§ 1701. Definitions

§ 1701. Definitions

(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, marriage and family 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 the Secretary considers appropriate for 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) Noninstitutional extended care services, including alternatives to institutional extended care that the Secretary may furnish directly, by contract, or through provision of case management by another provider or payer.

(F) 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.

(G) Travel and incidental expenses pursuant to section 111 of this title.

(H) Chiropractic services.

(I) The provision of medically necessary van lifts, raised doors, raised roofs, air conditioning, and wheelchair tiedowns for passenger use.

(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, chiropractic, 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) chiropractic examinations and services;

(G) immunizations against infectious diseases, including each immunization on the recommended adult immunization schedule at the time such immunization is indicated on that schedule;

(H) prevention of musculoskeletal deformity or other gradually developing disabilities of a metabolic or degenerative nature;

(I) genetic counseling concerning inheritance of genetically determined diseases;

(J) routine vision testing and eye care services;

(K) 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

(L) such other health-care services as the Secretary may determine to be necessary to provide effective and economical preventive health care.

(10) The term “recommended adult immunization schedule” means the schedule established (and periodically reviewed and, as appropriate, revised) by the Advisory Committee on Immunization Practices established by the Secretary of Health and Human Services and delegated to the Centers for Disease Control and Prevention.

(Pub. L. 85–857, Sept. 2, 1958, 72 Stat. 1141, § 601; Pub. L. 86–598, July 7, 1960, 74 Stat. 335; Pub. L. 86–639, § 2, July 12, 1960, 74 Stat. 472; Pub. L. 88–481, Aug. 22, 1964, 78 Stat. 593; Pub. L. 90–612, § 2, Oct. 21, 1968, 82 Stat. 1202; Pub. L. 93–82, title I, § 101, Aug. 2, 1973, 87 Stat. 179; Pub. L. 94–581, title I, § 102, title II, § 202(b), Oct. 21, 1976, 90 Stat. 2843, 2855; Pub. L. 95–520, § 5, Oct. 26, 1978, 92 Stat. 1820; Pub. L. 96–22, title I, § 102(c), title II, § 201(a), June 13, 1979, 93 Stat. 48, 54; Pub. L. 96–151, title II, §§ 201(b), 202, Dec. 20, 1979, 93 Stat. 1093, 1094; Pub. L. 97–72, title I, § 101, Nov. 3, 1981, 95 Stat. 1047; Pub. L. 97–251, § 4, Sept. 8, 1982, 96 Stat. 716; Pub. L. 98–105, Sept. 30, 1983, 97 Stat. 730; Pub. L. 98–160, title I, § 106(a), Nov. 21, 1983, 97 Stat. 998; Pub. L. 98–528, title I, § 103(a), Oct. 19, 1984, 98 Stat. 2688; Pub. L. 99–108, § 2, Sept. 30, 1985, 99 Stat. 481; Pub. L. 99–166, title I, § 102(a), Dec. 3, 1985, 99 Stat. 943; Pub. L. 99–272, title XIX, §§ 19011(d)(2), 19012(a), Apr. 7, 1986, 100 Stat. 378, 380; Pub. L. 99–576, title II, § 203, Oct. 28, 1986, 100 Stat. 3255; Pub. L. 100–322, title I, § 131, May 20, 1988, 102 Stat. 506; Pub. L. 102–54, § 14(b)(8), June 13, 1991, 105 Stat. 283; renumbered § 1701 and amended Pub. L. 102–83, §§ 4(a)(2)(E), (3)–(5), (b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–585, title V, § 513, Nov. 4, 1992, 106 Stat. 4958; Pub. L. 103–446, title XII, § 1202(b)(1), Nov. 2, 1994, 108 Stat. 4689; Pub. L. 104–262, title I, §§ 101(d)(1), 103(a), Oct. 9, 1996, 110 Stat. 3179, 3182; Pub. L. 106–117, title I, § 101(b), Nov. 30, 1999, 113 Stat. 1548; Pub. L. 107–135, title II, § 208(a)(1), (e)(2), Jan. 23, 2002, 115 Stat. 2461, 2463; Pub. L. 107–330, title III, § 308(g)(3), Dec. 6, 2002, 116 Stat. 2828; Pub. L. 108–170, title I, §§ 104(a), 106(a), Dec. 6, 2003, 117 Stat. 2044, 2045; Pub. L. 110–387, title III, § 301(a)(1), title VIII, § 801, Oct. 10, 2008, 122 Stat. 4120, 4140; Pub. L. 114–315, title VI, § 602(a), Dec. 16, 2016, 130 Stat. 1569; Pub. L. 115–141, div. J, title II, § 245(b), Mar. 23, 2018, 132 Stat. 823; Pub. L. 117–333, § 22, Jan. 5, 2023, 136 Stat. 6138.)

Editorial Notes

Codification

The text of section 1762 of this title, which was transferred to the end of this section, redesignated as par. (9), and amended by Pub. L. 102–585, was based on 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.

Prior Provisions

Prior sections 1700 and 1701 were renumbered sections 3500 and 3501 of this title, respectively.

Amendments

2023—Par. (6)(I). Pub. L. 117–333 added subpar. (I).

2018—Par. (6)(H). Pub. L. 115–141, § 245(b)(1), added subpar. (H).

Par. (8). Pub. L. 115–141, § 245(b)(2), inserted “chiropractic,” after “counseling,”.

Par. (9)(F) to (L). Pub. L. 115–141, § 245(b)(3), added subpar. (F) and redesignated former subpars. (F) to (K) as (G) to (L), respectively.

2016—Par. (9)(F). Pub. L. 114–315, § 602(a)(1), amended subpar. (F) generally. Prior to amendment, subpar. (F) read as follows: “immunizations against infectious disease;”.

Par. (10). Pub. L. 114–315, § 602(a)(2), added par. (10).

2008—Par. (5)(B). Pub. L. 110–387, § 301(a)(1), inserted “marriage and family counseling,” after “professional counseling,” and substituted “as the Secretary considers appropriate for” for “as may be essential to”.

Par. (6)(E) to (G). Pub. L. 110–387, § 801(2), added subpar. (E) and redesignated former subpars. (E) and (F) as (F) and (G), respectively.

Par. (10). Pub. L. 110–387, § 801(1), struck out par. (10) which read as follows:

“(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.”

2003—Par. (8). Pub. L. 108–170, § 104(a), struck out “(other than those types of vocational rehabilitation services provided under chapter 31 of this title)” after “programs”.

