Rep. John Conyers (D-MI) and Energy & Commerce Ranking Member John Dingell (D-MI) introduced legislation that seeks to cut costs in part by requiring mediation of medical malpractice claims prior to court action and authorizing arbitration of disputes where state law allows it. HR 3359 is the latest bill in Congress directed at reforming the medical malpractice system in hopes of reigning in rising insurance rates and limiting recovery of punitive damages. The bill also would limit punitive damages awards to claims involving gross negligence, reckless indifference to life, or intentional acts, and require that savings achieved through the bill be used to reduce insurance premiums. According to the bill, participation in mediation would serve as a substitute for existing state mediation programs or contractual agreements between parties to submit malpractice cases to some form of alternative dispute resolution. The bill would direct states to provide claimants with the option to commence mediation either prior to or after the filing in court of a medical malpractice claim. It also would require new regulations from the Justice Department, in consultation with the Department of Health and Human Services, to guarantee that mediations are carried out in the fairest manner possible. The regulations would be designed to ensure that mediations conducted under the auspices of the bill were affordable, timely, fair, and "reasonably convenient" for the parties. Arbitration would also be authorized under the bill if state law allows. However, it declares that any determinations made in mediation or arbitration would not be binding on the parties. A confidentiality provision in the bill holds that all "statements, offers, and communications" would not be admissible in any subsequent proceedings related to the medical malpractice claim.