USC Subchapter III

USC Subchapter III
in effect

38 U.S.C. § 1721 Power to make rules and regulations

Rules and regulations prescribed under section 501(a) of this title shall include rules and regulations to promote good conduct on the part of persons who are receiving hospital, nursing home, and domiciliary care and medical services in Department facilities. The Secretary may prescribe in rules and regulations under such section limitations in connection with the furnishing of such care and services during a period of national emergency (other than a period of war or an emergency described in section 8111A of this title).

38 U.S.C. § 1722 Determination of inability to defray necessary expenses; income thresholds

(a) For the purposes of section 1710(a)(2)(G) of this title, a veteran shall be considered to be unable to defray the expenses of necessary care if—(1) the veteran is eligible to receive medical assistance under a State plan approved under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); (2) the veteran is in receipt of pension under section 1521 of this title; or (3) the veteran’s attributable income is not greater than the amount set forth in subsection (b). (b)(1) For purposes of subsection (a)(3), the income threshold for the calendar year beginning on January 1, 1990, is—(A) $17,240 in the case of a veteran with no dependents; and (B) $20,688 in the case of a veteran with one dependent, plus $1,150 for each additional dependent. (2) For a calendar year beginning after December 31, 1990, the amounts in effect for purposes of this subsection shall be the amounts in effect for the preceding calendar year as adjusted under subsection (c) of this section. (c) Effective on January 1 of each year, the amounts in effect under subsection (b) of this section shall be increased by the percentage by which the maximum rates of pension were increased under section 5312(a) of this title during the preceding calendar year. (d)(1) Notwithstanding the attributable income of a veteran, the Secretary may refuse to make a determination described in paragraph (2) of this subsection if the corpus of the estate of the veteran is such that under all the circumstances it is reasonable that some part of the corpus of the estate of the veteran be consumed for the veteran’s maintenance. (2) A determination described in this paragraph is a determination that for purposes of subsection (a)(3) of this section a veteran’s attributable income is not greater than the amount determined under subsection (b) of this section. (3) For the purposes of paragraph (1) of this subsection, the corpus of the estate of a veteran shall be determined in the same manner as the manner in which determinations are made of the corpus of the estates of persons under section 1522 of this title. (e)(1) In order to avoid a hardship to a veteran described in paragraph (2) of this subsection, the Secretary may deem the veteran to have an attributable income during the previous year not greater than the amount determined under subsection (b) of this section. (2) A veteran is described in this paragraph for the purposes of subsection (a) of this section if—(A) the veteran has an attributable income greater than the amount determined under subsection (b) of this section; and (B) the current projections of such veteran’s income for the current year are that the veteran’s income for such year will be substantially below the amount determined under subsection (b). (f) For purposes of this section:(1) The term “attributable income” means the income of a veteran for the most recent year for which information is available determined in the same manner as the manner in which a determination is made of the total amount of income by which the rate of pension for such veteran under section 1521 of this title would be reduced if such veteran were eligible for pension under that section. (2) The term “corpus of the estate of the veteran” includes the corpus of the estates of the veteran’s spouse and dependent children, if any. (3) The term “previous year” means the calendar year preceding the year in which the veteran applies for care or services under section 1710(a) of this title. (g) For the purposes of section 1724(c) of this title, the fact that a veteran is—(1) eligible to receive medical assistance under a State plan approved under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); (2) a veteran with a service-connected disability; or (3) in receipt of pension under any law administered by the Secretary, shall be accepted as sufficient evidence of such veteran’s inability to defray necessary expenses.

38 U.S.C. § 1722A Copayment for medications

(a)(1) Subject to paragraph (2), the Secretary shall require a veteran to pay the United States $2 for each 30-day supply of medication furnished such veteran under this chapter on an outpatient basis for the treatment of a non-service-connected disability or condition. If the amount supplied is less than a 30-day supply, the amount of the charge may not be reduced. (2) The Secretary may not require a veteran to pay an amount in excess of the cost to the Secretary for medication described in paragraph (1). (3) Paragraph (1) does not apply—(A) to a veteran with a service-connected disability rated 50 percent or more; (B) to a veteran who is a former prisoner of war; (C) to a veteran whose annual income (as determined under section 1503 of this title) does not exceed the maximum annual rate of pension which would be payable to such veteran if such veteran were eligible for pension under section 1521 of this title; or (D) to a veteran who was awarded the medal of honor under section 7271, 8291, or 9271 of title 10 or section 491 11 See References in Text note below. of title 14. (4) Paragraph (1) does not apply to opioid antagonists furnished under this chapter to a veteran who is at high risk for overdose of a specific medication or substance in order to reverse the effect of such an overdose. (b) The Secretary, pursuant to regulations which the Secretary shall prescribe, may—(1) increase the copayment amount in effect under subsection (a); and (2) establish a maximum monthly and a maximum annual pharmaceutical copayment amount under subsection (a) for veterans who have multiple outpatient prescriptions. (c) Amounts collected under this section shall be deposited in the Department of Veterans Affairs Medical Care Collections Fund.