Par. (10)(A). Pub. L. 108–170, § 106(a), substituted “November 30, 1999, and ending on December 31, 2008,” for “the date of the enactment of the Veterans Millennium Health Care and Benefits Act and ending on December 31, 2003,”.

2002—Par. (5). Pub. L. 107–135, § 208(e)(2), substituted “1781(b)” for “1713(b)” in subpars. (B) and (C)(i).

Par. (6). Pub. L. 107–135, § 208(a)(1)(A), (B), substituted “services, the following:” for “services—” in introductory provisions and struck out concluding provisions which read as follows: “For the purposes of this paragraph, a dependent or survivor of a veteran receiving care under the last sentence of section 1713(b) of this title shall be eligible for the same medical services as a veteran.”

Par. (6)(A). Pub. L. 107–135, § 208(a)(1)(C), added subpar. (A) and struck out former subpar. (A) which read as follows: “(i) surgical services, dental services and appliances as described in sections 1710 and 1712 of this title, optometric and podiatric services, preventive health services, and (in the case of a person otherwise receiving care or services under this chapter) wheelchairs, artificial limbs, trusses, and similar appliances, special clothing made necessary by the wearing of prosthetic appliances, and such other supplies or services as the Secretary determines to be reasonable and necessary, except that the Secretary may not furnish sensori-neural aids other than in accordance with guidelines which the Secretary shall prescribe, and (ii) travel and incidental expenses pursuant to the provisions of section 111 of this title; and”.

Par. (6)(B) to (F). Pub. L. 107–135, § 208(a)(1)(A), (C), added subpars. (B) to (F) and struck out former subpar. (B) which included in the definition of “medical services” certain necessary consultation, professional counseling, training, and mental health services.

Par. (10)(A). Pub. L. 107–330, which directed the substitution of “November 30, 1999,” for “the date of the enactment of the Veterans’ Millennium Health Care and Benefits Act”, could not be executed because the word “Veterans’ ” did not appear in text.

1999—Par. (10). Pub. L. 106–117 added par. (10).

1996—Par. (6)(A)(i). Pub. L. 104–262, § 103(a), struck out “(in the case of a person otherwise receiving care or services under this chapter)” before “preventive health services,”, substituted “(in the case of a person otherwise receiving care or services under this chapter)” for “(except under the conditions described in section 1712(a)(5)(A) of this title),”, and inserted “except that the Secretary may not furnish sensori-neural aids other than in accordance with guidelines which the Secretary shall prescribe,” after “reasonable and necessary,”.

Par. (6)(B)(i)(I). Pub. L. 104–262, § 101(d)(1)(A), substituted “paragraph (1) or (2) of section 1710(a)” for “section 1712(a)”.

Par. (6)(B)(i)(II). Pub. L. 104–262, § 101(d)(1)(B), substituted “paragraph (1), (2) or (3) of section 1710(a)” for “section 1712(a)(5)(B)”.

1994—Par. (3). Pub. L. 103–446 made technical correction to directory language of Pub. L. 102–83, § 4(a)(2)(E). See 1991 Amendment note below.

1992—Par. (6)(A)(i). Pub. L. 102–585, § 513(b), substituted “preventive health services,” for “preventive health-care services as defined in section 1762 of this title,”.

Par. (9). Pub. L. 102–585, § 513(a), transferred the text of section 1762 of this title to the end of this section and redesignated it as par. (9), substituted “The term ‘preventive health service’ means” for “For the purposes of this subchapter, the term ‘preventive health-care services’ means”, and redesignated pars. (1) to (11) as subpars. (A) to (K), respectively. See Codification note above.

1991—Pub. L. 102–83, § 5(a), renumbered section 601 of this title as this section.

Par. (2). Pub. L. 102–54, § 14(b)(8)(A), struck out “any veteran of the Indian Wars, or” after “includes”.

Par. (3). Pub. L. 102–83, § 5(c)(1), substituted “1710” for “610” in subpar. (C).

Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” in subpars. (A) to (C).

Pub. L. 102–83, § 4(a)(2)(E), as amended by Pub. L. 103–446, substituted “facilities of the Department” for “Veterans’ Administration facilities”.

Pub. L. 102–54, § 14(b)(8)(B), (C), redesignated par. (4) as (3) and struck out former par. (3) which read as follows: “The term ‘period of war’ includes each of the Indian Wars.”

Par. (4). Pub. L. 102–83, § 4(a)(5), substituted “non-Department” for “non-Veterans’ Administration”.

Pub. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Pub. L. 102–54, § 14(b)(8)(E), redesignated par. (9) as (4).

Par. (5). Pub. L. 102–83, § 5(c)(1), substituted “1713(b)” for “613(b)” in subpars. (B) and (C)(i).

Par. (6). Pub. L. 102–83, § 5(c)(1), in subpar. (A) substituted “1710 and 1712” for “610 and 612”, “1762” for “662”, and “1712(a)(5)(A)” for “612(a)(5)(A)”, in subpar. (B) substituted “1712(a)” for “612(a)”, “1712(a)(5)(B)” for “612(a)(5)(B)”, and “1713(b)” for “613(b)”, and in last sentence substituted “1713(b)” for “613(b)”.

Pub. L. 102–83, § 4(b)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

Pub. L. 102–54, § 14(b)(8)(D), substituted “612(a)(5)(A)” for “612(f)(1)(A)(i)” in subpar. (A)(i) and “612(a)(5)(B)” for “612(f)(1)(A)(ii)” in subpar. (B)(i)(II).

Par. (9). Pub. L. 102–54, § 14(b)(8)(E), redesignated par. (9) as (4).

1988—Par. (4)(C). Pub. L. 100–322 added subpar. (C).

1986—Par. (4). Pub. L. 99–272, § 19012(a)(1), struck out cl. (C) and provision following such clause, both relating to private facilities under contract as Veterans’ Administration facilities.

Par. (6)(A)(i). Pub. L. 99–272, § 19011(d)(2)(A), substituted “section 612(f)(1)(A)(i)” for “section 612(f)(1)(A)”.

