NY State Senate Bill 2013-S2531

Senate Bill S2531

2013-2014 Legislative Session

Relates to the use of expert medical testimony and creates the health care courts pilot program; repealer

download bill text pdf

Archive: Last Bill Status - In Senate Committee Judiciary Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2014	referred to judiciary
Jan 18, 2013	referred to judiciary

2013-S2531 (ACTIVE) - Details

Current Committee:: Senate Judiciary
Law Section:: Civil Practice Law and Rules
Laws Affected:: Amd §3101, rpld sub (d) ¶ 1 sub¶ (ii), add Art 44-A §§4410 - 4417, CPLR; amd §6530, Ed L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S7159
2011-2012: S2349

2013-S2531 (ACTIVE) - Summary

Relates to the use of expert medical testimony; creates the health care courts pilot program; creates a new element of professional misconduct for providing expert witness testimony that is without reasonable medical foundation.

2013-S2531 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S2531

TITLE OF BILL:  An act to amend the civil practice law and rules and
the education law, in relation to the use of expert medical testimony;
to amend the civil practice law and rules, in relation to creating the
health care courts pilot program; and to repeal certain provisions of
the civil practice law and rules relating thereto

PURPOSE:  The purpose of the bill is to make revisions to the manner
by which medical liability claims are adjudicated

SUMMARY OF PROVISIONS:

Section one of the bill would amend the § 3101(d)(1)(i) of the Civil
Practice Law and Rules (CPLR) to remove the current provision
prohibiting the disclosure of the identity of a medical expert witness
who intends to testify in a medical liability action. This section
also provides that an individual may not serve as expert witness in an
action for medical, dental or podiatric malpractice unless such
individual is licensed to practice in the same profession, is engaged
in clinical practice or teaching and experienced in the care at issue,
and is board certified in the same speciality as the defendant if the
standard of care involves his or her speciality.

Section two replaces clause (ii) of paragraph 1 of subdivision (d) of
§ 3101 of the CPLR to require disclosure of the identity of any expert

testifying in an action for medical, dental or podiatric malpractice
case. Such disclosure shall be accompanied by a written report signed
by such expert. The report shall contain a complete statement of all
opinions to be expressed, the basis and reasons therefor; the data or
other information considered by such person in forming the opinions;
any exhibits to be used as a summary of or support for the opinions;
the qualifications of the person, including a list of all publications
authored by the person during the preceding ten years; the
compensation to be paid for the person's consideration of data or
other information and for his or her testimony; and a listing of any
other cases in which the person has testified as an expert at trial or
by oral deposition within the preceding four years. Additionally, this
bill requires a party to produce such expert for an examination before
trial (EBT), in accordance with Rule 3107 of the CPLR. Unless manifest
injustice would result, the court shall require that the party
noticing an oral deposition of such an expert witness pay such witness
a reasonable fee for time spent in attending such oral deposition.
Violation of these provisions shall preclude a party from offering
such expert's testimony at the trial of the action.

Section three of the bill creates a new Article 44-A of the CPLR to
establish a pilot program to authorize the Office of Court
Administration to set up specialized "medical courts" to adjudicate
medical liability actions within five counties across New York State.
Such courts would use specially trained judges and objective
independent medical expert witnesses, but would not otherwise
interfere with the statutory process for adjudicating an action for
medical, dental or podiatric malpractice.


Section four would amend section 6530 of the Education Law to create a
new element of professional misconduct for providing medical expert
witness testimony that is false or without reasonable medical
foundation.

Section five would establish an effective date ninety days from when
the bill is signed into law.

JUSTIFICATION:  The cost of medical liability insurance has risen
steadily over the last several years. Most New York physicians, who
were already paying enormously high liability premiums to begin with,
are now paying 30-47% more for liability insurance than they were in
2003. For many physician specialists practicing in the New York City
metropolitan area, the cost for such insurance over the last five
years has almost doubled. A recent report by the Center for Health
Workforce studies documented that many regions all across the state
have begun to see a considerable drop in the number of critically
needed surgical specialists, OB-GYNs and primary care physicians. A
significant factor is the high cost of liability insurance in New York
State.

