Floor Packet Page No. 271                                                   

	
Amend CSHB 4, ARTICLE 10 as follows:                                         
	On page 54, line 19 through page 55, line 13, strike SECTION 
10.10 and substitute a new SECTION 10.10 to read as follows:
	SECTION 10.10.  Section 11.03, Medical Liability and 
Insurance Improvement Act (Article 4590i, Vernon's Texas Civil 
Statutes), is amended to read as follows:
	Sec. 11.03.  LIMIT ON DAMAGES.  [ALTERNATIVE PARTIAL LIMIT ON 
CIVIL LIABILITY].  [In the event that Section 11.02(a) of this 
subchapter is stricken from this subchapter or is otherwise 
invalidated by a method other than through legislative means, the 
following shall become effective:]  (a)  Except as provided in 
Subsections (b) and (c), in an action on a health care liability 
claim where final judgment is rendered against a physician or 
health care provider, the limit of civil liability of each 
physician or health care provider for noneconomic damages shall be 
limited to an amount not to exceed $250,000.
	(b)  The limitation set forth in subsection (a) of this 
section shall not apply to a health care liability claim against a 
physician or health care provider if that physician or health care 
provider:
		(1)  was impaired by alcohol or drugs during the time 
relevant to the health liability claim;
		(2)  was disciplined or reprimanded by the Texas State 
Board of Medical Examiners for alcohol or drug abuse with five years 
of the relevant health care liability claim;
		(3)  has paid or caused to be paid, by way of judgment or 
settlement, compensation in two or more health care liability 
claims in the twelve months preceding the filing of the relevant 
health care liability claim; or
		(4)  has paid or caused to be paid, by way of judgment or 
settlement, compensation in ten or more health care liability 
claims.
	(c)  The limitation set forth in Subsection (a) does not apply 
to a health care liability claim against a hospital that has paid a 
criminal penalty or fine of civil fine or settlement relating to 
Medicare or Medicaid fraud within five years of the incident giving 
rise to the relevant health care liability claim.