Par. (6)(B). Pub. L. 99–576 amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: “such consultation, professional counseling, training, and mental health services as are necessary in connection with the treatment—

“(i) of the service-connected disability of a veteran pursuant to section 612(a) of this title, and

“(ii) in the discretion of the Administrator, of the non-service-connected disability of a veteran eligible for treatment under section 612(f)(1)(A)(ii) of this title where such services were initiated during the veteran’s hospitalization and the provision of such services on an outpatient basis is essential to permit the discharge of the veteran from the hospital,

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 the veteran (including, under the terms and conditions set forth in section 111 of this title, travel and incidental expenses of such family member or individual in the case of a veteran who is receiving care for a service-connected disability, or in the case of dependent or survivor of a veteran receiving care under the last sentence of section 613(b) of this title). For the purposes of this paragraph, a dependent or survivor of a veteran receiving care under the last sentence of section 613(b) of this title shall be eligible for the same medical services as a veteran.”

Par. (6)(B)(ii). Pub. L. 99–272, § 19011(d)(2)(B), substituted “section 612(f)(1)(A)(ii)” for “section 612(f)(1)(B)”.

Par. (9). Pub. L. 99–272, § 19012(a)(2), added par. (9).

1985—Par. (4)(C)(v). Pub. L. 99–166, § 102(a), substituted “with respect to the Commonwealth of Puerto Rico shall expire on September 30, 1988” for “(except with respect to Alaska and Hawaii) shall expire on October 31, 1985” and struck out “and to the Virgin Islands” before “of the restrictions in this subclause”.

Pub. L. 99–108 substituted “October 31, 1985” for “September 30, 1985”.

1984—Par. (4)(C)(v). Pub. L. 98–528 substituted “September 30, 1985” for “September 30, 1984”.

1983—Par. (4)(C)(v). Pub. L. 98–105 substituted “September 30, 1984” for “September 30, 1983”.

Par. (6)(a)(i). Pub. L. 98–160 inserted “(in the case of a person otherwise receiving care or services under this chapter) preventive health-care services as defined in section 662 of this title,”.

1982—Par. (4)(C)(v). Pub. L. 97–251 substituted “September 30, 1983” for “September 30, 1982”.

1981—Par. (4)(C)(v). Pub. L. 97–72 substituted “September 30, 1982” for “December 31, 1981”.

1979—Par. (4). Pub. L. 96–22, §§ 102(c)(1), 201(a), substituted “medical services for the treatment of any disability of a veteran described in clause (1)(B) or (2) of the first sentence, or the third sentence, of section 612(f) of this title or of a veteran described in section 612(g) of this title if the Administrator has determined, based on an examination by a physician employed by the Veterans’ Administration (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 facilities described in clauses (A) and (B) of this paragraph” for “medical services for the treatment of any disability of a veteran described in clause (1)(B) or (2) of section 612(f) of this title” in subcl. (ii) of cl. (C), and added subcl. (vi) of cl. (C) and the provisions following cl. (C) relating to the periodic review of the necessity for continuing contractual arrangements in the case of veterans receiving contract care.

Par. (4)(C)(iii). Pub. L. 96–151, § 202, inserted provisions respecting safe transfer of the veteran, and substituted “medical services in” for “hospital care in”.

Par. (5)(A). Pub. L. 96–151, § 201(b)(1), substituted “travel” for “transportation”.

Par. (5)(C). Pub. L. 96–151, § 201(b)(2), substituted provisions relating to travel and incidental expenses for provisions relating to transportation and incidental expenses.

Par. (6)(A)(i). Pub. L. 96–22, § 102(c)(2), substituted “described in sections 610 and 612 of this title” for “authorized in sections 612 (b), (c), (d), and (e) of this title”.

Par. (6)(B). Pub. L. 96–151, § 201(b)(3), substituted “travel and incidental expenses” for “necessary expenses of travel and subsistence”.

1978—Par. (4)(C)(v). Pub. L. 95–520 defined “Veterans’ Administration facilities” to include certain private facilities to provide medical services to obviate the need for hospital admission, deleted reference to hospital care for veterans in a territory, Commonwealth, or possession of the United States not contiguous to the forty-eight contiguous States, substituted provision requiring the annually determined hospital patient load and incidence of the provision of medical services to veterans hospitalized or treated at expense of Veterans’ Administration in Government and private facilities in each noncontiguous State to be consistent with patient load or incidence of the provision of medical services for veterans hospitalized or treated by the Veterans’ Administration within the forty-eight contiguous States for prior requirement that the annually determined average hospital patient load per thousand veteran population hospitalized at Veterans’ Administration expense in Government and private facilities in each noncontiguous State not exceed the average patient load per thousand veteran population hospitalized by the Veterans’ Administration within the forty-eight contiguous States; extended termination date for exercise of subcl. (v) authority to Dec. 31, 1981, from Dec. 31, 1978, except as to Alaska and Hawaii, and authorized waiver by the Administrator, to prevent hardship, of applicability to Puerto Rico and Virgin Islands of subcl. (v) restrictions with respect to hospital patient loads and incidence of provision of medical services.

1976—Par. (4)(A). Pub. L. 94–581, § 202(b)(1), substituted “direct jurisdiction” for “direct and exclusive jurisdiction”.

Par. (4)(C). Pub. L. 94–581, § 202(b)(2), inserted “when facilities described in clause (A) or (B) of this paragraph are not capable of furnishing economical care because of geographical inaccessibility or of furnishing the care or services required” after “contracts” in provisions preceding subcl. (i), substituted “to a veteran for the treatment of a service-connected disability or a disability for which a veteran was discharged” for “for persons suffering from service-connected disabilities or from disabilities for which such persons were discharged” in subcl. (i), added subcls. (ii) and (iii), redesignated former subcls. (ii) and (iii) as (iv) and (v), respectively, and in subcl. (v) as so redesignated, substituted “subclause (v)” for “clause (iii)”.

Par. (5)(A)(ii). Pub. L. 94–581, § 202(b)(3), substituted “pursuant to the provisions of section 111 of this title” for “for any veteran who is in need of treatment for a service-connected disability or who is unable to defray the expense of transportation”.

Par. (5)(B). Pub. L. 94–581, § 102(1), substituted “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 613(b) of this title; and” for “(including (i) necessary expenses for transportation if unable to defray such expenses; or (ii) necessary expenses of transportation and subsistence in the case of a veteran who is receiving care for a service-connected disability, or in the case of a dependent or survivor of a veteran receiving care under the last sentence of section 613(b) of this title, under the terms and conditions set forth in section 111 of this title) of the members of the immediate family (including legal guardians) of a veteran or such a dependent or survivor of a veteran, or in the case of a veteran or such dependent or survivor of a veteran who has no immediate family members (or legal guardian), the person in whose household such veteran, or such a dependent or survivor certifies his intention to live, as may be necessary or appropriate to the effective treatment and rehabilitation of a veteran or such a dependent or a survivor of a veteran; and”.

