TITLE 38 - US CODE - CHAPTER 17 - HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE

TITLE 38 - US CODE - SUBCHAPTER I - GENERAL

38 USC 1701 - Definitions

For the purposes of this chapter
(1) The term disability means a disease, injury, or other physical or mental defect.
(2) The term veteran of any war includes any veteran awarded the Medal of Honor.
(3) The term facilities of the Department means
(A) facilities over which the Secretary has direct jurisdiction;
(B) Government facilities for which the Secretary contracts; and
(C) public or private facilities at which the Secretary provides recreational activities for patients receiving care under section 1710 of this title.
(4) The term non-Department facilities means facilities other than Department facilities.
(5) The term hospital care includes
(A) 
(i) medical services rendered in the course of the hospitalization of any veteran, and
(ii)  travel and incidental expenses pursuant to the provisions of section 111 of this title;
(B) such mental health services, consultation, professional counseling, and training for the members of the immediate family or legal guardian of a veteran, or the individual in whose household such veteran certifies an intention to live, as may be essential to the effective treatment and rehabilitation of a veteran or dependent or survivor of a veteran receiving care under the last sentence of section 1781 (b) of this title; and
(C) 
(i) medical services rendered in the course of the hospitalization of a dependent or survivor of a veteran receiving care under the last sentence of section 1781 (b) of this title, and
(ii)  travel and incidental expenses for such dependent or survivor under the terms and conditions set forth in section 111 of this title.
(6) The term medical services includes, in addition to medical examination, treatment, and rehabilitative services, the following:
(A) Surgical services.
(B) Dental services and appliances as described in sections 1710 and 1712 of this title.
(C) Optometric and podiatric services.
(D) Preventive health services.
(E) In the case of a person otherwise receiving care or services under this chapter
(i) wheelchairs, artificial limbs, trusses, and similar appliances;
(ii) special clothing made necessary by the wearing of prosthetic appliances; and
(iii) such other supplies or services as the Secretary determines to be reasonable and necessary.
(F) Travel and incidental expenses pursuant to section 111 of this title.
(7) The term domiciliary care includes necessary medical services and travel and incidental expenses pursuant to the provisions of section 111 of this title.
(8) The term rehabilitative services means such professional, counseling, and guidance services and treatment programs as are necessary to restore, to the maximum extent possible, the physical, mental, and psychological functioning of an ill or disabled person.
(9) The term preventive health services means
(A) periodic medical and dental examinations;
(B) patient health education (including nutrition education);
(C) maintenance of drug use profiles, patient drug monitoring, and drug utilization education;
(D) mental health preventive services;
(E) substance abuse prevention measures;
(F) immunizations against infectious disease;
(G) prevention of musculoskeletal deformity or other gradually developing disabilities of a metabolic or degenerative nature;
(H) genetic counseling concerning inheritance of genetically determined diseases;
(I) routine vision testing and eye care services;
(J) periodic reexamination of members of likely target populations (high-risk groups) for selected diseases and for functional decline of sensory organs, together with attendant appropriate remedial intervention; and
(K) such other health-care services as the Secretary may determine to be necessary to provide effective and economical preventive health care.
(10) 
(A) During the period beginning on November 30, 1999, and ending on December 31, 2008, the term medical services includes noninstitutional extended care services.
(B) For the purposes of subparagraph (A), the term noninstitutional extended care services means such alternatives to institutional extended care which the Secretary may furnish
(i)  directly,
(ii)  by contract, or
(iii)  (through provision of case management) by another provider or payor.

38 USC 1702 - Presumption relating to psychosis

For the purposes of this chapter, any veteran of World War II, the Korean conflict, the Vietnam era, or the Persian Gulf War who developed an active psychosis
(1)  within two years after discharge or release from the active military, naval, or air service, and
(2)  before July 26, 1949, in the case of a veteran of World War II, before February 1, 1957, in the case of a veteran of the Korean conflict, before May 8, 1977, in the case of a Vietnam era veteran, or before the end of the two-year period beginning on the last day of the Persian Gulf War, in the case of a veteran of the Persian Gulf War, shall be deemed to have incurred such disability in the active military, naval, or air service.

38 USC 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 100322; 102 Stat. 501).
(d) 
(1) The Secretary shall conduct a program of recovery audits for fee basis contracts and other medical services contracts for the care of veterans under this section, and for beneficiaries under sections 1781, 1782, and 1783 of this title, with respect to overpayments resulting from processing or billing errors or fraudulent charges in payments for non-Department care and services. The program shall be conducted by contract.
(2) Amounts collected, by setoff or otherwise, as the result of an audit under the program conducted under this subsection shall be available, without fiscal year limitation, for the purposes for which funds are currently available to the Secretary for medical care and for payment to a contractor of a percentage of the amount collected as a result of an audit carried out by the contractor.
(3) The Secretary shall allocate all amounts collected under this subsection with respect to a designated geographic service area of the Veterans Health Administration, net of payments to the contractor, to that region.
(4) The authority of the Secretary under this subsection terminates on September 30, 2008.

38 USC 1704 - Preventive health services: annual report

Not later than October 31 each year, the Secretary shall submit to the Committees on Veterans Affairs of the Senate and House of Representatives a report on preventive health services. Each such report shall include the following:
(1) A description of the programs and activities of the Department with respect to preventive health services during the preceding fiscal year, including a description of the following:
(A) The programs conducted by the Department
(i) to educate veterans with respect to health promotion and disease prevention; and
(ii) to provide veterans with preventive health screenings and other clinical services, with such description setting forth the types of resources used by the Department to conduct such screenings and services and the number of veterans reached by such screenings and services.
(B) The means by which the Secretary addressed the specific preventive health services needs of particular groups of veterans (including veterans with service-connected disabilities, elderly veterans, low-income veterans, women veterans, institutionalized veterans, and veterans who are at risk for mental illness).
(C) The manner in which the provision of such services was coordinated with the activities of the Medical and Prosthetic Research Service of the Department and the National Center for Preventive Health.
(D) The manner in which the provision of such services was integrated into training programs of the Department, including initial and continuing medical training of medical students, residents, and Department staff.
(E) The manner in which the Department participated in cooperative preventive health efforts with other governmental and private entities (including State and local health promotion offices and not-for-profit organizations).
(F) The specific research carried out by the Department with respect to the long-term relationships among screening activities, treatment, and morbidity and mortality outcomes.
(G) The cost effectiveness of such programs and activities, including an explanation of the means by which the costs and benefits (including the quality of life of veterans who participate in such programs and activities) of such programs and activities are measured.
(2) A specific description of research activities on preventive health services carried out during that period using employees, funds, equipment, office space, or other support services of the Department, with such description setting forth
(A) the source of funds for those activities;
(B) the articles or publications (including the authors of the articles and publications) in which those activities are described;
(C) the Federal, State, or local governmental entity or private entity, if any, with which such activities were carried out; and
(D) the clinical, research, or staff education projects for which funding applications were submitted (including the source of the funds applied for) and upon which a decision is pending or was denied.
(3) An accounting of the expenditure of funds during that period by the National Center for Preventive Health under section 7318 of this title.

38 USC 1705 - Management of health care: patient enrollment system

(a) In managing the provision of hospital care and medical services under section 1710 (a) of this title, the Secretary, in accordance with regulations the Secretary shall prescribe, shall establish and operate a system of annual patient enrollment. The Secretary shall manage the enrollment of veterans in accordance with the following priorities, in the order listed:
(1) Veterans with service-connected disabilities rated 50 percent or greater.
(2) Veterans with service-connected disabilities rated 30 percent or 40 percent.
(3) Veterans who are former prisoners of war or who were awarded the Purple Heart, veterans with service-connected disabilities rated 10 percent or 20 percent, and veterans described in subparagraphs (B) and (C) of section 1710 (a)(2) of this title.
(4) Veterans who are in receipt of increased pension based on a need of regular aid and attendance or by reason of being permanently housebound and other veterans who are catastrophically disabled.
(5) Veterans not covered by paragraphs (1) through (4) who are unable to defray the expenses of necessary care as determined under section 1722 (a) of this title.
(6) All other veterans eligible for hospital care, medical services, and nursing home care under section 1710 (a)(2) of this title.
(7) Veterans described in section 1710 (a)(3) of this title who are eligible for treatment as a low-income family under section 3(b) of the United States Housing Act of 1937 (42 U.S.C. 1437a (b)) for the area in which such veterans reside, regardless of whether such veterans are treated as single person families under paragraph (3)(A) of such section 3 (b) or as families under paragraph (3)(B) of such section 3 (b).
(8) Veterans described in section 1710 (a)(3) of this title who are not covered by paragraph (7).
(b) In the design of an enrollment system under subsection (a), the Secretary
(1) shall ensure that the system will be managed in a manner to ensure that the provision of care to enrollees is timely and acceptable in quality;
(2) may establish additional priorities within each priority group specified in subsection (a), as the Secretary determines necessary; and
(3) may provide for exceptions to the specified priorities where dictated by compelling medical reasons.
(c) 
(1) The Secretary may not provide hospital care or medical services to a veteran under paragraph (2) or (3) of section 1710 (a) of this title unless the veteran enrolls in the system of patient enrollment established by the Secretary under subsection (a).
(2) The Secretary shall provide hospital care and medical services under section 1710 (a)(1) of this title, and under subparagraph (B) of section 1710 (a)(2) of this title, for the 12-month period following such veterans discharge or release from service, to any veteran referred to in such sections for a disability specified in the applicable subparagraph of such section, notwithstanding the failure of the veteran to enroll in the system of patient enrollment referred to in subsection (a) of this section.

38 USC 1706 - Management of health care: other requirements

(a) In managing the provision of hospital care and medical services under section 1710 (a) of this title, the Secretary shall, to the extent feasible, design, establish and manage health care programs in such a manner as to promote cost-effective delivery of health care services in the most clinically appropriate setting.
(b) 
(1) In managing the provision of hospital care and medical services under such section, the Secretary shall ensure that the Department (and each geographic service area of the Veterans Health Administration) maintains its capacity to provide for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, blindness, amputations, and mental illness) within distinct programs or facilities of the Department that are dedicated to the specialized needs of those veterans in a manner that
(A)  affords those veterans reasonable access to care and services for those specialized needs, and
(B)  ensures that overall capacity of the Department (and each geographic service area of the Veterans Health Administration) to provide such services is not reduced below the capacity of the Department, nationwide, to provide those services, as of October 9, 1996. The Secretary shall carry out this paragraph in consultation with the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans.
(2) For purposes of paragraph (1), the capacity of the Department (and each geographic service area of the Veterans Health Administration) to provide for the specialized treatment and rehabilitative needs of disabled veterans (including veterans with spinal cord dysfunction, traumatic brain injury, blindness, prosthetics and sensory aids, and mental illness) within distinct programs or facilities shall be measured for seriously mentally ill veterans as follows (with all such data to be provided by geographic service area and totaled nationally):
(A) For mental health intensive community-based care, the number of discrete intensive care teams constituted to provide such intensive services to seriously mentally ill veterans and the number of veterans provided such care.
(B) For opioid substitution programs, the number of patients treated annually and the amounts expended.
(C) For dual-diagnosis patients, the number treated annually and the amounts expended.
(D) For substance-use disorder programs
(i) the number of beds (whether hospital, nursing home, or other designated beds) employed and the average bed occupancy of such beds;
(ii) the percentage of unique patients admitted directly to outpatient care during the fiscal year who had two or more additional visits to specialized outpatient care within 30 days of their first visit, with a comparison from 1996 until the date of the report;
(iii) the percentage of unique inpatients with substance-use disorder diagnoses treated during the fiscal year who had one or more specialized clinic visits within three days of their index discharge, with a comparison from 1996 until the date of the report;
(iv) the percentage of unique outpatients seen in a facility or geographic service area during the fiscal year who had one or more specialized clinic visits, with a comparison from 1996 until the date of the report; and
(v) the rate of recidivism of patients at each specialized clinic in each geographic service area of the Veterans Health Administration.
(E) For mental health programs, the number and type of staff that are available at each facility to provide specialized mental health treatment, including satellite clinics, outpatient programs, and community-based outpatient clinics, with a comparison from 1996 to the date of the report.
(F) The number of such clinics providing mental health care, the number and type of mental health staff at each such clinic, and the type of mental health programs at each such clinic.
(G) The total amounts expended for mental health during the fiscal year.
(3) For purposes of paragraph (1), the capacity of the Department (and each geographic service area of the Veterans Health Administration) to provide for the specialized treatment and rehabilitative needs of disabled veterans within distinct programs or facilities shall be measured for veterans with spinal cord dysfunction, traumatic brain injury, blindness, or prosthetics and sensory aids as follows (with all such data to be provided by geographic service area and totaled nationally):
(A) For spinal cord injury and dysfunction specialized centers and for blind rehabilitation specialized centers, the number of staffed beds and the number of full-time equivalent employees assigned to provide care at such centers.
(B) For prosthetics and sensory aids, the annual amount expended.
(C) For traumatic brain injury, the number of patients treated annually and the amounts expended.
(4) In carrying out paragraph (1), the Secretary may not use patient outcome data as a substitute for, or the equivalent of, compliance with the requirement under that paragraph for maintenance of capacity.
(5) 
(A) Not later than April 1 of each year through 2008, the Secretary shall submit to the Committees on Veterans Affairs of the Senate and House of Representatives a report on the Secretarys compliance, by facility and by service-network, with the requirements of this subsection. Each such report shall include information on recidivism rates associated with substance-use disorder treatment.
(B) In preparing each report under subparagraph (A), the Secretary shall use standardized data and data definitions.
(C) Each report under subparagraph (A) shall be audited by the Inspector General of the Department, who shall submit to Congress a certification as to the accuracy of each such report.
(6) 
(A) To ensure compliance with paragraph (1), the Under Secretary for Health shall prescribe objective standards of job performance for employees in positions described in subparagraph (B) with respect to the job performance of those employees in carrying out the requirements of paragraph (1). Those job performance standards shall include measures of workload, allocation of resources, and quality-of-care indicators.
(B) Positions described in this subparagraph are positions in the Veterans Health Administration that have responsibility for allocating and managing resources applicable to the requirements of paragraph (1).
(C) The Under Secretary shall develop the job performance standards under subparagraph (A) in consultation with the Advisory Committee on Prosthetics and Special Disabilities Programs and the Committee on Care of Severely Chronically Mentally Ill Veterans.
(c) The Secretary shall ensure that each primary care health care facility of the Department develops and carries out a plan to provide mental health services, either through referral or direct provision of services, to veterans who require such services.

