§1703. Contracts for hospital care and medical services in non-Department facilities

(a) When Department facilities are not capable of furnishing economical hospital care or medical services because of geographical inaccessibility or are not capable of furnishing the care or services required, the Secretary, as authorized in section 1710 of this title, may contract with non-Department facilities in order to furnish any of the following:

(1) Hospital care or medical services to a veteran for the treatment of-

(A) a service-connected disability;

(B) a disability for which a veteran was discharged or released from the active military, naval, or air service; or

(C) a disability of a veteran who has a total disability permanent in nature from a service-connected disability.

(2) Medical services for the treatment of any disability of-

(A) a veteran described in section 1710(a)(1)(B) of this title;

(B) a veteran who (i) has been furnished hospital care, nursing home care, domiciliary care, or medical services, and (ii) requires medical services to complete treatment incident to such care or services; or

(C) a veteran described in section 1710(a)(2)(E) of this title, or a veteran who is in receipt of increased pension, or additional compensation or allowances based on the need of regular aid and attendance or by reason of being permanently housebound (or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance), if the Secretary has determined, based on an examination by a physician employed by the Department (or, in areas where no such physician is available, by a physician carrying out such function under a contract or fee arrangement), that the medical condition of such veteran precludes appropriate treatment in Department facilities.

(3) Hospital care or medical services for the treatment of medical emergencies which pose a serious threat to the life or health of a veteran receiving medical services in a Department facility or nursing home care under section 1720 of this title until such time following the furnishing of care in the non-Department facility as the veteran can be safely transferred to a Department facility.

(4) Hospital care for women veterans.

(5) Hospital care, or medical services that will obviate the need for hospital admission, for veterans in a State (other than the Commonwealth of Puerto Rico) not contiguous to the contiguous States, except that the annually determined hospital patient load and incidence of the furnishing of medical services to veterans hospitalized or treated at the expense of the Department in Government and non-Department facilities in each such noncontiguous State shall be consistent with the patient load or incidence of the furnishing of medical services for veterans hospitalized or treated by the Department within the 48 contiguous States and the Commonwealth of Puerto Rico.

(6) Diagnostic services necessary for determination of eligibility for, or of the appropriate course of treatment in connection with, furnishing medical services at independent Department out-patient clinics to obviate the need for hospital admission.

(7) Outpatient dental services and treatment, and related dental appliances, for a veteran described in section 1712(a)(1)(F) of this title.

(8) Diagnostic services (on an inpatient or outpatient basis) for observation or examination of a person to determine eligibility for a benefit or service under laws administered by the Secretary.

(b) In the case of any veteran for whom the Secretary contracts to furnish care or services in a non-Department facility pursuant to a provision of subsection (a) of this section, the Secretary shall periodically review the necessity for continuing such contractual arrangement pursuant to such provision.

(c) The Secretary shall include in the budget documents which the Secretary submits to Congress for any fiscal year a detailed report on the furnishing of contract care and services during the most recently completed fiscal year under this section, sections 1712A, 1720, 1720A, 1724, and 1732 of this title, and section 115 of the Veterans' Benefits and Services Act of 1988 (Public Law 100–322; 102 Stat. 501).

(Added Pub. L. 99–272, title XIX, §19012(b)(1), Apr. 7, 1986, 100 Stat. 380 , §603; amended Pub. L. 99–166, title I, §102(b)(1), Dec. 3, 1985, 99 Stat. 943 ; Pub. L. 99–272, title XIX, §19012(c)(5)(A), Apr. 7, 1986, 100 Stat. 382 ; Pub. L. 100–322, title I, §§101(e)(3), 104, 112(a), May 20, 1988, 102 Stat. 492 , 493, 499; Pub. L. 100–687, div. B, title XV, §1503(a)(1), Nov. 18, 1988, 102 Stat. 4133 ; Pub. L. 102–54, §14(b)(9), June 13, 1991, 105 Stat. 283 ; renumbered §1703 and amended Pub. L. 102–83, §§4(a)(1), (3)–(5), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 403–406 ; Pub. L. 102–585, title V, §501, Nov. 4, 1992, 106 Stat. 4955 ; Pub. L. 104–262, title I, §104(b), Oct. 9, 1996, 110 Stat. 3184 .)

