Collapse to view only § 8158. Deposit in escrow
- § 8151. Statement of congressional purpose
- § 8152. Definitions
- § 8153. Sharing of health-care resources
- § 8154. Exchange of medical information
- § 8155. Pilot programs; grants to medical schools
- § 8156. Coordination with health services development activities carried out under the National Health Planning and Resources Development Act of 1974
- § 8157. Joint title to medical equipment
- § 8158. Deposit in escrow
- § 8159. Authority to pay for services authorized but not subject to an agreement
§ 8151. Statement of congressional purpose
It is the purpose of this subchapter to strengthen the medical programs at Department facilities and improve the quality of health care provided veterans under this title by authorizing the Secretary to enter into agreements with health-care providers in order to share health-care resources with, and receive health-care resources from, such providers while ensuring no diminution of services to veterans.
(Added Pub. L. 89–785, title II, § 203, Nov. 7, 1966, 80 Stat. 1373, § 5051; amended Pub. L. 101–366, title II, § 202(a), Aug. 15, 1990, 104 Stat. 438; renumbered § 8151, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–83, § 4(a)(3), (4), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 103–210, § 3(a), Dec. 20, 1993, 107 Stat. 2497; Pub. L. 104–262, title III, § 301(a), Oct. 9, 1996, 110 Stat. 3191.)
§ 8152. Definitions
For the purposes of this subchapter—
(1) The term “health-care resource” includes hospital care and medical services (as those terms are defined in section 1701 of this title), services under sections 1782 and 1783 of this title, any other health-care service, and any health-care support or administrative resource.
(2) The term “health-care providers” includes health-care plans and insurers and any organizations, institutions, or other entities or individuals who furnish health-care resources.
(3) The term “hospital”, unless otherwise specified, includes any Federal, State, local, or other public or private hospital.
(Added Pub. L. 89–785, title II, § 203, Nov. 7, 1966, 80 Stat. 1373, § 5052; renumbered § 8152, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; amended Pub. L. 102–54, § 14(f)(8), June 13, 1991, 105 Stat. 288; Pub. L. 103–210, § 3(b), Dec. 20, 1993, 107 Stat. 2497; Pub. L. 104–262, title III, § 301(b), Oct. 9, 1996, 110 Stat. 3191; Pub. L. 107–135, title II, § 208(e)(8), Jan. 23, 2002, 115 Stat. 2464.)
§ 8153. Sharing of health-care resources
(a)
(1) To secure health-care resources which otherwise might not be feasibly available, or to effectively utilize certain other health-care resources, the Secretary may, when the Secretary determines it to be in the best interest of the prevailing standards of the Department medical care program, make arrangements, by contract or other form of agreement for the mutual use, or exchange of use, of health-care resources between Department health-care facilities and any health-care provider, or other entity or individual.
(2) The Secretary may enter into a contract or other agreement under paragraph (1) if such resources are not, or would not be, used to their maximum effective capacity.
(3)
(A) If the health-care resource required is a commercial service, the use of medical equipment or space, or research, and is to be acquired from an institution affiliated with the Department in accordance with section 7302 of this title, including medical practice groups and other entities associated with affiliated institutions, blood banks, organ banks, or research centers, the Secretary may make arrangements for acquisition of the resource without regard to any law or regulation (including any Executive order, circular, or other administrative policy) that would otherwise require the use of competitive procedures for acquiring the resource.
(B)
(i) If the health-care resource required is a commercial service or the use of medical equipment or space, and is not to be acquired from an entity described in subparagraph (A), any procurement of the resource may be conducted without regard to any law or regulation that would otherwise require the use of competitive procedures for procuring the resource, but only if the procurement is conducted in accordance with the simplified procedures prescribed pursuant to clause (ii).
(ii) The Secretary, in consultation with the Administrator for Federal Procurement Policy, may prescribe simplified procedures for the procurement of health-care resources under this subparagraph. The Secretary shall publish such procedures for public comment in accordance with section 1707 of title 41. Such procedures shall permit all responsible sources, as appropriate, to submit a bid, proposal, or quotation (as appropriate) for the resources to be procured and provide for the consideration by the Department of bids, proposals, or quotations so submitted.
(iii) Pending publication of the procedures under clause (ii), the Secretary shall (except as provided under subparagraph (A)) procure health-care resources referred to in clause (i) in accordance with all procurement laws and regulations.
(C) Any procurement of health-care resources other than those covered by subparagraph (A) or (B) shall be conducted in accordance with all procurement laws and regulations.
(D) For any procurement to be conducted on a sole source basis other than a procurement covered by subparagraph (A), a written justification shall be prepared that includes the information and is approved at the levels prescribed in section 3304(e) of title 41.