One cause of the problem is the randomness by which verdicts in
medical liability lawsuits are reached. Numerous studies have
concluded that the civil justice system frequently produces awards to
plaintiffs in medical liability actions where there has been no
negligence and, conversely, results in no payment to the plaintiff
when there was in fact negligence. Often virtually the same facts will
produce an award in one case but a verdict for the defendant in
another. There is a lack of consistency in litigation outcome. As a
result, this has led to numerous settlements in medical liability
actions due to concern that the severity of an injury will result in a
jury verdict for the plaintiff even if no negligence has been
committed, with the effect that medical liability insurance costs are
driven up substantially.

This legislation would begin to take steps to facilitate a more
objective analysis of medical liability disputes. Like statutes
already passed in many other states in the country, this bill would
assure that an expert witness who testifies in a medical liability
action has a similar educational and treating background as the
defendant health care provider. (The bill would also remove a
provision that currently exists under New York law that prohibits the
disclosure of the identity of an expert witness who is to testify at a
medical liability trial.)  This rule applies to no other type of
action in New York State, and runs completely contrary to the whole
premise of modem jurisprudence which seeks the early and complete
exchange of information between litigants.

Moreover, this legislation would permit the creation of special courts
to hear medical malpractice cases in up to five counties. Such courts
would use specially trained judges who could call independent expert
witnesses to provide greater clarity to the jury regarding the
specific care that is the subject of the lawsuit. These courts hold
the promise of improving the reliability of the system of resolving
medical liability disputes, which could ultimately result in reducing
the cost of medical liability insurance for physicians and hospitals.


This bill would take important first steps to reduce the increasingly
unaffordable cost of medical liability insurance by better
facilitating an objective analysis of medical liability disputes
without limiting the ability of a plaintiff to bring an action or to
be compensated for negligent actions on the part of health care
providers.

LEGISLATIVE HISTORY:

S.2349 of 2011-12 S.4149-A/A.8066-A of 2007-2008 S.7159/A.6514 of
2009-2010

FISCAL IMPLICATIONS: Undetermined.

EFFECTIVE DATE:  This act shall take effect on the ninetieth day after
it shall have become a law.

2013-S2531 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2531

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 18, 2013
                               ___________

Introduced  by  Sen.  HANNON -- read twice and ordered printed, and when
  printed to be committed to the Committee on Judiciary

AN ACT to amend the civil practice law and rules and the education  law,
  in relation to the use of expert medical testimony; to amend the civil
  practice law and rules, in relation to creating the health care courts
  pilot  program; and to repeal certain provisions of the civil practice
  law and rules relating thereto

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Subparagraph  (i)  of  paragraph  1 of subdivision (d) of
section 3101 of the civil practice law and rules, as amended by  chapter
184 of the laws of 1988, is amended to read as follows:
  (i) Upon request, each party shall identify each person whom the party
expects  to  call  as  an  expert witness at trial and shall disclose in
reasonable detail the subject matter on which each expert is expected to
testify, the substance of the facts and opinions on which each expert is
expected to testify, the qualifications of each  expert  witness  and  a
summary of the grounds for each expert's opinion. However, where a party
for  good  cause  shown retains an expert an insufficient period of time
before the commencement of trial to give appropriate notice thereof, the
party shall not thereupon be precluded  from  introducing  the  expert's
testimony  at  the  trial  solely  on grounds of noncompliance with this
paragraph. In that instance, upon motion of any party, made before or at
trial, or on its own initiative, the court may make whatever  order  may
be  just.  In an action for medical, dental or podiatric malpractice, [a
party, in responding to a request, may omit the names of medical, dental
or podiatric experts but shall be required to disclose all other  infor-
mation  concerning such experts otherwise required by this paragraph] NO
INDIVIDUAL SHALL BE QUALIFIED TO TESTIFY AS  AN  EXPERT  WITNESS  UNLESS
SUCH  INDIVIDUAL  IS  A HEALTH CARE PROFESSIONAL WHO: (A) IS LICENSED TO
PRACTICE IN AT LEAST ONE STATE IN THE SAME PROFESSION AS THE  DEFENDANT;

