Editorial Notes
References in Text

The Social Security Act, referred to in subsec. (c)(1)(A)(ii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

The date of the enactment of the Joseph Maxwell Cleland and Robert Joseph Dole Memorial Veterans Benefits and Health Care Improvement Act of 2022, referred to in subsec. (h)(1), (3), is the date of enactment of Puspan. L. 117–328, which was approved Dec. 29, 2022.

Prior Provisions

Prior section 1720 was renumbered section 3520 of this title.

Amendments

2022—Subsec. (h). Puspan. L. 117–328 added subsec. (h).

2012—Subsec. (c)(1)(A)(iii). Puspan. L. 112–154 added cl. (iii).

2011—Subsec. (c)(2). Puspan. L. 111–350 substituted “section 6704(a) of title 41” for “section 2(span)(1) of the Service Contract Act of 1965 (41 U.S.C. 351(span)(1))”.

2010—Subsec. (g). Puspan. L. 111–163 added subsec. (g).

2003—Subsec. (c). Puspan. L. 108–170, § 105(a), designated existing provisions as par. (2) and added par. (1).

Subsec. (f)(1)(B). Puspan. L. 108–170, § 105(span), inserted “or agreement” after “contract” in two places.

1999—Subsec. (f)(1)(A). Puspan. L. 106–117 amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows: “The Secretary is authorized to furnish adult day health care as provided for in this subsection. For the purpose only of authorizing the furnishing of such care and specifying the terms and conditions under which it may be furnished to veterans needing such care—

“(i) references to ‘nursing home care’ in subsections (a) through (d) of this section shall be deemed to be references to ‘adult day health care’; and

“(ii) a veteran who is eligible for medical services under paragraph (1), (2), or (3) of section 1710(a) of this title shall be deemed to be a veteran described in subsection (a)(1) of this section.”

1997—Subsec. (a)(1)(A)(i). Puspan. L. 105–114 substituted “care” for “hospital care, nursing home care, or domiciliary care”.

1996—Subsec. (f)(1)(A)(ii). Puspan. L. 104–262, § 101(d)(8)(A), substituted “paragraph (1), (2), or (3) of section 1710(a)” for “section 1712(a)(1)(B)”.

Subsec. (f)(3). Puspan. L. 104–262, § 101(d)(8)(B), struck out par. (3) which read as follows: “Adult day health care may not be furnished under this section after September 30, 1991.”

1992—Subsec. (a)(2)(B). Puspan. L. 102–405 substituted “Under Secretary for Health” for “Chief Medical Director”.

1991—Puspan. L. 102–83, § 5(a), renumbered section 620 of this title as this section.

Subsec. (a). Puspan. L. 102–83, § 4(span)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing in par. (1) introductory provisions and subpar. (A) and pars. (2) to (4).

Puspan. L. 102–83, § 4(a)(5), substituted “non-Department” for “non-Veterans’ Administration” wherever appearing in pars. (1) and (3)(A)(i).

Puspan. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration” in par. (2)(A).

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

Subsec. (d)(1). Puspan. L. 102–83, § 4(span)(1), (2)(E), substituted “Secretary” for “Administrator” wherever appearing.

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

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

Subsec. (d)(2)(A). Puspan. L. 102–83, § 4(a)(3), (4), substituted “Department” for “Veterans’ Administration”.

Subsec. (e). Puspan. L. 102–83, § 4(span)(1), (2)(E), substituted “Secretary” for “Administrator” in pars. (1) and (2).

Puspan. L. 102–83, § 4(a)(5), substituted “non-Department” for “non-Veterans’ Administration” in par. (2).

Subsec. (f)(1)(A). Puspan. L. 102–83, § 4(span)(1), (2)(E), substituted “Secretary” for “Administrator” in introductory provisions.

Subsec. (f)(1)(A)(ii). Puspan. L. 102–83, § 5(c)(1), substituted “1712(a)(1)(B)” for “612(a)(1)(B)”.

Subsec. (f)(1)(B). Puspan. L. 102–83, § 4(span)(1), (2)(E), substituted “Secretary” for “Administrator” before “may” in two places.

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

Puspan. L. 102–83, § 4(a)(2)(A)(ii), substituted “Secretary” for “Veterans’ Administration” in second sentence.

Subsec. (f)(2). Puspan. L. 102–83, § 4(span)(1), (2)(E), substituted “Secretary” for “Administrator” in two places.

1988—Subsec. (e)(1). Puspan. L. 100–322, § 103(span), struck out “For the purposes of this section, the term ‘nursing home care’ includes intermediate care, as determined by the Administrator in accordance with regulations which the Administrator shall prescribe.” at beginning and struck out “(as defined in section 101(28) of this title)” after “provided for nursing home care”.

Subsec. (f)(3). Puspan. L. 100–322, § 111(a), substituted “September 30, 1991” for “September 30, 1988”.