38 USC 1707 - Limitations

(a) Funds appropriated to carry out this chapter may not be used for purposes that are inconsistent with the Assisted Suicide Funding Restriction Act of 1997 (42 U.S.C. 14401 et seq.).
(b) The Secretary may furnish sensori-neural aids only in accordance with guidelines prescribed by the Secretary.

38 USC 1708 - Temporary lodging

(a) The Secretary may furnish persons described in subsection (b) with temporary lodging in a Fisher house or other appropriate facility in connection with the examination, treatment, or care of a veteran under this chapter or, as provided for under subsection (e)(5), in connection with benefits administered under this title.
(b) Persons to whom the Secretary may provide lodging under subsection (a) are the following:
(1) A veteran who must travel a significant distance to receive care or services under this title.
(2) A member of the family of a veteran and others who accompany a veteran and provide the equivalent of familial support for such veteran.
(c) In this section, the term Fisher house means a housing facility that
(1) is located at, or in proximity to, a Department medical facility;
(2) is available for residential use on a temporary basis by patients of that facility and others described in subsection (b)(2); and
(3) is constructed by, and donated to the Secretary by, the Zachary and Elizabeth M. Fisher Armed Services Foundation.
(d) The Secretary may establish charges for providing lodging under this section. The proceeds from such charges shall be credited to the medical care account and shall be available until expended for the purposes of providing such lodging.
(e) The Secretary shall prescribe regulations to carry out this section. Such regulations shall include provisions
(1) limiting the duration of lodging provided under this section;
(2) establishing standards and criteria under which charges are established for such lodging under subsection (d);
(3) establishing criteria for persons considered to be accompanying a veteran under subsection (b)(2);
(4) establishing criteria for the use of the premises of temporary lodging facilities under this section; and
(5) establishing any other limitations, conditions, and priorities that the Secretary considers appropriate with respect to lodging under this section.

TITLE 38 - US CODE - SUBCHAPTER II - HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL TREATMENT

38 USC 1710 - Eligibility for hospital, nursing home, and domiciliary care

(a) 
(1) The Secretary (subject to paragraph (4)) shall furnish hospital care and medical services which the Secretary determines to be needed
(A) to any veteran for a service-connected disability; and
(B) to any veteran who has a service-connected disability rated at 50 percent or more.
(2) The Secretary (subject to paragraph (4)) shall furnish hospital care and medical services, and may furnish nursing home care, which the Secretary determines to be needed to any veteran
(A) who has a compensable service-connected disability rated less than 50 percent or, with respect to nursing home care during any period during which the provisions of section 1710A (a) of this title are in effect, a compensable service-connected disability rated less than 70 percent;
(B) whose discharge or release from active military, naval, or air service was for a disability that was incurred or aggravated in the line of duty;
(C) who is in receipt of, or who, but for a suspension pursuant to section 1151 of this title (or both a suspension and the receipt of retired pay), would be entitled to disability compensation, but only to the extent that such veterans continuing eligibility for such care is provided for in the judgment or settlement provided for in such section;
(D) who is a former prisoner of war or who was awarded the Purple Heart;
(E) who is a veteran of the Mexican border period or of World War I;
(F) who was exposed to a toxic substance, radiation, or other conditions, as provided in subsection (e); or
(G) who is unable to defray the expenses of necessary care as determined under section 1722 (a) of this title.
(3) In the case of a veteran who is not described in paragraphs (1) and (2), the Secretary may, to the extent resources and facilities are available and subject to the provisions of subsections (f) and (g), furnish hospital care, medical services, and nursing home care which the Secretary determines to be needed.
(4) The requirement in paragraphs (1) and (2) that the Secretary furnish hospital care and medical services, the requirement in section 1710A (a) of this title that the Secretary provide nursing home care, the requirement in section 1710B of this title that the Secretary provide a program of extended care services, and the requirement in section 1745 of this title to provide nursing home care and prescription medicines to veterans with service-connected disabilities in State homes shall be effective in any fiscal year only to the extent and in the amount provided in advance in appropriations Acts for such purposes.
(5) During any period during which the provisions of section 1710A (a) of this title are not in effect, the Secretary may furnish nursing home care which the Secretary determines is needed to any veteran described in paragraph (1), with the priority for such care on the same basis as if provided under that paragraph.
(b) 
(1) The Secretary may furnish to a veteran described in paragraph (2) of this subsection such domiciliary care as the Secretary determines is needed for the purpose of the furnishing of medical services to the veteran.
(2) This subsection applies in the case of the following veterans:
(A) Any veteran whose annual income (as determined under section 1503 of this title) does not exceed the maximum annual rate of pension that would be applicable to the veteran if the veteran were eligible for pension under section 1521 (d) of this title.
(B) Any veteran who the Secretary determines has no adequate means of support.
(c) While any veteran is receiving hospital care or nursing home care in any Department facility, the Secretary may, within the limits of Department facilities, furnish medical services to correct or treat any non-service-connected disability of such veteran, in addition to treatment incident to the disability for which such veteran is hospitalized, if the veteran is willing, and the Secretary finds such services to be reasonably necessary to protect the health of such veteran. The Secretary may furnish dental services and treatment, and related dental appliances, under this subsection for a non-service-connected dental condition or disability of a veteran only
(1)  to the extent that the Secretary determines that the dental facilities of the Department to be used to furnish such services, treatment, or appliances are not needed to furnish services, treatment, or appliances for dental conditions or disabilities described in section 1712 (a) of this title, or
(2)  if
(A)  such non-service-connected dental condition or disability is associated with or aggravating a disability for which such veteran is receiving hospital care, or
(B)  a compelling medical reason or a dental emergency requires furnishing dental services, treatment, or appliances (excluding the furnishing of such services, treatment, or appliances of a routine nature) to such veteran during the period of hospitalization under this section.
(d) In no case may nursing home care be furnished in a hospital not under the direct jurisdiction of the Secretary except as provided in section 1720 of this title.
(e) 
(1) 
(A) A Vietnam-era herbicide-exposed veteran is eligible (subject to paragraph (2)) for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any disability, notwithstanding that there is insufficient medical evidence to conclude that such disability may be associated with such exposure.
(B) A radiation-exposed veteran is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any disease suffered by the veteran that is
(i) a disease listed in section 1112 (c)(2) of this title; or
(ii) any other disease for which the Secretary, based on the advice of the Advisory Committee on Environmental Hazards, determines that there is credible evidence of a positive association between occurrence of the disease in humans and exposure to ionizing radiation.
(C) Subject to paragraphs (2) and (3) of this subsection, a veteran who served on active duty in the Southwest Asia theater of operations during the Persian Gulf War is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any disability, notwithstanding that there is insufficient medical evidence to conclude that such disability may be associated with such service.
(D) Subject to paragraphs (2) and (3), a veteran who served on active duty in a theater of combat operations (as determined by the Secretary in consultation with the Secretary of Defense) during a period of war after the Persian Gulf War, or in combat against a hostile force during a period of hostilities (as defined in section 1712A (a)(2)(B) of this title) after November 11, 1998, is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any illness, notwithstanding that there is insufficient medical evidence to conclude that such condition is attributable to such service.
(E) Subject to paragraphs (2) and (3), a veteran who participated in a test conducted by the Department of Defense Deseret Test Center as part of a program for chemical and biological warfare testing from 1962 through 1973 (including the program designated as Project Shipboard Hazard and Defense (SHAD) and related land-based tests) is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any illness, notwithstanding that there is insufficient medical evidence to conclude that such illness is attributable to such testing.
(2) 
(A) In the case of a veteran described in paragraph (1)(A), hospital care, medical services, and nursing home care may not be provided under subsection (a)(2)(F) with respect to
(i) a disability that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than an exposure described in paragraph (4)(A)(ii); or
(ii) a disease for which the National Academy of Sciences, in a report issued in accordance with section 3 of the Agent Orange Act of 1991, has determined that there is limited or suggestive evidence of the lack of a positive association between occurrence of the disease in humans and exposure to a herbicide agent.
(B) In the case of a veteran described in subparagraph (C), (D), or (E) of paragraph (1), hospital care, medical services, and nursing home care may not be provided under subsection (a)(2)(F) with respect to a disability that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than the service or testing described in such subparagraph.
(3) Hospital care, medical services, and nursing home care may not be provided under or by virtue of subsection (a)(2)(F)
(A) in the case of care for a veteran described in paragraph (1)(A), after December 31, 2002;
(B) in the case of care for a veteran described in paragraph (1)(C), after December 31, 2002;
(C) in the case of care for a veteran described in paragraph (1)(D), after a period of 2 years beginning on the date of the veterans discharge or release from active military, naval, or air service; and
(D) in the case of care for a veteran described in paragraph (1)(E), after December 31, 2007.
(4) For purposes of this subsection
(A) The term Vietnam-era herbicide-exposed veteran means a veteran
(i)  who served on active duty in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, and
(ii)  who the Secretary finds may have been exposed during such service to dioxin or was exposed during such service to a toxic substance found in a herbicide or defoliant used for military purposes during such period.
(B) The term radiation-exposed veteran has the meaning given that term in section 1112 (c)(3) of this title.
(5) When the Secretary first provides care for veterans using the authority provided in paragraph (1)(D), the Secretary shall establish a system for collection and analysis of information on the general health status and health care utilization patterns of veterans receiving care under that paragraph. Not later than 18 months after first providing care under such authority, the Secretary shall submit to Congress a report on the experience under that authority. The Secretary shall include in the report any recommendations of the Secretary for extension of that authority.
(f) 
(1) The Secretary may not furnish hospital care or nursing home care under this section to a veteran who is eligible for such care under subsection (a)(3) of this section unless the veteran agrees to pay to the United States the applicable amount determined under paragraph (2) or (4) of this subsection.
(2) A veteran who is furnished hospital care or nursing home care under this section and who is required under paragraph (1) of this subsection to agree to pay an amount to the United States in order to be furnished such care shall be liable to the United States for an amount equal to
(A) the lesser of
(i) the cost of furnishing such care, as determined by the Secretary; or
(ii) the amount determined under paragraph (3) of this subsection; and
(B) before September 30, 2008, an amount equal to $10 for every day the veteran receives hospital care and $5 for every day the veteran receives nursing home care.
(3) 
(A) In the case of hospital care furnished during any 365-day period, the amount referred to in paragraph (2)(A)(ii) of this subsection is
(i) the amount of the inpatient Medicare deductible, plus
(ii) one-half of such amount for each 90 days of care (or fraction thereof) after the first 90 days of such care during such 365-day period.
(B) In the case of nursing home care furnished during any 365-day period, the amount referred to in paragraph (2)(A)(ii) of this subsection is the amount of the inpatient Medicare deductible for each 90 days of such care (or fraction thereof) during such 365-day period.
(C) 
(i) Except as provided in clause (ii) of this subparagraph, in the case of a veteran who is admitted for nursing home care under this section after being furnished, during the preceding 365-day period, hospital care for which the veteran has paid the amount of the inpatient Medicare deductible under this subsection and who has not been furnished 90 days of hospital care in connection with such payment, the veteran shall not incur any liability under paragraph (2) of this subsection with respect to such nursing home care until
(I) the veteran has been furnished, beginning with the first day of such hospital care furnished in connection with such payment, a total of 90 days of hospital care and nursing home care; or
(II) the end of the 365-day period applicable to the hospital care for which payment was made,

whichever occurs first.