(E) As used in this paragraph, the term “commercial service” means a service that is offered and sold competitively in the commercial marketplace, is performed under standard commercial terms and conditions, and is procured using firm-fixed price contracts.
(b) Arrangements entered into under this section shall provide for payment to the Department in accordance with procedures that provide appropriate flexibility to negotiate payment which is in the best interest of the Government. Any proceeds to the Government received therefrom shall be credited to the applicable Department medical appropriation and to funds that have been allotted to the facility that furnished the resource involved.
(c) Eligibility for hospital care and medical services furnished any veteran pursuant to this section shall be subject to the same terms as though provided in a Department health care facility, and provisions of this title applicable to persons receiving hospital care or medical services in a Department health care facility shall apply to veterans treated under this section.
(d) When a Department health care facility provides hospital care or medical services, pursuant to a contract or agreement authorized by this section, to an individual who is not eligible for such care or services under chapter 17 of this title and who is entitled to hospital or medical insurance benefits under title XVIII of the Social Security Act (
(e) The Secretary may make an arrangement that authorizes the furnishing of services by the Secretary under this section to individuals who are not veterans only if the Secretary determines—
(1) that veterans will receive priority under such an arrangement; and
(2) that such an arrangement—
(A) is necessary to maintain an acceptable level and quality of service to veterans at that facility; or
(B) will result in the improvement of services to eligible veterans at that facility.
(f) Any amount received by the Secretary from a non-Federal entity as payment for services provided by the Secretary during a prior fiscal year under an agreement entered into under this section may be obligated by the Secretary during the fiscal year in which the Secretary receives the payment.
(g) The Secretary shall submit to the Congress not later than February 1 of each year a report on the activities carried out under this section during the preceding fiscal year. Each report shall include—
(1) an appraisal of the effectiveness of the activities authorized in this section and the degree of cooperation from other sources, financial and otherwise; and
(2) recommendations for the improvement or more effective administration of such activities.
(Added Pub. L. 89–785, title II, § 203, Nov. 7, 1966, 80 Stat. 1374, § 5053; amended Pub. L. 91–496, § 4, Oct. 22, 1970, 84 Stat. 1092; Pub. L. 93–82, title III, § 303, Aug. 2, 1973, 87 Stat. 195; Pub. L. 94–581, title I, § 115(a)(1), title II, §§ 206(c), 210(e)(11), Oct. 21, 1976, 90 Stat. 2852, 2859, 2865; Pub. L. 96–151, title III, § 304, Dec. 20, 1979, 93 Stat. 1096; Pub. L. 97–295, § 4(95)(A), Oct. 12, 1982, 96 Stat. 1313; Pub. L. 98–160, title VII, § 702(20), Nov. 21, 1983, 97 Stat. 1010; Pub. L. 99–576, title II, § 231(c)(1), Oct. 28, 1986, 100 Stat. 3264; Pub. L. 101–366, title II, § 202(b), Aug. 15, 1990, 104 Stat. 438; renumbered § 8153, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–54, § 14(f)(9), June 13, 1991, 105 Stat. 288; Pub. L. 102–83, § 4(a)(3), (4), (b)(1), (2)(D), (E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 103–210, § 3(c), Dec. 20, 1993, 107 Stat. 2498; Pub. L. 104–262, title III, § 301(c), (d)(1), Oct. 9, 1996, 110 Stat. 3191, 3193; Pub. L. 105–114, title IV, § 402(d), (e), Nov. 21, 1997, 111 Stat. 2294; Pub. L. 106–419, title IV, § 404(b)(2), Nov. 1, 2000, 114 Stat. 1866; Pub. L. 108–170, title IV, § 405(d), Dec. 6, 2003, 117 Stat. 2063; Pub. L. 111–350, § 5(j)(8), Jan. 4, 2011, 124 Stat. 3850.)
§ 8154. Exchange of medical information
(a) The Secretary is authorized to enter into agreements with medical schools, hospitals, research centers, and individual members of the medical profession under which medical information and techniques will be freely exchanged and the medical information services of all parties to the agreement will be available for use by any party to the agreement under conditions specified in the agreement. In carrying out the purposes of this section, the Secretary shall utilize recent developments in electronic equipment to provide a close educational, scientific, and professional link between Department hospitals and major medical centers. Such agreements shall be utilized by the Secretary to the maximum extent practicable to create, at each Department hospital which is a part of any such agreement, an environment of academic medicine which will help such hospital attract and retain highly trained and qualified members of the medical profession.