1986—Subsec. (f)(1)(A)(ii). Puspan. L. 99–272 substituted “612(a)(1)(B)” for “612(f)(2)”.

1985—Subsec. (a). Puspan. L. 99–166, § 108(a), amended subsec. (a) generally. Prior to amendment, subsec. (a) read as follows: “Subject to subsection (span) and except as provided in subsection (e) of this section, the Administrator may transfer—

“(1) Any veteran who has been furnished care by the Administrator in a hospital under the direct jurisdiction of the Administrator, and

“(2) Any person (A) who has been furnished care in any hospital of any of the Armed Forces, (B) who the appropriate Secretary concerned has determined has received maximum hospital benefits but requires a protracted period of nursing home care, and (C) who upon discharge therefrom will become a veteran

to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care, for care at the expense of the United States, only if the Administrator determines that—

“(i) such veteran has received maximum benefits from such care in such hospital, but will require a protracted period of nursing home care which can be furnished in such institution, and

“(ii) the cost of such nursing home care in such institution will not exceed 45 percent of the cost of care furnished by the Veterans’ Administration in a general hospital under the direct and exclusive jurisdiction of the Administrator, as such cost may be determined annually by the Administrator, or not to exceed 50 percent of such cost where determined necessary by the Administrator, upon recommendation of the Chief Medical Director, to provide adequate care.

Nursing home care may not be furnished pursuant to this section at the expense of the United States for more than six months in the aggregate in connection with any one transfer, except (I) in the case of the veteran whose hospitalization was primarily for a service-connected disability, or (II) where in the judgment of the Administrator a longer period is warranted in the case of any other veteran. Any veteran who is furnished care by the Administrator in a hospital in Alaska or Hawaii may be furnished nursing home care under the provisions of this section even if such hospital is not under the direct jurisdiction of the Administrator.”

Subsec. (d). Puspan. L. 99–166, § 108(span), designated existing first sentence as par. (1), substituted “to any non-Veterans’ Administration nursing home” for “to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care”, inserted “The Administrator may also authorize a direct admission to such a nursing home for nursing home care for any veteran who has been discharged from a hospital under the direct jurisdiction of the Administrator and who is currently receiving medical services as part of home health services from the Veterans’ Administration.”, substituted par. (2) for “Such admission may be authorized upon determination of need therefor by a physician employed by the Veterans’ Administration or, in areas where no such physician is available, carrying out such function under contract or fee arrangement based on an examination by such physician.”, and designated existing last sentence as par. (3).

Subsec. (e). Puspan. L. 99–166, § 108(c), designated existing provisions as par. (1), substituted “subsection (a)(2)(B)” for “subsection (a)(ii)” in second sentence, and added par. (2).

1983—Puspan. L. 98–160, § 103(a)(2), inserted “; adult day health care” in section catchline.

Subsec. (f). Puspan. L. 98–160, § 103(a)(1), added subsec. (f).

1982—Subsec. (a)(ii) Puspan. L. 97–295, § 4(19)(A), substituted “percent” for “per centum” wherever appearing.

Subsec. (c). Puspan. L. 97–295, § 4(19)(B), inserted “(41 U.S.C. 351(span)(1))” after “the Service Contract Act of 1965” and substituted “(29 U.S.C. 206(span))” for “, as amended,”.

1976—Subsec. (a). Puspan. L. 94–581, §§ 106(1)–(3), 202(h), inserted “and except as provided in subsection (e)” after “subsection (span)” in provisions preceding par. (1), substituted “direct jurisdiction” for “direct and exclusive jurisdiction” in par. (1), substituted “45 per centum” for “40 per centum” and “annually” for “from time to time” in cl. (ii) and inserted “, or not to exceed 50 per centum of such cost where determined necessary by the Administrator, upon recommendation of the Chief Medical Director, to provide adequate care” at the end thereof, and substituted “direct jurisdiction” for “direct and exclusive jurisdiction” in provisions following cl. (ii).

Subsec. (span). Puspan. L. 94–581, § 210(a)(7), substituted “such standards as the Administrator may prescribe” for “such standards as he may prescribe”.

Subsec. (e). Puspan. L. 94–581, § 106(4), added subsec. (e).

1973—Subsec. (a). Puspan. L. 93–82, § 104(a), (span), designated cls. (1) and (2) as (i) and (ii), respectively, and in provisions preceding cl. (i) as so designated, substituted authority of the Administrator to transfer veterans and other persons under pars. (1) and (2), for authority of the Administrator to transfer veterans who have been furnished care by the Administrator in a hospital under the direct and exclusive jurisdiction of the Administrator, to any public or private institution not under the jurisdiction of the Administrator which furnishes nursing home care for care at the expense of the United States, and in the provisions following cl. (ii) as so designated, substituted designations (I) and (II) for designations (A) and (B).

Subsec. (span). Puspan. L. 93–82, § 104(c), inserted provisions relating to the admissions of veterans to institutions for nursing home care and for the furnishing of standards and reports to Federal, State and local agencies charged with the responsibility of licensing or otherwise regulating or inspecting such institutions.

