Custom Federal Regulations Service™

**This is supplemental material**

**for Book I of your set of**

**Federal Regulations**

Title 38, Parts 17, 46, 47, 51--52, and 58--61

*Medical*

**Veterans Benefits Administration**

Supplement No. 32

Covering period of *Federal Register* issues

through February 21, 2006

Copyright © 2006 Jonathan Publishing

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Copyright © 2005 Jonathan Publishing

> **GENERAL INSTRUCTIONS**

Custom Federal Regulations Service™

**Supplemental Materials for *Book I***

**Code of Federal Regulations**

**Title 38, Parts 17, 46, 47, 51--52, and 58--61**

***Medical***

**Veterans Benefits Administration**

**Supplement No. 32**

25 February 2006

Covering the period of Federal Register issues

through February 21, 2006

When **Book I** was originally prepared, it was current through final
regulations published in the *Federal Register* of 15 January 2000.
These supple­mental materials are designed to keep your regulations up to
date. You should file the attached pages immediately, and record the
fact that you did so on the *Supplement Filing Record* which is at page
I-8 of Book I, *Medical*.

> **To ensure accuracy and timeliness of your materials,**
>
> **it is important that you follow these simple procedures:**
>
> 1\. Always file your supplemental materials immediately upon receipt.
>
> 2\. Before filing, always check the Supplement Filing Record (page
> I-8) to be sure that all prior supplements have been filed. If you are
> missing any supple­ments, contact the Veterans Benefits Administration
> at the address listed on page I-2.
>
> 3\. After filing, enter the relevant information on the Supplement
> Filing Record sheet (page I-8)---the date filed, name/initials of
> filer, and date through which the *Federal Register* is covered.
>
> 4\. If as a result of a failure to file, or an undelivered supplement,
> you have more than one supplement to file at a time, be certain to
> file them in chronological order, lower number first.
>
> 5\. Always retain the filing instructions (simply insert them at the
> back of the book) as a backup record of filing and for reference in
> case of a filing error.
>
> 6\. Be certain that you *permanently discard* any pages indicated for
> removal in the filing instructions in order to avoid confusion later.

To execute the filing instructions, simply remove *and throw away* the
pages listed under *Remove These Old Pages,* and replace them in each
case with the corres­pond­ing pages from this supplement listed under *Add
These New Pages*. Occasionally new pages will be added without removal
of any old material (reflecting new regulations), and occasionally old
pages will be removed with­out addition of any new material (reflecting
rescinded regulations)---in these cases the word *None* will appear in
the appropriate column.

> **FILING INSTRUCTIONS**

**Book I, Supplement No. 32**

**February 25, 2006**

*Remove these Add these Section(s)*

*[old pages]{.underline} [new pages]{.underline} [Affected]{.underline}*

17.38-1 to 17.39-1 17.38-1 to 17.39-1 §17.39

**Do not file this supplement until you confirm that**

**all prior supplements have been filed**

**Be sure to complete the**

***Supplement Filing Record* (page I-8)**

**when you have finished filing this material.**

> **HIGHLIGHTS**

**Book I, Supplement No. 32**

**February 25, 2006**

***Supplement* Highlights *references***: Where substantive changes are
made in the text of regulations, the paragraphs of *Highlights* sections
are cited at the end of the relevant section of text. Thus, if you are
reading §17.100, you will see a note at the end of that section which
reads: "Supplement *Highlights* references---37(1)." This means that
paragraph 1 of the *Highlights* section in Supplement No. 37 contains
information about the changes made in §17.100. By keeping and filing the
*Highlights* sections, you will have a reference source explaining all
substantive changes in the text of the regulations.

***Supplement frequency***: Beginning 1 January 2000, supplements for
this Book I will be issued *every month* during which a final rule
addition or modification is made to the parts of Title 38 covered by
this book. Supplements will be numbered consecutively as issued.

**Modifications in this supplement include the following:**

1\. On 9 February 2006, the VA published a final rule, effective 13
March 2006, to provide eligibility for VA hospital care, nursing home
care, and outpatient services for any Filipino Commonwealth Army
veteran, including those recognized by authority of the United States
Army as belonging to organized Filipino guerilla forces, and for any
veteran of the new Philippine Scouts, provided that any such veteran
resides in the United States and is either a citizen of the United
States or is lawfully admitted to the United States for permanent
residence. Change:

• Revised §17.39.

**§17.38 Medical benefits package.**

\(a\) Subject to paragraphs (b) and (c) of this section, the following
hospital, outpatient, and extended care services constitute the "medical
benefits package" (basic care and preventive care):

\(1\) *Basic care*.

