69–010 

Calendar No. 579 

110TH CONGRESS REPORT " ! SENATE 2d Session 110–263 

VETERANS EMERGENCY CARE FAIRNESS ACT OF 2007 

FEBRUARY 25, 2008.—Ordered to be printed 

Mr. AKAKA, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany S. 2142] 

The Committee on Veterans’ Affairs (hereinafter, ‘‘the Committee’’), to which was referred the bill (S. 2142) to amend title 38, 

United States Code, to require the Secretary of Veterans Affairs to 

reimburse veterans receiving emergency treatment in non-Department of Veterans Affairs facilities for such treatment until such 

veterans are transferred to Department facilities, and for other 

purposes, having considered an amended version of the same, reports favorably thereon, and recommends that the bill, as amended, 

do pass. 

INTRODUCTION

On October 4, 2007, Committee member Senator Sherrod Brown 

introduced S. 2142, the proposed ‘‘Veterans Emergency Care Fairness Act of 2008.’’ On October 24, 2007, the Committee held a hearing on pending veterans’ health legislation at which testimony on 

an amended version of S. 2142, among other bills, was offered by: 

Michael J. Kussman, MD, MS, MACP, the Department of Veterans 

Affairs’ Under Secretary for Health; Carl Blake, National Legislative Director, Paralyzed Veterans of America; and Joy J. Ilem, Assistant National Legislative Director, Disabled American Veterans. 

The witnesses expressed support for S. 2142 on behalf of their respective organizations. VA supported the legislation, and Under 

Secretary Kussman indicated that VA was also working on improving the reimbursement process for veterans receiving emergency 

care at non-VA facilities. 


wwoods2 on PRODPC68 with REPORTS
2 

COMMITTEE MEETING

After carefully reviewing the testimony from the foregoing hearing, the Committee met in open session on November 14, 2007, to 

consider, among other legislation, an amended version of S. 2142. 

The Committee agreed by voice vote to report favorably S. 2142, as 

amended, to the Senate. 

SUMMARY OF S. 2142 AS REPORTED

S. 2142, as reported (hereinafter, ‘‘the Committee bill’’), would 

amend sections 1725 and 1728 of title 38, United States Code, to 

make reimbursement for emergency care received at non-VA facilities mandatory for eligible veterans. 

Section 2(a) would make the reimbursement of veterans for 

emergency care received at non-VA facilities mandatory by amending section 1725 of title 38. The amended text would also clarify 

when VA’s obligation to reimburse ends by more clearly defining 

the conditions for transfers and patient stabilization. 

Section 2(b) would amend section 1728 of title 38 to conform to 

section 1725 by making the provision mandatory. To ensure consistency, ‘‘care and services’’ would be replaced by ‘‘emergency 

treatment.’’ A new subsection, subsection (c), would also be added 

in order to use a consistent definition of ‘‘emergency treatment,’’ as 

defined in proposed new section 1725(f)(1). 

BACKGROUND AND DISCUSSION

The Committee bill was developed in response to the need for 

clearer procedures for reimbursement by VA when veterans receive 

emergency care at non-VA facilities. 

Under current law, section 1728 of title 38 authorizes the Secretary to pay the expenses incurred by a veteran for emergency 

treatment services when delay of such services would have been 

hazardous to the life or health of the veteran; treatment of a service-connected disability; treatment of a non-service-connected disability aggravating a service-connected disability; treatment of any 

disability of a veteran with a permanent and total disability; or for 

a covered vocational rehabilitation purpose. Expenses incurred 

after the medical emergency has ended, and after the point in time 

when the veteran may be transferred safely to VA or another Federal facility, may not be reimbursed. Pursuant to current section 

1725, the Secretary may also reimburse a veteran for expenses incurred for emergency treatment provided at a non-VA facility for 

a non-service connected disability. 

