House Passes Liability Reforms;
Senate Bill Introduced
March 14, 2003 - The House of Representatives March
13 passed medical liability reform legislation ("HEALTH
Act," H.R.
5) by a vote of 229 - 196. The base bill had been introduced
in February by Reps. Jim Greenwood (R-Pa.) and Christopher
Cox (R-Calif.). On March 12, in lieu of amendments recommended
by the Judiciary and Energy and Commerce committees, the Rules
Committee agreed to an amendment in the nature of a substitute,
which was offered by Energy and Commerce Committee Chairman
Billy Tauzin (R-La.) and Judiciary Chairman James Sensenbrenner
(R-Wisc.). The amendment was outlined in the Rules Committee
Report (H.
Rpt. 108-34).
The Tauzin/Sensenbrenner amendment maintains the key provisions
of the base bill, including a $250,000 cap on awards for non-economic
damages ("pain and suffering"). It sets punitive
awards at the greater of $250,000 or twice economic damages,
and allows defendants to introduce evidence of plaintiffs
receiving compensation for losses from outside sources (i.e.,
prevent double recoveries). The vote followed several months
of intensive advocacy efforts by the AAMC, American Medical
Association (AMA), American Hospital Association (AHA), many
physician specialty societies, the U.S. Chamber of Commerce,
insurers, and numerous other members of the healthcare community
in support of the legislation.
Under H.R. 5, courts may authorize the payment of certain
awards over time. It establishes a 3-year statute of limitations
and a "fair share" rule that allocates damages in
direct proportion to fault and limits contingency fees for
lawyers. Products meeting FDA requirements are exempt from
damages.
The legislation allows states to set their own cap on non-economic
damages, regardless of whether they exceed or fall below $250,000.
States could implement the cap before, during, or after enactment
of H.R. 5. The federal provisions would pre-empt certain state
laws unless the protections exceed those outlined in H.R.
5. The amendment added a "Sense of Congress" that
insurers be liable for damages when they disallow care that
is medically necessary and appropriate.
Democrats strongly opposed passage of H.R. 5, arguing that
it failed to hold medical device companies, HMOs, and drug
companies accountable. Several Democrats also criticized H.R.
5 for pre-empting or threatening states' patient rights laws.
Democratic Senators have suggested premium controls and increased
insurance regulation as more effective alternatives.
Sen. John Ensign (R-Nev.) March 12 introduced the Senate
version of the HEALTH Act (S.
607). Original cosponsors of S. 607 include Sens. Judd
Gregg (R-N.H.), Michael Enzi (R-Wyo.), Craig Thomas (R-Wyo.),
Jon Kyl (R-Ariz.), and George Voinovich (R-Ohio). The full
Senate has previously opposed the reforms outlined by the
HEALTH Act. Last year the House passed a version of liability
reform (H.R. 4600), but the legislation was never raised by
the Senate.
Information:
Christiane Mitchell, Senior Legislative Affairs Manager
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
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