[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 476 Introduced in House (IH)]
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115th CONGRESS
1st Session
H. R. 476
To amend title 38, United States Code, to clarify the emergency
hospital care furnished by the Secretary of Veterans Affairs to certain
veterans.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 12, 2017
Mr. Newhouse (for himself, Mr. Gohmert, Mr. Hensarling, Mr. Jones, Mr.
Marshall, Mr. Olson, Mrs. Radewagen, and Mr. Young of Iowa) introduced
the following bill; which was referred to the Committee on Veterans'
Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to clarify the emergency
hospital care furnished by the Secretary of Veterans Affairs to certain
veterans.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Veterans Emergency Treatment Act''
or the ``VET Act''.
SEC. 2. CLARIFICATION OF EMERGENCY HOSPITAL CARE FURNISHED BY THE
SECRETARY OF VETERANS AFFAIRS TO CERTAIN VETERANS.
(a) In General.--Chapter 17 of title 38, United States Code, is
amended by inserting after section 1730A the following new section:
``Sec. 1730B. Examination and treatment for emergency medical
conditions and women in labor
``(a) Medical Screening Examinations.--In carrying out this
chapter, if any enrolled veteran requests, or a request is made on
behalf of the veteran, for examination or treatment for a medical
condition, regardless of whether such condition is service-connected,
at a hospital emergency department of a medical facility of the
Department, the Secretary shall ensure that the veteran is provided an
appropriate medical screening examination within the capability of the
emergency department, including ancillary services routinely available
to the emergency department, to determine whether an emergency medical
condition exists.
``(b) Necessary Stabilizing Treatment for Emergency Medical
Conditions and Labor.--(1) If an enrolled veteran comes to a medical
facility of the Department and the Secretary determines that the
veteran has an emergency medical condition, the Secretary shall provide
either--
``(A) such further medical examination and such treatment
as may be required to stabilize the medical condition; or
``(B) for the transfer of the veteran to another medical
facility of the Department or a non-Department facility in
accordance with subsection (c).
``(2) The Secretary is deemed to meet the requirement of paragraph
(1)(A) with respect to an enrolled veteran if the Secretary offers the
veteran the further medical examination and treatment described in such
paragraph and informs the veteran (or an individual acting on behalf of
the veteran) of the risks and benefits to the veteran of such
examination and treatment, but the veteran (or individual) refuses to
consent to the examination and treatment. The Secretary shall take all
reasonable steps to secure the written informed consent of such veteran
(or individual) to refuse such examination and treatment.
``(3) The Secretary is deemed to meet the requirement of paragraph
(1) with respect to an enrolled veteran if the Secretary offers to
transfer the individual to another medical facility in accordance with
subsection (c) of this section and informs the veteran (or an
individual acting on behalf of the veteran) of the risks and benefits
to the veteran of such transfer, but the veteran (or individual)
refuses to consent to the transfer. The hospital shall take all
reasonable steps to secure the written informed consent of such veteran
(or individual) to refuse such transfer.
``(c) Restriction of Transfers Until Veteran Stabilized.--(1) If an
enrolled veteran at a medical facility of the Department has an
emergency medical condition that has not been stabilized, the Secretary
may not transfer the veteran to another medical facility of the
Department or a non-Department facility unless--
``(A)(i) the veteran (or a legally responsible individual
acting on behalf of the veteran), after being informed of the
obligation of the Secretary under this section and of the risk
of transfer, requests in writing a transfer to another medical
facility;
``(ii) a physician has signed a certification (including a
summary of the risks and benefits) that, based upon the
information available at the time of transfer, the medical
benefits reasonably expected from the provision of appropriate
medical treatment at another medical facility outweigh the
increased risks to the veteran and, in the case of labor, to
the unborn child from effecting the transfer; or
``(iii) if a physician is not physically present in the
emergency department at the time a veteran is transferred, a
qualified medical person (as defined by the Secretary in
regulations) has signed a certification described in clause
(ii) after a physician, in consultation with the person, has
made the determination described in such clause, and
subsequently countersigns the certification; and
``(B) the transfer is an appropriate transfer as described
in paragraph (2).