VA’s interpretation of the existing authority for emergency care 

reimbursement has created difficulties for veterans and non-VA 

hospitals seeking reimbursement. A November 16, 2005, VA Office 

of General Counsel memorandum supported a narrow interpretation of the statutory authorities, particularly in the context of an 

emergency that has terminated, thereby ending the obligation to 

pay. VA’s interpretation has tended to favor the denial of reimbursement claims for continuing care where a transfer attempt is 

made but VA does not have a bed available. The problems with securing reimbursement can make transfers to alternative (and potentially more suitable) facilities for treatment difficult when VA 

does not have a bed available. 


wwoods2 on PRODPC68 with REPORTS
3 

During a Committee field hearing in New Philadelphia, Ohio, on 

May 29, 2007, chaired by Senator Brown, problems with the current procedures were highlighted. Specifically, community hospitals 

in Ohio reported encountering difficulty transferring veterans to an 

appropriate VA Medical Center and subsequently obtaining reimbursement following emergency care at these facilities. Terry M. 

Carson, Chief Executive Officer of Harrison Community Hospital, 

addressed the issue, testifying: 

The problem that we experience has to do with treating 

initial emergency/urgent situations and having little success in being able to transfer veterans to the appropriate 

Veterans’ Hospital Center. Often, we wait days to receive 

transfer approval, and it is not uncommon for those approvals to be withdrawn during the actual transfer, and 

change of direction mid-stream. 

This testimony highlights the difficulties arising from the current 

system, which reflects the ambiguities and uncertainty of the existing statutory authorities. 

Delays in the transfer from community to VA facilities can jeopardize veterans’ health, and place hospitals in the position of being 

forced to proceed with treatments that would otherwise have been 

provided by VA. By delaying or refusing the acceptance of veteran 

transfers, VA adds unnecessary complexity to the reimbursement 

process. The net result is difficulty for veterans and the hospitals 

in receiving reimbursement for care. 

COMMITTEE BILL

Section 2(a) of the Committee bill would amend section 1725 of 

title 38 in subsections (a)(1) and (f)(1). Subsection (a)(1) would be 

amended by replacing ‘‘may reimburse’’ with ‘‘shall reimburse.’’ This change would make reimbursement for emergency care received at non-VA facilities mandatory for eligible veterans, rather 

than at the discretion of the Secretary. 

Subsection (f)(1) would be amended to provide greater specificity 

regarding the termination of VA’s obligation to reimburse. The ambiguities that have driven the restriction of VA’s obligation to pay 

would be eliminated through the more specific language proposed 

by the Committee bill, which would specify that VA’s obligation to 

reimburse terminates when the veteran may be transferred safely 

from the private facility to a VA hospital and the VA facility is capable of accepting the transfer. Alternatively, if VA does not initially have a bed available, VA’s obligation to reimburse will terminate only after the veteran is actually transferred to a VA or other 

Federal facility, so long as the private facility made and documented reasonable efforts to transfer the veteran when he or she 

was first able to be transferred safely. 

Section 2(b) of the Committee bill would amend section 1728 of 

title 38 so as to make that section, which relates to reimbursement 

for the emergency treatment of service-connected conditions, consistent with section 1725, as amended by section 2(a) of the Committee bill. Thus, reimbursement would also be made mandatory 

under Section 1728. The existing criteria, defining veteran eligibility for reimbursement for emergency care services, would be carried over in the revised statutory language. 


wwoods2 on PRODPC68 with REPORTS
4 

In addition, section 2(b) would further amend section 1728 so as 

to strike the phrase ‘‘care and services’’ in current subsection (b) of 

section 1728, and replace that phrase with ‘‘emergency treatment.’’

This proposed change is designed to promote consistency between 

section 1725 and 1728 of title 38. This goal of consistency is further 

reflected in the Committee bill’s proposed addition of subsection (c) 

to section 1728, to adopt the same definition of ‘‘emergency treatment’’ that would be established in section 1725(f)(1) of the Committee bill. 

COMMITTEE BILL COST ESTIMATE

In compliance with paragraph 11(a) of rule XXVI of the Standing 

Rules of the Senate, the Committee, based on information supplied 

by the CBO, estimates that enactment of the Committee bill would 

increase spending by $20 million in 2008 and by $323 million over 

the 2009–2013 period. Enactment of the Committee bill would not 

affect direct spending or receipts, and would not affect the budget 

of state, local or tribal governments. 

