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HAP and its allies are committed to improving the state's civil justice system by elevating awareness of key liability challenges and advocating for legal reform in our state and federal legislatures and in the courts. Creating even-handed laws and courts will benefit all Pennsylvanians by promoting a strong economic climate and helping to ensure access to health care, while at the same time delivering justice to those who have been harmed by others.

In response to longstanding concerns about Pennsylvania’s legal climate, The Hospital and Healthsystem Association of Pennsylvania (HAP) has joined with the state’s leading business and medical voices to form the Pennsylvania Coalition for Civil Justice Reform (PCCJR). A recent Chamber’s Institute for Legal Reform ranked Pennsylvania below 36 other states in terms of legal reform. The PCCJR mission is to improve the state’s civil justice system by elevating awareness of key challenges, advocating for legal reform in the legislature, and ensuring fairness in the courts.


At the federal level, HAP has supported comprehensive liability reform modeled after California’s successful Medical Injury Compensation Reform Act (MICRA). That legal reform framework ensures fair and efficient compensation for injured patients, improves communications between patients and health care providers, and ensures affordable and accessible liability insurance.

HAP supports legislation H.R. 548 / S. 527, the Health Care Safety Net Enhancement Act of 2017—to protect access to emergency services. The legislation, sponsored in the U.S. House by Congressman Charlie Dent (R, PA-15), extends liability protections under the Federal Tort Claims Act to emergency department and on-call physicians who are providing medical services pursuant to the Emergency Medical Treatment and Labor Act (EMTALA). This is the same liability coverage currently offered to health professionals who provide care at Community Health Centers and offer Medicaid services at free clinics.

In recent Congresses, HAP has also been supportive of the enactment of incremental steps to improve the liability climate:

  • H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA) included a provision, championed by Senator Pat Toomey (R, PA), clarifying that federal healthcare guidelines or regulations of federal health care policy which were not specifically designed to establish a legal standard should not be interpreted as creating a standard of care or duty of care for the purposes of determining medical negligence. Essentially, the provision ensures lawsuits could not be based solely on whether medical providers followed national guidelines created under our health laws.
  • The 21st Century Cures Act included liability language championed by Congressman Tim Murphy (R, PA-18) which provides liability protections for health care professional volunteers offering services at Community Health Centers. This common-sense policy will support the availability of trained professionals, and in particular, provide for greater access to mental health professionals.


HAP supports efforts to introduce legislation during the 2017-2018 state legislative session that would amend the Medical Care Availability and Reduction of Error (Mcare) Act to provide special liability protection for emergency physicians and emergency personnel by changing the standard of proof in judicial tort lawsuits from “preponderance of evidence” to “clear and convincing” evidence.

Last session, this legislation was introduced by Rep. Eli Evankovich (R-Westmoreland) and ensures that no physician or emergency personnel shall be held liable for any act, or failure to act, unless it is proven by clear and convincing evidence that the physician or healthcare provider’s actions were grossly negligent in that circumstance.  This new standard does not relieve the physician from providing quality care, but balances this responsibility with the amount of knowledge that they have of the patient’s health history.

HAP continues to support this effort and recognizes the critical and unique nature of emergency medicine and ensures that the “safety net” of emergency care remains available and accessible to all Pennsylvania citizens and visitors to our state.

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