[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9584 Introduced in House (IH)]
<DOC>
117th CONGRESS
2d Session
H. R. 9584
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 HOUSE OF REPRESENTATIVES
December 15, 2022
Mr. Hudson (for himself and Mr. Correa) 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 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Accessible Care by
Curbing Excessive lawSuitS Act of 2022'' or the ``ACCESS Act of 2022''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings and purpose.
Sec. 3. Encouraging speedy resolution of claims.
Sec. 4. Compensating patient injury.
Sec. 5. Maximizing patient recovery.
Sec. 6. Additional health benefits.
Sec. 7. Authorization of payment of future damages to claimants in
health care lawsuits.
Sec. 8. Product liability for health care providers.
Sec. 9. Communications following unanticipated outcome.
Sec. 10. Notice of intent to commence lawsuit.
Sec. 11. Affidavit of merit.
Sec. 12. Expert witness qualifications.
Sec. 13. Definitions.
Sec. 14. Effect on other laws.
Sec. 15. Rules of construction.
Sec. 16. Effective date.
SEC. 2. FINDINGS AND PURPOSE.
(a) Findings.--
(1) Effect on health care access and costs.--Congress finds
that the 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 without reform is a costly and inefficient
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 federal spending.--
(A) 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--
(i) the large number of individuals who
receive health care benefits under programs
operated or financed by the Federal Government;
(ii) 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
(iii) the large number of health care
providers who provide items or services for
which the Federal Government makes payments.
(B) Congress finds that the Federal deficit would
be reduced by $28,000,000,000 over the next decade if
Federal health care liability reforms were enacted, as
verified by the Congressional Budget Office.
(3) 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.
(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. ENCOURAGING SPEEDY RESOLUTION OF CLAIMS.
(a) Statute of Limitations.--The time for the commencement of a
health care lawsuit shall be 3 years after the date of injury or 1 year
after the claimant discovers, or through the use of reasonable
diligence should have discovered, the injury, whichever occurs first.
In no event shall the time for commencement of a health care lawsuit
exceed 3 years after the date of injury unless tolled for any of the
following--
(1) upon proof of 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.
Actions by a minor shall be commenced within 3 years from the date of
the injury except that actions by a minor under the full age of 6 years
shall be commenced within 3 years of injury, or 1 year after the injury
is discovered, or through the use of reasonable diligence should have
been discovered, or prior to the minor's 8th birthday, 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 have committed fraud or collusion in the failure to bring
an action on behalf of the injured minor.
(b) State Flexibility.--No provision of subsection (a) shall be
construed to preempt any State law (whether effective before, on, or
after the date of the enactment of this Act) that--
(1) specifies a time period of less than 3 years after the
date of injury or less than 1 year after the claimant
discovers, or through the use of reasonable diligence should
have discovered, the injury, for the filing of a health care
lawsuit;
(2) that specifies a different time period for the filing
of lawsuits by a minor;
(3) that triggers the time period based on the date of the
alleged negligence; or
(4) establishes a statute of repose for the filing of
health care lawsuit.
SEC. 4. 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 a claimant's recovery of the full amount of the available
economic damages, notwithstanding the limitation in subsection (b).
(b) Additional Noneconomic Damages.--In any health care lawsuit,
the amount of noneconomic damages, if available, shall not exceed
$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 injury.
(c) No Discount of Award for Noneconomic Damages.--For purposes of
applying the limitation in subsection (b), future noneconomic damages
shall not be discounted to present value. The jury shall not be
informed about the maximum award for noneconomic damages. An award for
noneconomic damages in excess of $250,000 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. If separate awards
are rendered for past and future noneconomic damages and the combined
awards exceed $250,000, 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. Whenever a judgment of
liability is rendered as to any party, 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.
(e) State Flexibility.--No provision of this section 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 economic or noneconomic 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 section.
SEC. 5. MAXIMIZING PATIENT RECOVERY.
