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H.R. 4280 (108th): Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2004

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The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on May 12, 2004.

Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2004 - Sets forth provisions regulating lawsuits for health care liability claims concerning the provision of health care goods or services or any medical product affecting interstate commerce.

(Sec. 3) Sets a statute of limitations of three years after the date of manifestation of injury or one year after the claimant discovers the injury, or should have discovered the injury, whichever comes first, unless tolled on the basis of fraud, intentional concealment, or the presence of a foreign body in the injured person. Provides that lawsuits on behalf of minors under the age of six years must be commenced within three years of the manifestation of the injury or prior to their eighth birthday, whichever provides the longer period, with certain exceptions. (Sec. 4) Allows the recovery of unlimited economic damages. Limits noneconomic damages to $250,000. Prohibits the jury from being informed of such limit. Makes each party liable only for the amount of damages directly proportional to such party's percentage of responsibility. (Sec. 5) Requires court supervision over payment arrangements to protect against conflicts of interest that may reduce the amount of damages awarded that are actually paid to claimants. Allows the court to restrict the payment of attorney contingency fees. Limits the fees to a percentage based on the amount awarded. (Sec. 6) Allows: (1) any party to a lawsuit involving injury or wrongful death to introduce evidence of collateral source benefits; and (2) any opposing party to then introduce evidence of any amount paid or contributed to secure the right to such benefits. Prevents providers of such benefits from recovering any amount against the claimant or receiving any lien or credit against the claimant's recovery or from being equitably or legally subrogated to the right of the claimant in a health care lawsuit involving injury or wrongful death. (Sec. 7) Allows an award of punitive damages only if: (1) the claimant proves by clear and convincing evidence that the person acted with malicious intent to injure the claimant, or that such person deliberately failed to avoid unnecessary injury that such person knew the claimant was substantially certain to suffer; and (2) compensatory damages are awarded. Establishes procedural requirements for a claim for punitive damages. Enumerates the factors to be considered for an award of punitive damages, including the severity of harm caused by the conduct of the party, the duration of the conduct or any concealment of it, the profitability of the conduct, and any criminal penalties imposed. Limits punitive damages to the greater of $250,000 or two times the amount of economic damages awarded. Prohibits the jury from being informed of such limit. Prohibits a punitive damage award in a product liability suit against a manufacturer, distributor, or supplier of a medical product that has been approved by the Food and Drug Administration (FDA) or that is generally recognized among qualified experts as safe and effective pursuant FDA conditions. Provides exceptions if: (1) the trier of fact finds by clear and convincing evidence that the product is substantially out of compliance with applicable labeling or packaging regulations; (2) a person knowingly misrepresented or withheld from the FDA required information that is material and causally related to the harm suffered by the claimant; or (3) an illegal payment is made to an FDA official to secure approval of the medical product. Prohibits a product liability suit against a medical care provider who prescribes or dispenses such a medical product approved by the FDA.

(Sec. 8) Provides for periodic payments of future damage awards over $50,000.

(Sec. 10) Exempts civil actions brought for vaccine-related injuries from this act to the extent that they are covered by the Public Health Service Act.

(Sec. 11) Preempts State law to the extent that it prevents the application of any provision of law established by this Act, but does not: (1) preempt State law that provides greater protections for health care providers or organizations or that specifies particular damage limits; or (2) affect any defenses available to a party under any other provision of State or Federal law.

(Sec. 13) Expresses the sense of Congress that a health insurer should be liable for damages for harm caused when it makes a decision as to what care is medically necessary and appropriate.