38 U.S.C. § 1722B Copayments: waiver of collection of copayments for telehealth and telemedicine visits of veterans

The Secretary may waive the imposition or collection of copayments for telehealth and telemedicine visits of veterans under the laws administered by the Secretary.

38 U.S.C. § 1722C Copayments: prohibition on collection of copayments for first three mental health care outpatient visits of veterans

(a) Prohibition.—Except as provided in subsection (b), notwithstanding section 1710(g) of this title or any other provision of law, the Secretary may not impose or collect a copayment for the first three mental health care outpatient visits of a veteran in a calendar year for which the veteran would otherwise be required to pay a copayment under the laws administered by the Secretary. (b) Copayment for Medications.—The prohibition under subsection (a) shall not apply with respect to the imposition or collection of copayments for medications pursuant to section 1722A of this title. (c) Mental Health Care Outpatient Visit Defined.—In this section, the term “mental health care outpatient visit” means an outpatient visit with a qualified mental health professional for the primary purpose of seeking mental health care or treatment for substance abuse disorder. (d) Sunset.—This section shall terminate on the date that is five years after the date of the enactment of the Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act of 2022.

38 U.S.C. § 1723 Furnishing of clothing

The Secretary shall not furnish clothing to persons who are in Department facilities, except (1) where the furnishing of such clothing to indigent persons is necessary to protect health or sanitation, and (2) where the Secretary furnishes veterans with special clothing made necessary by the wearing of prosthetic appliances.

38 U.S.C. § 1724 Hospital care, medical services, and nursing home care abroad

(a) Except as provided in subsections (b), (c), and (f), the Secretary shall not furnish hospital or domiciliary care or medical services outside any State. (b)(1) The Secretary may furnish hospital care and medical services outside a State to a veteran who is otherwise eligible to receive hospital care and medical services if the Secretary determines that such care and services are needed for the treatment of a service-connected disability of the veteran or as part of a rehabilitation program under chapter 31 of this title. (2) Care and services for a service-connected disability of a veteran who is not a citizen of the United States may be furnished under this subsection only—(A) if the veteran is in the Republic of the Philippines or in Canada; or (B) if the Secretary determines, as a matter of discretion and pursuant to regulations which the Secretary shall prescribe, that it is appropriate and feasible to furnish such care and services. (c) Within the limits of those facilities of the Veterans Memorial Medical Center at Manila, Republic of the Philippines, for which the Secretary may contract, the Secretary may furnish necessary hospital care to a veteran for any non-service-connected disability if such veteran is unable to defray the expenses of necessary hospital care. The Secretary may enter into contracts to carry out this section. (d) The Secretary may furnish nursing home care, on the same terms and conditions set forth in section 1720(a) of this title, to any veteran who has been furnished hospital care in the Philippines pursuant to this section, but who requires a protracted period of nursing home care. (e) Within the limits of an outpatient clinic in the Republic of the Philippines that is under the direct jurisdiction of the Secretary, the Secretary may furnish a veteran who has a service-connected disability with such medical services as the Secretary determines to be needed. (f)(1)(A) The Secretary may furnish hospital care and medical services in the Freely Associated States, subject to agreements the Secretary shall enter into with the governments of the Freely Associated States as described in section 209(a)(4)(A) of the Compact of Free Association Amendments Act of 2024, and subject to subparagraph (B), to a veteran who is otherwise eligible to receive hospital care and medical services. (B) The agreements described in subparagraph (A) shall incorporate, to the extent practicable, the applicable laws of the Freely Associated States and define the care and services that can be legally provided by the Secretary in the Freely Associated States. (2) In furnishing hospital care and medical services under paragraph (1), the Secretary may furnish hospital care and medical services through—(A) contracts or other agreements; (B) reimbursement; or (C) the direct provision of care by health care personnel of the Department. (3) In furnishing hospital care and medical services under paragraph (1), the Secretary may furnish hospital care and medical services for any condition regardless of whether the condition is connected to the service of the veteran in the Armed Forces. (4)(A) A veteran who has received hospital care or medical services in a country pursuant to this subsection shall remain eligible, to the extent determined advisable and practicable by the Secretary, for hospital care or medical services in that country regardless of whether the country continues to qualify as a Freely Associated State for purposes of this subsection. (B) If the Secretary determines it is no longer advisable or practicable to allow veterans described in subparagraph (A) to remain eligible for hospital care or medical services pursuant to such subparagraph, the Secretary shall—(i) provide direct notice of that determination to such veterans; and (ii) publish that determination and the reasons for that determination in the Federal Register. (5) In this subsection, the term “Freely Associated States” means—(A) the Federated States of Micronesia, during such time as it is a party to the Compact of Free Association set forth in section 201 of the Compact of Free Association Act of 1985 (Public Law 99–239; 48 U.S.C. 1901 note); (B) the Republic of the Marshall Islands, during such time as it is a party to the Compact of Free Association set forth in section 201 of the Compact of Free Association Act of 1985 (Public Law 99–239; 48 U.S.C. 1901 note); and (C) the Republic of Palau, during such time as it is a party to the Compact of Free Association between the United States and the Government of Palau set forth in section 201 of Joint 11 So in original. Probably should be preceded by “the”. Resolution entitled “Joint Resolution to approve the ‘Compact of Free Association’ between the United States and the Government of Palau, and for other purposes” (Public Law 99–658; 48 U.S.C. 1931 note).