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05785-01-3

S. 2531                             2

(B) IS ACTIVELY ENGAGED IN CLINICAL PRACTICE OR TEACHING AND EXPERIENCED
IN  THE  CARE  AT ISSUE; AND (C) IF THE DEFENDANT IS BOARD CERTIFIED AND
THE STANDARD OF CARE AT ISSUE INVOLVES HIS OR HER SPECIALTY, THE  EXPERT
MUST BE BOARD CERTIFIED IN THE SAME SPECIALTY.
  S  2.  Subparagraph  (ii) of paragraph 1 of subdivision (d) of section
3101 of the civil practice law and rules is REPEALED and a new  subpara-
graph (ii) is added to read as follows:
  (II) NOTWITHSTANDING ANY OTHER PROVISION OF THIS ARTICLE OR OF ARTICLE
THIRTY-TWO  OF  THIS CHAPTER, IN AN ACTION FOR MEDICAL, DENTAL OR PODIA-
TRIC MALPRACTICE, AT THE TIMES AND  IN  THE  SEQUENCE  DIRECTED  BY  THE
COURT,  SUCH  TIMES  TO  BE PRIOR TO THE SERVICE AND FILING OF A NOTE OF
ISSUE UNLESS THE COURT DIRECTS OTHERWISE  AND  PRESERVES  THE  RIGHT  OF
EVERY PARTY TO DEPOSE A PERSON WHOSE DISCLOSURE OCCURS SUBSEQUENT TO THE
FILING  OF  A  NOTE  OF  ISSUE,  EACH  PARTY SHALL DISCLOSE TO THE OTHER
PARTIES THE IDENTITY OF ANY PERSON WHO MAY BE USED AT TRIAL  TO  PROVIDE
EXPERT  TESTIMONY IN THE CASE AND EACH SUCH DISCLOSURE SHALL BE ACCOMPA-
NIED BY A WRITTEN REPORT PREPARED AND SIGNED BY SUCH PERSON. THE  REPORT
SHALL  CONTAIN  A COMPLETE STATEMENT OF ALL OPINIONS TO BE EXPRESSED AND
THE BASIS AND REASONS THEREFOR; THE DATA OR OTHER INFORMATION CONSIDERED
BY SUCH PERSON IN FORMING THE OPINIONS; ANY EXHIBITS TO  BE  USED  AS  A
SUMMARY  OF  OR  SUPPORT  FOR  THE  OPINIONS;  THE QUALIFICATIONS OF THE
PERSON, INCLUDING A LIST OF ALL  PUBLICATIONS  AUTHORED  BY  THE  PERSON
DURING  THE  PRECEDING  TEN  YEARS;  THE COMPENSATION TO BE PAID FOR THE
PERSON'S CONSIDERATION OF DATA OR OTHER INFORMATION AND FOR HIS  OR  HER
TESTIMONY;  AND  A  LISTING  OF  ANY OTHER CASES IN WHICH THE PERSON HAS
TESTIFIED AS AN EXPERT AT TRIAL OR BY ORAL DEPOSITION WITHIN THE PRECED-
ING FOUR YEARS. EACH PARTY SHALL BE REQUIRED TO PRODUCE EACH  PERSON  SO
IDENTIFIED BY SUCH PARTY AS AN EXPERT WITNESS, FOR EXAMINATION UPON ORAL
DEPOSITION  UPON  RECEIPT OF A NOTICE TO TAKE ORAL DEPOSITION IN ACCORD-
ANCE WITH RULE THIRTY-ONE HUNDRED SEVEN OF THIS ARTICLE. UNLESS MANIFEST
INJUSTICE WOULD RESULT, THE COURT SHALL REQUIRE THAT THE PARTY  NOTICING
AN  ORAL DEPOSITION OF SUCH AN EXPERT WITNESS PAY SUCH WITNESS A REASON-
ABLE FEE FOR TIME SPENT IN ATTENDING SUCH ORAL DEPOSITION. IF ANY  PARTY
FAILS  TO  IDENTIFY A PERSON AS AN EXPERT WITNESS IN ACCORDANCE WITH THE
PROVISIONS OF THIS SUBPARAGRAPH, OR IF  ANY  PARTY  FAILS  TO  MAKE  ANY
PERSON  IDENTIFIED  BY THE PARTY AS AN EXPERT WITNESS AVAILABLE FOR ORAL
DEPOSITION IN ACCORDANCE WITH THE PROVISIONS OF THIS SUBPARAGRAPH,  SUCH
PARTY  SHALL  BE  PRECLUDED FROM OFFERING SUCH EXPERT'S TESTIMONY AT THE
TRIAL OF THE ACTION.
  S 3. The civil practice law and rules is amended by adding a new arti-
cle 44-A to read as follows:
                              ARTICLE 44-A
                    HEALTH CARE COURTS PILOT PROGRAM
SECTION 4410. CREATION.
        4411. HEALTH CARE COURT JUDGES; SELECTION.
        4412. JUDICIAL TRAINING.
        4413. COURT APPOINTED MEDICAL EXPERTS.
        4414. PROCEDURE.
        4415. APPELLATE REVIEW.
        4416. REPORTS.
        4417. DISCLAIMER.
  S 4410. CREATION. THE OFFICE OF COURT ADMINISTRATION MAY SELECT UP  TO
FIVE  COUNTIES,  EACH WITHIN A SEPARATE JUDICIAL DISTRICT IN THIS STATE,
TO ESTABLISH SPECIALIZED HEALTH CARE COURTS WITHIN THE SUPREME COURT  OF
SUCH COUNTIES TO GOVERN CLAIMS FOR MEDICAL, DENTAL OR PODIATRIC MALPRAC-
TICE AS SET FORTH IN THIS SECTION. ONCE A SUPREME COURT WITHIN A PARTIC-