(b) In order to bring about utilization of all medical information in the surrounding medical community, particularly in remote areas, and to foster and encourage the widest possible cooperation and consultation among all members of the medical profession in such community, the educational facilities and programs established at Department hospitals and the electronic link to medical centers shall be made available for use by the surrounding medical community (including State home facilities furnishing domiciliary, nursing home, or hospital care to veterans). The Secretary may charge a fee for such services (on annual or like basis) at rates which the Secretary determines, after appropriate study, to be fair and equitable. The financial status of any user of such services shall be taken into consideration by the Secretary in establishing the amount of the fee to be paid. Any proceeds to the Government received therefrom shall be credited to the applicable Department medical appropriation.
(c) The Secretary is authorized to enter into agreements with public and nonprofit private institutions, organizations, corporations, and other entities in order to participate in cooperative health-care personnel education programs within the geographical area of any Department health-care facility located in an area remote from major academic health centers.
(Added Pub. L. 89–785, title II, § 203, Nov. 7, 1966, 80 Stat. 1374, § 5054; amended Pub. L. 94–424, § 1(1), Sept. 28, 1976, 90 Stat. 1332; Pub. L. 94–581, title II, §§ 206(d), 210(e)(12), Oct. 21, 1976, 90 Stat. 2859, 2865; Pub. L. 96–151, title I, § 102(a), Dec. 20, 1979, 93 Stat. 1092; Pub. L. 97–251, § 9, Sept. 8, 1982, 96 Stat. 716; renumbered § 8154, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–83, § 4(a)(3), (4), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.)
§ 8155. Pilot programs; grants to medical schools
(a) The Secretary may establish an Advisory Subcommittee on Programs for Exchange of Medical Information, of the Special Medical Advisory Group, established under section 7312 of this title, to advise the Secretary on matters regarding the administration of this section and to coordinate these functions with other research and education programs in the Department of Medicine and Surgery. The Assistant Under Secretary for Health charged with administration of the Department of Medicine and Surgery medical research program shall be an ex officio member of this Subcommittee.
(b) The Secretary, upon the recommendation of the Subcommittee, is authorized to make grants to medical schools, hospitals, and research centers to assist such medical schools, hospitals, and research centers in planning and carrying out agreements authorized by section 8154 of this title. Such grants may be used for the employment of personnel, the construction of facilities, the purchasing of equipment when necessary to implement such programs, and for such other purposes as will facilitate the administration of this section.
(c)
(1) There is hereby authorized to be appropriated an amount not to exceed $3,500,000 for fiscal year 1976; $1,700,000 for the period beginning July 1, 1976, and ending September 30, 1976; $4,000,000 for fiscal year 1977; $4,000,000 for fiscal year 1978; and $4,000,000 for fiscal year 1979 and for each of the three succeeding fiscal years, for the purpose of developing and carrying out medical information programs under this section on a pilot program basis and for the grants authority in subsection (b) of this section. Pilot programs authorized by this subsection shall be carried out at Department hospitals in geographically dispersed areas of the United States.
(2) Funds authorized under this section shall not be available to pay the cost of hospital, medical, or other care of patients except to the extent that such cost is determined by the Secretary to be incident to research, training, or demonstration activities carried out under this section.
(d) The Secretary, after consultation with the Subcommittee shall prescribe regulations covering the terms and conditions for making grants under this section.
(e) Each recipient of a grant under this section shall keep such records as the Secretary may prescribe, including records which fully disclose the amount and disposition by such recipient of the proceeds of such grant, the total cost of the project or undertaking in connection with which such grant is made or used, and the amount of that portion of the cost of the project or undertaking supplied by other sources, and such records as will facilitate an effective audit.
(f) The Secretary and the Comptroller General of the United States, or any of their duly authorized representatives, shall have access, for the purpose of audit and examination, to any books, documents, papers, and records of the recipient of any grant under this section which are pertinent to any such grant.
(Added Pub. L. 89–785, title II, § 203, Nov. 7, 1966, 80 Stat. 1375, § 5055; amended Pub. L. 92–69, Aug. 6, 1971, 85 Stat. 178; Pub. L. 94–424, § 1(2), Sept. 28, 1976, 90 Stat. 1332; Pub. L. 94–581, title II, §§ 206(e), 210(e)(13), Oct. 21, 1976, 90 Stat. 2859, 2865; Pub. L. 96–151, title I, § 102(b), Dec. 20, 1979, 93 Stat. 1092; renumbered § 8155 and amended Pub. L. 102–40, title IV, § 402(b)(1), (d)(1), May 7, 1991, 105 Stat. 238, 239; Pub. L. 102–83, § 4(a)(3), (4), (b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405; Pub. L. 102–405, title III, § 302(c)(1), Oct. 9, 1992, 106 Stat. 1984; Pub. L. 103–446, title XII, § 1201(d)(19), Nov. 2, 1994, 108 Stat. 4684.)
