extent that they conflict with any provision of the Act.
• Preserves state laws that provide greater protections from liability to health care providers and organizations than those provided under the Act, i.e., state laws establishing shorter statutes of limitations.
• Preserves state statutory limits on the amount of compensatory or punitive damages, or the total amount of damages, that may be awarded in a health care lawsuit whether or not the limits are greater than those established under the Act.
• Imposes limits on the amount of noneconomic and punitive damages on states that have not enacted statutory limitations.
• Preserves any defenses available to a defendant in a health care lawsuit available under state law.

To the extent that particular provisions of the HEALTH Act are neither addressed by nor in conflict with Section XXI of the Public Health Service Act governing civil actions for vaccine-related injury or death, the Act would apply to those actions. In addition, the Act preserves any defenses available under federal law to a defendant in a health care lawsuit. The bill supersedes Chapter 171 of title 28 of the United States Code related to tort claims procedures against the United States or its agencies and employees, or the military or naval forces of the United States, to the extent that it conflicts with specific provisions of the Act.

SUMMARY OF H. R. 4600: HELP EFFICIENT, ACCESSIBLE, LOW COST, TIMELY HEALTH CARE (HEALTH) ACT OF 2002

CBO Cost Estimate of the H.R. 4600: Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2002 (As ordered reported by the House Committee on Energy and Commerce on September 19, 2002)