House File 161 - Reprinted HOUSE FILE 161 BY COMMITTEE ON HEALTH AND HUMAN SERVICES (SUCCESSOR TO HF 102) (As Amended and Passed by the House February 8, 2023 ) A BILL FOR An Act relating to damage awards against health care providers, 1 creating a medical error task force, and including effective 2 date and applicability provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 HF 161 (3) 90 cm/ns

H.F. 161 DIVISION I 1 DAMAGE AWARDS AGAINST HEALTH CARE PROVIDERS 2 Section 1. Section 147.136A, subsection 1, paragraph b, 3 Code 2023, is amended to read as follows: 4 b. (1) “Noneconomic damages” means damages arising from 5 pain, suffering, inconvenience, physical impairment, mental 6 anguish, emotional pain and suffering, loss of chance, loss of 7 consortium, or any other nonpecuniary damages. 8 (2) “Noneconomic damages” does not include the loss of 9 dependent care, including the loss of child care, due to the 10 death of or severe injury to a spouse or parent who is the 11 primary caregiver of a child under the age of eighteen or a 12 disabled adult. Such damages shall be considered economic 13 damages. 14 Sec. 2. Section 147.136A, subsection 2, Code 2023, is 15 amended to read as follows: 16 2. The Subject to subsection 4, the total amount recoverable 17 in any civil action for noneconomic damages for personal injury 18 or death, whether in tort, contract, or otherwise, against a 19 health care provider shall be limited to two hundred fifty 20 thousand dollars for any occurrence resulting in injury or 21 death of a patient regardless of the number of plaintiffs, 22 derivative claims, theories of liability, or defendants in 23 the civil action, shall not exceed two hundred fifty thousand 24 dollars unless the jury determines that there is a substantial 25 or permanent loss or impairment of a bodily function, 26 substantial disfigurement, loss of pregnancy, or death, which 27 warrants a finding that imposition of such a limitation would 28 deprive the plaintiff of just compensation for the injuries 29 sustained , in which case the amount recoverable shall not 30 exceed one million dollars, or two million dollars if the civil 31 action includes a hospital as defined in section 135B.1 . 32 Sec. 3. Section 147.136A, Code 2023, is amended by adding 33 the following new subsection: 34 NEW SUBSECTION . 4. The limitations on damages contained 35 -1- HF 161 (3) 90 cm/ns 1/ 4

H.F. 161 in subsection 2 shall increase by two and one-tenth percent 1 on January 1, 2028, and each January 1 thereafter. In any 2 civil action described in this section, such limitations on 3 damages shall be the amount effective at the time of the 4 occurrence. The commissioner of insurance shall publish the 5 amount of the limitations on damages contained in this section 6 on the insurance division’s internet site and shall update the 7 published amount annually. 8 Sec. 4. Section 668A.1, subsection 2, paragraphs a and b, 9 Code 2023, are amended to read as follows: 10 a. If the answer or finding pursuant to subsection 1 , 11 paragraph “b” , is affirmative, or if the claim is against any 12 physician and surgeon, osteopathic physician and surgeon, 13 dentist, podiatric physician, optometrist, pharmacist, 14 chiropractor, physician assistant, or nurse, licensed under 15 chapter 147, or a hospital licensed under chapter 135B, arising 16 out of patient care, then the full amount of the punitive or 17 exemplary damages awarded shall be paid to the claimant. 18 b. If the answer or finding pursuant to subsection 1 , 19 paragraph “b” , is negative, and if the claim is not against 20 any physician and surgeon, osteopathic physician and surgeon, 21 dentist, podiatric physician, optometrist, pharmacist, 22 chiropractor, physician assistant, or nurse, licensed under 23 chapter 147, or a hospital licensed under chapter 135B, arising 24 out of patient care, then after payment of all applicable 25 costs and fees, an amount not to exceed twenty-five percent 26 of the punitive or exemplary damages awarded may be ordered 27 paid to the claimant, with the remainder of the award to be 28 ordered paid into a civil reparations trust fund administered 29 by the state court administrator. Funds placed in the civil 30 reparations trust shall be under the control and supervision of 31 the executive council, and shall be disbursed only for purposes 32 of indigent civil litigation programs or insurance assistance 33 programs. 34 Sec. 5. EFFECTIVE DATE. This division of this Act, being 35 -2- HF 161 (3) 90 cm/ns 2/ 4

H.F. 161 deemed of immediate importance, takes effect upon enactment. 1 Sec. 6. APPLICABILITY. This division of this Act applies to 2 causes of action accrued on or after the effective date of this 3 division of this Act. 4 DIVISION II 5 MEDICAL ERROR TASK FORCE 6 Sec. 7. MEDICAL ERROR TASK FORCE. 7 1. The department of health and human services shall 8 convene a task force to review medical error rates of licensed 9 physicians in this state and shall make recommendations to the 10 general assembly and the director of health and human services 11 including recommendations that address options for reducing 12 medical error rates, improvements in education and training 13 to minimize medical errors, and whether applicable penalties 14 for medical errors and physician licensure review measures are 15 sufficient. 16 2. a. The task force shall include all of the following 17 voting members: 18 (1) The director of health and human services, or the 19 director’s designee. 20 (2) The director of inspections and appeals, or the 21 director’s designee. 22 (3) The executive director of the board of medicine. 23 (4) The ombudsman. 24 (5) A representative of the Iowa medical society. 25 (6) A representative of the board of regents affiliated with 26 the university of Iowa hospitals and clinics. 27 (7) The commissioner of insurance, or the commissioner’s 28 designee. 29 (8) The attorney general, or the attorney general’s 30 designee. 31 b. The task force shall also include four members of the 32 general assembly serving as ex officio, nonvoting members, one 33 representative to be appointed by the speaker of the house of 34 representatives, one representative to be appointed by the 35 -3- HF 161 (3) 90 cm/ns 3/ 4

H.F. 161 minority leader of the house of representatives, one senator to 1 be appointed by the president of the senate after consultation 2 with the majority leader of the senate, and one senator to be 3 appointed by the minority leader of the senate. 4 c. The director of health and human services, or the 5 director’s designee, may add members to the task force as 6 necessary to complete the work of the task force. 7 3. The department of health and human services shall provide 8 administrative support to the task force. The director of 9 health and human services, or the director’s designee, shall 10 serve as chairperson of the task force, and shall schedule 11 meetings of the task force as necessary to complete the work 12 of the task force. 13 4. The task force shall dissolve upon submission of the 14 report to the general assembly and the director of health and 15 human services, but no later than January 8, 2024. 16 -4- HF 161 (3) 90 cm/ns 4/ 4