Text: H.R.6183 — 102nd Congress (1991-1992)All Information (Except Text)

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--H.R.6183--
H.R.6183
One Hundred Second Congress of the United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Friday, the third day of January,
one thousand nine hundred and ninety-two
An Act
To amend the Public Health Service Act to provide protections from legal
liability for certain health care professionals providing services pursuant
to such Act.
  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 `Federally Supported Health Centers Assistance
  Act of 1992'.
SEC. 2. LIABILITY PROTECTIONS FOR CERTAIN HEALTH CARE PROFESSIONALS.
  (a) IN GENERAL- Section 224 of the Public Health Service Act (42 U.S.C. 233)
  is amended by adding at the end the following new subsection:
  `(g)(1) For purposes of this section, an entity described in paragraph
  (4) and any officer, employee, or contractor (subject to paragraph (5))
  of such an entity who is a physician or other licensed or certified health
  care practitioner shall be deemed to be an employee of the Public Health
  Service for a calendar year that begins during a fiscal year for which a
  transfer of the full amount estimated under subsection (k)(1)(A) was made
  under subsection (k)(3) (subject to paragraph (3)). The remedy against the
  United States for an entity described in paragraph (4) and any officer,
  employee, or contractor (subject to paragraph (5)) of such an entity who
  is deemed to be an employee of the Public Health Service pursuant to this
  paragraph shall be exclusive of any other civil action or proceeding to the
  same extent as the remedy against the United States is exclusive pursuant
  to subsection (a).
  `(2) If, with respect to an entity or person deemed to be an employee for
  purposes of paragraph (1), a cause of action is instituted against the
  United States pursuant to this section, any claim of the entity or person
  for benefits under an insurance policy with respect to medical malpractice
  relating to such cause of action shall be subrogated to the United States.
  `(3) This subsection shall apply with respect to a cause of action arising
  from an act or omission which occurs on or after January 1, 1993. This
  subsection shall not apply with respect to a cause of action arising from
  an act or omission which occurs on or after January 1, 1996.
  `(4) An entity described in this paragraph is a public or non-profit private
  entity receiving Federal funds under any of the following grant programs:
  `(A) Section 329 (relating to grants for migrant health centers).
  `(B) Section 330 (relating to grants for community health centers).
  `(C) Section 340 (relating to grants for health services for the homeless).
  `(D) Section 340A (relating to grants for health services for residents
  of public housing).
  `(5) For purposes of paragraph (1), an individual may be considered a
  contractor of an entity described in paragraph (4) only if--
  `(A) the individual normally performs on average at least 32 1/2  hours
  of service per week for the entity for the period of the contract; or
  `(B) in the case of an individual who normally performs on average less
  than 32 1/2  hours of services per week for the entity for the period of the
  contract and is a licensed or certified provider of obstetrical services--
  `(i) the individual's medical malpractice liability insurance coverage
  does not extend to services performed by the individual for the entity
  under the contract, or
  `(ii) the Secretary finds that patients to whom the entity furnishes
  services will be deprived of obstetrical services if such individual is
  not considered a contractor of the entity for purposes of paragraph (1).'.
  (b) REQUIREMENT OF APPROPRIATE POLICIES AND PROCEDURES REGARDING HEALTH
  CARE PROFESSIONALS- Section 224 of the Public Health Service Act, as
  amended by subsection (a), is further amended by adding at the end the
  following new subsection:
  `(h) Notwithstanding subsection (g)(1), the Secretary, in consultation
  with the Attorney General, may not deem an entity described in subsection
  (g)(4) to be an employee of the Public Health Service Act for purposes of
  this section unless the entity--
  `(1) has implemented appropriate policies and procedures to reduce the
  risk of malpractice and the risk of lawsuits arising out of any health or
  health-related functions performed by the entity;
  `(2) has reviewed and verified the professional credentials, references,
  claims history, fitness, professional review organization findings, and
  license status of its physicians and other licensed or certified health
  care practitioners, and, where necessary, has obtained the permission from
  these individuals to gain access to this information;
  `(3) has no history of claims having been filed against the United States as
  a result of the application of this section to the entity or its officers,
  employees, or contractors as provided for under this section, or, if such a
  history exists, has fully cooperated with the Attorney General in defending
  against any such claims and either has taken, or will take, any necessary
  corrective steps to assure against such claims in the future; and
  `(4) has fully cooperated with the Attorney General in providing information
  relating to an estimate described under subsection (k).'.
  (c) AUTHORIZATION FOR THE ATTORNEY GENERAL TO EXCLUDE CERTAIN HEALTH CARE
  PROFESSIONALS FROM COVERAGE- Section 224 of the Public Health Service Act,
  as amended by subsections (a) and (b), is further amended by adding at
  the end the following new subsection:
  `(i)(1) Notwithstanding subsection (g)(1), the Attorney General, in
  consultation with the Secretary, may determine, after notice and opportunity
  for a hearing, that an individual physician or other licensed or certified
  health care practitioner who is an officer, employee, or contractor of
  an entity described in subsection (g)(4) shall not be deemed to be an
  employee of the Public Health Service for purposes of this section, if
  treating such individual as such an employee would expose the Government
  to an unreasonably high degree of risk of loss because such individual--
  `(A) does not comply with the policies and procedures that the entity has
  implemented pursuant to subsection (h)(1);
  `(B) has a history of claims filed against him or her as provided for
  under this section that is outside the norm for licensed or certified
  health care practitioners within the same specialty;
  `(C) refused to reasonably cooperate with the Attorney General in defending
  against any such claim;
  `(D) provided false information relevant to the individual's performance of
  his or her duties to the Secretary, the Attorney General, or an applicant
  for or recipient of funds under this Act; or
  `(E) was the subject of disciplinary action taken by a State medical
  licensing authority or a State or national professional society.