(ii) In the case of a veteran who is admitted for nursing home care under this section after being furnished, during any 365-day period, hospital care for which the veteran has paid an amount under subparagraph (A)(ii) of this paragraph and who has not been furnished 90 days of hospital care in connection with such payment, the amount of the liability of the veteran under paragraph (2) of this subsection with respect to the number of days of such nursing home care which, when added to the number of days of such hospital care, is 90 or less, is the difference between the inpatient Medicare deductible and the amount paid under such subparagraph until
(I) the veteran has been furnished, beginning with the first day of such hospital care furnished in connection with such payment, a total of 90 days of hospital care and nursing home care; or
(II) the end of the 365-day period applicable to the hospital care for which payment was made,

whichever occurs first.

(D) In the case of a veteran who is admitted for hospital care under this section after having been furnished, during the preceding 365-day period, nursing home care for which the veteran has paid the amount of the inpatient Medicare deductible under this subsection and who has not been furnished 90 days of nursing home care in connection with such payment, the veteran shall not incur any liability under paragraph (2) of this subsection with respect to such hospital care until
(i) the veteran has been furnished, beginning with the first day of such nursing home care furnished in connection with such payment, a total of 90 days of nursing home care and hospital care; or
(ii) the end of the 365-day period applicable to the nursing home care for which payment was made,

whichever occurs first.

(E) A veteran may not be required to make a payment under this subsection for hospital care or nursing home care furnished under this section during any 90-day period in which the veteran is furnished medical services under paragraph (3) of subsection (a) to the extent that such payment would cause the total amount paid by the veteran under this subsection for hospital care and nursing home care furnished during that period and under subsection (g) for medical services furnished during that period to exceed the amount of the inpatient Medicare deductible in effect on the first day of such period.
(F) A veteran may not be required to make a payment under this subsection or subsection (g) for any days of care in excess of 360 days of care during any 365-calendar-day period.
(4) In the case of a veteran covered by this subsection who is also described by section 1705 (a)(7) of this title, the amount for which the veteran shall be liable to the United States for hospital care under this subsection shall be an amount equal to 20 percent of the total amount for which the veteran would otherwise be liable for such care under subparagraphs (2)(B) and (3)(A) but for this paragraph.
(5) For the purposes of this subsection, the term inpatient Medicare deductible means the amount of the inpatient hospital deductible in effect under section 1813(b) of the Social Security Act (42 U.S.C. 1395e (b)) on the first day of the 365-day period applicable under paragraph (3) of this subsection.
(g) 
(1) The Secretary may not furnish medical services under subsection (a) of this section (including home health services under section 1717 of this title) to a veteran who is eligible for hospital care under this chapter by reason of subsection (a)(3) of this section unless the veteran agrees to pay to the United States in the case of each outpatient visit the applicable amount or amounts established by the Secretary by regulation.
(2) A veteran who is furnished medical services under subsection (a) of this section and who is required under paragraph (1) of this subsection to agree to pay an amount to the United States in order to be furnished such services shall be liable to the United States, in the case of each visit in which such services are furnished to the veteran, for an amount which the Secretary shall establish by regulation.
(3) This subsection does not apply with respect to home health services under section 1717 of this title to the extent that such services are for improvements and structural alterations.
(h) Nothing in this section requires the Secretary to furnish care to a veteran to whom another agency of Federal, State, or local government has a duty under law to provide care in an institution of such government.

38 USC 1710A - Required nursing home care

(a) The Secretary (subject to section 1710 (a)(4) of this title) shall provide nursing home care which the Secretary determines is needed
(1)  to any veteran in need of such care for a service-connected disability, and
(2)  to any veteran who is in need of such care and who has a service-connected disability rated at 70 percent or more.
(b) 
(1) The Secretary shall ensure that a veteran described in subsection (a) who continues to need nursing home care is not, after placement in a Department nursing home, transferred from the facility without the consent of the veteran, or, in the event the veteran cannot provide informed consent, the representative of the veteran.
(2) Nothing in subsection (a) may be construed as authorizing or requiring that a veteran who is receiving nursing home care in a Department nursing home on the date of the enactment of this section be displaced, transferred, or discharged from the facility.
(c) The provisions of subsection (a) shall terminate on December 31, 2008.

38 USC 1710B - Extended care services

(a) The Secretary (subject to section 1710 (a)(4) of this title and subsection (c) of this section) shall operate and maintain a program to provide extended care services to eligible veterans in accordance with this section. Such services shall include the following:
(1) Geriatric evaluation.
(2) Nursing home care
(A)  in facilities operated by the Secretary, and
(B)  in community-based facilities through contracts under section 1720 of this title.
(3) Domiciliary services under section 1710 (b) of this title.
(4) Adult day health care under section 1720 (f) of this title.
(5) Such other noninstitutional alternatives to nursing home care as the Secretary may furnish as medical services under section 1701 (10) of this title.
(6) Respite care under section 1720B of this title.
(b) The Secretary shall ensure that the staffing and level of extended care services provided by the Secretary nationally in facilities of the Department during any fiscal year is not less than the staffing and level of such services provided nationally in facilities of the Department during fiscal year 1998.
(c) 
(1) Except as provided in paragraph (2), the Secretary may not furnish extended care services for a non-service-connected disability other than in the case of a veteran who has a compensable service-connected disability unless the veteran agrees to pay to the United States a copayment (determined in accordance with subsection (d)) for any period of such services in a year after the first 21 days of such services provided that veteran in that year.
(2) Paragraph (1) shall not apply
(A) to a veteran whose annual income (determined under section 1503 of this title) is less than the amount in effect under section 1521 (b) of this title;
(B) to a veteran being furnished hospice care under this section; or
(C) with respect to an episode of extended care services that a veteran is being furnished by the Department on November 30, 1999.
(d) 
(1) A veteran who is furnished extended care services under this chapter and who is required under subsection (c) to pay an amount to the United States in order to be furnished such services shall be liable to the United States for that amount.
(2) In implementing subsection (c), the Secretary shall develop a methodology for establishing the amount of the copayment for which a veteran described in subsection (c) is liable. That methodology shall provide for
(A) establishing a maximum monthly copayment (based on all income and assets of the veteran and the spouse of such veteran);
(B) protecting the spouse of a veteran from financial hardship by not counting all of the income and assets of the veteran and spouse (in the case of a spouse who resides in the community) as available for determining the copayment obligation; and
(C) allowing the veteran to retain a monthly personal allowance.
(e) 
(1) There is established in the Treasury of the United States a revolving fund known as the Department of Veterans Affairs Extended Care Fund (hereinafter in this section referred to as the fund). Amounts in the fund shall be available, without fiscal year limitation and without further appropriation, exclusively for the purpose of providing extended care services under subsection (a).
(2) All amounts received by the Department under this section shall be deposited in or credited to the fund.

38 USC 1711 - Care during examinations and in emergencies

(a) The Secretary may furnish hospital care incident to physical examinations where such examinations are necessary in carrying out the provisions of other laws administered by the Secretary.
[(b) Repealed. Pub. L. 107–135, title II, § 208(d), Jan. 23, 2002, 115 Stat. 2463.]
(c) 
(1) The Secretary may contract with any organization named in, or approved by the Secretary under, section 5902 of this title to provide for the furnishing by the Secretary, on a reimbursable basis (as prescribed by the Secretary), of emergency medical services to individuals attending any national convention of such organization, except that reimbursement shall not be required for services furnished under this subsection to the extent that the individual receiving such services would otherwise be eligible under this chapter for medical services.
(2) The authority of the Secretary to enter into contracts under this subsection shall be effective for any fiscal year only to such extent or in such amounts as are provided in appropriation Acts.

38 USC 1712 - Dental care; drugs and medicines for certain disabled veterans; vaccines

(a) 
(1) Outpatient dental services and treatment, and related dental appliances, shall be furnished under this section only for a dental condition or disability
(A) which is service-connected and compensable in degree;
(B) which is service-connected, but not compensable in degree, but only if
(i) the dental condition or disability is shown to have been in existence at the time of the veterans discharge or release from active military, naval, or air service;
(ii) the veteran had served on active duty for a period of not less than 180 days or, in the case of a veteran who served on active duty during the Persian Gulf War, 90 days immediately before such discharge or release;
(iii) application for treatment is made within 90 days after such discharge or release, except that
(I)  in the case of a veteran who reentered active military, naval, or air service within 90 days after the date of such veterans prior discharge or release from such service, application may be made within 90 days from the date of such veterans subsequent discharge or release from such service, and
(II)  if a disqualifying discharge or release has been corrected by competent authority, application may be made within 90 days after the date of correction; and
(iv) the veterans certificate of discharge or release from active duty does not bear a certification that the veteran was provided, within the 90-day period immediately before the date of such discharge or release, a complete dental examination (including dental X-rays) and all appropriate dental services and treatment indicated by the examination to be needed;
(C) which is a service-connected dental condition or disability due to combat wounds or other service trauma, or of a former prisoner of war;
(D) which is associated with and is aggravating a disability resulting from some other disease or injury which was incurred in or aggravated by active military, naval, or air service;
(E) which is a non-service-connected condition or disability of a veteran for which treatment was begun while such veteran was receiving hospital care under this chapter and such services and treatment are reasonably necessary to complete such treatment;
(F) from which a veteran who is a former prisoner of war is suffering;
(G) from which a veteran who has a service-connected disability rated as total is suffering; or
(H) the treatment of which is medically necessary
(i)  in preparation for hospital admission, or
(ii)  for a veteran otherwise receiving care or services under this chapter.
(2) The Secretary concerned shall at the time a member of the Armed Forces is discharged or released from a period of active military, naval, or air service of not less than 180 days or, in the case of a veteran who served on active duty during the Persian Gulf War, 90 days provide to such member a written explanation of the provisions of clause (B) of paragraph (1) of this subsection and enter in the service records of the member a statement signed by the member acknowledging receipt of such explanation (or, if the member refuses to sign such statement, a certification from an officer designated for such purpose by the Secretary concerned that the member was provided such explanation).
(3) The total amount which the Secretary may expend for furnishing, during any twelve-month period, outpatient dental services, treatment, or related dental appliances to a veteran under this section through private facilities for which the Secretary has contracted under clause (1), (2), or (5) of section 1703 (a) of this title may not exceed $1,000 unless the Secretary determines, prior to the furnishing of such services, treatment, or appliances and based on an examination of the veteran by a dentist employed by the Department (or, in an area where no such dentist is available, by a dentist conducting such examination under a contract or fee arrangement), that the furnishing of such services, treatment, or appliances at such cost is reasonably necessary.
(4) 
(A) Except as provided in subparagraph (B) of this paragraph, in any year in which the Presidents Budget for the fiscal year beginning October 1 of such year includes an amount for expenditures for contract dental care under the provisions of this subsection and section 1703 of this title during such fiscal year in excess of the level of expenditures made for such purpose during fiscal year 1978, the Secretary shall, not later than February 15 of such year, submit a report to the appropriate committees of the Congress justifying the requested level of expenditures for contract dental care and explaining why the application of the criteria prescribed in section 1703 of this title for contracting with private facilities and in the second sentence of section 1710 (c) of this title for furnishing incidental dental care to hospitalized veterans will not preclude the need for expenditures for contract dental care in excess of the fiscal year 1978 level of expenditures for such purpose. In any case in which the amount included in the Presidents Budget for any fiscal year for expenditures for contract dental care under such provisions is not in excess of the level of expenditures made for such purpose during fiscal year 1978 and the Secretary determines after the date of submission of such budget and before the end of such fiscal year that the level of expenditures for such contract dental care during such fiscal year will exceed the fiscal year 1978 level of expenditures, the Secretary shall submit a report to the appropriate committees of the Congress containing both a justification (with respect to the projected level of expenditures for such fiscal year) and an explanation as required in the preceding sentence in the case of a report submitted pursuant to such sentence. Any report submitted pursuant to this paragraph shall include a comment by the Secretary on the effect of the application of the criteria prescribed in the second sentence of section 1710 (c) of this title for furnishing incidental dental care to hospitalized veterans.
(B) A report under subparagraph (A) of this paragraph with respect to a fiscal year is not required if, in the documents submitted by the Secretary to the Congress in justification for the amounts included for Department programs in the Presidents Budget, the Secretary specifies with respect to contract dental care described in such subparagraph
(i) the actual level of expenditures for such care in the fiscal year preceding the fiscal year in which such Budget is submitted;
(ii) a current estimate of the level of expenditures for such care in the fiscal year in which such Budget is submitted; and
(iii) the amount included in such Budget for such care.
(b) Dental services and related appliances for a dental condition or disability described in paragraph (1)(B) of subsection (a) shall be furnished on a one-time completion basis, unless the services rendered on a one-time completion basis are found unacceptable within the limitations of good professional standards, in which event such additional services may be afforded as are required to complete professionally acceptable treatment.
(c) Dental appliances, wheelchairs, artificial limbs, trusses, special clothing, and similar appliances to be furnished by the Secretary under this section may be procured by the Secretary either by purchase or by manufacture, whichever the Secretary determines may be advantageous and reasonably necessary.
(d) The Secretary shall furnish to each veteran who is receiving additional compensation or allowance under chapter 11 of this title, or increased pension as a veteran of a period of war, by reason of being permanently housebound or in need of regular aid and attendance, such drugs and medicines as may be ordered on prescription of a duly licensed physician as specific therapy in the treatment of any illness or injury suffered by such veteran. The Secretary shall continue to furnish such drugs and medicines so ordered to any such veteran in need of regular aid and attendance whose pension payments have been discontinued solely because such veterans annual income is greater than the applicable maximum annual income limitation, but only so long as such veterans annual income does not exceed such maximum annual income limitation by more than $1,000.
(e) In order to assist the Secretary of Health and Human Services in carrying out national immunization programs under other provisions of law, the Secretary may authorize the administration of immunizations to eligible veterans who voluntarily request such immunizations in connection with the provision of care for a disability under this chapter in any Department health care facility. Any such immunization shall be made using vaccine furnished by the Secretary of Health and Human Services at no cost to the Department. For such purpose, notwithstanding any other provision of law, the Secretary of Health and Human Services may provide such vaccine to the Department at no cost. Section 7316 of this title shall apply to claims alleging negligence or malpractice on the part of Department personnel granted immunity under such section.