Par. (6). Pub. L. 94–581, § 102(2), expanded definition of “medical services” to include rehabilitation services, podiatric services, and travel and incidental expenses pursuant to the provisions of section 111 of this title, and, 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 the veteran, such consultation, professional counseling, training, and mental health services as are necessary in connection with the treatment of the service-connected disability of a veteran pursuant to section 612(a) of this title, and, in the discretion of the Administrator, of the non-service-connected disability of a veteran eligible for treatment under section 612(f)(1)(B) of this title where such services were initiated during the veteran’s hospitalization and the provision of such services on an outpatient basis is essential to permit the discharge of the veteran from the hospital.

Par. (7). Pub. L. 94–581, § 102(3), substituted “necessary medical services and travel and incidental expenses pursuant to the provisions of section 111 of this title” for “transportation and incidental expenses for veterans who are unable to defray the expenses of transportation”.

Par. (8). Pub. L. 94–581, § 102(4), added par. (8).

1973—Par. (4)(C). Pub. L. 93–82, § 101(a), extended the Administrator’s contract authority for providing hospital care and medical services to persons suffering from service-connected disabilities or from disabilities for which such persons were discharged or released from the active military, naval, or air service and removed the limitation on such authority that such care be rendered in emergency cases only.

Par. (5). Pub. L. 93–82, § 101(b), incorporated existing provisions in subpar. (A) and added subpars. (B) and (C).

Par. (6). Pub. L. 93–82, § 101(c), expanded definition of “medical services” to include home health services determined by the Secretary to be necessary or appropriate for the effective and economical treatment of a disability of a veteran or a dependent or survivor of a veteran receiving care under section 613(b) of this title.

1968—Par. (4)(C)(iii). Pub. L. 90–612 expanded category of veterans of wars in the Territories, Commonwealths, or possessions of the United States to include, until December 31, 1978, veterans of such wars in States not contiguous to the forty-eight contiguous States, with the annually determined average hospital patient load per thousand of hospitalized veteran population in each such noncontiguous States not to exceed the average within the forty-eight contiguous States.

1964—Par. (2). Pub. L. 88–481 included any veteran awarded the Medal of Honor.

1960—Par. (6). Pub. L. 86–639 inserted “(except under the conditions described in section 612(f)(1))”.

Pub. L. 86–598 inserted “optometrists’ services” after “medical examination and treatment”.

Statutory Notes and Related Subsidiaries

Effective Date of 1994 Amendment

Pub. L. 103–446, title XII, § 1202(b), Nov. 2, 1994, 108 Stat. 4689, provided that the amendment made by that section is effective Aug. 6, 1991, and as if included in the enactment of Pub. L. 102–83.

Effective Date of 1986 Amendment

Amendment by section 19011(d)(2) of Pub. L. 99–272 applicable to hospital care, nursing home care, and medical services furnished on or after July 1, 1986, see section 19011(f) of Pub. L. 99–272, set out as a note under section 1710 of this title.

Effective Date of 1979 Amendment

Amendment by Pub. L. 96–151 effective Jan. 1, 1980, see section 206 of Pub. L. 96–151, set out as a note under section 111 of this title.

Pub. L. 96–22, title I, § 107, June 13, 1979, 93 Stat. 53, provided that: “The amendments made to title 38, United States Code, by sections 102, 103, 104, 105, and 106 of this Act [see Tables for classification] shall be effective on October 1, 1979.”

Effective Date of 1976 Amendment

Amendment by Pub. L. 94–581 effective Oct. 21, 1976, see section 211 of Pub. L. 94–581, set out as a note under section 111 of this title.

Effective Date of 1973 Amendment

Pub. L. 93–82, title V, § 501, Aug. 2, 1973, 87 Stat. 196, provided that: “The provisions of this Act [see Tables for classification] shall become effective the first day of the first calendar month following the date of enactment [Aug. 2, 1973], except that sections 105 and 106 [amending section 626 [now 1726] of this title and enacting section 628 [now 1728] of this title] shall be effective on January 1, 1971; section 107 [enacting sections 631 and 632 [now 1731 and 1732] of this title and provisions set out as note under section 1732 of this title] shall be effective July 1, 1973; and section 203 [amending former section 4107 of this title] shall become effective beginning the first pay period following thirty days after the date of enactment of this Act [Aug. 2, 1973].”

Construction of 2016 Amendment

Pub. L. 114–315, title VI, § 602(d), Dec. 16, 2016, 130 Stat. 1570, provided that: “Nothing in this section [amending this section and section 1704 of this title] or the amendments made by this section may be construed to require a veteran to receive an immunization that the veteran does not want to receive.”