(a) Court Supervision of Share of Damages Actually Paid to
Claimants.--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. In particular, 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. In no
event shall the total of all contingent fees for representing all
claimants in a health care lawsuit exceed the following limits:
(1) Forty percent of the first $50,000 recovered by the
claimant(s).
(2) Thirty-three and one-third percent of the next $50,000
recovered by the claimant(s).
(3) Twenty-five percent of the next $500,000 recovered by
the claimant(s).
(4) Fifteen percent of any amount by which the recovery by
the claimant(s) is in excess of $600,000.
(b) Applicability.--The limitations in this section shall apply
whether the recovery is by judgment, settlement, mediation,
arbitration, or any other form of alternative dispute resolution. 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. The requirement for court
supervision in the first two sentences of subsection (a) applies only
in civil actions.
(c) State Flexibility.--No provision of this section 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 lesser
percentage or lesser total value of damages which may be claimed by an
attorney representing a claimant in a health care lawsuit.
SEC. 6. ADDITIONAL HEALTH BENEFITS.
(a) Collateral Source Benefits.--In any health care lawsuit
involving injury or wrongful death, any party may introduce evidence of
collateral source benefits. If a party elects to introduce such
evidence, any opposing party may introduce evidence of any amount paid
or contributed or reasonably likely to be paid or contributed in the
future by or on behalf of the opposing party to secure the right to
such collateral source benefits.
(b) Subrogation.--No provider of collateral source benefits shall
recover any amount against the claimant or receive any lien or credit
against the claimant's recovery or be equitably or legally subrogated
to the right of the claimant in a health care lawsuit involving injury
or wrongful death.
(c) Applicability.--This section shall apply to any health care
lawsuit that is settled as well as a health care lawsuit that is
resolved by a fact finder. This section shall not apply to section
1862(b) (42 U.S.C. 1395y(b)) or section 1902(a)(25) (42 U.S.C.
1396a(a)(25)) of the Social Security Act.
(d) State Flexibility.--No provision of subsection (a) 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 mandatory
offset of collateral source benefits against an award in a health care
liability lawsuit.
SEC. 7. 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.
(c) State Flexibility.--No provision of this section shall be
construed to preempt any State law (whether effective before, on, or
after the date of the enactment of this Act) that specifies periodic
payments for future damages at any amount other than $50,000 or that
mandates such payments absent the request of either party.
SEC. 8. PRODUCT LIABILITY FOR HEALTH CARE PROVIDERS.
A health care provider who prescribes, or who dispenses pursuant to
a prescription, a medical product approved, licensed, or cleared by the
Food and Drug Administration shall not be named as a party to a product
liability lawsuit involving such product and shall not be liable to a
claimant in a class action lawsuit against the manufacturer,
distributor, or seller of such product.
SEC. 9. COMMUNICATIONS FOLLOWING UNANTICIPATED OUTCOME.
(a) Provider Communications.--In any health care liability action,
any and all statements, affirmations, gestures, or conduct expressing
apology, fault, sympathy, commiseration, condolence, compassion, or a
general sense of benevolence which are made by a health care provider
or an employee of a health care provider to the patient, a relative of
the patient, or a representative of the patient and which relate to the
discomfort, pain, suffering, injury, or death of the patient as the
result of the unanticipated outcome of medical care shall be
inadmissible for any purpose as evidence of an admission of liability
or as evidence of an admission against interest.
(b) State Flexibility.--No provision of this section shall be
construed to preempt any State law (whether effective before, on, or
after the date of the enactment of this Act) that makes additional
communications inadmissible as evidence of an admission of liability or
as evidence of an admission against interest.
SEC. 10. NOTICE OF INTENT TO COMMENCE LAWSUIT.
(a) Advance Notice.--A person shall not commence an action against
a health care provider unless the person has given the health care
provider 90 days written notice before the action is commenced.
(b) Exceptions.--A lawsuit against a health care provider filed
within 6 months of the statute of limitations expiring as to any
claimant, or within 1 year of the statute of repose expiring as to any
claimant, shall be exempt from compliance with this section.