38 USC 1712A - Eligibility for readjustment counseling and related mental health services

(a) 
(1) 
(A) Upon the request of any veteran referred to in subparagraph (B), the Secretary shall furnish counseling to the veteran to assist the veteran in readjusting to civilian life. Such counseling may include a general mental and psychological assessment of the veteran to ascertain whether such veteran has mental or psychological problems associated with readjustment to civilian life.
(B) Subparagraph (A) applies to the following veterans:
(i) Any veteran who served on active duty
(I) in a theater of combat operations (as determined by the Secretary in consultation with the Secretary of Defense) during the Vietnam era; or
(II) after May 7, l975, in an area at a time during which hostilities occurred in that area.
(ii) Any veteran (other than a veteran covered by clause (i)) who served on active duty during the Vietnam era who seeks or is furnished such counseling before January 1, 2004.
(2) 
(A) Upon the request of any veteran (other than a veteran covered by paragraph (1)) who served in the active military, naval, or air service in a theater of combat operations (as so determined) during a period of war, or in any other area during a period in which hostilities (as defined in subparagraph (B)) occurred in such area, the Secretary may furnish counseling to the veteran to assist the veteran in readjusting to civilian life.
(B) For the purposes of subparagraph (A), the term hostilities means an armed conflict in which the members of the Armed Forces are subjected to danger comparable to the danger to which members of the Armed Forces have been subjected in combat with enemy armed forces during a period of war, as determined by the Secretary in consultation with the Secretary of Defense.
(b) 
(1) If, on the basis of the assessment furnished under subsection (a) of this section, a physician or psychologist employed by the Department (or, in areas where no such physician or psychologist is available, a physician or psychologist carrying out such function under a contract or fee arrangement with the Secretary) determines that the provision of mental health services to such veteran is necessary to facilitate the successful readjustment of the veteran to civilian life, such veteran shall, within the limits of Department facilities, be furnished such services on an outpatient basis. For the purposes of furnishing such mental health services, the counseling furnished under subsection (a) of this section shall be considered to have been furnished by the Department as a part of hospital care. Any hospital care and other medical services considered necessary on the basis of the assessment furnished under subsection (a) of this section shall be furnished only in accordance with the eligibility criteria otherwise set forth in this chapter (including the eligibility criteria set forth in section 1784 of this title).
(2) Mental health services furnished under paragraph (1) of this subsection may, if determined to be essential to the effective treatment and readjustment of the veteran, include such consultation, counseling, training, services, and expenses as are described in sections 1782 and 1783 of this title.
[(c) Repealed. Pub. L. 104–262, title III, § 331(b), Oct. 9, 1996, 110 Stat. 3198.]
(d) The Under Secretary for Health may provide for such training of professional, paraprofessional, and lay personnel as is necessary to carry out this section effectively, and, in carrying out this section, may utilize the services of paraprofessionals, individuals who are volunteers working without compensation, and individuals who are veteran-students (as described in section 3485 of this title) in initial intake and screening activities.
(e) 
(1) In furnishing counseling and related mental health services under subsections (a) and (b) of this section, the Secretary shall have available the same authority to enter into contracts with private facilities that is available to the Secretary (under sections 1703 (a)(2) and 1710 (a)(1)(B) of this title) in furnishing medical services to veterans suffering from total service-connected disabilities.
(2) Before furnishing counseling or related mental health services described in subsections (a) and (b) of this section through a contract facility, as authorized by this subsection, the Secretary shall approve (in accordance with criteria which the Secretary shall prescribe by regulation) the quality and effectiveness of the program operated by such facility for the purpose for which the counseling or services are to be furnished.
(3) The authority of the Secretary to enter into contracts under this subsection shall be effective for any fiscal year only to such extent or in such amounts as are provided in appropriation Acts.
(f) The Secretary, in cooperation with the Secretary of Defense, shall take such action as the Secretary considers appropriate to notify veterans who may be eligible for assistance under this section of such potential eligibility.
(g) 
(1) 
(A) Except as provided in subparagraph (C) of this paragraph, the Secretary may close or relocate a center in existence on January 1, 1988, only as described in the national plan required by paragraph (3) of this subsection (or in a revision to such plan under paragraph (4) of this subsection in which the closure or relocation of that center is proposed).
(B) A closure or relocation of a center which is proposed in such national plan may be carried out only after the end of the 120-day period beginning on the date on which the national plan is submitted. A closure or relocation of a center not proposed in such plan may be carried out only after the end of the 60-day period beginning on the date the Secretary submits a revision to such plan in which the closure or relocation of that center is proposed.
(C) The Secretary may relocate a center in existence on January 1, 1988, without regard to the national plan (including any revision to such plan) if such relocation is to a new location away from a Department general health-care facility when such relocation is necessitated by circumstances beyond the control of the Department. Such a relocation may be carried out only after the end of the 30-day period beginning on the date on which the Secretary notifies the Committees on Veterans Affairs of the Senate and the House of Representatives of the proposed relocation, of the circumstances making it necessary, and of the reason for the selection of the new site for the center.
(2) 
(A) Not later than April 1, 1988, the Secretary shall submit to the Committees on Veterans Affairs of the Senate and House of Representatives a report on the Secretarys evaluation of the effectiveness in helping to meet the readjustment needs of veterans who served on active duty during the Vietnam era of the readjustment counseling and mental health services provided pursuant to this section (and of outreach efforts with respect to such counseling and services). Such report shall give particular attention, in light of the results of the study required by section 102 of the Veterans Health Care Amendments of 1983 (Public Law 98160), to the provision of such counseling and services to veterans with post-traumatic stress disorder and to the diagnosis and treatment of such disorder.
(B) The report required by subparagraph (A) of this paragraph shall include
(i) the opinion of the Secretary with respect to
(I)  the extent to which the readjustment needs of veterans who served on active duty during the Vietnam era remain unmet, and
(II)  the extent to which the provision of readjustment counseling services under this section in centers is needed to meet such needs; and
(ii) in light of the opinion submitted pursuant to clause (i) of this subparagraph, such recommendations for amendments to this subsection and for other legislative and administrative action as the Secretary considers appropriate.
(3) 
(A) The Secretary, after considering the recommendations of the Under Secretary for Health, shall submit to such committees a report setting forth a national plan for all centers in existence on January 1, 1988. Such national plan shall set forth the Secretarys proposals as to each such center for a period (to be determined by the Secretary) of not less than 12 months beginning on the date of the submission of the report. The plan shall include, as to each center, whether the Secretary proposes to relocate the center to a general Department facility, relocate the center to a new location away from a general Department facility, expand the center in the same location, or close the center. The plan shall also set forth any proposal of the Secretary to open additional centers.
(B) The plan shall include the Secretarys evaluation as to how, in light of each of the criteria described in subparagraph (C) of this paragraph, the proposal set forth in the plan for each center covered by the plan would ensure the continued availability and effective furnishing of readjustment counseling services to eligible veterans needing such services in the geographic area served by that center.
(C) The Secretary shall make the evaluation described in subparagraph (B) of this paragraph with respect to any center in light of the following:
(i) The distribution of Vietnam-era veterans in the geographic area served by the center and the relationships between the location of such center and the general Department facility and such distribution.
(ii) The distance between the center and the general Department facility.
(iii) The availability of other entities (such as State, local, or private outreach facilities) which provide assistance to Vietnam-era veterans in the area served by the center.
(iv) The availability of transportation to, and parking at, the center and the general Department facility.
(v) The availability, cost, and suitability of the space at the general Department facility.
(vi) The overall cost impact of the proposed closure or relocation, including a comparison of the recurring nonpersonnel costs of providing readjustment counseling to the same estimated number of veterans at the center and the general Department facility.
(vii) The workload trends over the two previous fiscal years, and projected over the next fiscal year (or longer), at the center.
(viii) Such other factors as the Secretary determines to be relevant to making the evaluation described in subparagraph (B) of this paragraph.
(D) For the purposes of this paragraph, the term general Department facility means a Department facility which is not a center and at which readjustment counseling would be furnished in a particular geographic area upon the closure or relocation of a center.
(4) After submitting the plan required by paragraph (3) of this subsection, the Secretary may submit to the committees a revision to such plan in order to modify the proposal set forth in the plan as to any center. Any such revision shall include, with respect to each center addressed in the revision, a description of the Secretarys evaluation of the matters specified in paragraphs (3)(B) and (3)(C) of this subsection.
(5) For purposes of determining a period of time under paragraph (1)(B) of this subsection, if the national plan (or a revision to the national plan) is submitted to the committees during the 121-day period beginning 60 days before and ending 60 days after the final day of a session of the Congress, it shall be deemed to have been submitted on the sixty-first day after the final day of such session.
[(h) Repealed. Pub. L. 102–83, § 4(b)(6), Aug. 6, 1991, 105 Stat. 405.]
(i) For the purposes of this section:
(1) The term center means a facility (including a Resource Center designated under subsection (h)(3)(A) of this section) which is operated by the Department for the provision of services under this section and which
(A)  is situated apart from Department general health-care facilities, or
(B)  was so situated but has been relocated to a Department general health-care facility.
(2) The term Department general health-care facility means a health-care facility which is operated by the Department for the furnishing of health-care services under this chapter, not limited to services provided through the program established under this section.

38 USC 1712B - Counseling for former prisoners of war

The Secretary may establish a program under which, upon the request of a veteran who is a former prisoner of war, the Secretary, within the limits of Department facilities, furnishes counseling to such veteran to assist such veteran in overcoming the psychological effects of the veterans detention or internment as a prisoner of war.

38 USC 1713 - Renumbered 1781]

38 USC 1714 - Fitting and training in use of prosthetic appliances; guide dogs; service dogs

(a) Any veteran who is entitled to a prosthetic appliance shall be furnished such fitting and training, including institutional training, in the use of such appliance as may be necessary, whether in a Department facility or other training institution, or by outpatient treatment, including such service under contract, and including travel and incidental expenses (under the terms and conditions set forth in section 111 of this title) to and from such veterans home to such hospital or training institution.
(b) The Secretary may provide guide dogs trained for the aid of the blind to veterans who are enrolled under section 1705 of this title. The Secretary may also provide such veterans with mechanical or electronic equipment for aiding them in overcoming the disability of blindness.
(c) The Secretary may, in accordance with the priority specified in section 1705 of this title, provide
(1) service dogs trained for the aid of the hearing impaired to veterans who are hearing impaired and are enrolled under section 1705 of this title; and
(2) service dogs trained for the aid of persons with spinal cord injury or dysfunction or other chronic impairment that substantially limits mobility to veterans with such injury, dysfunction, or impairment who are enrolled under section 1705 of this title.
(d) In the case of a veteran provided a dog under subsection (b) or (c), the Secretary may pay travel and incidental expenses for that veteran under the terms and conditions set forth in section 111 of this title to and from the veterans home for expenses incurred in becoming adjusted to the dog.

38 USC 1715 - Tobacco for hospitalized veterans

The Secretary may furnish tobacco to veterans receiving hospital or domiciliary care.

38 USC 1716 - Hospital care by other agencies of the United States

When so specified in an appropriation or other Act, the Secretary may make allotments and transfers to the Departments of Health and Human Services (Public Health Service), the Army, Navy, Air Force, or Interior, for disbursement by them under the various headings of their appropriations, of such amounts as are necessary for the care and treatment of veterans entitled to hospitalization from the Department under this chapter. The amounts to be charged the Department for care and treatment of veterans in hospitals shall be calculated on the basis of a per diem rate approved by the Office of Management and Budget.