S. 2531                             3

ULAR  COUNTY  HAS  ESTABLISHED  A HEALTH CARE COURT AS SET FORTH IN THIS
SECTION, SUCH COURT SHALL  HAVE  EXCLUSIVE  JURISDICTION  OVER  ALL  THE
CLAIMS  FOR  MEDICAL, DENTAL OR PODIATRIC MALPRACTICE BROUGHT WITHIN THE
SUPREME COURT OF SUCH COUNTY.
  S  4411. HEALTH CARE COURT JUDGES; SELECTION. JUDGES SHALL BE SELECTED
TO SERVE IN THE HEALTH CARE COURT DIVISION FROM AMONG THOSE  JUDGES  WHO
ARE  ELECTED  OR  APPOINTED TO THE SUPREME COURT IN A COUNTY SELECTED TO
PARTICIPATE IN THE HEALTH CARE COURTS PILOT PROGRAM.   FOR THE  PURPOSES
OF THIS ARTICLE, "JUDGE" SHALL MEAN A JUDGE OF THE HEALTH CARE DIVISION.
  S  4412. JUDICIAL TRAINING. (A) UPON SELECTION OF A PARTICULAR SUPREME
COURT JUDGE TO HEAR CASES IN THE COUNTY'S HEALTH CARE COURT AND PRIOR TO
HEARING SUCH CASES,  EACH  JUDGE  SHALL  COMPLETE  A  JUDICIAL  TRAINING
PROGRAM  ON  THE  LAW  AND SCIENCE OF MEDICINE THAT MAY BE THE BASIS FOR
CASES FALLING UNDER THE JURISDICTION OF  THE  HEALTH  CARE  COURT.  SUCH
PROGRAM SHALL BE ADMINISTERED BY THE OFFICE OF COURT ADMINISTRATION.
  (B)  A  COMMITTEE  SHALL  BE  CREATED TO DEVELOP THE CURRICULUM OF THE
JUDICIAL TRAINING PROGRAM. A TASK FORCE  SHALL  BE  COORDINATED  BY  THE
OFFICE  OF  COURT  ADMINISTRATION AND SHALL INCLUDE EQUAL REPRESENTATION
FROM THE MEDICAL SOCIETY OF THE STATE OF NEW YORK AND THE NEW YORK STATE
BAR ASSOCIATION.
  (C) THE CURRICULUM TO BE CREATED PURSUANT TO SUBDIVISION (B)  OF  THIS
SECTION SHALL INCLUDE BOTH IN-CLASSROOM CLINICAL TRAINING AND AN INTERN-
SHIP.  THE  IN-CLASSROOM  CLINICAL TRAINING SHALL INCLUDE AT THE MINIMUM
THE FOLLOWING: AN OVERVIEW OF  THE  MAJOR  BODY  SYSTEMS,  PHARMACOLOGY,
COMMON DISEASE PATHOLOGY, ALTERNATIVE MEDICINE THERAPIES, AND THE EDUCA-
TION AND TRAINING REQUIRED FOR VARIOUS HEALTH PROFESSIONALS. THE INTERN-
SHIP  SHALL  PROVIDE JUDGES AN OPPORTUNITY TO FOLLOW A PRACTICING PHYSI-