> \(i\) Outpatient medical, surgical, and mental healthcare, including
> care for substance abuse.
>
> \(ii\) Inpatient hospital, medical, surgical, and mental healthcare,
> including care for substance abuse.
>
> \(iii\) Prescription drugs, including over-the-counter drugs and
> medical and surgical supplies available under the VA national
> formulary system.
>
> \(iv\) Emergency care in VA facilities; and emergency care in non-VA
> facilities in accordance with sharing contracts or if authorized by
> §§17.52(a)(3), 17.53, 17.54, 17.120--132.
>
> \(v\) Bereavement counseling as authorized in §17.98.
>
> \(vi\) Comprehensive rehabilitative services other than vocational
> services provided under 38 U.S.C. chapter 31.
>
> \(vii\) Consultation, professional counseling, training, and mental
> health services for the members of the immediate family or legal
> guardian of the veteran or the individual in whose household the
> veteran certifies an intention to live, if needed to treat:
>
> \(A\) The service-connected disability of a veteran; or
>
> \(B\) The nonservice-connected disability of a veteran where these
> services were first given during the veteran's hospitalization and
> continuing them is essential to permit the veteran's release from
> inpatient care.
>
> \(viii\) Durable medical equipment and prosthetic and orthotic
> devices, including eyeglasses and hearing aids as authorized under
> §17.149.
>
> \(ix\) Home health services authorized under 38 U.S.C. 1717 and 1720C.
>
> \(x\) Reconstructive (plastic) surgery required as a result of disease
> or trauma, but not including cosmetic surgery that is not medically
> necessary.
>
> \(xi\) (A) Hospice care, palliative care, and institutional respite
> care; and
>
> \(B\) Noninstitutional geriatric evaluation, noninstitutional adult
> day health care, and noninstitutional respite care.
>
> \(xii\) Payment of travel and travel expenses for veterans eligible
> under §17.143 if authorized by that section.
>
> \(xiii\) Pregnancy and delivery services, to the extent authorized by
> law.
>
> \(xiv\) Completion of forms (e.g., Family Medical Leave forms, life
> insurance applications, Department of Education forms for loan
> repayment exemptions based on disability, non-VA disability program
> forms) by healthcare professionals based on an examination or
> knowledge of the veteran's condition, but not including the completion
> of forms for examinations if a third party customarily will pay health
> care practitioners for the examination but will not pay VA.

\(2\) *Preventive care, as defined in 38 U.S.C. 1701(9), which
includes*:

> \(i\) Periodic medical exams.
>
> \(ii\) Health education, including nutrition education.
>
> \(iii\) Maintenance of drug-use profiles, drug monitoring, and drug
> use education.
>
> \(iv\) Mental health and substance abuse preventive services.
>
> \(v\) Immunizations against infectious disease.
>
> \(vi\) Prevention of musculoskeletal deformity or other gradually
> developing disabilities of a metabolic or degenerative nature.
>
> \(vii\) Genetic counseling concerning inheritance of genetically
> determined diseases.
>
> \(viii\) Routine vision testing and eye-care services.
>
> \(ix\) Periodic reexamination of members of high-risk groups for
> selected diseases and for functional decline of sensory organs, and
> the services to treat these diseases and functional declines.

\(b\) *Provision of the "medical benefits package"*. Care referred to in
the "medical benefits package" will be provided to individuals only if
it is determined by appropriate healthcare professionals that the care
is needed to promote, preserve, or restore the health of the individual
and is in accord with generally accepted standards of medical practice.

\(1\) *Promote health*. Care is deemed to promote health if the care
will enhance the quality of life or daily functional level of the
veteran, identify a predisposition for development of a condition or
early onset of disease which can be partly or totally ameliorated by
monitoring or early diagnosis and treatment, and prevent future disease.

\(2\) *Preserve health*. Care is deemed to preserve health if the care
will maintain the current quality of life or daily functional level of
the veteran, prevent the progression of disease, cure disease, or extend
life span.

\(3\) *Restoring health*. Care is deemed to restore health if the care
will restore the quality of life or daily functional level that has been
lost due to illness or injury.

\(c\) In addition to the care specifically excluded from the "medical
benefits package" under paragraphs (a) and (b) of this section, the
"medical benefits package" does not include the following:

> \(1\) Abortions and abortion counseling.
>
> \(2\) In vitro fertilization.
>
> \(3\) Drugs, biologicals, and medical devices not approved by the Food
> and Drug Administration unless the treating medical facility is
> conducting formal clinical trials under an Investigational Device
> Exemption (IDE) or an Investigational New Drug (IND) application, or
> the drugs, biologicals, or medical devices are prescribed under a
> compassionate use exemption.
>
> \(4\) Gender alterations.
>
> \(5\) Hospital and outpatient care for a veteran who is either a
> patient or inmate in an institution of another government agency if
> that agency has a duty to give the care or services.
>
> \(6\) Membership in spas and health clubs. (Authority: 38 U.S.C. 101,
> 501, 1701, 1705, 1710, 1710A, 1721, 1722)

\[64 FR 54217, Oct. 6, 1999, as amended at 67 FR 35039, May 17, 2002\]

**Supplement *Highlights* references**: 37(1). Book I, 9(1).

**§17.39 Certain Filipino veterans.**

\(a\) Any Filipino Commonwealth Army veteran, including one who was
recognized by authority of the U.S. Army as belonging to organized
Filipino guerilla forces, or any new Philippine Scout is eligible for
hospital care, nursing home care, and outpatient medical services within
the United States in the same manner and subject to the same terms and
conditions as apply to U.S. veterans, if such veteran or scout resides
in the United States and is a citizen or lawfully admitted to the United
States for permanent residence. For purposes of these VA health care
benefits, the standards described in 38 CFR 3.42(c) will be accepted as
proof of U.S. citizenship or lawful permanent residence.

\(b\) Commonwealth Army Veterans, including those who were recognized by
authority of the U.S. Army as belonging to organized Filipino guerilla
forces, and new Philippine Scouts are not eligible for VA health care
benefits if they do not meet the residency and citizenship requirements
described in §3.42(c). (Authority: 38 U.S.C. 501, 1734 )

(The Office of Management and Budget has approved the information
collection requirements in this section under control number 2900-0091.)

\[67 FR 41179, June 17, 2002, as amended at 71 FR 6680, Feb. 9, 2006\]

**Supplement *Highlights* references**: Book I, 10(1), 32(1).