38 USC 1717 - Home health services; invalid lifts and other devices

(a) 
(1) As part of medical services furnished to a veteran under section 1710 (a) of this title, the Secretary may furnish such home health services as the Secretary finds to be necessary or appropriate for the effective and economical treatment of the veteran.
(2) Improvements and structural alterations may be furnished as part of such home health services only as necessary to assure the continuation of treatment for the veterans disability or to provide access to the home or to essential lavatory and sanitary facilities. The cost of such improvements and structural alterations (or the amount of reimbursement therefor) under this subsection may not exceed
(A) $4,100 in the case of medical services furnished under section 1710 (a)(1) of this title, or for a disability described in section 1710 (a)(2)(C) of this title; or
(B) $1,200 in the case of medical services furnished under any other provision of section 1710 (a) of this title.
(3) The Secretary may furnish home health services to a veteran in any setting in which the veteran is residing. The Secretary may not furnish such services in such a manner as to relieve any other person or entity of a contractual obligation to furnish services to the veteran. When home health services are furnished in a setting other than the veterans home, such services may not include any structural improvement or alteration.
(b) The Secretary may furnish an invalid lift, or any type of therapeutic or rehabilitative device, as well as other medical equipment and supplies (excluding medicines), if medically indicated, to any veteran who is receiving
(1)  compensation under section 1114 (l)(p) of this title (or the comparable rates provided pursuant to section 1134 of this title), or
(2)  pension under chapter 15 of this title by reason of being in need of regular aid and attendance.
(c) The Secretary may furnish devices for assisting in overcoming the handicap of deafness (including telecaptioning television decoders) to any veteran who is profoundly deaf and is entitled to compensation on account of hearing impairment.

38 USC 1718 - Therapeutic and rehabilitative activities

(a) In providing rehabilitative services under this chapter, the Secretary, upon the recommendation of the Under Secretary for Health, may use the services of patients and members in Department health care facilities for therapeutic and rehabilitative purposes. Such patients and members shall not under these circumstances be held or considered as employees of the United States for any purpose. The Secretary shall prescribe the conditions for the use of such services.
(b) 
(1) In furnishing rehabilitative services under this chapter, the Secretary, upon the recommendation of the Under Secretary for Health, may enter into a contract or other arrangement with any appropriate source (whether or not an element of the Department of Veterans Affairs or of any other Federal entity) to provide for therapeutic work for patients and members in Department health care facilities.
(2) Notwithstanding any other provision of law, the Secretary may also furnish rehabilitative services under this subsection through contractual arrangements with nonprofit">nonprofit entities to provide for such therapeutic work for such patients. The Secretary shall establish appropriate fiscal, accounting, management, recordkeeping, and reporting requirements with respect to the activities of any such nonprofit">nonprofit entity in connection with such contractual arrangements.
(c) 
(1) There is hereby established in the Treasury of the United States a revolving fund known as the Department of Veterans Affairs Special Therapeutic and Rehabilitation Activities Fund (hereinafter in this section referred to as the fund) for the purpose of furnishing rehabilitative services authorized in subsection (b) or (d). Such amounts of the fund as the Secretary may determine to be necessary to establish and maintain operating accounts for the various rehabilitative services activities may be deposited in checking accounts in other depositaries selected or established by the Secretary.
(2) All funds received by the Department under contractual arrangements made under subsection (b) or (d), or by nonprofit">nonprofit entities described in subsection (b)(2), shall be deposited in or credited to the fund, and the Secretary shall distribute out of the fund moneys to participants at rates not less than the wage rates specified in the Fair Labor Standards Act of 1938 (29 U.S.C. 201 et seq.) and regulations prescribed thereunder for work of similar character.
(3) The Under Secretary for Health shall prepare, for inclusion in the annual report submitted to Congress under section 529 of this title, a description of the scope and achievements of activities carried out under this section (including pertinent data regarding productivity and rates of distribution) during the prior twelve months and an estimate of the needs of the program of therapeutic and rehabilitation activities to be carried out under this section for the ensuing fiscal year.
(d) In providing to a veteran rehabilitative services under this chapter, the Secretary may furnish the veteran with the following:
(1) Work skills training and development services.
(2) Employment support services.
(3) Job development and placement services.
(e) In providing rehabilitative services under this chapter, the Secretary shall take appropriate action to make it possible for the patient to take maximum advantage of any benefits to which such patient is entitled under chapter 31, 34, or 35 of this title, and, if the patient is still receiving treatment of a prolonged nature under this chapter, the provision of rehabilitative services under this chapter shall be continued during, and coordinated with, the pursuit of education and training under such chapter 31, 34, or 35.
(f) The Secretary shall prescribe regulations to ensure that the priorities set forth in section 1705 of this title shall be applied, insofar as practicable, to participation in therapeutic and rehabilitation activities carried out under this section.
(g) 
(1) The Secretary may not consider any of the matters stated in paragraph (2) as a basis for the denial or discontinuance of a rating of total disability for purposes of compensation or pension based on the veterans inability to secure or follow a substantially gainful occupation as a result of disability.
(2) Paragraph (1) applies to the following:
(A) A veterans participation in an activity carried out under this section.
(B) A veterans receipt of a distribution as a result of participation in an activity carried out under this section.
(C) A veterans participation in a program of rehabilitative services that
(i)  is provided as part of the veterans care furnished by a State home and
(ii)  is approved by the Secretary as conforming appropriately to standards for activities carried out under this section.
(D) A veterans receipt of payment as a result of participation in a program described in subparagraph (C).
(3) A distribution of funds made under this section and a payment made to a veteran under a program of rehabilitative services described in paragraph (2)(C) shall be considered for the purposes of chapter 15 of this title to be a donation from a public or private relief or welfare organization.

38 USC 1719 - Repair or replacement of certain prosthetic and other appliances

The Secretary may repair or replace any artificial limb, truss, brace, hearing aid, spectacles, or similar appliance (not including dental appliances) reasonably necessary to a veteran and belonging to such veteran which was damaged or destroyed by a fall or other accident caused by a service-connected disability for which such veteran is in receipt of, or but for the receipt of retirement pay would be entitled to, disability compensation.

38 USC 1720 - Transfers for nursing home care; adult day health care

(a) 
(1) Subject to subsection (b) of this section, the Secretary may transfer to a non-Department nursing home, for care at the expense of the United States
(A) a veteran
(i) who has been furnished care by the Secretary in a facility under the direct jurisdiction of the Secretary; and
(ii) who the Secretary determines
(I) requires a protracted period of nursing home care which can be furnished in the non-Department nursing home; and
(II) in the case of a veteran who has been furnished hospital care in a facility under the direct jurisdiction of the Secretary, has received maximum benefits from such care; and
(B) a member of the Armed Forces
(i) who has been furnished care in a hospital of the Armed Forces;
(ii) who the Secretary concerned determines has received maximum benefits from such care but requires a protracted period of nursing home care; and
(iii) who upon discharge from the Armed Forces will become a veteran.
(2) The Secretary may transfer a person to a nursing home under this subsection only if the Secretary determines that the cost to the United States of the care of such person in the nursing home will not exceed
(A) the amount equal to 45 percent of the cost of care furnished by the Department in a general hospital under the direct jurisdiction of the Secretary (as such cost may be determined annually by the Secretary); or
(B) the amount equal to 50 percent of such cost, if such higher amount is determined to be necessary by the Secretary (upon the recommendation of the Under Secretary for Health) to provide adequate care.
(3) Nursing home care may not be furnished under this subsection at the expense of the United States for more than six months in the aggregate in connection with any one transfer except
(A) in the case of a veteran
(i) who is transferred to a non-Department nursing home from a hospital under the direct jurisdiction of the Secretary; and
(ii) whose hospitalization was primarily for a service-connected disability;
(B) in a case in which the nursing home care is required for a service-connected disability; or
(C) in a case in which, in the judgment of the Secretary, a longer period of nursing home care is warranted.
(4) A veteran who is furnished care by the Secretary in a hospital or domiciliary facility in Alaska or Hawaii may be furnished nursing home care at the expense of the United States under this subsection even if such hospital or domiciliary facility is not under the direct jurisdiction of the Secretary.
(b) No veteran may be transferred or admitted to any institution for nursing home care under this section, unless such institution is determined by the Secretary to meet such standards as the Secretary may prescribe. The standards prescribed and any report of inspection of institutions furnishing care to veterans under this section made by or for the Secretary shall, to the extent possible, be made available to all Federal, State, and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions.
(c) 
(1) 
(A) In furnishing nursing home care, adult day health care, or other extended care services under this section, the Secretary may enter into agreements for furnishing such care or services with
(i) in the case of the medicare program, a provider of services that has entered into a provider agreement under section 1866(a) of the Social Security Act (42 U.S.C. 1395cc (a)); and
(ii) in the case of the medicaid program, a provider participating under a State plan under title XIX of such Act (42 U.S.C. 1396 et seq.).
(B) In entering into an agreement under subparagraph (A) with a provider of services described in clause (i) of that subparagraph or a provider described in clause (ii) of that subparagraph, the Secretary may use the procedures available for entering into provider agreements under section 1866(a) of the Social Security Act.
(2) In applying the provisions of section 2(b)(1) of the Service Contract Act of 1965 (41 U.S.C. 351 (b)(1)) with respect to any contract entered into under this section to provide nursing home care of veterans, the payment of wages not less than those specified in section 6(b) of the Fair Labor Standards Act of 1938 (29 U.S.C. 206 (b)) shall be deemed to constitute compliance with such provisions.
(d) 
(1) Subject to subsection (b) of this section, the Secretary may authorize for any veteran requiring nursing home care for a service-connected disability direct admission for such care at the expense of the United States to any non-Department nursing home. The Secretary may also authorize a direct admission to such a nursing home for nursing home care for any veteran who has been discharged from a hospital under the direct jurisdiction of the Secretary and who is currently receiving medical services as part of home health services from the Department.
(2) Direct admission authorized by paragraph (1) of this subsection may be authorized upon determination of need therefor
(A) by a physician employed by the Department; or
(B) in areas where no such physician is available, by a physician carrying out such function under contract or fee arrangement,

based on an examination by such physician.

(3) The amount which may be paid for such care and the length of care available under this subsection shall be the same as authorized under subsection (a) of this section.
(e) 
(1) The cost of intermediate care for purposes of payment by the United States pursuant to subsection (a)(2)(B) of this section shall be determined by the Secretary except that the rate of reimbursement shall be commensurately less than that provided for nursing home care.
(2) For the purposes of this section, the term non-Department nursing home means a public or private institution not under the direct jurisdiction of the Secretary which furnishes nursing home care.
(f) 
(1) 
(A) The Secretary may furnish adult day health care services to a veteran enrolled under section 1705 (a) of this title who would otherwise require nursing home care.
(B) The Secretary may provide in-kind assistance (through the services of Department employees and the sharing of other Department resources) to a facility furnishing care to veterans under subparagraph (A) of this paragraph. Any such in-kind assistance shall be provided under a contract or agreement between the Secretary and the facility concerned. The Secretary may provide such assistance only for use solely in the furnishing of adult day health care and only if, under such contract or agreement, the Department receives reimbursement for the full cost of such assistance, including the cost of services and supplies and normal depreciation and amortization of equipment. Such reimbursement may be made by reduction in the charges to the United States or by payment to the United States. Any funds received through such reimbursement shall be credited to funds allotted to the Department facility that provided the assistance.
(2) The Secretary may conduct, at facilities over which the Secretary has direct jurisdiction, programs for the furnishing of adult day health care to veterans who are eligible for such care under paragraph (1) of this subsection, except that necessary travel and incidental expenses (or transportation in lieu thereof) may be furnished under such a program only under the terms and conditions set forth in section 111 of this title. The furnishing of care under any such program shall be subject to the limitations that are applicable to the duration of adult day health care furnished under paragraph (1) of this subsection.