(c) State Flexibility.--No provision of this section shall be
construed to preempt any State law (whether effective before, on, or
after the date of the enactment of this Act) that establishes a
different time period for the filing of written notice.
SEC. 11. AFFIDAVIT OF MERIT.
(a) Required Filing.--Subject to subsection (b), the plaintiff in
an action alleging medical negligence or, if the plaintiff is
represented by an attorney, the plaintiff's attorney shall file
simultaneously with the health care lawsuit an affidavit of merit
signed by a health professional who meets the requirements for an
expert witness under Sec. 12 of this Act. The affidavit of merit shall
certify that the health professional has reviewed the notice and all
medical records supplied to him or her by the plaintiff's attorney
concerning the allegations contained in the notice and shall contain a
statement of each of the following:
(1) The applicable standard of practice or care.
(2) The health professional's opinion that the applicable
standard of practice or care was breached by the health
professional or health facility receiving the notice.
(3) The actions that should have been taken or omitted by
the health professional or health facility in order to have
complied with the applicable standard of practice or care.
(4) The manner in which the breach of the standard of
practice or care was the proximate cause of the injury alleged
in the notice.
(5) A listing of the medical records reviewed.
(b) Filing Extension.--Upon motion of a party for good cause shown,
the court in which the complaint is filed may grant the plaintiff or,
if the plaintiff is represented by an attorney, the plaintiff's
attorney an additional 28 days in which to file the affidavit required
under subsection (1).
(c) State Flexibility.--No provision of this section shall be
construed to preempt any State law (whether effective before, on, or
after the date of the enactment of this Act) that establishes
additional requirements for the filing of an affidavit of merit or
similar pre-litigation documentation.
SEC. 12. EXPERT WITNESS QUALIFICATIONS.
(a) In General.--In any health care lawsuit, an individual shall
not give expert testimony on the appropriate standard of practice or
care involved unless the individual is licensed as a health
professional in 1 or more States and the individual meets the following
criteria:
(1) If the party against whom or on whose behalf the
testimony is to be offered is or claims to be a specialist, the
expert witness shall specialize at the time of the occurrence
that is the basis for the lawsuit in the same specialty or
claimed specialty as the party against whom or on whose behalf
the testimony is to be offered. If the party against whom or on
whose behalf the testimony is to be offered is or claims to be
a specialist who is board certified, the expert witness shall
be a specialist who is board certified in that specialty or
claimed specialty.
(2) During the 1-year period immediately preceding the
occurrence of the action that gave rise to the lawsuit, the
expert witness shall have devoted a majority of the
individual's professional time to one or more of the following:
(A) The active clinical practice of the same health
profession as the defendant and, if the defendant is or
claims to be a specialist, in the same specialty or
claimed specialty.
(B) The instruction of students in an accredited
health professional school or accredited residency or
clinical research program in the same health profession
as the defendant and, if the defendant is or claims to
be a specialist, in an accredited health professional
school or accredited residency or clinical research
program in the same specialty or claimed specialty.
(3) If the defendant is a general practitioner, the expert
witness shall have devoted a majority of the witness's
professional time in the 1-year period preceding the occurrence
of the action giving rise to the lawsuit to one or more of the
following:
(A) Active clinical practice as a general
practitioner.
(B) Instruction of students in an accredited health
professional school or accredited residency or clinical
research program in the same health profession as the
defendant.
(b) Lawsuits Against Entities.--If the defendant in a health care
lawsuit is an entity that employs a person against whom or on whose
behalf the testimony is offered, the provisions of paragraph (1) apply
as if the person were the party or defendant against whom or on whose
behalf the testimony is offered.
(c) Power of Court.--Nothing in this subsection shall limit the
power of the trial court in a health care lawsuit to disqualify an
expert witness on grounds other than the qualifications set forth under
this subsection.
(d) Limitation.--An expert witness in a health care lawsuit shall
not be permitted to testify if the fee of the witness is in any way
contingent on the outcome of the lawsuit.
(e) State Flexibility.--No provision of this section shall be
construed to preempt any State law (whether effective before, on, or
after the date of the enactment of this Act) that places additional
qualification requirements upon any individual testifying as an expert
witness.