The cost estimate provided by CBO, setting forth a detailed 

breakdown of costs, follows: 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, January 16, 2008. 

Hon. DANIEL K. AKAKA, 

Chairman, Committee on Veterans’ Affairs, 

U.S. Senate, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for S. 2142, the Veterans Emergency Care Fairness Act of 2007. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Sunita D’Monte. 

Sincerely, 

PETER R. ORSZAG, Director. 

Enclosure. 

Summary: S. 2142 would require the Department of Veterans Affairs (VA) to pay for the emergency care certain veterans receive 

at non-VA medical facilities, or to reimburse veterans if they have 

paid for that care. CBO estimates that implementing S. 2142 would 

cost $20 million in 2008 and an additional $323 million over the 

2009–2013 period, assuming appropriation of the estimated 

amounts. Enacting the bill would not affect direct spending or revenues. 

S. 2142 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA) 

and would impose no costs on state, local, or tribal governments. 

Estimated cost to the Federal Government: The estimated budgetary impact of S. 2142 is shown in the following table. The costs 

of this legislation fall within budget function 700 (veterans benefits 

and services). 


wwoods2 on PRODPC68 with REPORTS
5 

By fiscal year, in millions of dollars— 

2008 2009 2010 2011 2012 2013 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Estimated Authorization Level .................................................................. 22 52 58 65 73 82 

Estimated Outlays .................................................................................... 20 49 57 64 72 81 

Basis of estimate: For this estimate, CBO assumes that the legislation will be enacted around the middle of fiscal year 2008, that 

the estimated amounts will be appropriated each year, and that 

outlays will follow historical spending patterns for the VA medical 

services program. 

Under two different sections of law, VA currently has the authority to reimburse certain veterans or to pay for emergency care provided at non-VA facilities. S. 2142 would amend and enhance those 

authorities. Based on information from VA, CBO estimates that by 

requiring VA to pay for longer (on average) lengths of stay in private medical facilities, the bill would cost $20 million in 2008 and 

another $323 million over the 2009–2013 period, assuming appropriation of the estimated amounts. 

Reimbursements under current law 

Under 38 U.S.C. 1725, VA may reimburse veterans or pay for 

emergency treatment of a nonservice-connected condition, if VA is 

the payer of last resort. Under this section of law, emergency treatment is defined as care or services provided for a medical emergency where a prudent layperson could reasonably expect that a 

delay in seeking medical attention would be hazardous to life or 

health. According to VA data on payments made under 38 U.S.C. 

1725, VA paid a total of $123 million in 2006—$103 million for inpatient treatment provided to about 18,200 veterans ($1,200 per 

day, for an average length of stay of 4.7 days) and $20 million for 

ancillary care. 

Under 38 U.S.C. 1728, VA may reimburse certain veterans with 

service-connected conditions or those who are covered for purposes 

of a vocational rehabilitation program if medical professionals determine that a medical emergency exists. Data from VA on payments made under 38 U.S.C. 1728 indicate that in 2006 VA paid 

$83 million for treatment provided to 7,800 veterans ($1,900 per 

day, for an average length of stay of 5.6 days). 

Under both sections of current law, VA can make payments only 

until the veteran’s condition has stabilized and he or she can be 

transferred safely to a VA or other federal facility, regardless of 

whether any such facility is actually available to accept such a 

transfer. 

Additional reimbursements under S. 2142 

S. 2142 would amend those authorities by establishing the prudent layperson definition of emergency treatment for both sections 

of law and requiring VA to pay for treatment until the veteran is 

transferred to a VA or other federal facility, or the veteran is otherwise discharged from the hospital. Under the bill, some veterans 

who incur medical costs after they are deemed to be stable but before they are transferred to a VA or other federal facility would 

now be eligible for additional payments from VA. 


wwoods2 on PRODPC68 with REPORTS
6 

Data from the 2005 National Hospital Discharge Survey indicate 

that male patients over age 45 who were admitted through the 

emergency department stayed in the hospital for an average of 5.4 

days. CBO estimates that under the bill, the average length of stay 

for which veterans would be reimbursed would rise from 4.7 days 

to 5.4 days, and VA’s costs under 38 U.S.C. 1725 would increase 

by $10 million in 2008 and by an average of $30 million a year over 

the 2009–2013 period, assuming appropriation of the estimated 

amounts. (Costs rise sharply starting in 2009, because CBO assumes the bill would be enacted in mid-2008.) 