38 U.S.C. § 1725 Reimbursement for emergency treatment

(a) General Authority.—(1) Subject to subsections (c) and (d), the Secretary shall reimburse a veteran described in subsection (b) for the reasonable value of emergency treatment furnished the veteran in a non-Department facility. (2) In any case in which reimbursement is authorized under subsection (a)(1), the Secretary, in the Secretary’s discretion, may, in lieu of reimbursing the veteran, make payment of the reasonable value of the furnished emergency treatment directly—(A) to a hospital or other health care provider that furnished the treatment; or (B) to the person or organization that paid for such treatment on behalf of the veteran. (b) Eligibility.—(1) A veteran referred to in subsection (a)(1) is an individual who is an active Department health-care participant who is personally liable for emergency treatment furnished the veteran in a non-Department facility. (2) A veteran is an active Department health-care participant if—(A) the veteran is enrolled in the health care system established under section 1705(a) of this title; and (B) the veteran received care under this chapter within the 24-month period preceding the furnishing of such emergency treatment. (3) A veteran is personally liable for emergency treatment furnished the veteran in a non-Department facility if the veteran—(A) is financially liable to the provider of emergency treatment for that treatment; (B) has no entitlement to care or services under a health-plan contract (determined, in the case of a health-plan contract as defined in subsection (h)(2)(B) or (h)(2)(C), without regard to any requirement or limitation relating to eligibility for care or services from any department or agency of the United States); (C) has no other contractual or legal recourse against a third party that would, in whole, extinguish such liability to the provider; and (D) is not eligible for reimbursement for medical care or services under section 1728 of this title. (c) Limitations on Reimbursement.—(1) The Secretary, in accordance with regulations prescribed by the Secretary, shall—(A) establish the maximum amount payable under subsection (a); (B) delineate the circumstances under which such payments may be made, to include such requirements on requesting reimbursement as the Secretary shall establish; and (C) provide that in no event may a payment under that subsection include any amount for which the veteran is not personally liable. (2) Subject to paragraph (1), the Secretary may provide reimbursement under this section only after the veteran or the provider of emergency treatment has exhausted without success all claims and remedies reasonably available to the veteran or provider against a third party for payment of such treatment. (3) Payment by the Secretary under this section on behalf of a veteran to a provider of emergency treatment shall, unless rejected and refunded by the provider within 30 days of receipt, extinguish any liability on the part of the veteran for that treatment. Neither the absence of a contract or agreement between the Secretary and the provider nor any provision of a contract, agreement, or assignment to the contrary shall operate to modify, limit, or negate the requirement in the preceding sentence. (4)(A) If the veteran has contractual or legal recourse against a third party that would only, in part, extinguish the veteran’s liability to the provider of the emergency treatment, and payment for the treatment may be made both under subsection (a) and by the third party, the amount payable for such treatment under such subsection shall be the amount by which the costs for the emergency treatment exceed the amount payable or paid by the third party, except that the amount payable may not exceed the maximum amount payable established under paragraph (1)(A). (B) In any case in which a third party is financially responsible for part of the veteran’s emergency treatment expenses, the Secretary shall be the secondary payer. (C) A payment in the amount payable under subparagraph (A) shall be considered payment in full and shall extinguish the veteran’s liability to the provider. (D) The Secretary may not reimburse a veteran under this section for any copayment or similar payment that the veteran owes the third party or for which the veteran is responsible under a health-plan contract. (d) Independent Right of Recovery.—(1) In accordance with regulations prescribed by the Secretary, the United States shall have the independent right to recover any amount paid under this section when, and to the extent that, a third party subsequently makes a payment for the same emergency treatment. (2) Any amount paid by the United States to the veteran (or the veteran’s personal representative, successor, dependents, or survivors) or to any other person or organization paying for such treatment shall constitute a lien in favor of the United States against any recovery the payee subsequently receives from a third party for the same treatment. (3) Any amount paid by the United States to the provider that furnished the veteran’s emergency treatment shall constitute a lien against any subsequent amount the provider receives from a third party for the same emergency treatment for which the United States made payment. (4) The veteran (or the veteran’s personal representative, successor, dependents, or survivors) shall ensure that the Secretary is promptly notified of any payment received from any third party for emergency treatment furnished to the veteran. The veteran (or the veteran’s personal representative, successor, dependents, or survivors) shall immediately forward all documents relating to such payment, cooperate with the Secretary in the investigation of such payment, and assist the Secretary in enforcing the United States right to recover any payment made under subsection (c)(3). (e) Waiver.—The Secretary, in the Secretary’s discretion, may waive recovery of a payment made to a veteran under this section that is otherwise required by subsection (d)(1) when the Secretary determines that such waiver would be in the best interest of the United States, as defined by regulations prescribed by the Secretary. (f) Submittal of Claims for Direct Payment.—An individual or entity seeking payment under subsection (a)(2) for treatment provided to a veteran in lieu of reimbursement to the veteran shall submit a claim for such payment not later than 180 days after the latest date on which such treatment was provided. (g) Hold Harmless.—No veteran described in subsection (b) may be held liable for payment for emergency treatment described in such subsection if—(1) a claim for direct payment was submitted by an individual or entity under subsection (f); and (2) such claim was submitted after the deadline established by such subsection due to—(A) an administrative error made by the individual or entity, such as submission of the claim to the wrong Federal agency, under the wrong reimbursement authority (such as section 1728 of this title), or submission of the claim after the deadline; or (B) an administrative error made by the Department, such as misplacement of a paper claim or deletion of an electronic claim. (h) Definitions.—For purposes of this section:(1) The term “emergency treatment” means medical care or services furnished, in the judgment of the Secretary—(A) when Department or other Federal facilities are not feasibly available and an attempt to use them beforehand would not be reasonable; (B) when such care or services are rendered in a medical emergency of such nature that a prudent layperson reasonably expects that delay in seeking immediate medical attention would be hazardous to life or health; and (C) until—(i) such time as the veteran can be transferred safely to a Department facility or other Federal facility and such facility is capable of accepting such transfer; or (ii) such time as a Department facility or other Federal facility accepts such transfer if—(I) at the time the veteran could have been transferred safely to a Department facility or other Federal facility, no Department facility or other Federal facility agreed to accept such transfer; and (II) the non-Department facility in which such medical care or services was furnished made and documented reasonable attempts to transfer the veteran to a Department facility or other Federal facility. (2) The term “health-plan contract” includes any of the following:(A) An insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar arrangement under which health services for individuals are provided or the expenses of such services are paid. (B) An insurance program described in section 1811 of the Social Security Act (42 U.S.C. 1395c) or established by section 1831 of that Act (42 U.S.C. 1395j). (C) A State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.). (D) A workers’ compensation law or plan described in section 1729(a)(2)(A) of this title. (3) The term “third party” means any of the following:(A) A Federal entity. (B) A State or political subdivision of a State. (C) An employer or an employer’s insurance carrier. (D) An automobile accident reparations insurance carrier. (E) A person or entity obligated to provide, or to pay the expenses of, health services under a health-plan contract.