38 USC 1720A - Treatment and rehabilitative services for persons with drug or alcohol dependency

(a) The Secretary, in consultation with the Secretary of Labor and the Director of the Office of Personnel Management, may take appropriate steps to
(1)  urge all Federal agencies and appropriate private and public firms, organizations, agencies, and persons to provide appropriate employment and training opportunities for veterans who have been provided treatment and rehabilitative services under this title for alcohol or drug dependence or abuse disabilities and have been determined by competent medical authority to be sufficiently rehabilitated to be employable, and
(2)  provide all possible assistance to the Secretary of Labor in placing such veterans in such opportunities.
(b) Upon receipt of an application for treatment and rehabilitative services under this title for an alcohol or drug dependence or abuse disability from any individual who has been discharged or released from active military, naval, or air service but who is not eligible for such treatment and services, the Secretary shall
(1) provide referral services to assist such individual, to the maximum extent practicable, in obtaining treatment and rehabilitative services from sources outside the Department; and
(2) if pertinent, advise such individual of such individuals rights to apply to the appropriate military, naval, or air service and the Department for review of such individuals discharge or release from such service.
(c) 
(1) Any person serving in the active military, naval, or air service who is determined by the Secretary concerned to have an alcohol or drug dependence or abuse disability may be transferred to any facility in order for the Secretary to furnish care or treatment and rehabilitative services for such disability. Care and services provided to a member so transferred shall be provided as if such member were a veteran. Any transfer of any such member for such care and services shall be made pursuant to such terms as may be agreed upon by the Secretary concerned and the Secretary, subject to the provisions of sections 1535 and 1536 of title 31.
(2) No person serving in the active military, naval, or air service may be transferred pursuant to an agreement made under paragraph (1) of this subsection unless such person requests such transfer in writing for a specified period of time. No such person transferred pursuant to such a request may be furnished such care and services by the Secretary beyond the period of time specified in such request unless such person requests in writing an extension for a further specified period of time and such request is approved by the Secretary.
(d) 
(1) The Secretary shall ensure that each medical center of the Department develops and carries out a plan to provide treatment for substance use disorders, either through referral or direct provision of services, to veterans who require such treatment.
(2) Each plan under paragraph (1) shall make available clinically proven substance abuse treatment methods, including opioid substitution therapy, to veterans with respect to whom a qualified medical professional has determined such treatment methods to be appropriate.

38 USC 1720B - Respite care

(a) The Secretary may furnish respite care services to a veteran who is enrolled to receive care under section 1710 of this title.
(b) For the purpose of this section, the term respite care services means care and services which
(1) are of limited duration;
(2) are furnished on an intermittent basis to a veteran who is suffering from a chronic illness and who resides primarily at home; and
(3) are furnished for the purpose of helping the veteran to continue residing primarily at home.
(c) In furnishing respite care services, the Secretary may enter into contract arrangements.

38 USC 1720C - Noninstitutional alternatives to nursing home care

(a) The Secretary may furnish medical, rehabilitative, and health-related services in noninstitutional settings for veterans who are eligible under this chapter for, and are in need of, nursing home care. The Secretary shall give priority for participation in such program to veterans who
(1) are in receipt of, or are in need of, nursing home care primarily for the treatment of a service-connected disability; or
(2) have a service-connected disability rated at 50 percent or more.
(b) 
(1) Under the program conducted pursuant to subsection (a), the Secretary shall
(A)  furnish appropriate health-related services solely through contracts with appropriate public and private agencies that provide such services, and
(B)  designate Department health-care employees to furnish case management services to veteran furnished services under the program.
(2) For the purposes of paragraph (1), the term case management services includes the coordination and facilitation of all services furnished to a veteran by the Department of Veterans Affairs, either directly or through contract, including assessment of needs, planning, referral (including referral for services to be furnished by the Department, either directly or through a contract, or by an entity other than the Department), monitoring, reassessment, and followup.
(c) The Secretary may provide in-kind assistance (through the services of Department of Veterans Affairs employees and the sharing of other Department resources) to a facility furnishing services to veterans under subsection (b)(1)(A). Any such in-kind assistance shall be provided under a contract between the Department and the facility concerned. The Secretary may provide such assistance only for use solely in the furnishing of appropriate services under this section and only if, under such contract, the Department receives reimbursement for the full cost of such assistance (including the cost of services and supplies and normal depreciation and amortization of equipment). Such reimbursement may be made by reduction in the charges to the United States or by payment to the United States. Any funds received through such reimbursement shall be credited to funds allotted to the Department facility that provided the assistance.
(d) The total cost of providing services or in-kind assistance in the case of any veteran for any fiscal year under the program may not exceed 65 percent of the cost that would have been incurred by the Department during that fiscal year if the veteran had been furnished, instead, nursing home care under section 1710 of this title during that fiscal year.
(e) The authority of the Secretary to enter into contracts under this section shall be effective for any fiscal year only to the extent that appropriations are available.

38 USC 1720D - Counseling and treatment for sexual trauma

(a) 
(1) The Secretary shall operate a program under which the Secretary provides counseling and appropriate care and services to veterans who the Secretary determines require such counseling and care and services to overcome psychological trauma, which in the judgment of a mental health professional employed by the Department, resulted from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the veteran was serving on active duty or active duty for training.
(2) In furnishing counseling to a veteran under this subsection, the Secretary may provide such counseling pursuant to a contract with a qualified mental health professional if
(A)  in the judgment of a mental health professional employed by the Department, the receipt of counseling by that veteran in facilities of the Department would be clinically inadvisable, or
(B)  Department facilities are not capable of furnishing such counseling to that veteran economically because of geographical inaccessibility.
(b) 
(1) The Secretary shall give priority to the establishment and operation of the program to provide counseling and care and services under subsection (a). In the case of a veteran eligible for counseling and care and services under subsection (a), the Secretary shall ensure that the veteran is furnished counseling and care and services under this section in a way that is coordinated with the furnishing of such care and services under this chapter.
(2) In establishing a program to provide counseling under subsection (a), the Secretary shall
(A) provide for appropriate training of mental health professionals and such other health care personnel as the Secretary determines necessary to carry out the program effectively;
(B) seek to ensure that such counseling is furnished in a setting that is therapeutically appropriate, taking into account the circumstances that resulted in the need for such counseling; and
(C) provide referral services to assist veterans who are not eligible for services under this chapter to obtain those from sources outside the Department.
(c) The Secretary shall provide information on the counseling and treatment available to veterans under this section. Efforts by the Secretary to provide such information
(1) shall include availability of a toll-free telephone number (commonly referred to as an 800 number);
(2) shall ensure that information about the counseling and treatment available to veterans under this section
(A) is revised and updated as appropriate;
(B) is made available and visibly posted at appropriate facilities of the Department; and
(C) is made available through appropriate public information services; and
(3) shall include coordination with the Secretary of Defense seeking to ensure that individuals who are being separated from active military, naval, or air service are provided appropriate information about programs, requirements, and procedures for applying for counseling and treatment under this section.
(d) In this section, the term sexual harassment means repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character.

38 USC 1720E - Nasopharyngeal radium irradiation

(a) The Secretary may provide any veteran a medical examination, and hospital care, medical services, and nursing home care, which the Secretary determines is needed for the treatment of any cancer of the head or neck which the Secretary finds may be associated with the veterans receipt of nasopharyngeal radium irradiation treatments in active military, naval, or air service.
(b) The Secretary shall provide care and services to a veteran under subsection (a) only on the basis of evidence in the service records of the veteran which document nasopharyngeal radium irradiation treatment in service, except that, notwithstanding the absence of such documentation, the Secretary may provide such care to a veteran who
(1) served as an aviator in the active military, naval, or air service before the end of the Korean conflict; or
(2) underwent submarine training in active naval service before January 1, 1965.

38 USC 1720F - Comprehensive program for suicide prevention among veterans

(a) Establishment.— 
The Secretary shall develop and carry out a comprehensive program designed to reduce the incidence of suicide among veterans incorporating the components described in this section.
(b) Staff Education.— 
In carrying out the comprehensive program under this section, the Secretary shall provide for mandatory training for appropriate staff and contractors (including all medical personnel) of the Department who interact with veterans. This training shall cover information appropriate to the duties being performed by such staff and contractors. The training shall include information on
(1) recognizing risk factors for suicide;
(2) proper protocols for responding to crisis situations involving veterans who may be at high risk for suicide; and
(3) best practices for suicide prevention.
(c) Health Assessments of Veterans.— 
In carrying out the comprehensive program, the Secretary shall direct that medical staff offer mental health in their overall health assessment when veterans seek medical care at a Department medical facility (including a center established under section 1712A of this title) and make referrals, at the request of the veteran concerned, to appropriate counseling and treatment programs for veterans who show signs or symptoms of mental health problems.
(d) Designation of Suicide Prevention Counselors.— 
In carrying out the comprehensive program, the Secretary shall designate a suicide prevention counselor at each Department medical facility other than centers established under section 1712A of this title. Each counselor shall work with local emergency rooms, police departments, mental health organizations, and veterans service organizations to engage in outreach to veterans and improve the coordination of mental health care to veterans.
(e) Best Practices Research.— 
In carrying out the comprehensive program, the Secretary shall provide for research on best practices for suicide prevention among veterans. Research shall be conducted under this subsection in consultation with the heads of the following entities:
(1) The Department of Health and Human Services.
(2) The National Institute of Mental Health.
(3) The Substance Abuse and Mental Health Services Administration.
(4) The Centers for Disease Control and Prevention.
(f) Sexual Trauma Research.— 
In carrying out the comprehensive program, the Secretary shall provide for research on mental health care for veterans who have experienced sexual trauma while in military service. The research design shall include consideration of veterans of a reserve component.
(g) 24-Hour Mental Health Care.— 
In carrying out the comprehensive program, the Secretary shall provide for mental health care availability to veterans on a 24-hour basis.
(h) Hotline.— 
In carrying out the comprehensive program, the Secretary may provide for a toll-free hotline for veterans to be staffed by appropriately trained mental health personnel and available at all times.
(i) Outreach and Education for Veterans and Families.— 
In carrying out the comprehensive program, the Secretary shall provide for outreach to and education for veterans and the families of veterans, with special emphasis on providing information to veterans of Operation Iraqi Freedom and Operation Enduring Freedom and the families of such veterans. Education to promote mental health shall include information designed to
(1) remove the stigma associated with mental illness;
(2) encourage veterans to seek treatment and assistance for mental illness;
(3) promote skills for coping with mental illness; and
(4) help families of veterans with
(A) understanding issues arising from the readjustment of veterans to civilian life;
(B) identifying signs and symptoms of mental illness; and
(C) encouraging veterans to seek assistance for mental illness.
(j) Peer Support Counseling Program.— 

(1) In carrying out the comprehensive program, the Secretary may establish and carry out a peer support counseling program, under which veterans shall be permitted to volunteer as peer counselors
(A) to assist other veterans with issues related to mental health and readjustment; and
(B) to conduct outreach to veterans and the families of veterans.
(2) In carrying out the peer support counseling program under this subsection, the Secretary shall provide adequate training for peer counselors.
(k) Other Components.— 
In carrying out the comprehensive program, the Secretary may provide for other actions to reduce the incidence of suicide among veterans that the Secretary considers appropriate.

TITLE 38 - US CODE - SUBCHAPTER III - MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS

38 USC 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 USC 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 veterans 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 veterans maintenance.
(2) A determination described in this paragraph is a determination that for purposes of subsection (a)(3) of this section a veterans 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 veterans income for the current year are that the veterans 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 previous year 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 veterans 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 veterans inability to defray necessary expenses.

38 USC 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; or
(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.
(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 USC 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 USC 1724 - Hospital care, medical services, and nursing home care abroad

(a) Except as provided in subsections (b) and (c), 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.

38 USC 1725 - Reimbursement for emergency treatment

(a) General Authority.— 

(1) Subject to subsections (c) and (d), the Secretary may 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 Secretarys 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 (f)(2)(B) or (f)(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 or in part, 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.
(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 veterans 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 veterans 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 veterans 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 veterans 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 Secretarys 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) 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 such time as the veteran can be transferred safely 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.
(E) A law of a State or political subdivision described in section 1729 (a)(2)(B) 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 employers 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 USC 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 USC 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 USC 1728 - Reimbursement of certain medical expenses

(a) The Secretary may, under such regulations as the Secretary shall prescribe, reimburse veterans entitled to hospital care or medical services under this chapter for the reasonable value of such care or services (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
(1) such care or services were rendered in a medical emergency of such nature that delay would have been hazardous to life or health;
(2) such care or services were rendered to a veteran in need thereof
(A)  for an adjudicated service-connected disability,
(B)  for a non-service-connected disability associated with and held to be aggravating a service-connected disability,
(C)  for any disability of a veteran who has a total disability permanent in nature from a service-connected disability, or
(D)  for any illness, injury, or dental condition in the case of a veteran who
(i)  is a participant in a vocational rehabilitation program (as defined in section 3101 (9) of this title), and
(ii)  is medically determined to have been in need of care or treatment to make possible such veterans 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; and
(3) Department or other Federal facilities were not feasibly available, and an attempt to use them beforehand would not have been reasonable, sound, wise, or practical.
(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 care or services directly
(1) to the hospital or other health facility furnishing the care or services; or
(2) to the person or organization making such expenditure on behalf of such veteran.