Based on information from VA, CBO estimates that under S. 

2142, veterans who are eligible for reimbursement under 38 U.S.C. 

1728—primarily veterans with service-connected disabilities—

would be reimbursed for hospital stays averaging 6.6 days. CBO 

also expects that by establishing a prudent layperson definition of 

medical emergencies, the bill would increase the number of eligible 

veterans by 5 percent each year. Thus, CBO estimates that under 

the bill, costs under 38 U.S.C. 1728 would rise by $10 million in 

2008 and by an average of $35 million a year over the 2009–2013 

period, assuming appropriation of the estimated amounts. 

Intergovernmental and private-sector impact: S. 2142 contains no 

intergovernmental or private-sector mandates as defined in UMRA 

and would impose no costs on state, local, or tribal governments. 

Estimate prepared by: Federal costs: Sunita D’Monte; Impact on 

state, local, and tribal governments: Lisa Ramirez-Branum; Impact 

on the private sector: Victoria Liu. 

Estimate approved by: Theresa Gullo, Deputy Assistant Director 

for Budget Analysis. 

REGULATORY IMPACT STATEMENT

In compliance with paragraph 11(b) of rule XXVI of the Standing 

Rules of the Senate, the Committee has made an evaluation of the 

regulatory impact that would be incurred in carrying out the Committee bill. The Committee finds that the Committee bill would not 

entail any regulation of individuals or businesses or result in any 

impact on the personal privacy of any individuals and that the paperwork resulting from enactment would be minimal. 

TABULATION OF VOTES CAST IN COMMITTEE

In compliance with paragraph 7 of rule XXVI of the Standing 

Rules of the Senate, the following is a tabulation of votes cast in 

person or by proxy by members of the Committee at its November 

14, 2007, meeting. On that date, the Committee, by voice vote, ordered S. 2142, as amended, reported favorably to the Senate. 

AGENCY REPORT

On October 24, 2007, Michael J. Kussman, MD, MS, MACP, the 

Department of Veterans Affairs Under Secretary for Health, appeared before the Committee and submitted testimony on, among 

other things, the Veterans Emergency Care Fairness Act of 2007. 

Excerpts of this statement are reprinted below: 


wwoods2 on PRODPC68 with REPORTS
7 

STATEMENT OF THE VIEWS OF THE ADMINISTRATION

Michael J. Kussman, MD, MS, MACP, Under Secretary for Health 

for the Department of Veterans Affairs 

Good morning Mr. Chairman and Members of the Committee: 

Thank you for inviting me here today to present the Administration’s views on several bills that would affect Department of Veterans Affairs (VA) programs that provide veterans benefits and 

services. With me today is Walter A. Hall, Assistant General Counsel. I will address the five bills on today’s agenda and then I would 

be happy to answer any questions you and the Committee members 

may have. 

S. 2142 ‘‘VETERANS EMERGENCY CARE FAIRNESS ACT OF 2007’’

S. 2142 would make mandatory, standardize, and enhance the 

two existing authorities the Secretary has to pay for expenses incurred in connection with a veteran’s receipt of emergency treatment in a non-VA facility. The two authorities under which the 

Secretary may currently pay these claims are discretionary in nature (‘‘may reimburse’’ as opposed to ‘‘shall reimburse’’) and cover 

different veteran populations and use different standards to define 

a medical emergency. 

As background, the Secretary is authorized to pay the reasonable 

expenses incurred by a veteran for non-VA emergency treatment of 

a service-connected disability, a non-service-connected disability aggravating a service-connected disability, any disability of a veteran 

with a permanent and total disability, or for a covered vocational 

rehabilitation purpose. In these claims, VA medical professionals 

must determine whether a medical emergency existed (i.e., if there 

was an actual emergency of such nature that delay in obtaining 

treatment would have been hazardous to life or health). Expenses 

incurred after the medical emergency has ended, that is, after the 

point in time the veteran could have been transferred safely to VA 

or another Federal facility, may not be reimbursed. 

