Custom Federal Regulations Service™

**This is supplemental material**

**for Book I of your set of**

**Federal Regulations**

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

*Medical*

**Veterans Benefits Administration**

Supplement No. 25

Covering period of *Federal Register* issues

through November 25, 2004

Copyright © 2004 Jonathan Publishing

**Need Assistance?**

Printing for all supplements is performed by the United States
Government

Printing Office. Distribution is the responsibility of the

VA Forms and Publications Depot. Accordingly:

Questions concerning **[missing supplements]{.smallcaps}**, need for
**[additional books]{.smallcaps}**, and other **[distribution
list]{.smallcaps}** issues for this loose-leaf service should be
directed to:

Department of Veterans Affairs

Veterans Benefits Administration

Directives, Forms and Records Staff

Mail Code: 20S5

810 Vermont Avenue, N.W.

Washington DC 20420

Telephone: 202/273-7080

Fax: 202/275-5947

Questions concerning the **[filing instructions]{.smallcaps}** for this
loose-leaf service,

or the reporting of **[substantive errors]{.smallcaps}** in the text,

may be directed to:

Jonathan Publishing

855 Yorks Crossing

Driftwood TX 78619

Telephone: 512/858-1225

Fax: 512/858-1230

E-mail: garyknight@ev1.net

**Internet: http://www.jonpub.com**

Copyright © 2004 Jonathan Publishing

> **GENERAL INSTRUCTIONS**

Custom Federal Regulations Service™

**Supplemental Materials for *Book I***

**Code of Federal Regulations**

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

***Medical***

**Veterans Benefits Administration**

**Supplement No. 25**

25 November 2004

Covering the period of Federal Register issues

through November 25, 2004

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. 25**

**November 25, 2004**

*Remove these Add these Section(s)*

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

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

**all prior supplements have been filed**

17.104-1 to 17.106-1 17.104-1 to 17.106-1 §17.105

**Be sure to complete the**

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

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

> **HIGHLIGHTS**

**Book I, Supplement No. 25**

**November 25, 2004**

***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 25 October 2004, the VA published a final rule, effective 24
November 2004, to amend the VA's medical regulation to give Fiscal
Officers at VA medical facilities the authority to waive veterans' debts
arising from the medical care co-payments. Change:

In §17.105, revised paragraph (a); redesignated paragraph (c) as (d);
and added a new paragraph (c).

**§17.104 Terminations and suspensions.**

Any proposal to suspend or terminate collection action on any charges or
claim for \$20,000 or less asserted by the Department of Veterans
Affairs in connection with the medical program shall be referred as
follows;

\(a\) *Of charges for medical services*. If the debt represents charges
made under §17.101 (a) or (b) questions concerning suspension or
termination of collection action shall be referred to the Chief of the
Fiscal activity of the station for application of the collection
standards in §1.900, *et seq*. of this chapter, or

\(b\) *Of other debts*. If the debt is of a type other than those
contemplated in paragraph (a) of this section, questions concerning
suspension or termination of collection action shall be referred in
accordance with the same referral procedures for compromise offers
(except the Fiscal activity shall make final determinations in
terminations or suspensions involving claims of \$150 or less pursuant
to the provisions of §1.900, *et seq*. of this chapter.)

\[34 FR 7807, May 16, 1969, as amended at 39 FR 26403, July 19, 1974.
Redesignated and amended at 61 FR 21966, 21967, May 13, 1996\]

**§17.105 Waivers.**

Applications or requests for waiver of debts or claims asserted by the
Department of Veterans Affairs in connection with the medical program
generally will be denied by the facility Fiscal activity on the basis
there is no legal authority to waive debts, unless the question of
waiver should be referred as follows:

\(a\) *Of charges for medical services*. If the debt represents charges
made under §17.102, the application or request for waiver should be
referred for disposition under §1.900, *et seq*. of this chapter to the
field facility Committee on Waivers and Compromises which shall take
final action, or

\(b\) *Of claims against third persons and other claims*. If the debt is
of a type contemplated in §17.103(b), the waiver question should be
referred in accordance with the same referral procedures for compromise
offers in such categories of claims, or

\(c\) *Of charges for copayments*. If the debt represents charges for
outpatient medical care, inpatient hospital care, medication or extended
care services copayments made under §§17.108, 17.110 or 17.111 of this
chapter, the claimant must request a waiver by submitting VA Form 5655
(Financial Status Report) to a Fiscal Officer at a VA medical facility
where all or part of the debt was incurred. The claimant must submit
this form within the time period provided in §1.963(b) of this chapter
and may request a hearing under §1.966(a) of this chapter. The Fiscal
Officer may extend the time period for submitting a claim if the
Chairperson of the Committee on Waivers and Compromises could do so
under §1.963(b) of this chapter. The Fiscal Officer will apply the
standard "equity and good conscience" in accordance with §§1.965 and
1.966(a) of this chapter, and may waive all or part of the claimant's
debts. A decision by the Fiscal Officer under this provision is final
(except that the decision may be reversed or modified based on new and
material evidence, fraud, a change in law or interpretation of law, or
clear and unmistakable error shown by the evidence in the file at the
time of the prior decision as provided in §1.969 of this chapter) and
may be appealed in accordance with 38 CFR parts 19 and 20.

\(d\) *Other debts*. If the debt represents any claim or charges other
than those contemplated in paragraphs (a) and (b) of this section, and
is a debt for which waiver has been specifically provided for by law or
under the terms of a contract, initial action shall be taken at the
station level for referral of the request for waiver through channels
for action by the appropriate designated official. If, however, the
question of waiver may also involve a concurrent opportunity to
negotiate a compromise settlement, the application shall be referred to
the Committee on Waivers and Compromises.

(The Office of Management and Budget has approved the information
collection requirements in this section under control number 2900-0165.)

(Authority: 38 U.S.C. 501, 1721, 1722A, 1724)

\[39 FR 26403, July 19, 1974. Redesignated and amended at 61 FR 21966,
21967, May 13, 1996; 69 FR 62204, Oct. 25, 2004\]

Reserved

**Disciplinary Control of Beneficiaries Receiving Hospital,**

**Domiciliary or Nursing Home Care**

**§17.106 Authority for disciplinary action.**

The good conduct of beneficiaries receiving hospitalization for
observation and examination or for treatment, or receiving domiciliary
or nursing home care in facilities under direct and exclusive
jurisdiction of the Department of Veterans Affairs, will be maintained
by corrective and disciplinary procedure formulated by the Department of
Veterans Affairs. Such corrective and disciplinary measures, to be
selectively applied in keeping with the comparative gravity of the
particular offense, will consist, in respect to hospital patients, of
such penalties as the withholding for a determined period of pass
privileges, exclusion from entertainments, or disciplinary discharge;
and, in respect to domiciled members, such penalties as confinement to
sections or grounds, deprivation of privileges, enforced furlough, or
disciplinary discharge. Also, for any violation of the Department of
Veterans Affairs rules set forth in §1.218, or other Federal laws on
Department of Veterans Affairs property, a beneficiary is subject to the
penalty prescribed for the offense.

\[38 FR 24366, Sept. 7, 1973. Redesignated at 61 FR 21966, May 13,
1996\]

*Next Section is §17.108*