1. U.S. Code
  2. title 38
  3. part II
  4. chapter 17
  5. subchapter VIII
  6. § 1784

Collapse to view only § 1784. Humanitarian care

§ 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,
(3) the surviving spouse or child of a person who died in the active military, naval, air, or space service in the line of duty and not due to such person’s own misconduct, and
(4) an individual designated as a primary provider of personal care services under section 1720G(a)(7)(A) of this title who is not entitled to care or services under a health-plan contract (as defined in section 1725(h) of this title),
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 child’s own willful misconduct and which results in such child’s inability to continue or resume such child’s 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.
(e) Payment by the Secretary under this section on behalf of a covered beneficiary for medical care shall constitute payment in full and extinguish any liability on the part of the beneficiary for that care.
(Added Pub. L. 93–82, title I, § 103(b), Aug. 2, 1973, 87 Stat. 181, § 613; amended Pub. L. 94–581, title I, § 104, title II, § 210(a)(4), Oct. 21, 1976, 90 Stat. 2845, 2862; Pub. L. 96–151, title II, § 205(a), Dec. 20, 1979, 93 Stat. 1094; Pub. L. 97–72, title I, § 105, Nov. 3, 1981, 95 Stat. 1050; Pub. L. 97–251, § 5(a), Sept. 8, 1982, 96 Stat. 716; renumbered § 1713 and amended Pub. L. 102–83, §§ 4(a)(3), (4), (b)(1), (2)(B), (E), 5(a), Aug. 6, 1991, 105 Stat. 404–406; Pub. L. 102–190, div. A, title VII, § 704(b)(2), Dec. 5, 1991, 105 Stat. 1402; Pub. L. 107–14, § 3, June 5, 2001, 115 Stat. 25; renumbered § 1781 and amended Pub. L. 107–135, title II, § 208(c), Jan. 23, 2002, 115 Stat. 2463; Pub. L. 107–330, title III, § 308(g)(8), Dec. 6, 2002, 116 Stat. 2829; Pub. L. 111–163, title I, § 102, title V, § 503, May 5, 2010, 124 Stat. 1139, 1157; Pub. L. 114–58, title VI, § 601(7), Sept. 30, 2015, 129 Stat. 538; Pub. L. 116–283, div. A, title IX, § 926(a)(30), Jan. 1, 2021, 134 Stat. 3830; Pub. L. 117–328, div. U, title I, § 142(c)(4), Dec. 29, 2022, 136 Stat. 5424.)

CITE AS: 38 USC 1781

§ 1782. Counseling, training, and mental health services for immediate family members and caregivers
(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, marriage and family 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, marriage and family counseling, training, and mental health services as are necessary in connection with that treatment.
(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;
(2) a family caregiver of an eligible veteran or a caregiver of a covered veteran (as those terms are defined in section 1720G of this title); or
(3) 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.
(Added Pub. L. 107–135, title II, § 208(b), Jan. 23, 2002, 115 Stat. 2462; amended Pub. L. 110–387, title III, § 301(a)(2), Oct. 10, 2008, 122 Stat. 4120; Pub. L. 111–163, title I, § 103(a), (b), May 5, 2010, 124 Stat. 1139, 1140.)

CITE AS: 38 USC 1782

§ 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, air, or space service in the line of duty and under circumstances not due to the person’s 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.
(Added Pub. L. 107–135, title II, § 208(b), Jan. 23, 2002, 115 Stat. 2463; amended Pub. L. 109–461, title II, § 216, Dec. 22, 2006, 120 Stat. 3424; Pub. L. 116–283, div. A, title IX, § 926(a)(31), Jan. 1, 2021, 134 Stat. 3830.)

CITE AS: 38 USC 1783

§ 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.

(Added Pub. L. 107–135, title II, § 208(b), Jan. 23, 2002, 115 Stat. 2463.)