References in Text

Section 115 of the Veterans' Benefits and Services Act of 1988, referred to in subsec. (c), is set out as a note under section 1712 of this title.

Amendments

1996-Subsec. (a). Pub. L. 104–262, §104(b)(1), struck out "or 1712" after ", as authorized in section 1710" in introductory provisions.

Subsec. (a)(2)(A). Pub. L. 104–262, §104(b)(2)(A), substituted "1710(a)(1)(B)" for "1712(a)(1)(B)".

Subsec. (a)(2)(B). Pub. L. 104–262, §104(b)(2)(B), added subpar. (B) and struck out former subpar. (B) which read as follows: "a veteran described in paragraph (2), (3), or (4) of section 1712(a) of this title, for a purpose described in section 1712(a)(5)(B) of this title;".

Subsec. (a)(2)(C). Pub. L. 104–262, §104(b)(2)(C), substituted "section 1710(a)(2)(E) of this title, or a veteran who is in receipt of increased pension, or additional compensation or allowances based on the need of regular aid and attendance or by reason of being permanently housebound (or who, but for the receipt of retired pay, would be in receipt of such pension, compensation, or allowance)," for "section 1712(a)(3) (other than a veteran who is a former prisoner of war) of this title".

Subsec. (a)(7). Pub. L. 104–262, §104(b)(3), substituted "1712(a)(1)(F)" for "1712(b)(1)(F)".

1992-Subsec. (a)(1)(C). Pub. L. 102–585 added subpar. (C).

1991-Pub. L. 102–83, §5(a), renumbered section 603 of this title as this section.

Pub. L. 102–83, §4(a)(5), substituted "non-Department" for "non-Veterans' Administration" in section catchline.

Subsec. (a). Pub. L. 102–83, §5(c)(1), substituted "1710 or 1712" for "610 or 612" in introductory provisions, "1712(a)(1)(B)" for "612(a)(1)(B)" in par. (2)(A), "1712(a)" for "612(a)" and "1712(a)(5)(B)" for "612(a)(5)(B)" in par. (2)(B), "1712(a)(3)" for "612(a)(3)" in par. (2)(C), "1720" for "620" in par. (3), and "1712(b)(1)(F)" for "612(b)(1)(F)" in par. (7).

Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in introductory provisions and in par. (2)(C).

Pub. L. 102–83, §4(a)(5), substituted "non-Department" for "non-Veterans' Administration" in introductory provisions and in pars. (3) and (5).

Pub. L. 102–83, §4(a)(3), (4), substituted "Department" for "Veterans' Administration" wherever appearing in introductory provisions and pars. (2), (3), (5), and (6).

Subsec. (a)(2)(B). Pub. L. 102–54, §14(b)(9)(A), struck out "section" before "paragraph".

Subsec. (a)(7). Pub. L. 102–54, §14(b)(9)(B), substituted "section 612(b)(1)(F)" for "section 612(b)(1)(G)".

Subsec. (a)(8). Pub. L. 102–83, §4(a)(1), substituted "administered by the Secretary" for "administered by the Veterans' Administration".

Subsec. (b). Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places.

Pub. L. 102–83, §4(a)(5), substituted "non-Department" for "non-Veterans' Administration".

Subsec. (c). Pub. L. 102–83, §5(c)(1), substituted "1712A, 1720, 1720A, 1724, and 1732" for "612A, 620, 620A, 624, and 632".

Pub. L. 102–83, §4(b)(1), (2)(E), substituted "Secretary" for "Administrator" in two places.

Pub. L. 102–54, §14(b)(9)(C), inserted before period at end "(Public Law 100–322; 102 Stat. 501)".

1988-Subsec. (a). Pub. L. 100–322, §104(b)(1), substituted  "furnish  any  of  the  following:"  for "furnish-".

Subsec. (a)(1). Pub. L. 100–322, §104(b)(2), (3), substituted "Hospital" for "hospital" and the period for semicolon at end.