Department of Veterans Affairs Treatment and Research of Prostate Cancer

Pub. L. 117–328, div. U, title I, § 102, Dec. 29, 2022, 136 Stat. 5408, provided that: “(a) Findings.—Congress makes the following findings:“(1) Prostate cancer is the number one cancer diagnosed in the Veterans Health Administration. “(2) A 1996 report published by the National Academy of Sciences, Engineering, and Medicine established a link between prostate cancer and exposure to herbicides, such as Agent Orange. “(3) It is essential to acknowledge that due to these circumstances, certain veterans are made aware that they are high-risk individuals when it comes to the potential to develop prostate cancer. “(4) In being designated as ‘high risk’, it is essential that veterans are proactive in seeking earlier preventative clinical services for the early detection and successful treatment of prostate cancer, whether that be through the Veterans Health Administration or through a community provider. “(5) Clinical preventative services and initial detection are some of the most important components in the early detection of prostate cancer for veterans at high risk of prostate cancer. “(6) For veterans with prostate cancer, including prostate cancer that has metastasized, precision oncology, including biomarker-driven clinical trials and innovations underway through the Prostate Cancer Foundation and Department of Veterans Affairs partnership, represents one of the most promising areas of interventions, treatments, and cures for such veterans and their families. “(b) Establishment of Clinical Pathway.—“(1) In general.—Not later than 365 days after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs shall establish an interdisciplinary clinical pathway for all stages of prostate cancer, from early detection to end of life care. The clinical pathway shall be established in the National Surgery Office of the Department of Veterans Affairs in close collaboration with the National Program Office of Oncology, the Office of Research and Development, and other relevant entities of the Department, including Primary Care. “(2) Elements.—The national clinical pathway established under this subsection shall include the following elements:“(A) A diagnosis pathway for prostate cancer that includes early screening and diagnosis protocol, including screening recommendations for veterans with evidence-based risk factors. “(B) A treatment pathway that details the respective roles of each office of the Department that will interact with veterans receiving prostate cancer care, including treatment protocol recommendations for veterans with evidence-based risk factors. “(C) Treatment recommendations for all stages of prostate cancer that reflect nationally recognized standards for oncology, including National Comprehensive Cancer Network guidelines. “(D) A suggested protocol timeframe for each point of care, from early screening to treatment and end-of-life care, based on severity and stage of cancer. “(E) A plan that includes, as appropriate, both Department medical facilities and community-based partners and providers and research centers specializing in prostate cancer, especially such centers that have entered into partnerships with the Department. “(3) Collaboration and coordination.—In establishing the clinical pathway required under this section, the Secretary may collaborate and coordinate with—“(A) the National Institutes of Health; “(B) the National Cancer Institute; “(C) the National Institute on Minority Health and Health Disparities; “(D) the Centers for Disease Control and Prevention; “(E) the Centers for Medicare and Medicaid Services; “(F) the Patient-Centered Outcomes Research Institute; “(G) the Food and Drug Administration; “(H) the Department of Defense; and “(I) other Institutes and Centers as the Secretary determines necessary. “(4) Consultation requirement.—In establishing the clinical pathway required under this section, the Secretary shall consult with, and incorporate feedback from, veterans who have received prostate cancer care at Department medical facilities as well as experts in multi-disciplinary cancer care and clinical research. “(5) Publication.—The Secretary shall—“(A) publish the clinical pathway established under this subsection on a publicly available Department website; and “(B) update the clinical pathway as needed by review of the medical literature and available evidence-based guidelines at least annually, in accordance with the criteria under paragraph (2). “(c) Development of Comprehensive Prostate Cancer Program and Implementation of the Prostate Cancer Clinical Pathway.—“(1) Establishment.—Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to Congress a plan to establish a prostate cancer program using the comprehensive prostate cancer clinical pathway developed under subsection (b). “(2) Program requirements.—The comprehensive prostate cancer program shall—“(A) receive direct oversight from the Deputy Undersecretary for Health of the Department of Veterans Affairs; “(B) include a yearly program implementation evaluation to facilitate replication for other disease states or in other healthcare institutions; “(C) be metric driven and include the development of biannual reports on the quality of prostate cancer care, which shall be provided to the leadership of the Department, medical centers, and providers and made publicly available in an electronic form; and “(D) include an education plan for patients and providers. “(3) Program implementation evaluation.—The Secretary shall establish a program evaluation tool to learn best practices and to inform the Department and Congress regarding further use of the disease specific model of care delivery. “(4) Prostate cancer research.—The Secretary shall submit to Congress a plan that provides for continual funding through the Office of Research and Development of the Department of Veterans for supporting prostate cancer research designed to position the Department as a national resource for prostate cancer detection and treatment. Such plan shall—“(A) include details regarding the funding of and coordination between the National Precision Oncology Program of the Department and the PCF–VA Precision Oncology Centers of Excellence as related to the requirements of this Act [div. U of Pub. L. 117–328, see Tables for classification]; and “(B) affirm that no funding included in such funding plan is duplicative in nature. “(d) Report on National Registry.—The Secretary of Veterans Affairs shall submit to Congress a report on the barriers and challenges associated with creating a national prostate cancer registry. Such report shall include recommendations for centralizing data about veterans with prostate cancer for the purpose of improving outcomes and serving as a resource for providers. “(e) Definitions.—In this section:“(1) Clinical pathway.—The term ‘clinical pathway’ means a health care management tool designed around research and evidence-backed practices that provides direction for the clinical care and treatment of a specific episode of a condition or ailment. “(2) Evidence-based risk factors.—The term ‘evidence-based risk factors’ includes race, ethnicity, socioeconomic status, geographic location, exposure risks, genetic risks, including family history, and such other factors as the Secretary determines appropriate.”

Strategic Plan To Ensure Continuity of Care in the Case of the Realignment of a Medical Facility of the Department

Pub. L. 117–328, div. U, title I, § 126, Dec. 29, 2022, 136 Stat. 5418, provided that: “(a) Sense of Congress.—It is the sense of Congress that the Veterans Health Administration should ensure that veterans do not experience a lapse of care when transitioning in receiving care due to the realignment of a medical facility of the Department of Veterans Affairs. “(b) Development of Strategic Plan.—“(1) In general.—The Secretary of Veterans Affairs, acting through the Office of Integrated Veteran Care, the Chief Strategy Office, the Office of Asset Enterprise Management, or any successor office that has similar and related functions, shall develop and periodically update a strategic plan to ensure continuity of health care through care furnished at a facility of the Department or through the Community Care Program for veterans impacted by the realignment of a medical facility of the Department. “(2) Elements.—The strategic plan required under paragraph (1) shall include, at a minimum, the following:“(A) An assessment of the progress of the Department in identifying impending realignments of medical facilities of the Department and the impact of such realignments on access of veterans to care, including any impact on the network of health care providers under the Community Care Program. “(B) The progress of the Department in establishing operated sites of care and related activities to address the impact of such a realignment. “(C) An outline of collaborative actions and processes the Department can take to address potential gaps in health care created by such a realignment, including actions and processes to be taken by the Office of Integrated Veteran Care, the Chief Strategy Office, and the Office of Asset Enterprise Management of the Department. “(D) A description of how the Department can identify to Third Party Administrators changes in the catchment areas of medical facilities to be realigned and develop a process with Third Party Administrators to strengthen provider coverage in advance of such realignments. “(3) Submittal to congress.—Not later than 180 days after the date of the enactment of this Act [Dec. 29, 2022], the Under Secretary for Health of the Department shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives the plan developed under paragraph (1). “(c) Definitions.—In this section:“(1) Community care program.—The term ‘Community Care Program’ means the Veterans Community Care Program under section 1703 of title 38, United States Code. “(2) Realignment.—The term ‘realignment’, with respect to a facility of the Department of Veterans Affairs, includes—“(A) any action that changes the number of facilities or relocates services, functions, or personnel positions; and “(B) strategic collaborations between the Department and non-Federal Government entities, including tribal organizations and Urban Indian Organizations. “(3) Third party administrator.—The term ‘Third Party Administrator’ means an entity that manages a provider network and performs administrative services related to such network within the Veterans Community Care Program under section 1703 of title 38, United States Code. “(4) Tribal organization.—The term ‘tribal organization’ has the meaning given that term in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304). “(5) Urban indian organization.—The term ‘Urban Indian Organization’ has the meaning given that term in section 4 of the Indian Health Care Improvement Act (25 U.S.C. 1603).”