CITE AS: 38 USC 1784

§ 1784A. Examination and treatment for emergency medical conditions and women in labor
(a)In General.—In the case of a hospital of the Department that has an emergency department, if any individual comes to the hospital or the campus of the hospital and a request is made on behalf of the individual for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists.
(b)Necessary Stabilizing Treatment for Emergency Medical Conditions and Labor.—
(1) If any individual comes to a hospital of the Department that has an emergency department or the campus of such a hospital and the hospital determines that the individual has an emergency medical condition, the hospital must provide either—
(A) within the staff and facilities available at the hospital, for such further medical examination and such treatment as may be required to stabilize the medical condition; or
(B) for transfer of the individual to another medical facility in accordance with subsection (c).
(2) A hospital is deemed to meet the requirement of paragraph (1)(A) with respect to an individual if the hospital offers the individual the further medical examination and treatment described in that paragraph and informs the individual (or a person acting on behalf of the individual) of the risks and benefits to the individual of such examination and treatment, but the individual (or a person acting on behalf of the individual) refuses to consent to the examination and treatment. The hospital shall take all reasonable steps to secure the written informed consent of the individual (or person) to refuse such examination and treatment.
(3) A hospital is deemed to meet the requirement of paragraph (1)(B) with respect to an individual if the hospital offers to transfer the individual to another medical facility in accordance with subsection (c) and informs the individual (or a person acting on behalf of the individual) of the risks and benefits to the individual of such transfer, but the individual (or a person acting on behalf of the individual) refuses to consent to the transfer. The hospital shall take all reasonable steps to secure the written informed consent of the individual (or person) to refuse such transfer.
(c)Restricting Transfers Until Individual Stabilized.—
(1) If an individual at a hospital of the Department has an emergency medical condition that has not been stabilized, the hospital may not transfer the individual unless—
(A)
(i) the individual (or a legally responsible person acting on behalf of the individual), after being informed of the obligations of the hospital under this section and of the risk of transfer, requests, in writing, transfer to another medical facility;
(ii) a physician of the Department has signed a certification 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 individual and, in the case of labor, to the unborn child from effecting the transfer; or
(iii) if a physician of the Department is not physically present in the emergency department at the time an individual is transferred, a qualified medical person (as defined by the Secretary for purposes of this section) has signed a certification described in clause (ii) after a physician of the Department, 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 to that facility.
(2) A certification described in clause (ii) or (iii) of paragraph (1)(A) shall include a summary of the risks and benefits upon which the certification is based.
(3) For purposes of paragraph (1)(B), an appropriate transfer to a medical facility is a transfer—
(A) in which the transferring hospital provides the medical treatment within its capacity that minimizes the risks to the health of the individual 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 individual; and
(ii) has agreed to accept transfer of the individual and to provide appropriate medical treatment;
(C) in which the transferring hospital sends to the receiving facility all medical records (or copies thereof) available at the time of the transfer relating to the emergency medical condition for which the individual has presented, including—
(i) observations of signs or symptoms;
(ii) preliminary diagnosis;
(iii) treatment provided;
(iv) the results of any tests; and
(v) the informed written request or certification (or copy thereof) provided under paragraph (1)(A);
(D) in which the transfer is effected through qualified personnel and transportation equipment, including the use of necessary and medically appropriate life support measures during the transfer; and
(E) that meets such other requirements as the Secretary considers necessary in the interest of the health and safety of the individual or individuals transferred.
(d)Payment to the Department.—The Secretary shall charge for any care or services provided under this section in accordance with billing and reimbursement authorities available to the Secretary under other provisions of law.
(e)Definitions.—In this section:
(1) The term “campus” means, with respect to a hospital of the Department—
(A) the physical area immediately adjacent to the main buildings of the hospital;
(B) other areas and structures that are not strictly contiguous to the main buildings but are located not more than 250 yards from the main buildings; and
(C) any other areas determined by the Secretary to be part of the campus of the hospital.
(2) 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 individual (or, with respect to 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) in the case of a pregnant woman, a stage of labor that a medical provider determines indicates—
(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.
(3)
(A) The term “to stabilize” means—
(i) with respect to an emergency medical condition described in paragraph (2)(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 individual from a facility; or
(ii) with respect to an emergency medical condition described in paragraph (2)(B), to deliver (including the placenta).
(B) The term “stabilized” means—
(i) with respect to an emergency medical condition described in paragraph (2)(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
(ii) with respect to an emergency medical condition described in paragraph (2)(B), that the woman has delivered (including the placenta).
(4) The term “transfer” means the movement (including the discharge) of an individual outside the facilities of a hospital of the Department at the direction of any person employed by (or affiliated or associated, directly or indirectly, with) the hospital, 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.
(Added Pub. L. 114–315, title VI, § 606(a), Dec. 16, 2016, 130 Stat. 1572.)