``(2) An appropriate transfer to a medical facility is a transfer--
``(A) in which the transferring medical facility provides
the medical treatment within the capacity of the facility that
minimizes the risks to the health of the enrolled veteran and,
in the case of a woman in labor, the health of the unborn
child;
``(B) in which the receiving facility--
``(i) has available space and qualified personnel
for the treatment of the veteran; and
``(ii) has agreed to accept transfer of the veteran
and to provide appropriate medical treatment;
``(C) in which the transferring facility sends to the
receiving facility all medical records (or copies thereof),
related to the emergency condition for which the veteran has
presented, available at the time of the transfer, including
records related to the emergency medical condition of the
veteran, observations of signs or symptoms, preliminary
diagnosis, treatment provided, results of any tests and the
informed written consent or certification (or copy thereof)
provided under paragraph (1)(A), and the name and address of
any on-call physician (described in subsection (d)(1)(C) of
this section) who has refused or failed to appear within a
reasonable time to provide necessary stabilizing treatment;
``(D) in which the transfer is effected through qualified
personnel and transportation equipment, as required including
the use of necessary and medically appropriate life support
measures during the transfer; and
``(E) that meets such other requirements as the Secretary
may find necessary in the interest of the health and safety of
veterans transferred.
``(d) Charges.--(1) Nothing in this section may be construed to
affect any charges that the Secretary may collect from a veteran or
third party.
``(2) The Secretary shall treat any care provided by a non-
Department facility pursuant to this section as care otherwise provided
by a non-Department facility pursuant to this chapter for purposes of
paying such non-Department facility for such care.
``(e) Nondiscrimination.--A medical facility of the Department or a
non-Department facility, as the case may be, that has specialized
capabilities or facilities (such as burn units, shock-trauma units,
neonatal intensive care units, or (with respect to rural areas)
regional referral centers as identified by the Secretary in regulation)
shall not refuse to accept an appropriate transfer of an enrolled
veteran who requires such specialized capabilities or facilities if the
facility has the capacity to treat the veteran.
``(f) No Delay in Examination or Treatment.--A medical facility of
the Department or a non-Department facility, as the case may be, may
not delay provision of an appropriate medical screening examination
required under subsection (a) or further medical examination and
treatment required under subsection (b) of this section in order to
inquire about the method of payment or insurance status of an enrolled
veteran.
``(g) Whistleblower Protections.--The Secretary may not take
adverse action against an employee of the Department because the
employee refuses to authorize the transfer of an enrolled veteran with
an emergency medical condition that has not been stabilized or because
the employee reports a violation of a requirement of this section.
``(h) Definitions.--In this section:
``(1) The term `emergency medical condition' means--
``(A) a medical condition manifesting itself by
acute symptoms of sufficient severity (including severe
pain) such that the absence of immediate medical
attention could reasonably be expected to result in--
``(i) placing the health of the enrolled
veteran (or, with respect to an enrolled
veteran who is a pregnant woman, the health of
the woman or her unborn child) in serious
jeopardy;
``(ii) serious impairment to bodily
functions; or
``(iii) serious dysfunction of any bodily
organ or part; or
``(B) with respect to an enrolled veteran who is a
pregnant woman having contractions--
``(i) that there is inadequate time to
effect a safe transfer to another hospital
before delivery; or
``(ii) that transfer may pose a threat to
the health or safety of the woman or the unborn
child.
``(2) The term `enrolled veteran' means a veteran who is
enrolled in the health care system established under section
1705(a) of this title.
``(3) The term `to stabilize' means, with respect to an
emergency medical condition described in paragraph (1)(A), to
provide such medical treatment of the condition as may be
necessary to assure, within reasonable medical probability,
that no material deterioration of the condition is likely to
result from or occur during the transfer of the enrolled
veteran from a facility, or, with respect to an emergency
medical condition described in paragraph (1)(B), to deliver
(including the placenta).
``(4) The term `stabilized' means, with respect to an
emergency medical condition described in paragraph (1)(A), that
no material deterioration of the condition is likely, within
reasonable medical probability, to result from or occur during
the transfer of the individual from a facility, or, with
respect to an emergency medical condition described in
paragraph (1)(B), that the woman has delivered (including the
placenta).
``(5) The term `transfer' means the movement (including the
discharge) of an enrolled veteran outside the facilities of a
medical facility of the Department at the direction of any
individual employed by (or affiliated or associated, directly
or indirectly, with) the Department, but does not include such
a movement of an individual who--
``(A) has been declared dead; or
``(B) leaves the facility without the permission of
any such person.''.
(b) Clerical Amendment.--The table of sections of such chapter is
amended by inserting after the item relating to section 1730A the
following new item:
``1730B. Examination and treatment for emergency medical conditions and
women in labor.''.
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