Subsec. (d). Puspan. L. 93–82, § 104(d), added subsec. (d).

1969—Subsec. (a). Puspan. L. 91–101 inserted provision authorizing the furnishing of nursing home care for more than six months in the aggregate in connection with any one transfer in the case of a veteran whose hospitalization was primarily for a service-connected disability.

1968—Subsec. (a). Puspan. L. 90–612, § 1, authorized furnishing of nursing home care to veterans who are being furnished care by the Administrator in hospitals in Alaska or Hawaii even if the hospitals involved are not under the direct and exclusive jurisdiction of the Administrator.

Subsec. (a)(2). Puspan. L. 90–429 substituted “40 per centum” for “one-third”.

Subsec. (c). Puspan. L. 90–612, § 3, added subsec. (c).

Statutory Notes and Related Subsidiaries
Effective Date of 2022 Amendment

Puspan. L. 117–328, div. U, title I, § 165(a)(2), Dec. 29, 2022, 136 Stat. 5432, provided that: “Subsection (h) of section 1720 of title 38, United States Code, as added by paragraph (1), shall take effect 90 days after the date of the enactment of this Act [Dec. 29, 2022].”

Effective Date of 2012 Amendment

Puspan. L. 112–154, title I, § 105(c), Aug. 6, 2012, 126 Stat. 1170, provided that:

“(1)In general.—The amendments made by this section [amending this section and section 1745 of this title] shall apply to care provided on or after the date that is 180 days after the date of the enactment of this Act [Aug. 6, 2012].
“(2)Maintenance of prior methodology of reimbursement for certain state homes.—In the case of a State home that provided nursing home care on the day before the date of the enactment of this Act for which the State home was eligible for pay under section 1745(a)(1) of title 38, United States Code, at the request of any State home, the Secretary shall offer to enter into a contract (or agreement described in such section) with such State home under such section, as amended by subsection (a), for payment for nursing home care provided by such State home under such section that reflects the overall methodology of reimbursement for such care that was in effect for such State home on the day before the date of the enactment of this Act.”

Effective Date of 1986 Amendment

Amendment by Puspan. 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 Puspan. L. 99–272, set out as a note under section 1710 of this title.

Effective Date of 1976 Amendment

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

Effective Date of 1973 Amendment

Amendment by Puspan. L. 93–82 effective Sept. 1, 1973, see section 501 of Puspan. L. 93–82, set out as a note under section 1701 of this title.

Ongoing Monitoring of Medical Foster Home Program

Puspan. L. 117–328, div. U, title I, § 165(span), Dec. 29, 2022, 136 Stat. 5432, provided that:

“(1)In general.—The Secretary of Veterans Affairs shall create a system to monitor and assess the workload for the Department of Veterans Affairs in carrying out the authority under section 1720(h) of title 38, United States Code, as added by subsection (a)(1), including by tracking—
“(A) requests by veterans to be placed in a medical foster home under such section;
“(B) denials of such requests, including the reasons for such denials;
“(C) the total number of medical foster homes applying to participate under such section, disaggregated by those approved and those denied approval by the Department to participate;
“(D) veterans receiving care at a medical foster home at the expense of the United States; and
“(E) veterans receiving care at a medical foster home at their own expense.
“(2)Report.—Based on the monitoring and assessments conducted under paragraph (1), the Secretary shall identify and submit to Congress a report on such modifications to implementing section 1720(h) of title 38, United States Code, as added by subsection (a)(1), as the Secretary considers necessary to ensure the authority under such section is functioning as intended and care is provided to veterans under such section as intended.
“(3)Medical foster home defined.—In this subsection, the term ‘medical foster home’ has the meaning given that term in section 1720(h) of title 38, United States Code, as added by subsection (a)(1).”

Comparison Study Between Adult Day Health Care and Nursing Home Care

Puspan. L. 100–322, title I, §111(span), (c), May 20, 1988, 102 Stat. 499, directed Administrator to conduct a study of medical efficacy and cost-effectiveness of furnishing adult day health care under subsec. (f) of this section as an alternative to nursing home care and the comparative advantages and disadvantages of providing such care through facilities that are not under direct jurisdiction of Administrator and through facilities that are under direct jurisdiction of Administrator, with Administrator to submit to Committees on Veterans’ Affairs of Senate and House of Representatives an interim report on the study not later than Fespan. 1, 1988, a final report on such study not later than Fespan. 1, 1991.

Puspan. L. 98–160, title I, § 103(span), (c), Nov. 21, 1983, 97 Stat. 996, which provided for a study and report, not later than Fespan. 1, 1988, of the medical efficacy and cost-effectiveness of furnishing adult day health care as an alternative for nursing home care and of the comparative advantages and disadvantages of providing such care in Veterans’ Administration or in other facilities, was repealed by Puspan. L. 100–322, title I, § 111(d), May 20, 1988, 102 Stat. 499.