  `(2) A final determination by the Attorney General under this subsection
  that an individual physician or other licensed or certified health care
  professional shall not be deemed to be an employee of the Public Health
  Service shall be effective upon receipt by the entity employing such
  individual of notice of such determination, and shall apply only to acts
  or omissions occurring after the date such notice is received.'.
SEC. 3. HOSPITAL ADMITTING PRIVILEGES FOR CERTAIN HEALTH CARE PROVIDERS.
  Section 224 of the Public Health Service Act, as amended by section 2,
  is further amended by adding at the end the following new subsection:
  `(j) In the case of a health care provider who is an officer, employee,
  or contractor of an entity described in subsection (g)(4), section 335(e)
  shall apply with respect to the provider to the same extent and in the
  same manner as such section applies to any member of the National Health
  Service Corps.'.
SEC. 4. PAYMENT OF JUDGMENTS.
  Section 224 of the Public Health Service Act, as amended by sections 2
  and 3, is further amended by adding at the end the following new subsection:
  `(k)(1)(A) For each of the fiscal years 1993, 1994, and 1995, the Attorney
  General, in consultation with the Secretary, shall estimate by the beginning
  of the year (except that an estimate shall be made for fiscal year 1993
  by December 31, 1992, subject to an adjustment within 90 days thereafter)
  the amount of all claims which are expected to arise under this section
  (together with related fees and expenses of witnesses) for which payment
  is expected to be made in accordance with section 1346 and chapter 171
  of title 28, United States Code, from the acts or omissions, during the
  calendar year that begins during that fiscal year, of entities described
  in subsection (g)(4) and of officers, employees, or contractors (subject
  to subsection (g)(5)) of such entities.
  `(B) The estimate under subparagraph (A) shall take into account--
  `(i) the value and frequency of all claims for damage for personal injury,
  including death, resulting from the performance of medical, surgical,
  dental, or related functions by entities described in subsection (g)(4)
  or by officers, employees, or contractors (subject to subsection (g)(5))
  of such entities who are deemed to be employees of the Public Health Service
  under subsection (g)(1) that, during the preceding 5-year period, are filed
  under this section or, with respect to years occurring before this subsection
  takes effect, are filed against persons other than the United States,
  `(ii) the amounts paid during that 5-year period on all claims described in
  clause (i), regardless of when such claims were filed, adjusted to reflect
  payments which would not be permitted under section 1346 and chapter 171
  of title 28, United States Code, and
  `(iii) amounts in the fund established under paragraph (2) but unspent
  from prior fiscal years.
  `(2) Subject to appropriations, for each of the fiscal years 1993, 1994,
  and 1995, the Secretary shall establish a fund of an amount equal to the
  amount estimated under paragraph (1) that is attributable to entities
  receiving funds under each of the grant programs described in paragraph
  (4) of subsection (g), but not to exceed a total of $30,000,000 for each
  such fiscal year.
  `(3) In order for payments to be made for judgments against the United
  States (together with related fees and expenses of witnesses) pursuant to
  this section arising from the acts or omissions of entities described in
  subsection (g)(4) and of officers, employees, or contractors (subject to
  subsection (g)(5)) of such entities, the total amount contained within the
  fund established by the Secretary under paragraph (2) for a fiscal year
  shall be transferred not later than the December 31 that occurs during
  the fiscal year to the appropriate accounts in the Treasury.'.
SEC. 5. REPORT ON RISK EXPOSURE OF COVERED ENTITIES.
  (a) IN GENERAL- Not later than April 1, 1995, the Attorney General, in
  consultation with the Secretary of Health and Human Services (hereafter
  referred to as the `Secretary'), shall submit a report to Congress on the
  medical malpractice liability claims experience of entities subject to
  section 224(g) of the Public Health Service Act (as added by section 2(a))
  and the risk exposure associated with such entities.
  (b) EFFECT OF LIABILITY PROTECTIONS ON COSTS INCURRED BY COVERED ENTITIES-
  The Attorney General's report under subsection (a) shall include an analysis
  by the Secretary comparing--
  (1) the Secretary's estimate of the aggregate amounts that such entities
  (together with the officers, employees, and contractors of such entities who
  are subject to section 224(g) of such Act) would have directly or indirectly
  paid to obtain medical malpractice liability insurance coverage had section
  224(g) of the Public Health Service Act not been enacted into law, with
  (2) the aggregate amounts by which the grants received by such entities
  under the Public Health Service Act were reduced as a result of the
  enactment of section 224(k)(2) of such Act.
SEC. 6. EFFECTIVE DATE.
  The amendments made by this Act shall take effect on the date of the
  enactment of this Act.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.