Establishment of Strategic Plan Requirement for Office of Connected Care of Department of Veterans Affairs

Pub. L. 117–328, div. U, title I, § 151, Dec. 29, 2022, 136 Stat. 5425, provided that: “(a) Findings.—Congress makes the following findings:“(1) The COVID–19 pandemic caused the Department of Veterans Affairs to exponentially increase telehealth and virtual care modalities, including VA Video Connect, to deliver health care services to veteran patients. “(2) Between January 2020 and January 2021, the number of telehealth appointments offered by the Department increased by 1,831 percent. “(3) The Department maintains strategic partnerships, such as the Digital Divide Consult, with a goal of ensuring veterans who reside in rural, highly rural, or medically underserved areas have access to high-quality telehealth services offered by the Department. “(4) As of 2019, veterans who reside in rural and highly rural areas make up approximately ⅓ of veteran enrollees in the patient enrollment system, and are on average, older than their veteran peers in urban areas, experience higher degrees of financial instability, and live with a greater number of complex health needs and comorbidities. “(5) The Federal Communications Commission estimated in 2020 that 15 percent of veteran households do not have an internet connection. “(6) Under the Coronavirus Aid, Relief, and Economic Security Act (Public Law 116–136) [see Tables for classification], Congress granted the Department additional authority to enter into short-term agreements or contracts with private sector telecommunications companies to provide certain broadband services for the purposes of providing expanded mental health services to isolated veterans through telehealth or VA Video Connect during a public health emergency. “(7) The authority described in paragraph (6) was not utilized to the fullest extent by the Department. “(8) Though the Department has made significant progress in expanding telehealth services offered to veterans who are enrolled in the patient enrollment system, significant gaps still exist to ensure all veterans receive equal and high-quality access to virtual care. “(9) Questions regarding the efficacy of using telehealth for certain health care services and specialties remain, and should be further studied. “(10) The Department continues to expand telehealth and virtual care offerings for primary care, mental health care, specialty care, urgent care, and even remote intensive care units. “(b) Sense of Congress.—It is the sense of Congress that the telehealth services offered by the Department of Veterans Affairs should be routinely measured and evaluated to ensure the telehealth technologies and modalities delivered to veteran patients to treat a wide variety of health conditions are as effective as in-person treatment for primary care, mental health care, and other forms of specialty care. “(c) Development of Strategic Plan.—“(1) In general.—Not later than one year after the date of the enactment of this Act [Dec. 29, 2022], the Secretary of Veterans Affairs, acting through the Office of Connected Care of the Department of Veterans Affairs, shall develop a strategic plan to ensure the effectiveness of the telehealth technologies and modalities delivered by the Department to veterans who are enrolled in the patient enrollment system. “(2) Update.—“(A) In general.—The Secretary shall update the strategic plan required under paragraph (1) not less frequently than once every three years following development of the plan. “(B) Consultation.—The Secretary shall prepare any update required under subparagraph (A) in consultation with the following:“(i) The Chief Officer of the Office of Connected Care of the Department. “(ii) The Executive Director of Telehealth Services of the Office of Connected Care. “(iii) The Executive Director of Connected Health of the Office of Connected Care. “(iv) The Executive Director of the Office of Rural Health of the Department. “(v) The Executive Director of Solution Delivery, IT Operations and Services of the Office of Information and Technology of the Department. “(3) Elements.—The strategic plan required under paragraph (1), and any update to that plan under paragraph (2), shall include, at a minimum, the following:“(A) A comprehensive list of all health care specialties the Department is currently delivering by telehealth or virtual care. “(B) An assessment of the effectiveness and patient outcomes for each type of health care specialty delivered by telehealth or virtual care by the Department. “(C) An assessment of satisfaction of veterans in receiving care through telehealth or virtual care disaggregated by age group and by Veterans Integrated Service Network. “(D) An assessment of the percentage of virtual visits delivered by the Department through each modality including standard telephone telehealth, VA Video Connect, and the Accessing Telehealth through Local Area Stations program of the Department. “(E) An outline of all current partnerships maintained by the Department to bolster telehealth or virtual care services for veterans. “(F) An assessment of the barriers faced by the Department in delivering telehealth or virtual care services to veterans residing in rural and highly rural areas, and the strategies the Department is deploying beyond purchasing hardware for veterans who are enrolled in the patient enrollment system. “(G) A detailed plan illustrating how the Department is working with other Federal agencies, including the Department of Health and Human Services, the Department of Agriculture, the Federal Communications Commission, and the National Telecommunications and Information Administration, to enhance connectivity in rural, highly rural, and medically underserved areas to better reach all veterans. “(H) The feasibility and advisability of partnering with Federally qualified health centers, rural health clinics, and critical access hospitals to fill the gap for health care services that exists for veterans who reside in rural and highly rural areas. “(I) An evaluation of the number of veterans who are enrolled in the patient enrollment system who have previously received care under the Veterans Community Care Program under section 1703 of title 38, United States Code. “(d) Submittal to Congress.—Not later than 180 days after the development of the strategic plan under paragraph (1) of subsection (c), and not later than 180 days after each update under paragraph (2) of such subsection thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report that includes the following:“(1) The completed strategic plan or update, as the case may be. “(2) An identification of areas of improvement by the Department in the delivery of telehealth and virtual care services to veterans who are enrolled in the patient enrollment system, with a timeline for improvements to be implemented. “(e) Definitions.—“(1) Patient enrollment system.—The term ‘patient enrollment system’ means the system of annual patient enrollment of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code. “(2) Rural; highly rural.—The terms ‘rural’ and ‘highly rural’ have the meanings given those terms in the Rural-Urban Commuting Areas coding system of the Department of Agriculture. “(3) VA video connect.—The term ‘VA Video Connect’ means the program of the Department of Veterans Affairs to connect veterans with their health care team from anywhere, using encryption to ensure a secure and private connection.”