38 USC 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 a veteran is furnished 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 reasonable charges for such care or services (as determined by the Secretary) from a third party to the extent that the veteran (or the 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 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 veterans 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 veteran 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 States or subdivisions expense for personal injuries suffered as the result of such crime;
(D) that is incurred by a veteran
(i) who does not have a service-connected disability; and
(ii) 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 before October 1, 2008, 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 veteran
(A) the veterans 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 veteran (or the veterans 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 veteran (or the veterans 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 veteran by the Secretary under this chapter;
(ii) the United States has sent written notice by certified mail to the veteran at the veterans last-known address (or to the veterans 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 Generals 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) A veteran 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 a veteran 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 veteran; and
(B) that the provision of such care or services to the veteran meets criteria generally applicable under the health-plan contract involved.
(2) A veteran described in this paragraph is a veteran 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 veteran.
(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 employers 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 USC 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 106117; 38 U.S.C. 8111 note ).
(10) Public Law 87693, 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 USC 1729B - Repealed. Pub. L. 1087, div. K, title I, 113(a)(1), Feb. 20, 2003, 117 Stat. 482]

Section, added Pub. L. 106–117, title II, § 202(a), Nov. 30, 1999, 113 Stat. 1561; amended Pub. L. 107–103, title V, § 509(c), Dec. 27, 2001, 115 Stat. 997; Pub. L. 107–330, title III, § 308(g)(7), Dec. 6, 2002, 116 Stat. 2829, related to the Department of Veterans Affairs Health Services Improvement Fund.

38 USC 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 Secretarys approval of a facility for the purposes of this section shall be based upon the Secretarys 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.

TITLE 38 - US CODE - SUBCHAPTER IV - HOSPITAL CARE AND MEDICAL TREATMENT FOR VETERANS IN THE REPUBLIC OF THE PHILIPPINES

38 USC 1731 - Assistance to the Republic of the Philippines

The President is authorized to assist the Republic of the Philippines in fulfilling its responsibility in providing medical care and treatment for Commonwealth Army veterans and new Philippine Scouts in need of such care and treatment for service-connected disabilities and non-service-connected disabilities under certain conditions.

38 USC 1732 - Contracts and grants to provide for the care and treatment of United States veterans by the Veterans Memorial Medical Center

(a) The President, with the concurrence of the Republic of the Philippines, may authorize the Secretary to enter into contracts with the Veterans Memorial Medical Center, with the approval of the appropriate department of the Government of the Republic of the Philippines, covering the period beginning on October 1, 1981, and ending on September 30, 1994, under which the United States
(1) will provide for payments for hospital care and medical services (including nursing home care) in the Veterans Memorial Medical Center, as authorized by section 1724 of this title and on the terms and conditions set forth in such section, to eligible United States veterans at a per diem rate to be jointly determined for each fiscal year by the two Governments to be fair and reasonable; and
(2) may provide that payments for such hospital care and medical services provided to eligible United States veterans may consist in whole or in part of available medicines, medical supplies, and equipment furnished by the Secretary to the Veterans Memorial Medical Center at valuations therefor as determined by the Secretary, who may furnish such medicines, medical supplies, and equipment through the revolving supply fund pursuant to section 8121 of this title.
(b) 
(1) To further assure the effective care and treatment of United States veterans in the Veterans Memorial Medical Center, there is authorized to be appropriated for each fiscal year during the period beginning on October 1, 1981, and ending on September 30, 1990, the sum of $1,000,000 to be used by the Secretary for making grants to the Veterans Memorial Medical Center for the purpose of assisting the Republic of the Philippines in the replacement and upgrading of equipment and in rehabilitating the physical plant and facilities of such center.
(2) Grants under this subsection shall be made on such terms and conditions as prescribed by the Secretary. Such terms and conditions may include a requirement of prior approval by the Secretary of the uses of the funds provided by such grants.
(3) Funds for such grants may be provided only from appropriations made to the Department for the specific purpose of making such grants.
(c) The Secretary may stop payments under a contract or grant under this section upon reasonable notice as stipulated by the contract or grant if the Republic of the Philippines and the Veterans Memorial Medical Center do not maintain the medical center in a well-equipped and effective operating condition as determined by the Secretary.
(d) 
(1) The authority of the Secretary to enter into contracts and to make grants under this section is effective for any fiscal year only to the extent that appropriations are available for that purpose.
(2) Appropriations made for the purpose of this section shall remain available until expended.

38 USC 1733 - Supervision of program by the President

The President, or any officer of the United States to whom the President may delegate authority under this section, may from time to time prescribe such rules and regulations and impose such conditions on the receipt of financial aid as may be necessary to carry out this subchapter.

38 USC 1734 - Hospital and nursing home care and medical services in the United States

(a) The Secretary shall furnish hospital and nursing home care and medical services to any individual described in subsection (b) in the same manner, and subject to the same terms and conditions, as apply to the furnishing of such care and services to individuals who are veterans as defined in section 101 (2) of this title. Any disability of an individual described in subsection (b) that is a service-connected disability for purposes of this subchapter (as provided for under section 1735 (2) of this title) shall be considered to be a service-connected disability for purposes of furnishing care and services under the preceding sentence.
(b) Subsection (a) applies to any individual who is a Commonwealth Army veteran or new Philippine Scout and who
(1) is residing in the United States; and
(2) is a citizen of the United States or an alien lawfully admitted to the United States for permanent residence.

38 USC 1735 - Definitions

For the purposes of this subchapter
(1) The term Commonwealth Army veterans means persons who served before July 1, 1946, in the organized military forces of the Government of the Philippines, while such forces were in the service of the Armed Forces pursuant to the military order of the President dated July 26, 1941, including among such military forces organized guerrilla forces under commanders appointed, designated, or subsequently recognized by the Commander in Chief, Southwest Pacific Area, or other competent authority in the Army of the United States, and who were discharged or released from such service under conditions other than dishonorable. The term new Philippine Scouts means persons who served in the Philippine Scouts under section 14 of the Armed Forces Voluntary Recruitment Act of 1945, and who were discharged or released from such service under conditions other than dishonorable.
(2) The term service-connected disabilities means disabilities determined by the Secretary under laws administered by the Secretary to have been incurred in or aggravated by the service described in paragraph (1) in line of duty.

TITLE 38 - US CODE - SUBCHAPTER V - PAYMENTS TO STATE HOMES

38 USC 1741 - Criteria for payment

(a) 
(1) Except as provided in section 1745 of this title, the Secretary shall pay each State at the per diem rate of
(A) $8.70 for domiciliary care; and
(B) $20.35 for nursing home care and hospital care,

for each veteran receiving such care in a State home, if such veteran is eligible for such care in a Department facility.

(2) The Secretary may pay each State per diem at a rate determined by the Secretary for each veteran receiving extended care services described in any of paragraphs (4) through (6) of section 1710B (a) of this title under a program administered by a State home, if such veteran is eligible for such care under laws administered by the Secretary.
(b) In no case shall the payments made with respect to any veteran under this section exceed one-half of the cost of the veterans care in such State home.
(c) Whenever the Secretary makes a determination pursuant to section 1720 (a)(2)(A) of this title that the cost of care furnished by the Department in a general hospital under the direct jurisdiction of the Secretary has increased, the Secretary may, effective no earlier than the date of such determination, increase the rates paid under subsection (a) of this section by a percentage not greater than the percentage by which the Secretary has determined that such cost of care has increased.
(d) Subject to section 1743 of this title, the payment of per diem for care furnished in a State home facility shall commence on the date of the completion of the inspection for recognition of the facility under section 1742 (a) of this title if the Secretary determines, as a result of that inspection, that the State home meets the standards described in such section.
(e) Payments to States pursuant to this section shall not be considered a liability of a third party, or otherwise be used to offset or reduce any other payment made to assist veterans.
(f) Any State home that requests payment or reimbursement for services provided to a veteran under this section shall provide to the Secretary such information as the Secretary considers necessary to identify each individual veteran eligible for payment under such section.

38 USC 1742 - Inspections of such homes; restrictions on beneficiaries

(a) The Secretary may inspect any State home at such times as the Secretary deems necessary. No payment or grant may be made to any home under this subchapter unless such home is determined by the Secretary to meet such standards as the Secretary shall prescribe, which standards with respect to nursing home care shall be no less stringent than those prescribed pursuant to section 1720 (b) of this title.
(b) The Secretary may ascertain the number of persons on account of whom payments may be made under this subchapter on account of any State home, but shall have no authority over the management or control of any State home.

38 USC 1743 - Applications

Payments on account of any veteran cared for in a State home shall be made under this subchapter only from the date the Secretary receives a request for determination of such veterans eligibility; however, if such request is received by the Secretary within ten days after care of such veteran begins, payments shall be made on account of such veteran from the date care began.

38 USC 1744 - Hiring and retention of nurses: payments to assist States

(a) Payment Program.— 
The Secretary shall make payments to States under this section for the purpose of assisting State homes in the hiring and retention of nurses and the reduction of nursing shortages at State homes.
(b) Eligible Recipients.— 
Payments to a State for a fiscal year under this section shall, subject to submission of an application, be made to any State that during that fiscal year
(1) receives per diem payments under this subchapter for that fiscal year; and
(2) has in effect an employee incentive scholarship program or other employee incentive program at a State home designed to promote the hiring and retention of nursing staff and to reduce nursing shortages at that home.
(c) Use of Funds Received.— 
A State may use an amount received under this section only to provide funds for a program described in subsection (b)(2). Any program shall meet such criteria as the Secretary may prescribe. In prescribing such criteria, the Secretary shall take into consideration the need for flexibility and innovation.
(d) Limitations on Amount of Payment.— 

(1) A payment under this section may not be used to provide more than 50 percent of the costs for a fiscal year of the employee incentive scholarship or other employee incentive program for which the payment is made.
(2) The amount of the payment to a State under this section for any fiscal year is, for each State home in that State with a program described in subsection (b)(2), the amount equal to 2 percent of the amount of payments estimated to be made to that State, for that State home, under section 1741 of this title for that fiscal year.
(e) Applications.— 
A payment under this section for any fiscal year with respect to any State home may only be made based upon an application submitted by the State seeking the payment with respect to that State home. Any such application shall describe the nursing shortage at the State home and the employee incentive scholarship program or other employee incentive program described in subsection (c) for which the payment is sought.
(f) Source of Funds.— 
Payments under this section shall be made from funds available for other payments under this subchapter.
(g) Disbursement.— 
Payments under this section to a State home shall be made as part of the disbursement of payments under section 1741 of this title with respect to that State home.
(h) Use of Certain Receipts.— 
The Secretary shall require as a condition of any payment under this section that, in any case in which the State home receives a refund payment made by an employee in breach of the terms of an agreement for employee assistance that used funds provided under this section, the payment shall be returned to the State homes incentive program account and credited as a non-Federal funding source.
(i) Annual Report From Payment Recipients.— 
Any State home receiving a payment under this section for any fiscal year, shall, as a condition of the payment, be required to agree to provide to the Secretary a report setting forth in detail the use of funds received through the payment, including a descriptive analysis of how effective the incentive program has been on nurse staffing in the State home during that fiscal year. The report for any fiscal year shall be provided to the Secretary within 60 days of the close of the fiscal year and shall be subject to audit by the Secretary. Eligibility for a payment under this section for any later fiscal year is contingent upon the receipt by the Secretary of the annual report under this subsection for the previous fiscal year in accordance with this subsection.
(j) Regulations.— 
The Secretary shall prescribe regulations to carry out this section. The regulations shall include the establishment of criteria for the award of payments under this section.

38 USC 1745 - Nursing home care and medications for veterans with service-connected disabilities

(a) 
(1) The Secretary shall pay each State home for nursing home care at the rate determined under paragraph (2), in any case in which such care is provided to any veteran as follows:
(A) Any veteran in need of such care for a service-connected disability.
(B) Any veteran who
(i) has a service-connected disability rated at 70 percent or more; and
(ii) is in need of such care.
(2) The rate determined under this paragraph with respect to a State home is the lesser of
(A) the applicable or prevailing rate payable in the geographic area in which the State home is located, as determined by the Secretary, for nursing home care furnished in a non-Department nursing home (as that term is defined in section 1720 (e)(2) of this title); or
(B) a rate not to exceed the daily cost of care, as determined by the Secretary, following a report to the Secretary by the director of the State home.
(3) Payment by the Secretary under paragraph (1) to a State home for nursing home care provided to a veteran described in that paragraph constitutes payment in full to the State home for such care furnished to that veteran.
(b) The Secretary shall furnish such drugs and medicines as may be ordered on prescription of a duly licensed physician as specific therapy in the treatment of illness or injury to any veteran as follows:
(1) Any veteran who
(A) is not being provided nursing home care for which payment is payable under subsection (a); and
(B) is in need of such drugs and medicines for a service-connected disability.
(2) Any veteran who
(A) has a service-connected disability rated at 50 percent or more;
(B) is not being provided nursing home care for which payment is payable under subsection (a); and
(C) is in need of such drugs and medicines.
(c) Any State home that requests payment or reimbursement for services provided to a veteran under this section shall provide to the Secretary such information as the Secretary considers necessary to identify each individual veteran eligible for payment under such section.

TITLE 38 - US CODE - SUBCHAPTER VI - SICKLE CELL ANEMIA

38 USC 1751 - Screening, counseling, and medical treatment

The Secretary is authorized to carry out a comprehensive program of providing sickle cell anemia screening, counseling, treatment, and information under the provisions of this chapter.

38 USC 1752 - Research

The Secretary is authorized to carry out research and research training in the diagnosis, treatment, and control of sickle cell anemia based upon the screening examinations and treatment provided under this subchapter.