CITE AS: 38 USC 1784A

§ 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 2812 of the Public Health Service Act (42 U.S.C. 300hh) 1
1 See References in Text note below.
is activated by the Secretary of Health and Human Services under 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 Secretary’s 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.
(Added Pub. L. 107–287, § 4(a)(1), Nov. 7, 2002, 116 Stat. 2028; amended Pub. L. 109–444, § 8(a)(2), Dec. 21, 2006, 120 Stat. 3313; Pub. L. 109–461, title X, §§ 1004(a)(2), 1006(b), Dec. 22, 2006, 120 Stat. 3465, 3468; Pub. L. 111–275, title X, § 1001(c)(2), Oct. 13, 2010, 124 Stat. 2896.)

CITE AS: 38 USC 1785

§ 1786. Care for newborn children of women veterans receiving maternity care
(a)In General.—Except as provided in subsection (c), the Secretary may furnish health care services described in subsection (b) and transportation necessary to receive such services to a newborn child of a woman veteran who is receiving maternity care furnished by the Department for not more than seven days after the birth of the child if the veteran delivered the child in—
(1) a facility of the Department;
(2) another facility pursuant to a Department contract for services relating to such delivery; or
(3) another location, including a health care facility, if the veteran delivers the child before arriving at a facility described in paragraph (1) or (2).
(b)Covered Health Care Services.—Health care services described in this subsection are all post-delivery care services, including routine care services, that a newborn child requires, including necessary health care services provided by a facility other than the facility where the newborn child was delivered (including a specialty pediatric hospital) that accepts transfer of the newborn child and responsibility for treatment of the newborn child.
(c)Exception Based on Medical Necessity.—Pursuant to such regulations as the Secretary shall prescribe to carry out this section, the Secretary may furnish more than seven days of health care services described in subsection (b), and may furnish transportation necessary to receive such services, to a newborn child based on medical necessity if the child is in need of additional care, including if the child has been discharged or released from a hospital and requires readmittance to ensure the health and welfare of the child.
(d)Transportation.—
(1) Transportation furnished under subsection (a) to, from, or between care settings to meet the needs of a newborn child includes costs for either or both the newborn child and parents.
(2) Transportation furnished under subsection (a) includes transportation by ambulance, including air ambulance, or other appropriate medically staffed modes of transportation—
(A) to another health care facility (including a specialty pediatric hospital) that accepts transfer of the newborn child or otherwise provides post-delivery care services when the treating facility is not capable of furnishing the care or services required; or
(B) to a health care facility 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.
(3) Amounts paid by the Department for transportation under this section shall be derived from the Medical Services appropriations account of the Department.
(e)Reimbursement or Payment for Health Care Services or Transportation.—
(1) Pursuant to regulations the Secretary shall prescribe to establish rates of reimbursement and any limitations thereto under this section, the Secretary shall directly reimburse a covered entity for health care services or transportation services provided under this section, unless the cost of the services or transportation is covered by an established agreement or contract. If such an agreement or contract exists, its negotiated payment terms shall apply.
(2)
(A) Reimbursement or payment by the Secretary under this section on behalf of an individual to a covered entity shall, unless rejected and refunded by the covered entity within 30 days of receipt, extinguish any liability on the part of the individual for the health care services or transportation covered by such payment.
(B) Neither the absence of a contract or agreement between the Secretary and a covered entity nor any provision of a contract, agreement, or assignment to the contrary shall operate to modify, limit, or negate the requirements of subparagraph (A).
(3) In this subsection, the term “covered entity” means any individual, transportation carrier, organization, or other entity that furnished or paid for health care services or transportation under this section.
(Added Pub. L. 111–163, title II, § 206(a), May 5, 2010, 124 Stat. 1145; amended Pub. L. 116–283, div. H, title XCI, § 9102, Jan. 1, 2021, 134 Stat. 4781; Pub. L. 116–315, title III, § 3006(a), Jan. 5, 2021, 134 Stat. 4994.)