Improved Accessibility and Accuracy of Data Provided by Department of Veterans Affairs

Pub. L. 117–328, div. U, title I, § 195(b), (c), Dec. 29, 2022, 136 Stat. 5445, provided that: “(b) Requirements of Website.—“(1) In general.—Not later than one year after the date of the enactment of this Act [Dec. 29, 2022], in addition to the requirements of section 206(b)(4) of the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113–146; 128 Stat. 1781) [38 U.S.C. 1701 note], the Secretary shall ensure that the Website meets the following requirements:“(A) The Website is directly accessible from—“(i) the main homepage of the publicly accessible internet website of the Department; and “(ii) the main homepage of the publicly accessible internet website of each medical center of the Department. “(B) Where practicable, the Website is organized and searchable by each medical center of the Department. “(C) The Website is easily understandable and usable by the general public. “(2) Consultation and contract authority.—In carrying out the requirements of paragraph (1)(C), the Secretary—“(A) shall consult with—“(i) veterans service organizations; and “(ii) veterans and caregivers of veterans from geographically diverse areas and representing different eras of service in the Armed Forces; and “(B) may enter into a contract to design the Website with a company, non-profit entity, or other entity specializing in website design that has substantial experience in presenting health care data and information in a easily understandable and usable manner to patients and consumers. “(c) Accuracy of Data.—“(1) Annual process.—Not later than 18 months after the date of the enactment of this Act, the Secretary shall develop and implement a process to annually audit a generalizable subset of the data contained on the Website to assess the accuracy and completeness of the data. “(2) Criteria.—The Secretary shall ensure that each audit under paragraph (1)—“(A) determines the extent that the medical record information, clinical information, data, and documentation provided by each medical facility of the Department that is used to calculate the information on the Website is accurate and complete; “(B) identifies any deficiencies in the recording of medical record information, clinical information, or data by medical facilities of the Department that affects the accuracy and completeness of the information on the Website; and “(C) provides recommendations to medical facilities of the Department on how to—“(i) improve the accuracy and completeness of the medical record information, clinical information, data, and documentation that is used to calculate the information on the Website; and “(ii) ensure that each medical facility of the Department provides such information in a uniform manner. “(3) Annual report.—Not later than two years after the date of the enactment of this Act, and annually thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the findings of each audit under paragraph (1).”

Improvement of Sleep Disorder Care Furnished by Department of Veterans Affairs

Pub. L. 117–328, div. V, title V, § 502, Dec. 29, 2022, 136 Stat. 5514, provided that: “(a) In General.—Pursuant to the analysis conducted under subsection (b), the Secretary of Veterans Affairs shall take such action as the Secretary considers appropriate to improve the assessment and treatment of veterans with sleep disorders, including by conducting in-home sleep studies for veterans. “(b) Analysis.—The Secretary shall conduct an analysis of the ability of the Department of Veterans Affairs to treat sleep disorders among veterans, including—“(1) assessment and treatment options for such disorders; “(2) barriers to care for such disorders, such as wait time, travel time, and lack of staffing; “(3) the efficacy of the clinical practice guidelines of the Department of Veterans Affairs and the Department of Defense for such disorders; and “(4) the availability of and efficacy of the use by the Department of Veterans Affairs of cognitive behavioral therapy for insomnia. “(c) Report.—Not later than two years after the date of the enactment of this Act [Dec. 29, 2022], the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on—“(1) the findings from the analysis conducted under subsection (b); and “(2) any actions taken under subsection (a) to improve the assessment and treatment of veterans with sleep disorders. “(d) Authorization of Appropriations for In-Home Sleep Studies.—There is authorized to be appropriated to the Secretary of Veterans Affairs $5,000,000 to be used to conduct in-home sleep studies for veterans, as part of sleep disorder assessment and treatment conducted by the Department of Veterans Affairs.”

Strengthening and Amplifying Vaccination Efforts to Locally Immunize All Veterans and Every Spouse

Pub. L. 117–4, Mar. 24, 2021, 135 Stat. 247, provided that: “SECTION 1. SHORT TITLE.“This Act may be cited as the ‘Strengthening and Amplifying Vaccination Efforts to Locally Immunize All Veterans and Every Spouse Act’ or the ‘SAVE LIVES Act’. “SEC. 2. AUTHORITY OF SECRETARY OF VETERANS AFFAIRS TO FURNISH COVID–19 VACCINE TO CERTAIN INDIVIDUALS NOT ENROLLED IN PATIENT ENROLLMENT SYSTEM OF DEPARTMENT OF VETERANS AFFAIRS.“(a) In General.—The Secretary of Veterans Affairs may furnish a vaccine for COVID–19 to a covered individual during the COVID–19 public health emergency. “(b) Prioritization.—In furnishing vaccines for COVID–19 under the laws administered by the Secretary, the Secretary shall—“(1) prioritize the vaccination of veterans who are enrolled in the patient enrollment system, veterans who receive hospital care and medical services pursuant to subsection (c)(2) of section 1705 of title 38, United States Code, and accompanying caregivers of such veterans before the vaccination of covered individuals not otherwise described in this paragraph; and “(2) only furnish vaccines for COVID–19 to covered individuals under this section to the extent that such vaccines are available. “(c) Timing of Vaccines Provided to Spouses of Veterans.—The Secretary may determine the timing for offering a vaccine for COVID–19 to the spouse of a veteran from the Department of Veterans Affairs. “(d) Vaccine Allocation.—It is the sense of Congress that, to the extent practicable based on the current national supply chain, the Secretary of Health and Human Services should adjust the allocation for the Department of Veterans Affairs for the vaccine for COVID–19 based on the additional eligibility of covered individuals under this section. “(e) Definitions.—In this section:“(1) Accompanying caregiver.—The term ‘accompanying caregiver’ means a caregiver described in subparagraph (D), (E), or (F) of paragraph (2) who is accompanying a veteran who is receiving a vaccine for COVID–19 furnished by the Department. “(2) Covered individual.—The term ‘covered individual’ means any of the following individuals:“(A) A veteran who is not eligible to enroll in the patient enrollment system. “(B) A veteran who is eligible for care under section 1724 of title 38, United States Code. “(C) A beneficiary under section 1781 of such title. “(D) A family caregiver of a veteran participating in the program of comprehensive assistance for family caregivers under section 1720G(a) of such title. “(E) A caregiver of a veteran participating in the program of general caregiver support services under section 1720G(b) of such title. “(F) A caregiver of a veteran participating in the Medical Foster Home Program, Bowel and Bladder Program, Home Based Primary Care Program, or Veteran Directed Care Program of the Department of Veterans Affairs. “(G) A spouse of a veteran. “(3) Covered public health emergency.—The term ‘covered public health emergency’ means an emergency with respect to COVID–19 declared by a Federal, State, or local authority. “(4) COVID–19.—The term ‘COVID–19’ means the coronavirus disease 2019. “(5) Patient enrollment system.—The term ‘patient enrollment system’ means the system of annual patient enrollment of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code. “(6) Veteran.—The term ‘veteran’ has the meaning given that term in section 101(2) of title 38, United States Code.”