38 USC 1753 - Voluntary participation; confidentiality

(a) The participation by any person in any program or portion thereof under this subchapter shall be wholly voluntary and shall not be a prerequisite to eligibility for or receipt of any other service or assistance from, or to participation in, any other program under this title.
(b) Patient records prepared or obtained under this subchapter shall be held confidential in the same manner and under the same conditions prescribed in section 7332 of this title.

38 USC 1754 - Reports

The Secretary shall include in the annual report to the Congress required by section 529 of this title a comprehensive report on the administration of this subchapter, including such recommendations for additional legislation as the Secretary deems necessary.

1761 to 1764. Repealed. Pub. L. 102585, title V, 514(a), Nov. 4, 1992, 106 Stat. 4958]

Section 1761, added Pub. L. 96–22, title I, § 105(a), June 13, 1979, 93 Stat. 52, 661; amended Pub. L. 98–160, title I, § 106(b), Nov. 21, 1983, 97 Stat. 998; renumbered 1761, Pub. L. 102–83, § 5(a), Aug. 6, 1991, 105 Stat. 406, related to purpose of this subchapter, which established a preventive health-care services pilot program. Prior section 1761 was renumbered section 3561 of this title. Section 1762, added Pub. L. 96–22, title I, § 105(a), June 13, 1979, 93 Stat. 52, 662; renumbered 1762 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5 (a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–585, title V, § 513(a), Nov. 4, 1992, 106 Stat. 4958, defined the term preventive health-care services for purposes of this subchapter. Section 1762 of this title was transferred to section 1701 (9) of this title by Pub. L. 102–585. Prior section 1762 was renumbered section 3562 of this title. Section 1763, added Pub. L. 96–22, title I, § 105(a), June 13, 1979, 93 Stat. 52, 663; amended Pub. L. 96–128, title V, § 501(d), Nov. 28, 1979, 93 Stat. 987; Pub. L. 98–160, title I, § 106(c), Nov. 21, 1983, 97 Stat. 998; Pub. L. 99–272, title XIX, § 19011(d)(6), Apr. 7, 1986, 100 Stat. 379; renumbered 1763 and amended Pub. L. 102–83, §§ 4(a)(3), (4), (b)(1), (2)(E), 5 (a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406, related to provision of preventive health-care services under this subchapter. Prior section 1763 was renumbered section 3563 of this title. Another prior section 1763, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1201, provided for control by agencies of the United States, prior to repeal by Pub. L. 89–358, § 3(a)(3), Mar. 3, 1966, 80 Stat. 20. See section 3682 of this title. Section 1764, added Pub. L. 96–22, title I, § 105(a), June 13, 1979, 93 Stat. 53, 664; amended Pub. L. 98–160, title I, § 106(d), Nov. 21, 1983, 97 Stat. 999; renumbered 1764 and amended Pub. L. 102–83, §§ 4(b)(1), (2)(E), 5 (a), Aug. 6, 1991, 105 Stat. 404–406, directed Secretary to include comprehensive reports on administration of this subchapter in annual reports to Congress for fiscal years 1984 through 1988. Prior section 1764, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1201, provided for dismissal for conflict of interest, prior to repeal by Pub. L. 89–358, §§ 3(a)(3), 12 (a), Mar. 3, 1966, 80 Stat. 20, 28, effective Mar. 3, 1966. See section 3683 of this title. Prior section 1765 was renumbered section 3565 of this title. Another prior section 1765, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1202, provided for reports by institutions, prior to repeal by Pub. L. 89–358, § 3(a)(3), Mar. 3, 1966, 80 Stat. 20. See section 3684 of this title. Prior section 1766 was renumbered section 3566 of this title. Another prior section 1766, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1202, related to overpayments to eligible persons, prior to repeal by Pub. L. 89–358, § 3(a)(3), Mar. 3, 1966, 80 Stat. 20. See section 3685 of this title. Prior section 1767, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1202, related to examination of records, prior to repeal by Pub. L. 89–358, § 3(a)(3), Mar. 3, 1966, 80 Stat. 20. Prior section 1768, Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1202, related to false or misleading statements, prior to repeal by Pub. L. 89–358, § 3(a)(3), Mar. 3, 1966, 80 Stat. 20. A prior section 1770 was renumbered section 3670 of this title.

[SUBCHAPTER VII - TRANSFERRED]

1771 to 1774. Renumbered 2031 to 2034]

TITLE 38 - US CODE - SUBCHAPTER VIII - HEALTH CARE OF PERSONS OTHER THAN VETERANS

38 USC 1781 - Medical care for survivors and dependents of certain veterans

(a) The Secretary is authorized to provide medical care, in accordance with the provisions of subsection (b) of this section, for
(1) the spouse or child of a veteran who has a total disability, permanent in nature, resulting from a service-connected disability,
(2) the surviving spouse or child of a veteran who
(A)  died as a result of a service-connected disability, or
(B)  at the time of death had a total disability permanent in nature, resulting from a service-connected disability, and
(3) the surviving spouse or child of a person who died in the active military, naval, or air service in the line of duty and not due to such persons own misconduct,

who are not otherwise eligible for medical care under chapter 55 of title 10 (CHAMPUS).

(b) In order to accomplish the purposes of subsection (a) of this section, the Secretary shall provide for medical care in the same or similar manner and subject to the same or similar limitations as medical care is furnished to certain dependents and survivors of active duty and retired members of the Armed Forces under chapter 55 of title 10 (CHAMPUS), by
(1) entering into an agreement with the Secretary of Defense under which that Secretary shall include coverage for such medical care under the contract, or contracts, that Secretary enters into to carry out such chapter 55, and under which the Secretary of Veterans Affairs shall fully reimburse the Secretary of Defense for all costs and expenditures made for the purposes of affording the medical care authorized pursuant to this section; or
(2) contracting in accordance with such regulations as the Secretary shall prescribe for such insurance, medical service, or health plans as the Secretary deems appropriate.

In cases in which Department medical facilities are equipped to provide the care and treatment, the Secretary is also authorized to carry out such purposes through the use of such facilities not being utilized for the care of eligible veterans. A dependent or survivor receiving care under the preceding sentence shall be eligible for the same medical services as a veteran, including services under sections 1782 and 1783 of this title.

(c) For the purposes of this section, a child between the ages of eighteen and twenty-three (1) who is eligible for benefits under subsection (a) of this section, (2) who is pursuing a full-time course of instruction at an educational institution approved under chapter 36 of this title, and (3) who, while pursuing such course of instruction, incurs a disabling illness or injury (including a disabling illness or injury incurred between terms, semesters, or quarters or during a vacation or holiday period) which is not the result of such childs own willful misconduct and which results in such childs inability to continue or resume such childs chosen program of education at an approved educational institution shall remain eligible for benefits under this section until the end of the six-month period beginning on the date the disability is removed, the end of the two-year period beginning on the date of the onset of the disability, or the twenty-third birthday of the child, whichever occurs first.
(d) 
(1) 
(A) An individual otherwise eligible for medical care under this section who is also entitled to hospital insurance benefits under part A of the medicare program is eligible for medical care under this section only if the individual is also enrolled in the supplementary medical insurance program under part B of the medicare program.
(B) The limitation in subparagraph (A) does not apply to an individual who
(i) has attained 65 years of age as of June 5, 2001; and
(ii) is not enrolled in the supplementary medical insurance program under part B of the medicare program as of that date.
(2) Subject to paragraph (3), if an individual described in paragraph (1) receives medical care for which payment may be made under both this section and the medicare program, the amount payable for such medical care under this section shall be the amount by which
(A)  the costs for such medical care exceed
(B)  the sum of
(i) the amount payable for such medical care under the medicare program; and
(ii) the total amount paid or payable for such medical care by third party payers other than the medicare program.
(3) The amount payable under this subsection for medical care may not exceed the total amount that would be paid under subsection (b) if payment for such medical care were made solely under subsection (b).
(4) In this subsection:
(A) The term medicare program means the program of health insurance administered by the Secretary of Health and Human Services under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
(B) The term third party has the meaning given that term in section 1729 (i)(3) of this title.

38 USC 1782 - Counseling, training, and mental health services for immediate family members

(a) Counseling for Family Members of Veterans Receiving Service-Connected Treatment.— 
In the case of a veteran who is receiving treatment for a service-connected disability pursuant to paragraph (1) or (2) of section 1710 (a) of this title, the Secretary shall provide to individuals described in subsection (c) such consultation, professional counseling, training, and mental health services as are necessary in connection with that treatment.
(b) Counseling for Family Members of Veterans Receiving Non-Service-Connected Treatment.— 
In the case of a veteran who is eligible to receive treatment for a non-service-connected disability under the conditions described in paragraph (1), (2), or (3) of section 1710 (a) of this title, the Secretary may, in the discretion of the Secretary, provide to individuals described in subsection (c) such consultation, professional counseling, training, and mental health services as are necessary in connection with that treatment if
(1) those services were initiated during the veterans hospitalization; and
(2) the continued provision of those services on an outpatient basis is essential to permit the discharge of the veteran from the hospital.
(c) Eligible Individuals.— 
Individuals who may be provided services under this subsection are
(1) the members of the immediate family or the legal guardian of a veteran; or
(2) the individual in whose household such veteran certifies an intention to live.
(d) Travel and Transportation Authorized.— 
Services provided under subsections (a) and (b) may include, under the terms and conditions set forth in section 111 of this title, travel and incidental expenses of individuals described in subsection (c) in the case of any of the following:
(1) A veteran who is receiving care for a service-connected disability.
(2) A dependent or survivor receiving care under the last sentence of section 1783 (b) of this title.

38 USC 1783 - Bereavement counseling

(a) Deaths of Veterans.— 
In the case of an individual who was a recipient of services under section 1782 of this title at the time of the death of the veteran, the Secretary may provide bereavement counseling to that individual in the case of a death
(1) that was unexpected; or
(2) that occurred while the veteran was participating in a hospice program (or a similar program) conducted by the Secretary.
(b) Deaths In Active Service.— 

(1) The Secretary may provide bereavement counseling to an individual who is a member of the immediate family of a member of the Armed Forces who dies in the active military, naval, or air service in the line of duty and under circumstances not due to the persons own misconduct.
(2) For purposes of this subsection, the members of the immediate family of a member of the Armed Forces described in paragraph (1) include the parents of such member.
(c) Provision of Counseling Through Vet Centers.— 
Bereavement counseling may be provided under this section through the facilities and personnel of centers for the provision of readjustment counseling and related mental health services under section 1712A of this title.
(d) Bereavement Counseling Defined.— 
For purposes of this section, the term bereavement counseling means such counseling services, for a limited period, as the Secretary determines to be reasonable and necessary to assist an individual with the emotional and psychological stress accompanying the death of another individual.

38 USC 1784 - Humanitarian care

The Secretary may furnish hospital care or medical services as a humanitarian service in emergency cases, but the Secretary shall charge for such care and services at rates prescribed by the Secretary.

38 USC 1785 - Care and services during certain disasters and emergencies

(a) Authority To Provide Hospital Care and Medical Services.— 
During and immediately following a disaster or emergency referred to in subsection (b), the Secretary may furnish hospital care and medical services to individuals responding to, involved in, or otherwise affected by that disaster or emergency.
(b) Covered Disasters and Emergencies.— 
A disaster or emergency referred to in this subsection is any disaster or emergency as follows:
(1) A major disaster or emergency declared by the President under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.).
(2) A disaster or emergency in which the National Disaster Medical System established pursuant to section 2811(b) of the Public Health Service Act (42 U.S.C. 300hh–11 (b))1 is activated by the Secretary of Health and Human Services under paragraph (3)(A) of that section or as otherwise authorized by law.
(c) Applicability to Eligible Individuals Who Are Veterans.— 
The Secretary may furnish care and services under this section to an individual described in subsection (a) who is a veteran without regard to whether that individual is enrolled in the system of patient enrollment under section 1705 of this title.
(d) Reimbursement From Other Federal Departments and Agencies.— 

(1) The cost of any care or services furnished under this section to an officer or employee of a department or agency of the United States other than the Department or to a member of the Armed Forces shall be reimbursed at such rates as may be agreed upon by the Secretary and the head of such department or agency or the Secretary concerned, in the case of a member of the Armed Forces, based on the cost of the care or service furnished.
(2) Amounts received by the Department under this subsection shall be credited to the Medical Care Collections Fund under section 1729A of this title.
(e) Report to Congressional Committees.— 
Within 60 days of the commencement of a disaster or emergency referred to in subsection (b) in which the Secretary furnishes care and services under this section (or as soon thereafter as is practicable), the Secretary shall submit to the Committees on Veterans Affairs of the Senate and the House of Representatives a report on the Secretarys allocation of facilities and personnel in order to furnish such care and services.
(f) Regulations.— 
The Secretary shall prescribe regulations governing the exercise of the authority of the Secretary under this section.
[1] See References in Text note below.