Since 2000, increased tension and conflict between patients, their insurers, the medical community and its insurers, trial lawyers, and victims’ rights groups have helped spawn a new movement in addressing medical malpractice: tort reform. In 2005 alone, more than 48 states introduced over 400 bills and modified or amended their laws to reflect the need to effect real change. More than half the states now limit damage awards and many have established limits on attorney fees. Moreover, almost all states now have two year statutes of limitation for standard claims, and have eliminated joint and several liability in malpractice law suits. At the federal level, Congress still struggled with the notion of federal legislation that would preempt all existing state laws governing medical malpractice lawsuits.