Subsec. (a)(2). Pub. L. 100–322, §104(b)(2), (3), substituted "Medical" for "medical" and the period for semicolon at end.

Subsec. (a)(2)(B). Pub. L. 100–687 substituted "paragraph (2), (3), or (4) of section 612(a)" for "612(a)(4)", and "612(a)(5)(B)" for "612(a)(5)".

Pub. L. 100–322, §101(e)(3)(A), substituted "section 612(a)(4) of this title, for a purpose described in section 612(a)(5) of this title" for "section 612(f)(1)(A)(ii) of this title".

Subsec. (a)(2)(C). Pub. L. 100–322, §101(e)(3)(B), substituted "section 612(a)(3) (other than a veteran who is a former prisoner of war)" for "section 612(g)".

Subsec. (a)(3). Pub. L. 100–322, §104(a)(1), (b)(2), (3), substituted "Hospital" for "hospital", inserted "or nursing home care under section 620 of this title", and substituted the period for semicolon at end.

Subsec. (a)(4), (5). Pub. L. 100–322, §104(b)(2), (3), substituted "Hospital" for "hospital" and the period for semicolon at end.

Subsec. (a)(6). Pub. L. 100–322, §104(b)(2), (4), substituted "Diagnostic" for "diagnostic" and the period for "; or".

Subsec. (a)(7). Pub. L. 100–322, §104(b)(2), substituted "Outpatient" for "outpatient".

Subsec. (a)(8). Pub. L. 100–322, §104(a)(2), added par. (8).

Subsec. (c). Pub. L. 100–322, §112(a), added subsec. (c).

1986-Subsec. (a)(5). Pub. L. 99–272, §19012(c)(5)(A), made conforming amendment to Pub. L. 99–166, §102(b)(1). See 1985 Amendment note below.

1985-Subsec. (a)(5). Pub. L. 99–166, §102(b)(1), as amended by Pub. L. 99–272, §19012(c)(5)(A), inserted "(other than the Commonwealth of Puerto Rico)" after "in a State" and substituted "contiguous States and the Commonwealth of Puerto Rico" for "contiguous States, but the authority of the Administrator under this paragraph with respect to the Commonwealth of Puerto Rico shall expire on September 30, 1988, and until such date the Administrator may, if necessary to prevent hardship, waive the applicability to the Commonwealth of Puerto Rico of the restrictions in this paragraph with respect to hospital patient loads and the incidence of the furnishing of medical services".

Effective Date of 1988 Amendments

Section 1503(b) of Pub. L. 100–687 provided that: "The amendments made by subsection (a)(1) [amending this section] shall apply with respect to the furnishing of medical services by contract to veterans who apply to the Veterans' Administration for medical services after June 30, 1988."

Section 101(i) of Pub. L. 100–322 provided that: "The amendments made by this section [amending this section and sections 612 and 617 [now 1712 and 1717] of this title] shall apply with respect to the furnishing of medical services to veterans who apply for such services after June 30, 1988."

Effective Date of 1985 Amendment

Section 102(b)(1) of Pub. L. 99–166, as amended by Pub. L. 99–272, title XIX, §19012(c)(5)(A), Apr. 7, 1986, 100 Stat. 382 , provided that the amendment made by that section is effective Oct. 1, 1988.

Ratification of Medical Services Contracts

Section 1503(c) of Pub. L. 100–687 ratified actions of the Administrator in contracting with facilities other than Veterans' Administration facilities for furnishing medical services incident to treatment of certain veterans receiving hospital, nursing home, or domiciliary care, who applied for such services during the period beginning July 1, 1988, and ending Nov. 18, 1988.

Puerto Rico Contract Care; Limitation on Incurring of Obligations

Section 102(b)(2)–(5) of Pub. L. 99–166, as amended by Pub. L. 99–272, title XIX, §19012(c)(5)(B), Apr. 7, 1986, 100 Stat. 382 , limited Administrator's authority to incur obligations for medical services for veterans residing in Puerto Rico during fiscal years 1986 to 1988.

Section Referred to in Other Sections

This section is referred to in sections 1712, 1712A, 2303 of this title; title 42 section 1395cc.