38 U.S.C. § 1725A Access to walk-in care

(a) Procedures To Ensure Access to Walk-In Care.—The Secretary shall develop procedures to ensure that eligible veterans are able to access walk-in care from qualifying non-Department entities or providers. (b) Eligible Veterans.—For purposes of this section, an eligible veteran is any individual who—(1) is enrolled in the health care system established under section 1705(a) of this title; and (2) has received care under this chapter within the 24-month period preceding the furnishing of walk-in care under this section. (c) Qualifying Non-Department Entities or Providers.—For purposes of this section, a qualifying non-Department entity or provider is a non-Department entity or provider that has entered into a contract, agreement, or other arrangement with the Secretary to furnish services under this section. (d) Federally-Qualified Health Centers.—Whenever practicable, the Secretary may use a Federally-qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1396d(l)(2)(B))) to carry out this section. (e) Continuity of Care.—The Secretary shall ensure continuity of care for those eligible veterans who receive walk-in care services under this section, including through the establishment of a mechanism to receive medical records from walk-in care providers and provide pertinent patient medical records to providers of walk-in care. (f) Copayments.—(1)(A) The Secretary may require an eligible veteran to pay the United States a copayment for each episode of hospital care or medical services provided under this section if the eligible veteran would be required to pay a copayment under this title. (B) An eligible veteran not required to pay a copayment under this title may access walk-in care without a copayment for the first two visits in a calendar year. For any additional visits, a copayment at an amount determined by the Secretary may be required. (C) An eligible veteran required to pay a copayment under this title may be required to pay a regular copayment for the first two walk-in care visits in a calendar year. For any additional visits, a higher copayment at an amount determined by the Secretary may be required. (2) After the first two episodes of care furnished to an eligible veteran under this section, the Secretary may adjust the copayment required of the veteran under this subsection based upon the priority group of enrollment of the eligible veteran, the number of episodes of care furnished to the eligible veteran during a year, and other factors the Secretary considers appropriate under this section. (3) The amount or amounts of the copayments required under this subsection shall be prescribed by the Secretary by rule. (4) Sections 8153(c) and 1703A(j) of this title shall not apply to this subsection. (g) Regulations.—Not later than 1 year after the date of the enactment of the Caring for Our Veterans Act of 2018, the Secretary shall promulgate regulations to carry out this section. (h) Walk-In Care Defined.—In this section, the term “walk-in care” means non-emergent care provided by a qualifying non-Department entity or provider that furnishes episodic care and not longitudinal management of conditions and is otherwise defined through regulations the Secretary shall promulgate.