CIAN AND OTHER  HEALTH  CARE  PROFESSIONALS  IN  DIFFERENT  HEALTH  CARE
SETTINGS.  THE TRAINING PROGRAM MAY ALSO INCLUDE A LEGAL COMPONENT WHICH
SHALL INCLUDE A REVIEW OF MEDICAL LEGAL ISSUES THAT MAY BE THE BASIS  OF
CASES FALLING UNDER THE JURISDICTION OF THE HEALTH CARE COURT.
  S  4413.  COURT  APPOINTED  MEDICAL EXPERTS. (A) THE HEALTH CARE COURT
SHALL MAINTAIN A LIST OF QUALIFIED MEDICAL EXPERTS WHO MAY  BE  UTILIZED
BY  THE  COURT TO PROVIDE INDEPENDENT EXPERT OPINIONS TO THE JUDGE. SUCH
EXPERTS MAY PROVIDE OPINIONS IN WRITING TO THE JUDGE OR MAY BE CALLED BY
THE JUDGE TO TESTIFY BEFORE THE COURT TO CLARIFY  OR  INTERPRET  MEDICAL
TESTIMONY OR EVIDENCE, OR FOR ANY OTHER PURPOSE THE JUDGE DEEMS RELEVANT
TO THE PROCEEDINGS.
  (B)  A  COURT APPOINTED MEDICAL EXPERT MUST MEET THE FOLLOWING MINIMUM
EXPERT WITNESS REQUIREMENTS:
  (1) HOLDS AN ACTIVE LICENSE IN THE SAME PROFESSION AS  THE  DEFENDANT.
IF  THE  DEFENDANT  IS  LICENSED TO PRACTICE MEDICINE IN THIS STATE, THE
EXPERT WITNESS MUST ALSO BE LICENSED TO PRACTICE MEDICINE IN THIS STATE;
  (2) IS TRAINED AND EXPERIENCED IN THE SAME  DISCIPLINE  OR  SCHOOL  OF
PRACTICE  AS  THE  DEFENDANT  AND  CAN DEMONSTRATE BY COMPETENT EVIDENCE
THAT, AS A RESULT OF TRAINING,  EDUCATION, KNOWLEDGE, AND EXPERIENCE  IN
THE  EVALUATION, DIAGNOSIS, AND TREATMENT OF THE DISEASE OR INJURY WHICH
IS THE SUBJECT MATTER OF THE LAWSUIT AGAINST THE DEFENDANT, THE INDIVID-
UAL WAS SUBSTANTIALLY FAMILIAR WITH THE APPLICABLE STANDARDS OF CARE AND
PRACTICE AS THEY RELATE TO THE ACT OR OMISSION WHICH IS THE  SUBJECT  OF
THE LAWSUIT ON THE DATE OF THE INCIDENT;
  (3)  IF THE DEFENDANT IS CERTIFIED BY A BOARD RECOGNIZED BY THE AMERI-
CAN BOARD OF MEDICAL SPECIALITIES OR THE  AMERICAN  OSTEOPATHIC  ASSOCI-
ATION,  THE  EXPERT  MUST  BE CERTIFIED IN THE SAME SPECIALTY BY A BOARD
RECOGNIZED BY THE AMERICAN BOARD OF MEDICAL SPECIALITIES OR THE AMERICAN
OSTEOPATHIC ASSOCIATION AND MUST HAVE ACKNOWLEDGED EXPERTISE AND  TRAIN-

