S.F. 2220 Section 1. Section 147.136A, subsection 1, paragraph b, 1 Code 2024, is amended to read as follows: 2 b. (1) “Noneconomic damages” means damages arising from 3 pain, suffering, inconvenience, physical impairment, mental 4 anguish, emotional pain and suffering, loss of chance, loss of 5 consortium, or any other nonpecuniary damages. 6 (2) “Noneconomic damages” does not include the loss of 7 dependent care, including the loss of child care, due to the 8 death of or severe injury to a spouse or parent who is the 9 primary caregiver of a child under the age of eighteen or a 10 disabled adult. Such damages shall be considered economic 11 damages. 12 Sec. 2. Section 147.136A, subsection 2, Code 2024, is 13 amended to read as follows: 14 2. Subject to subsection 4 , the The total amount recoverable 15 in any civil action for noneconomic damages for personal injury 16 or death, whether in tort, contract, or otherwise, against a 17 health care provider shall be limited to two hundred fifty 18 thousand dollars for any occurrence resulting in injury or 19 death of a patient regardless of the number of plaintiffs, 20 derivative claims, theories of liability, or defendants in 21 the civil action, shall not exceed two hundred fifty thousand 22 dollars unless the jury determines that there is a substantial 23 or permanent loss or impairment of a bodily function, 24 substantial disfigurement, loss of pregnancy, or death, which 25 warrants a finding that imposition of such a limitation would 26 deprive the plaintiff of just compensation for the injuries 27 sustained , in which case the amount recoverable shall not 28 exceed one million dollars, or two million dollars if the civil 29 action includes a hospital as defined in section 135B.1 . 30 Sec. 3. Section 147.136A, subsection 4, Code 2024, is 31 amended by striking the subsection. 32 Sec. 4. Section 668A.1, subsection 2, paragraphs a and b, 33 Code 2024, are amended to read as follows: 34 a. If the answer or finding pursuant to subsection 1 , 35 -1- LSB 6098XS (4) 90 cm/jh 1/ 3

S.F. 2220 paragraph “b” , is affirmative, or if the claim is against any 1 physician and surgeon, osteopathic physician and surgeon, 2 dentist, podiatric physician, optometrist, pharmacist, 3 chiropractor, physician assistant, or nurse, licensed under 4 chapter 147 , or a hospital licensed under chapter 135B , arising 5 out of patient care, or if the claim is part of a civil action 6 involving the operation of a commercial motor vehicle, then the 7 full amount of the punitive or exemplary damages awarded shall 8 be paid to the claimant. 9 b. If the answer or finding pursuant to subsection 1 , 10 paragraph “b” , is negative, and if the claim is not against 11 any physician and surgeon, osteopathic physician and surgeon, 12 dentist, podiatric physician, optometrist, pharmacist, 13 chiropractor, physician assistant, or nurse, licensed under 14 chapter 147 , or a hospital licensed under chapter 135B , 15 arising out of patient care, and if the claim is not part of 16 a civil action involving the operation of a commercial motor 17 vehicle, then after payment of all applicable costs and fees, 18 an amount not to exceed twenty-five percent of the punitive or 19 exemplary damages awarded may be ordered paid to the claimant, 20 with the remainder of the award to be ordered paid into a 21 civil reparations trust fund administered by the state court 22 administrator. Funds placed in the civil reparations trust 23 shall be under the control and supervision of the executive 24 council, and shall be disbursed only for purposes of indigent 25 civil litigation programs or insurance assistance programs. 26 EXPLANATION 27 The inclusion of this explanation does not constitute agreement with 28 the explanation’s substance by the members of the general assembly. 29 This bill relates to noneconomic, punitive, and exemplary 30 damage awards against health care providers. Under current 31 law, the damages for loss of dependent care due to death of 32 or severe injury to a spouse or parent who is the primary 33 caregiver are considered economic damages. The bill repeals 34 this provision and provides that economic damages do not 35 -2- LSB 6098XS (4) 90 cm/jh 2/ 3

S.F. 2220 include loss of dependent care. 1 Current law limits the amount of noneconomic damages 2 that a jury can award a plaintiff to $250,000, but provides 3 an exception for cases where a jury finds that there is 4 a substantial or permanent loss or impairment of a bodily 5 function, substantial disfigurement, loss of pregnancy, or 6 death in which case the limit is increased to $1 million, or $2 7 million if the action includes a hospital. The bill provides 8 that if the exception to the $250,000 cap applies, there is no 9 limit to the amount of noneconomic damages that may be awarded, 10 and removes loss of pregnancy as a qualifying exception. 11 Current law provides for a 2.1 percent annual increase in the 12 damages cap. The bill repeals this provision. 13 Under current law, punitive or exemplary damages may be 14 awarded if, by a preponderance of clear, convincing, and 15 satisfactory evidence, the conduct of the defendant from which 16 the claim arose constituted willful and wanton disregard for 17 the rights or safety of another. In cases involving a medical 18 provider or hospital and arising out of medical care, the full 19 amount of the award of punitive or exemplary damages shall be 20 paid to the claimant. Under the bill, in cases involving a 21 medical provider or hospital and arising out of medical care, 22 the amount of punitive and exemplary damages paid to a claimant 23 shall not exceed 25 percent, with the remainder awarded to 24 the civil reparations trust fund, unless the conduct of the 25 defendant was directed specifically at the claimant, or at the 26 person from which the claimant’s claim is derived. Funds in 27 the civil reparations trust are used for purposes of indigent 28 civil litigation programs or insurance assistance programs. 29 -3- LSB 6098XS (4) 90 cm/jh 3/ 3