38 U.S.C. § 1726 Reimbursement for loss of personal effects by natural disaster

The Secretary shall, under regulations which the Secretary shall prescribe, reimburse veterans in Department hospitals and domiciliaries for any loss of personal effects sustained by fire, earthquake, or other natural disaster while such effects were stored in designated locations in Department hospitals or domiciliaries.

38 U.S.C. § 1727 Persons eligible under prior law

Persons who have a status which would, under the laws in effect on December 31, 1957, entitle them to the medical services, hospital and domiciliary care, and other benefits, provided for in this chapter, but who do not meet the service requirements contained in this chapter, shall be entitled to such benefits notwithstanding failure to meet such service requirements.

38 U.S.C. § 1728 Reimbursement of certain medical expenses

(a) The Secretary shall, under such regulations as the Secretary prescribes, reimburse veterans eligible for hospital care or medical services under this chapter for the customary and usual charges of emergency treatment (including travel and incidental expenses under the terms and conditions set forth in section 111 of this title) for which such veterans have made payment, from sources other than the Department, where such emergency treatment was rendered to such veterans in need thereof for any of the following:(1) An adjudicated service-connected disability. (2) A non-service-connected disability associated with and held to be aggravating a service-connected disability. (3) Any disability of a veteran if the veteran has a total disability permanent in nature from a service-connected disability. (4) Any illness, injury, or dental condition of a veteran who—(A) is a participant in a vocational rehabilitation program (as defined in section 3101 of this title); and (B) is medically determined to have been in need of care or treatment to make possible the veteran’s entrance into a course of training, or prevent interruption of a course of training, or hasten the return to a course of training which was interrupted because of such illness, injury, or dental condition. (b) In any case where reimbursement would be in order under subsection (a) of this section, the Secretary may, in lieu of reimbursing such veteran, make payment of the reasonable value of emergency treatment directly—(1) to the hospital or other health facility furnishing the emergency treatment; or (2) to the person or organization making such expenditure on behalf of such veteran. (c) No veteran described in subsection (a) may be held liable for payment for emergency treatment described in such subsection if—(1) a claim for direct payment was submitted by an individual or entity under subsection (b)(2); and (2) such claim was submitted after a deadline established by the Secretary for purposes of this section due to—(A) an administrative error made by the individual or entity, such as submission of the claim to the wrong Federal agency or submission of the claim after the deadline; or (B) an administrative error made by the Department, such as misplacement of a paper claim or deletion of an electronic claim. (d) In this section, the term “emergency treatment” has the meaning given such term in section 1725(h)(1) of this title.