§ 8156. Coordination with health services development activities carried out under the National Health Planning and Resources Development Act of 1974
The Secretary and the Secretary of Health and Human Services shall, to the maximum extent practicable, coordinate programs carried out under this subchapter and programs carried out under part F of title XVI of the Public Health Service Act (42 U.S.C. 300t et seq.).
(Added Pub. L. 89–785, title II, § 203, Nov. 7, 1966, 80 Stat. 1375, § 5056; amended Pub. L. 94–581, title I, § 115(a)(2), Oct. 21, 1976, 90 Stat. 2853; Pub. L. 97–295, § 4(93), (95)(A), Oct. 12, 1982, 96 Stat. 1313; renumbered § 8156, Pub. L. 102–40, title IV, § 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102–83, § 4(b)(1), (2)(E), Aug. 6, 1991, 105 Stat. 404, 405.)
§ 8157. Joint title to medical equipment
(a) Subject to subsection (b), the Secretary may enter into agreements with institutions described in section 8153(a) of this title for the joint acquisition of medical equipment.
(b)
(1) The Secretary may not pay more than one-half of the purchase price of equipment acquired through an agreement under subsection (a).
(2) Any equipment to be procured under such an agreement shall be procured by the Secretary. Title to such equipment shall be held jointly by the United States and the institution.
(3) Before equipment acquired under such an agreement may be used, the parties to the agreement shall arrange by contract under section 8153 of this title for the exchange or use of the equipment.
(4) The Secretary may not contract for the acquisition of medical equipment to be purchased jointly under an agreement under subsection (a) until the institution which enters into the agreement provides to the Secretary its share of the purchase price of the medical equipment.
(c)
(1) Notwithstanding any other provision of law, the Secretary may transfer the interest of the Department in equipment acquired through an agreement under subsection (a) to the institution which holds joint title to the equipment if the Secretary determines that the transfer would be justified by compelling clinical considerations or the economic interest of the Department. Any such transfer may only be made upon agreement by the institution to pay to the Department the amount equal to one-half of the depreciated purchase price of the equipment. Any such payment when received shall be credited to the applicable Department medical appropriation.
(2) Notwithstanding any other provision of law, the Secretary may acquire the interest of an institution in equipment acquired under subsection (a) if the Secretary determines that the acquisition would be justified by compelling clinical considerations or the economic interests of the Department. The Secretary may not pay more than one-half the depreciated purchase price of that equipment.
(Added Pub. L. 102–405, title I, § 103(a)(1), Oct. 9, 1992, 106 Stat. 1973.)
§ 8158. Deposit in escrow
(a) To facilitate the procurement of medical equipment pursuant to section 8157 of this title, the Secretary may enter into escrow agreements with institutions described in section 8153(a) of this title. Any such agreement shall provide that—
(1) the institutions shall pay to the Secretary the funds necessary to make a payment under section 8157(b)(4) of this title;
(2) the Secretary, as escrow agent, shall administer those funds in an escrow account; and
(3) the Secretary shall disburse the escrowed funds to pay for such equipment upon its delivery or in accordance with the contract to procure the equipment and shall disburse all accrued interest or other earnings on the escrowed funds to the institution.
(b) As escrow agent for funds placed in escrow pursuant to an agreement under subsection (a), the Secretary may—
(1) invest the escrowed funds in obligations of the Federal Government or obligations which are insured or guaranteed by the Federal Government;
(2) retain in the escrow account interest or other earnings on such investments;
(3) disburse the funds pursuant to the escrow agreement; and
(4) return undisbursed funds to the institution.
(c)
(1) If the Secretary enters into an escrow agreement under this section, the Secretary may enter into an agreement to procure medical equipment if one-half the purchase price of the equipment is available in an appropriation or fund for the expenditure or obligation.
(2) Funds held in an escrow account under this section shall not be considered to be public funds.
(Added Pub. L. 102–405, title I, § 103(a)(1), Oct. 9, 1992, 106 Stat. 1974.)
§ 8159. Authority to pay for services authorized but not subject to an agreement
(a)In General.—If, in the course of furnishing hospital care, a medical service, or an extended care service authorized by the Secretary and pursuant to a contract, agreement, or other arrangement with the Secretary, a provider who is not a party to the contract, agreement, or other arrangement furnishes hospital care, a medical service, or an extended care service that the Secretary considers necessary, the Secretary may compensate the provider for the cost of such care or service.
(b)New Contracts and Agreements.—The Secretary shall take reasonable efforts to enter into a contract, agreement, or other arrangement with a provider described in subsection (a) to ensure that future care and services authorized by the Secretary and furnished by the provider are subject to such a contract, agreement, or other arrangement.
(Added Pub. L. 115–182, title I, § 112(a), June 6, 2018, 132 Stat. 1421.)