Summary: H.R.3084 — 99th Congress (1985-1986)All Information (Except Text)

There is one summary for H.R.3084. Bill summaries are authored by CRS.

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Introduced in House (07/25/1985)

Medical Offer and Recovery Act - Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act to provide for an alternative liability system for medical malpractice.

Prohibits an individual from bringing a civil action against a participating health care provider for a disease or injury arising from health care services provided pursuant to Medicare, Medicaid (title XIX of the Social Security Act), an armed forces' or veterans' health plan, the Federal employees' health benefits program, or any other participating health benefits plan, if such provider provides the individual with a timely written tender to pay compensation benefits in accordance with this Act. Allows the individual to serve the provider with a written request for arbitration if such provider fails to provide the individual with a written tender in a timely manner.

States that this Act does not foreclose civil actions for intentionally caused injuries.

Permits a health care provider to join an entity which is potentially liable for the injury. Provides that any disagreement between such entities regarding their share of costs shall be submitted to binding arbitration and such share shall be based on comparative fault. Sets forth provisions regarding the subrogation of parties.

States that the amount of compensation benefits payable for a personal injury shall be equal to the net economic loss resulting from such injury, plus attorney's fees. Defines "net economic loss."

Requires compensation benefits to be paid within 30 days after reasonable proof of the fact and amount of economic loss has been submitted to the initiating compensation obligor. Provides that if reasonable proof is supplied for only a portion of the net economic loss, and that portion totals $100 or more, the compensation for such portion shall be paid without regard to the remainder of the loss.

Sets a five year statute of limitations for claims under this Act.

Requires a compensation obligor who rejects a claim for compensation benefits to give the claimant prompt notice of the rejection and the reasons therefor.

Requires the disclosure of specified information, including: (1) the earnings of the injured individual; and (2) a copy of every written report concerning any medical treatment or examination of the injured individual in regard to the injury in question.

Allows the injured individual or compensation obligor to petition a court for an order for discovery, including the right to oral or written depositions. Allows the compensation obligor to petition a court for an order directing the individual to submit to a mental or physical examination by a physician.

Allows the injured individual or compensation obligor to apply to a court for a declaration as to the amount of compensation benefits owed.

Permits an obligation to pay compensation benefits to be discharged by a settlement or lump sum payment if the net economic loss is less than $5,000. Allows a settlement or lump sum payment where the net economic loss exceeds $5,000 if a court determines that such a settlement is fair to the injured individual.

Permits a court to enter a judgment declaring the compensation obligor liable for forseeable future treatment. Permits an agreement or judgment to be modified upon a finding that a material and substantial change of circumstances has occurred.

Requires a health care provider to participate in an assigned claims plan meeting the requirements of this Act in order to participate in the alternative liability program described in this Act. Permits entities within a State to organize and maintain an assigned claims plan. Provides that where such a plan is not established within a State, the Secretary of Health and Human Services shall establish and maintain such a plan for that State.

Provides that an injured individual entitled to compensation benefits may obtain such benefits through the assigned claims plan if the initiating compensation obligor is financially unable to fulfill its obligation. Directs the assigned claims plan to assign such claim to another member of the plan. Allows such assignee to seek payment from the initiating compensation obligor of 120 percent of the costs and expenses incurred in fulfilling such obligation.

Requires participating health care providers to submit written reports to appropriate health care licensing boards where the provider: (1) takes actions which adversely affects the clinical privileges of a health care professional; or (2) terminates or fails to renew a contract with a health care professional. States that such reports shall not be subject to discovery, except upon the request of the health care professional against whom the adverse action is taken. Precludes liability for damages for any entity transmitting such reports unless the information transmitted is false and the entity knows such information is false and acts with malice.

Requires physicians participating in the alternative liability program to obtain malpractice insurance.

Provides that the preceding provisions of this Act shall not apply to any personal injury occurring: (1) before January 1, 1988; or (2) in a State which has in effect an alternative medical liability law which meets specified requirements.