38 U.S.C. § 1729 Recovery by the United States of the cost of certain care and services

(a)(1) Subject to the provisions of this section, in any case in which the United States is required by law to furnish or pay for care or services under this chapter for a non-service-connected disability described in paragraph (2) of this subsection, the United States has the right to recover or collect from a third party the reasonable charges of care or services so furnished or paid for to the extent that the recipient or provider of the care or services would be eligible to receive payment for such care or services from such third party if the care or services had not been furnished or paid for by a department or agency of the United States. (2) Paragraph (1) of this subsection applies to a non-service-connected disability—(A) that is incurred incident to the individual’s employment and that is covered under a workers’ compensation law or plan that provides for payment for the cost of health care and services provided to the individual by reason of the disability; (B) that is incurred as the result of a motor vehicle accident to which applies a State law that requires the owners or operators of motor vehicles registered in that State to have in force automobile accident reparations insurance; (C) that is incurred as the result of a crime of personal violence that occurred in a State, or a political subdivision of a State, in which a person injured as the result of such a crime is entitled to receive health care and services at such State’s or subdivision’s expense for personal injuries suffered as the result of such crime; (D) that is incurred by an individual who is entitled to care (or payment of the expenses of care) under a health-plan contract; or (E) for which care and services are furnished under this chapter to a veteran who—(i) has a service-connected disability; and (ii) is entitled to care (or payment of the expenses of care) under a health-plan contract. (3) In the case of a health-plan contract that contains a requirement for payment of a deductible or copayment by the individual—(A) the individual’s not having paid such deductible or copayment with respect to care or services furnished under this chapter shall not preclude recovery or collection under this section; and (B) the amount that the United States may collect or recover under this section shall be reduced by the appropriate deductible or copayment amount, or both. (b)(1) As to the right provided in subsection (a) of this section, the United States shall be subrogated to any right or claim that the individual (or the individual’s personal representative, successor, dependents, or survivors) may have against a third party. (2)(A) In order to enforce any right or claim to which the United States is subrogated under paragraph (1) of this subsection, the United States may intervene or join in any action or proceeding brought by the individual (or the individual’s personal representative, successor, dependents, or survivors) against a third party. (B) The United States may institute and prosecute legal proceedings against the third party if—(i) an action or proceeding described in subparagraph (A) of this paragraph is not begun within 180 days after the first day on which care or services for which recovery is sought are furnished to the individual by the Secretary under this chapter; (ii) the United States has sent written notice by certified mail to the individual at the individual’s last-known address (or to the individual’s personal representative or successor) of the intention of the United States to institute such legal proceedings; and (iii) a period of 60 days has passed following the mailing of such notice. (C) A proceeding under subparagraph (B) of this paragraph may not be brought after the end of the six-year period beginning on the last day on which the care or services for which recovery is sought are furnished. (c)(1) The Secretary may compromise, settle, or waive any claim which the United States has under this section. (2)(A) The Secretary, after consultation with the Comptroller General of the United States, shall prescribe regulations for the purpose of determining reasonable charges for care or services under subsection (a)(1) of this section. Any determination of such charges shall be made in accordance with such regulations. (B) Such regulations shall provide that reasonable charges for care or services sought to be recovered or collected from a third-party liable under a health-plan contract may not exceed the amount that such third party demonstrates to the satisfaction of the Secretary it would pay for the care or services if provided by facilities (other than facilities of departments or agencies of the United States) in the same geographic area. (C) Not later than 45 days after the date on which the Secretary prescribes such regulations (or any amendment to such regulations), the Comptroller General shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives the Comptroller General’s comments on and recommendations regarding such regulations (or amendment). (d) Any contract or agreement into which the Secretary enters with a person under section 3718 of title 31 for collection services to recover indebtedness owed the United States under this section shall provide, with respect to such services, that such person is subject to sections 5701 and 7332 of this title. (e) An individual eligible for care or services under this chapter—(1) may not be denied such care or services by reason of this section; and (2) may not be required by reason of this section to make any copayment or deductible payment in order to receive such care. (f) No law of any State or of any political subdivision of a State, and no provision of any contract or other agreement, shall operate to prevent recovery or collection by the United States under this section or with respect to care or services furnished under section 1784 of this title. [(g) Repealed. Pub. L. 105–33, title VIII, § 8023(b)(4), Aug. 5, 1997, 111 Stat. 667.] (h)(1) Subject to paragraph (3) of this subsection, the Secretary shall make available medical records of an individual described in paragraph (2) of this subsection for inspection and review by representatives of the third party concerned for the sole purposes of permitting the third party to verify—(A) that the care or services for which recovery or collection is sought were furnished to the individual; and (B) that the provision of such care or services to the individual meets criteria generally applicable under the health-plan contract involved. (2) An individual described in this paragraph is an individual who is a beneficiary of a health-plan contract under which recovery or collection is sought under this section from the third party concerned for the cost of the care or services furnished to the individual. (3) Records shall be made available under this subsection under such conditions to protect the confidentiality of such records as the Secretary shall prescribe in regulations. (i) For purposes of this section—(1)(A) The term “health-plan contract” means an insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar arrangement, under which health services for individuals are provided or the expenses of such services are paid. (B) Such term does not include—(i) an insurance program described in section 1811 of the Social Security Act (42 U.S.C. 1395c) or established by section 1831 of such Act (42 U.S.C. 1395j); (ii) a State plan for medical assistance approved under title XIX of such Act (42 U.S.C. 1396 et seq.); (iii) a workers’ compensation law or plan described in subparagraph (A) of subsection (a)(2) of this section; or (iv) a program, plan, or policy under a law described in subparagraph (B) or (C) of such subsection. (2) The term “payment” includes reimbursement and indemnification. (3) The term “third party” means—(A) a State or political subdivision of a State; (B) an employer or an employer’s insurance carrier; (C) an automobile accident reparations insurance carrier; or (D) a person obligated to provide, or to pay the expenses of, health services under a health-plan contract.

38 U.S.C. § 1729A Department of Veterans Affairs Medical Care Collections Fund

(a) There is in the Treasury a fund to be known as the Department of Veterans Affairs Medical Care Collections Fund. (b) Amounts recovered or collected under any of the following provisions of law shall be deposited in the fund:(1) Section 1710(f) of this title. (2) Section 1710(g) of this title. (3) Section 1711 of this title. (4) Section 1722A of this title. (5) Section 1725 of this title. (6) Section 1729 of this title. (7) Section 1784 of this title. (8) Section 8165(a) of this title. (9) Section 113 of the Veterans Millennium Health Care and Benefits Act (Public Law 106–117; 38 U.S.C. 8111 note). (10) Public Law 87–693, popularly known as the “Federal Medical Care Recovery Act” (42 U.S.C. 2651 et seq.), to the extent that a recovery or collection under that law is based on medical care or services furnished under this chapter. (c)(1) Subject to the provisions of appropriations Acts, amounts in the fund shall be available, without fiscal year limitation, to the Secretary for the following purposes:(A) Furnishing medical care and services under this chapter, to be available during any fiscal year for the same purposes and subject to the same limitations (other than with respect to the period of availability for obligation) as apply to amounts appropriated from the general fund of the Treasury for that fiscal year for medical care. (B) Expenses of the Department for the identification, billing, auditing, and collection of amounts owed the United States by reason of medical care and services furnished under this chapter. (2) Amounts available under paragraph (1) may not be used for any purpose other than a purpose set forth in subparagraph (A) or (B) of that paragraph. (d) Of the total amount recovered or collected by the Department during a fiscal year under the provisions of law referred to in subsection (b) and made available from the fund, the Secretary shall make available to each Department health care facility of the Department an amount that bears the same ratio to the total amount so made available as the amount recovered or collected by such facility during that fiscal year under such provisions of law bears to such total amount recovered or collected during that fiscal year. The Secretary shall make available to each facility the entirety of the amount specified to be made available to such facility by the preceding sentence. (e) Amounts recovered or collected under the provisions of law referred to in subsection (b) shall be treated for the purposes of sections 251 and 252 of the Balanced Budget and Emergency Deficit Control Act of 1985 (2 U.S.C. 901, 902) as offsets to discretionary appropriations (rather than as offsets to direct spending) to the extent that such amounts are made available for expenditure in appropriations Acts for the purposes specified in subsection (c).