CITE AS: 38 USC 1786

§ 1787. Health care of family members of veterans stationed at Camp Lejeune, North Carolina
(a)In General.—Subject to subsection (b), a family member of a veteran described in subparagraph (F) of section 1710(e)(1) of this title who resided at Camp Lejeune, North Carolina, for not fewer than 30 days during the period described in such subparagraph or who was in utero during such period while the mother of such family member resided at such location shall be eligible for hospital care and medical services furnished by the Secretary for any of the illnesses or conditions described in such subparagraph, notwithstanding that there is insufficient medical evidence to conclude that such illnesses or conditions are attributable to such residence.
(b)Limitations.—
(1) The Secretary may only furnish hospital care and medical services under subsection (a) to the extent and in the amount provided in advance in appropriations Acts for such purpose.
(2) Hospital care and medical services may not be furnished under subsection (a) for an illness or condition of a family member that is found, in accordance with guidelines issued by the Under Secretary for Health, to have resulted from a cause other than the residence of the family member described in that subsection.
(3) The Secretary may provide reimbursement for hospital care or medical services provided to a family member under this section only after the family member or the provider of such care or services has exhausted without success all claims and remedies reasonably available to the family member or provider against a third party (as defined in section 1725(h) of this title) for payment of such care or services, including with respect to health-plan contracts (as defined in such section).
(Added Pub. L. 112–154, title I, § 102(b)(1), Aug. 6, 2012, 126 Stat. 1168; amended Pub. L. 117–328, div. U, title I, § 142(c)(5), Dec. 29, 2022, 136 Stat. 5424.)

CITE AS: 38 USC 1787

§ 1788. Transplant procedures with live donors and related services
(a)In General.—Subject to subsections (b) and (c), in a case in which a veteran is eligible for a transplant procedure from the Department, the Secretary may provide for an operation on a live donor to carry out such procedure for such veteran, notwithstanding that the live donor may not be eligible for health care from the Department.
(b)Other Services.—Subject to the availability of appropriations for such purpose, the Secretary shall furnish to a live donor any care or services before and after conducting the transplant procedure under subsection (a) that may be required in connection with such procedure.
(c)Use of Non-Department Facilities.—In carrying out this section, the Secretary may provide for the operation described in subsection (a) on a live donor and furnish to the live donor the care and services described in subsection (b) at a non-Department facility pursuant to an agreement entered into by the Secretary under this title. The live donor shall be deemed to be an individual eligible for hospital care and medical services at a non-Department facility pursuant to such an agreement solely for the purposes of receiving such operation, care, and services at the non-Department facility.
(Added Pub. L. 115–182, title I, § 153(a), June 6, 2018, 132 Stat. 1437; amended Pub. L. 115–251, title II, § 211(a)(10), Sept. 29, 2018, 132 Stat. 3175.)

CITE AS: 38 USC 1788

§ 1789. Mental health services for members of the reserve components of the Armed Forces

The Secretary, in consultation with the Secretary of Defense, may furnish mental health services to members of the reserve components of the Armed Forces.

(Added Pub. L. 116–283, div. A, title VII, § 763(a), Jan. 1, 2021, 134 Stat. 3725.)

CITE AS: 38 USC 1789