American Health Quality Act

American Health Quality Act - Declares that the Congress finds that health care liability systems impact on interstate commerce by contributing to the high cost of health care and premiums for malpractice and products liability insurance purchased by health care providers and producers.

Title I: Alternative Dispute Resolution Systems - Directs the Secretary of Health and Human Services to establish a program to make enhanced Medicaid (title XIX of the Social Security Act) bonus payments for a two-year period to eligible States that submit a plan for the development or implementation of alternative dispute resolution systems (ADRS) to resolve health care liability claims as an alternative to a judicial proceeding in a Federal or State court. Sets forth eligibility, approval, and review requirements for such program.

Directs the Agency for Health Care Policy and Research to make recommendations to the Secretary concerning such requirements.

Requires the Agency to appoint a panel of advisers to: (1) assist in developing criteria for an ADRS that States must meet to be eligible to receive enhanced payments and assist States in preparing applications; (2) as part of such criteria, assist States receiving enhanced payments in complying with data gathering and evaluation guidelines; (3) provide advice and assistance to representatives from State governments concerning the establishment of an ADRS; (4) develop qualification standards and assist States applying to be quality improvement States; (5) report, not later than four years after the approval of an application, to the Secretary and the appropriate congressional committees on States receiving enhanced payments; (6) recommend to such entities, not later than four years after enactment of this Act, on the feasibility of a mandated ADRS; and (7) report to such entities, not later than four years after approval of the first quality improvement State plan, concerning the reform of State health profession disciplinary boards or alternative quality assurance plans.

Directs the Secretary to establish a program to award grants to private entities for the establishment of demonstration alternative dispute resolution programs in the private sector. Sets forth application requirements for such program.

Requires the panel: (1) to provide assistance to such entities in designing and implementing an ADRS; and (2) report to the Agency, the Secretary, and the appropriate congressional committees with data collected on such systems, together with recommendations for improvements.

Authorizes appropriations for the demonstration programs for FY 1992 through 1996.

Amends the Social Security Act to revise certain Medicaid payment provisions to conform with enhanced payments made under this title.

Title II: Uniform Standards for Health Care Liability Claims - Establishes uniform rules for health care liability actions brought in any Federal or State court and any health care action resolved through an ADRS.

Establishes procedures for settlement offers, including the calculation of attorney fees.

Requires mandatory periodic payments of awards exceeding $100,000. Limits non-economic damages to $250,000. Mandates reductions in damages received by an individual, where other payments will be or have been made to compensate such individual. Limits attorney fees to 25 percent of the first $150,000 of any award or settlement and 15 percent of any additional amount in excess of $150,000.

Prohibits punitive damages from exceeding twice the award of compensatory damages. Allows a separate proceeding to decide if punitive damages are to be awarded or to decide the amount of such award. Requires that 50 percent of all awards of punitive damages resulting from health care liability actions be transferred to a State health care disciplinary trust fund to assist the State in the improvement of health care quality programs. Permits claimants pursuing punitive damages to collect reasonable attorney fees.

Declares that the liability of each defendant for non-economic damages shall be several only and shall not be joint.

Prohibits health care liability actions from being initiated after the expiration of the two-year period that begins on the date on which the alleged injury should reasonably have been discovered, but in no event later than four years after the date of the alleged occurrence of the injury. Provides an exception for minors.

Requires a higher standard of proof in obstetric cases where the physician delivering the baby has not provided prenatal services prior to delivery.

Prohibits punitive damages from being awarded against a manufacturer or product seller of a drug or device that caused a complaint, if the drug or device is in compliance with Food and Drug Administration approval processes.

Declares that this title supersedes any State law only to the extent that such law establishes higher payment limits, applies joint and several liability to all damages, permits the recovery of a greater amount of damages or the awarding of a greater amount of attorney fees, or establishes a longer period during which a health care liability claim may be initiated.

Title III: Health Care Injury Prevention - Directs the Secretary to establish a program to make enhanced Medicaid bonus payments for a two-year period to eligible States that submit a State plan for the development or implementation of a health care injury prevention program or an approved alternative. Sets forth eligibility and application requirements for States. Designates a State that receives enhanced payments as a quality improvement State.

Requires a quality improvement State to: (1) establish a Statewide health care injury prevention program; and (2) cooperate with Federal research efforts with respect to patient outcomes, clinical effectiveness and clinical practice guidelines.

Directs the Secretary to promulgate regulations that establish performance criteria for the health care practitioner disciplinary board of such State in performing its oversight functions concerning health care professionals. Requires the State to: (1) allocate certain fees for the conduct of disciplinary actions with respect to health care professionals; (2) ensure that the general public is represented on such board; (3) grant immunity to such board from liability; (4) include a continuing education requirement in performance criteria for physicians who have been disciplined by such board.

Title IV: Community Health Centers - Amends the Public Health Service Act to direct the Secretary to make a grant to an entity that represents recipients of assistance under provisions relating to migrant and community health centers to enable the entity to develop a business plan for, and to establish, a nationwide risk retention group as provided for in the Liability Risk Retention Act of 1986, and that meets other requirements. Allows the group to negotiate with other entities for the purpose of managing and administering the group, and for obtaining reinsurance. Requires the group to provide professional liability insurance, and other types of profitable insurance approved for issuance by the Secretary, to migrant and community health centers. Requires the centers, subject to exception, to become members of the group and purchase the group's insurance. Makes all professional staff members of the centers eligible to obtain the group's insurance.

Requires the group to engage outside experts in insurance, financing, and business to analyze and audit the group. Requires the experts to provide the group with an evaluation of the plan and group.

Requires the group to submit the plan and the evaluation to the Secretary. Directs the Secretary to permit implementation of the plan and operation of the group if it will result in an increase in the amount of funds available for use by community and migrant health centers and other entities receiving assistance under the specified provisions.

Authorizes appropriations for preparation of the plan, establishment of the group, and capitalization of the group. Requires assets remaining after dissolution of the group to be used by the Secretary to pay the remaining expenses of the group.

Authorizes appropriations to carry out specified provisions relating to migrant and community health centers.