38 U.S.C. § 1729B Consolidated patient accounting centers

(a) In General.—Not later than five years after the date of the enactment of this section, the Secretary of Veterans Affairs shall establish not more than seven consolidated patient accounting centers for conducting industry-modeled regionalized billing and collection activities of the Department. (b) Functions.—The centers shall carry out the following functions:(1) Reengineer and integrate all business processes of the revenue cycle of the Department. (2) Standardize and coordinate all activities of the Department related to the revenue cycle for all health care services furnished to veterans for non-service-connected medical conditions. (3) Apply commercial industry standards for measures of access, timeliness, and performance metrics with respect to revenue enhancement of the Department. (4) Apply other requirements with respect to such revenue cycle improvement as the Secretary may specify.

38 U.S.C. § 1730 Community residential care

(a) Subject to this section and regulations to be prescribed by the Secretary under this section, the Secretary may assist a veteran by referring such veteran for placement in, and aiding such veteran in obtaining placement in, a community residential-care facility if—(1) at the time of initiating the assistance the Secretary—(A) is furnishing the veteran medical services on an outpatient basis or hospital, domiciliary, or nursing home care; or (B) has furnished the veteran such care or services within the preceding 12 months; and (2) placement of the veteran in a community residential-care facility is appropriate. (b)(1) The Secretary may not provide assistance under subsection (a) of this section with respect to a community residential-care facility unless such facility is approved by the Secretary for the purposes of this section. (2) The Secretary’s approval of a facility for the purposes of this section shall be based upon the Secretary’s determination, after inspection of the facility, that the facility meets the standards established in regulations prescribed under this section. Such standards shall include the following:(A) Health and safety criteria, including a requirement of compliance with applicable State laws and local ordinances relating to health and safety. (B) A requirement that the costs charged for care by a facility be reasonable, as determined by the Secretary, giving consideration to such factors as (i) the level of care, supervision, and other services to be provided, (ii) the cost of goods and services in the geographic area in which the facility is located, and (iii) comparability with other facilities in such area providing similar services. (C) Criteria for determining the resources that a facility needs in order to provide an appropriate level of services to veterans. (D) Such other criteria as the Secretary determines are appropriate to protect the welfare of veterans placed in a facility under this section. (3) Payment of the charges of a community residential-care facility for any care or service provided to a veteran whom the Secretary has referred to that facility under this section is not the responsibility of the United States or of the Department. (c)(1) In order to determine continued compliance by community residential-care facilities that have been approved under subsection (b) of this section with the standards established in regulations prescribed under this section, the Secretary shall provide for periodic inspection of such facilities. (2) If the Secretary determines that a facility is not in compliance with such standards, the Secretary (in accordance with regulations prescribed under this section)—(A) shall cease to refer veterans to such facility; and (B) may, with the permission of the veteran (or the person or entity authorized by law to give permission on behalf of the veteran), assist in removing a veteran from such fa­cility. Regulations prescribed to carry out this paragraph shall provide for reasonable notice and, upon request made on behalf of the facility, a hearing before any action authorized by this paragraph is taken. (d) The Secretary shall prescribe regulations to carry out this section. Such regulations shall include the standards required by subsection (b) of this section. (e)(1) To the extent possible, the Secretary shall make available each report of an inspection of a community residential-care facility under subsection (b)(2) or (c)(1) of this section to each Federal, State, and local agency charged with the responsibility of licensing or otherwise regulating or inspecting such facility. (2) The Secretary shall make the standards prescribed in regulations under subsection (d) of this section available to all Federal, State, and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting community residential-care facilities. (f) For the purpose of this section, the term “community residential-care facility” means a facility that provides room and board and such limited personal care for and supervision of residents as the Secretary determines, in accordance with regulations prescribed under this section, are necessary for the health, safety, and welfare of residents.