S. 2531                             4

ING  DIRECTLY  RELATED TO THE PARTICULAR HEALTH CARE OR MATTER AT ISSUE;
AND
  (4)  WITHIN  FIVE  YEARS  OF THE DATE OF THE ALLEGED OCCURRENCE GIVING
RISE TO THE CLAIM, WAS IN ACTIVE MEDICAL PRACTICE IN THE SAME DISCIPLINE
OR SCHOOL OF PRACTICE AS THE DEFENDANT OR DEVOTED A SUBSTANTIAL  PORTION
OF  HIS TIME TEACHING AT AN ACCREDITED MEDICAL SCHOOL, OR IN UNIVERSITY-
BASED RESEARCH IN RELATION TO THE MEDICAL CARE AND TYPE OF TREATMENT  AT
ISSUE.
  (C)  A  COURT APPOINTED MEDICAL EXPERT SHALL HAVE NO FINANCIAL TIES OR
FAMILIAL RELATIONSHIP WITH ANY PARTY TO THE LAWSUIT, ANY  EXPERT  CALLED
TO TESTIFY, OR ANY ATTORNEY REPRESENTING ANY PARTY TO THE LAWSUIT.
  (D) THE COURT APPOINTED MEDICAL EXPERT SHALL HAVE NO EX PARTE COMMUNI-
CATIONS WITH ANY PARTY TO THE LAWSUIT, EXCEPT AS PERMITTED BY THE COURT.
  (E)  THE  PLAINTIFF  AND  DEFENDANT SHALL EQUALLY COMPENSATE THE COURT
APPOINTED MEDICAL EXPERT BASED ON THE PREVAILING FEE FOR MEDICAL EXPERTS
WITH SIMILAR QUALIFICATIONS.
  S 4414. PROCEDURE. CLAIMS ADJUDICATED THROUGH THE  HEALTH  CARE  COURT
SHALL  ADHERE  TO  THIS CHAPTER EXCEPT AS OTHERWISE PROVIDED FOR IN THIS
ARTICLE.
  S 4415. APPELLATE REVIEW. ANY PARTY TO AN  ACTION  IN  A  HEALTH  CARE
COURT  MAY AVAIL THEMSELVES OF ALL APPEAL RIGHTS THAT OTHERWISE WOULD BE
AVAILABLE UNDER THIS CHAPTER.
  S 4416. REPORTS. THE OFFICE OF COURT ADMINISTRATION  SHALL  SUBMIT  AN
ANNUAL REPORT TO THE SPEAKER OF THE ASSEMBLY, THE TEMPORARY PRESIDENT OF
THE  SENATE,  THE  MINORITY LEADER OF THE SENATE, THE MINORITY LEADER OF
THE ASSEMBLY AND THE GOVERNOR DESCRIBING THE FUNCTIONING OF  THE  HEALTH
CARE  COURTS,  INCLUDING  THE NUMBER OF DISPUTES HEARD BY THE COURTS AND
RECOMMENDATIONS FOR IMPROVING THE ABILITY  OF  SUCH  COURTS  TO  RESOLVE
CLAIMS INVOLVING MEDICAL, DENTAL OR PODIATRIC MALPRACTICE.
  S  4417.  DISCLAIMER.  NOTHING  IN  THIS ARTICLE SHALL BE CONSTRUED TO
REMOVE THE JURY AS THE ULTIMATE FINDER OF FACT IN AN ACTION FOR MEDICAL,
DENTAL OR PODIATRIC MALPRACTICE.
  S 4. Section 6530 of the education law is  amended  by  adding  a  new
subdivision 50 to read as follows:
  50.  PROVIDING  EXPERT  MEDICAL  TESTIMONY THAT IS FALSE OR COMPLETELY
WITHOUT REASONABLE MEDICAL FOUNDATION IN ANY ACTION FOR INJURY OR  DEATH
ARISING  OUT  OF  THE  PROVISION  OF  OR  FAILURE TO PROVIDE HEALTH CARE
SERVICES. AS USED IN THIS SUBDIVISION, TESTIMONY MAY BE CONSIDERED FALSE
OR COMPLETELY WITHOUT REASONABLE MEDICAL FOUNDATION IF  IT  WAS  WITHOUT
FOUNDATION IN ACCEPTED PEER REVIEWED SCIENCE-BASED MEDICAL RESEARCH.
  S  5.  This  act shall take effect on the ninetieth day after it shall
have become a law.

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