Prohibition on Copayments and Cost Sharing for Veterans During Emergency Relating to COVID–19

Pub. L. 117–2, title VIII, § 8007, Mar. 11, 2021, 135 Stat. 116, provided that: “(a) In General.—The Secretary of Veterans Affairs—“(1) shall provide for any copayment or other cost sharing with respect to health care under the laws administered by the Secretary received by a veteran during the period specified in subsection (b); and “(2) shall reimburse any veteran who paid a copayment or other cost sharing for health care under the laws administered by the Secretary received by a veteran during such period the amount paid by the veteran. “(b) Period Specified.—The period specified in this subsection is the period beginning on April 6, 2020, and ending on September 30, 2021. “(c) Funding.—In addition to amounts otherwise available, there is appropriated to the Secretary of Veterans Affairs for fiscal year 2021, out of any money in the Treasury not otherwise appropriated, $1,000,000,000, to remain available until expended, to carry out this section, except for health care furnished pursuant to section 1703(c)(2)–(c)(4) of title 38, United States Code.”

Oversight for State Homes Regarding COVID–19 Infections, Response Capacity, and Staffing Levels

Pub. L. 116–315, title III, § 3003, Jan. 5, 2021, 134 Stat. 4991, provided that: “(a) Reporting.—“(1) In general.—During a covered public health emergency, each State home shall submit weekly to the Secretary of Veterans Affairs and the National Healthcare Safety Network of the Centers for Disease Control and Prevention, through an electronic medium and in a standardized format specified by the Secretary, a report on the emergency. “(2) Elements.—Each report required by paragraph (1) for a State home shall include the following:“(A) The number of suspected and confirmed COVID–19 infections among residents and staff, including residents previously treated for COVID–19, disaggregated by—“(i) veteran, spouse of a veteran, staff, and other; “(ii) race and ethnicity; “(iii) gender; and “(iv) age. “(B) The number of total deaths and COVID–19 deaths among residents and staff, disaggregated by—“(i) veteran, spouse of a veteran, staff, and other; “(ii) race and ethnicity; “(iii) gender; and “(iv) age. “(C) An assessment of the supply of personal protective equipment and hand hygiene supplies. “(D) An assessment of ventilator capacity and supplies. “(E) The number of resident beds and the occupancy rate, disaggregated by veteran, spouse of a veteran, and other. “(F) An assessment of the access of residents to testing for COVID–19. “(G) An assessment of staffing shortages, if any. “(H) Such other information as the Secretary may specify. “(b) Publication of Total Infections and Deaths.—“(1) In general.—Not later than 30 days after the date of the enactment of this Act [Jan. 5, 2021], and not less frequently than weekly thereafter, the Secretary shall post on a publicly available website of the Department of Veterans Affairs—“(A) the total number of residents and staff of State homes who are infected with COVID–19; and “(B) the total number of such residents and staff who have died from COVID–19. “(2) Information on residents and staff.—The Secretary shall disaggregate information on residents and staff published under paragraph (1) by veteran, staff, and other. “(c) Definitions.—In this section:“(1) Covered public health emergency.—The term ‘covered public health emergency’ means an emergency with respect to COVID–19 declared by a Federal, State, or local authority. “(2) State home.—The term ‘State home’ has the meaning given that term in section 101(19) of title 38, United States Code.”

Process and Requirements for Scheduling Appointments for Health Care From Department of Veterans Affairs and Non-Department Health Care

Pub. L. 116–315, title III, § 3101, Jan. 5, 2021, 134 Stat. 4999, provided that: “(a) Process and Requirements.—“(1) In general.—Not later than 60 days after the date of the enactment of this Act [Jan. 5, 2021], the Secretary of Veterans Affairs shall—“(A) establish a process and requirements for scheduling appointments for—“(i) health care from the Department of Veterans Affairs; and “(ii) health care furnished through the Veterans Community Care Program under section 1703 of title 38, United States Code, by a non-Department health care provider; and “(B) submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a description of such process and requirements. “(2) Elements of description.—The description of the process and requirements for scheduling appointments for health care required to be submitted under paragraph (1)(B) shall include—“(A) information on how such process and requirements take into account the access standards established under section 1703B of title 38, United States Code; and “(B) the maximum number of days allowed to complete each step of such process. “(3) Periodic revision.—“(A) In general.—The Secretary may revise the process and requirements required under paragraph (1) as the Secretary considers necessary. “(B) Submittal to congress.—Not later than 30 days before revising the process and requirements under subparagraph (A), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a description of such revised process and requirements, including a description of any modifications to the certification and training under subsection (b). “(b) Certification and Training on Process and Requirements.—“(1) Certification.—Not later than one year after the date of the enactment of this Act, the Secretary shall require each individual involved in the scheduling of appointments for health care from the Department or health care described in subsection (a)(1)(A)(ii), including schedulers, clinical coordinators, and supervisors, to certify to the Secretary that the individual understands the process and requirements established under subsection (a), including the maximum number of days allowed to complete each step of such process. “(2) New employees.—The Secretary shall require each employee hired by the Department on or after the date of the enactment of this Act who is to be involved in the scheduling of appointments for health care from the Department or health care described in subsection (a)(1)(A)(ii)—“(A) to undergo training on the process and requirements established under subsection (a) as part of training for the position for which the employee has been hired; and “(B) to make the certification to the Secretary required under paragraph (1). “(c) Method to Monitor Compliance.—“(1) In general.—Not later than 180 days after the date of the enactment of this Act [Jan. 5, 2021], the Secretary shall establish or maintain a method or tool—“(A) to enable monitoring of the compliance of the Department with the process and requirements established under subsection (a), including compliance with policies of the Department relating to the maximum number of days allowed to complete each step of such process; and “(B) to ensure that each medical facility of the Department complies with such process and requirements. “(2) Use throughout department.—“(A) In general.—The Secretary shall require each medical facility of the Department to use the method or tool described in paragraph (1). “(B) Report.—Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report indicating whether each medical facility of the Department is using the method or tool described in paragraph (1). “(d) Comptroller General Report.—Not later than two years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the compliance of the Secretary with the requirements of this section.”

Audits Regarding Scheduling of Appointments and Management of Consultations for Health Care From Department of Veterans Affairs and Non-Department Health Care