38 U.S.C. § 1730A Prohibition on collection of copayments from certain veterans

(a) Prohibition.—Notwithstanding subsections (f) and (g) of section 1710 and section 1722A(a) of this title or any other provision of law, the Secretary may not require a covered veteran to make any copayment for the receipt of hospital care or medical services under the laws administered by the Secretary. (b) Covered Veteran Defined.—In this section, the term “covered veteran” means a veteran who—(1) is catastrophically disabled, as defined by the Secretary; or (2) is an Indian or urban Indian (as those terms are defined in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603)).

38 U.S.C. § 1730B Access to State prescription drug monitoring programs

(a) Access to Programs.—(1) Any licensed health care provider or delegate of such a provider shall be considered an authorized recipient or user for the purpose of querying and receiving data from the national network of State-based prescription drug monitoring programs, or any individual State or regional prescription drug monitoring program, to support the safe and effective prescribing of controlled substances to covered patients. (2) Under the authority granted by paragraph (1)—(A) licensed health care providers or delegates of such providers shall query the national network of State-based prescription monitoring programs, or, if providing care in a State that does not participate in such national network, an individual State or regional prescription drug monitoring program, in accordance with applicable regulations and policies of the Veterans Health Administration; and (B) notwithstanding any general or specific provision of law, rule, or regulation of a State, no State may restrict the access of licensed health care providers or delegates of such providers from accessing that State’s prescription drug monitoring programs. (3) No State shall deny or revoke the license, registration, or certification of a licensed health care provider or delegate who otherwise meets that State’s qualifications for holding the license, registration, or certification on the basis that the licensed health care provider or delegate queried or received data, or attempted to query or receive data, from the national network of State-based prescription drug monitoring programs, or any individual State or regional prescription drug monitoring program, under this section. (b) Covered Patients.—For purposes of this section, a covered patient is a patient who—(1) receives a prescription for a controlled substance; and (2) is not receiving palliative care or enrolled in hospice care. (c) Definitions.—In this section:(1) The term “controlled substance” has the meaning given such term in section 102(6) of the Controlled Substances Act (21 U.S.C. 802(6)). (2) The term “delegate” means a person or automated system accessing the national network of State-based prescription monitoring programs, or any individual State or regional prescription drug monitoring program, at the direction or under the supervision of a licensed health care provider. (3) The term “licensed health care provider” means a health care provider employed by the Department who is licensed, certified, or registered within any State to fill or prescribe medications within the scope of his or her practice as a Department employee. (4) The term “national network of State-based prescription monitoring programs” means an interconnected nation-wide system that facilitates the transfer to State prescription drug monitoring program data across State lines. (5) The term “State” means a State, as defined in section 101(20) of this title, or a political subdivision of a State.

38 U.S.C. § 1730C Licensure of health care professionals providing treatment via telemedicine

(a) In General.—Notwithstanding any provision of law regarding the licensure of health care professionals, a covered health care professional may practice the health care profession of the health care professional at any location in any State or any of the Freely Associated States (as defined in section 1724(f) of this title), regardless of where the covered health care professional or the patient is located, if the covered health care professional is using telemedicine to provide treatment to an individual under this chapter. (b) Covered Health Care Professionals.—For purposes of this section, a covered health care professional is any of the following individuals:(1) A health care professional who—(A) is an employee of the Department appointed under section 7306, 7401, 7405, 7406, or 7408 of this title or under title 5; (B) is authorized by the Secretary to provide health care under this chapter; (C) is required to adhere to all standards for quality relating to the provision of health care in accordance with applicable policies of the Department; and (D)(i) has an active, current, full, and unrestricted license, registration, or certification in a State to practice the health care profession of the health care professional; or (ii) with respect to a health care profession listed under section 7402(b) of this title, has the qualifications for such profession as set forth by the Secretary. (2) A postgraduate health care employee who—(A) is appointed under section 7401(1), 7401(3), or 7405 of this title or title 5 for any category of personnel described in paragraph (1) or (3) of section 7401 of this title; (B) must obtain an active, current, full, and unrestricted license, registration, or certification or meet qualification standards set forth by the Secretary within a specified time frame; and (C) is under the clinical supervision of a health care professional described in paragraph (1); or (3) A health professions trainee who—(A) is appointed under section 7405 or 7406 of this title; and (B) is under the clinical supervision of a health care professional described in paragraph (1). (c) Property of Federal Government.—Subsection (a) shall apply to a covered health care professional providing treatment to a patient regardless of whether the covered health care professional or patient is located in a facility owned by the Federal Government during such treatment. (d) Relation to State Law.—(1) The provisions of this section shall supersede any provisions of the law of any State to the extent that such provision of State law are inconsistent with this section. (2) No State shall deny or revoke the license, registration, or certification of a covered health care professional who otherwise meets the qualifications of the State for holding the license, registration, or certification on the basis that the covered health care professional has engaged or intends to engage in activity covered by subsection (a). (e) Rule of Construction.—Nothing in this section may be construed to remove, limit, or otherwise affect any obligation of a covered health care professional under the Controlled Substances Act (21 U.S.C. 801 et seq.). (f) State Defined.—In this section, the term “State” means a State, as defined in section 101(20) of this title, or a political subdivision of a State.

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