SEC. 13. 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) 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.
(5) Economic damages.--The term ``economic damages'' means
objectively verifiable monetary losses incurred as a result of
the provision or use of (or failure to provide or use) 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, unless otherwise defined
under applicable State law. In no circumstances shall damages
for health care services or medical products exceed the amount
actually paid or incurred by or on behalf of the claimant.
(6) Future damages.--The term ``future damages'' means any
damages that are incurred after the date of judgment,
settlement, or other resolution (including mediation, or any
other form of alternative dispute resolution).
(7) Health care lawsuit.--The term ``health care lawsuit''
means any health care liability claim concerning the provision
of goods or services for which coverage was provided in whole
or in part via a Federal program, subsidy or tax benefit, or
any health care liability action concerning the provision of
goods or services for which coverage was provided in whole or
in part via a Federal program, subsidy or tax benefit, brought
in a State or Federal court or pursuant to an alternative
dispute resolution system, against a health care provider
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. Such
term does not include a claim or action which is based on
criminal liability; which seeks civil fines or penalties paid
to Federal, State, or local government; or which is grounded in
antitrust.
(8) 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 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.
(9) 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, including, but
not limited to, third-party claims, cross-claims, counter-
claims, or contribution claims, which are based upon the
provision or use of (or the failure to provide or use) health
care services or medical products, 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.
(10) Health care provider.--The term ``health care
provider'' means any person or entity required by State or
Federal laws or regulations 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, as well as any
other individual or entity defined as a health care provider,
health care professional, or health care institution under
State law.
(11) Health care services.--The term ``health care
services'' means the provision of any goods or services by a
health care provider, or by any individual working under the
supervision of a health care provider, that relates to the
diagnosis, prevention, or treatment of any human disease or
impairment, or the assessment or care of the health of human
beings.
(12) Medical product.--The term ``medical product'' means a
drug, device, or biological product intended for humans, and
the terms ``drug'', ``device'', and ``biological product'' 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(g)(1)
and (h)) and section 351(a) of the Public Health Service Act
(42 U.S.C. 262(a)), respectively, including any component or
raw material used therein, but excluding health care services.
(13) 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 incurred as a result
of the provision or use of (or failure to provide or use)
health care services or medical products, unless otherwise
defined under applicable State law.
(14) 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.
(15) Relative.--The term ``relative'' means a victim's
spouse, parent, grandparent, stepfather, stepmother, child,
grandchild, brother, sister, half brother, half sister, or
spouse's parents. The term includes said relationships that are
created as a result of adoption.
(16) Representative.--The term ``representative'' means a
legal guardian, attorney, person designated to make decisions
on behalf of a patient under a medical power of attorney, or
any person recognized in law or custom as a patient's agent.
(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.
(18) Unanticipated outcome.--The term ``unanticipated
outcome'' means the outcome of a medical treatment or procedure
that differs from an expected result.
SEC. 14. EFFECT ON OTHER LAWS.
(a) Vaccine Injury.--
(1) 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 does 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) 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) Other Federal Law.--Except as provided in this section, nothing
in this Act shall be deemed to affect any defense available to a
defendant in a health care lawsuit or action under any other provision
of Federal law.
SEC. 15. RULES OF CONSTRUCTION.
(a) Health Care Lawsuits.--Unless otherwise specified in this Act,
the provisions governing health care lawsuits set forth in this Act
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, or mandates or permits subrogation
or a lien on collateral source benefits.
(b) Protection of States' Rights and Other Laws.--Any issue that is
not governed by any provision of law established by or under this Act
(including State standards of negligence) shall be governed by
otherwise applicable State or Federal law.
(c) State Flexibility.--No provision of this Act shall be construed
to preempt any defense available to a party in a health care lawsuit
under any other provision of State or Federal law.
SEC. 16. 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 the enactment of this Act shall be
governed by the applicable statute of limitations provisions in effect
at the time the cause of action accrued.
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