The Secretary may also reimburse or pay a veteran for expenses 

incurred for non-VA emergency treatment of a non-service connected disability. In these claims, the law requires use of a prudent 

layperson standard to determine the need for the non-VA emergency treatment. Thus, if it turns out that the veteran’s condition 

was not an actual medical emergency, VA can still pay the expenses if a prudent layperson would have thought it reasonable for 

the veteran to seek immediate medical treatment. This happens, 

for instance, when a veteran goes to the nearest emergency room 

because of the belief he or she is having a heart attack but turns 

out only to have a severe case of heartburn. Similar to claims for 

service-connected conditions, the Secretary is only authorized to 

pay for the emergency treatment expenses, and the emergency 

ends at the point the veteran can be transferred safely to a VA facility or other Federal facility. 

S. 2142 would amend both existing authorities by requiring the 

Secretary to pay the expenses of any veteran who meets eligibility 

criteria. It would also standardize these programs by applying the 

prudent layperson definition of ‘‘emergency treatment’’ in both situations. And most importantly it would define ‘‘emergency treatVerDate Aug 31 2005 21:02 Feb 26, 2008 Jkt 069010 PO 00000 Frm 00007 Fmt 6659 Sfmt 6602 E:\HR\OC\SR263.XXX SR263

wwoods2 on PRODPC68 with REPORTS
8 

ment’’ as continuing until (1) the point in time the veteran can be 

transferred safely to a VA or other Federal facility, or (2) such time 

as a VA facility or other Federal facility agrees to accept such 

transfer if, at the time the veteran could have been transferred 

safely, the non-VA provider makes and documents reasonable attempts to transfer the veteran to a VA facility or other Federal facility. 

VA strongly supports S. 2142; effective emergency room reimbursement has been an issue of concern to the Department. In fact, 

VA is in the process of drafting regulations to address these concerns within the authority it has under current law. 

It is VA’s expectation that facilities aggressively work to accept 

the transfer of a veteran in these situations. We are aware, however, that there have been cases where VA has been unable to find 

a facility that had the bed, capability, staff, or resources needed to 

furnish the care required by the veteran. In those cases, which we 

believe are the exception and not the norm, the non-VA providers 

ultimately billed the veterans for those expenses. This can impose 

a serious monetary hardship for our beneficiaries. 

S. 2142 would properly put the financial onus on the Department 

to provide appropriate care either in the VA or Federal system or 

at the non-VA facility. Enrolled veterans are eligible for needed 

hospital or medical care. Good medical practice demands we furnish such care in a manner that advances a seamless continuum 

of care and reduces fragmentation of such care. Clearly these goals 

are best achieved by bringing the veteran into the VA health care 

system as soon as possible. In those rare cases where VA cannot 

immediately agree to accept the patient transfer, it would be entirely appropriate for VA to be responsible for the expenses related 

to the veteran’s needed continued hospital care in the private facility until the point VA can take over. 

When VA initiated drafting regulations for this program choice, 

it determined funds were available within the FY2008 President’s 

Budget level for this expanded benefit. 

As a final and more technical matter, I would like to clarify that 

if a veteran currently meets the eligibility criteria on which his or 

her claim is based, VA invariably pays the claim. Thus, changing 

the Secretary’s authority from ‘‘may’’ to ‘‘shall’’ for purposes of both 

types of claims would have no practical effect. Nevertheless, we do 

not object to such a change. 

* * * * * * * 

CHANGES IN EXISTING LAW MADE BY THE COMMITTEE BILL, AS

REPORTED

In compliance with rule XXVI paragraph 12 of the Standing 

Rules of the Senate, changes in existing law made by the Committee bill, as reported, are shown as follows (existing law proposed 

to be omitted is enclosed in black brackets, new matter is printed 

in italic, existing law in which no change is proposed is shown in 

roman): 


wwoods2 on PRODPC68 with REPORTS
9 

TITLE 38, UNITED STATES CODE 

PART II—GENERAL BENEFITS 

CHAPTER 17—HOSPITAL, NURSING HOME, 

DOMICILIARY, AND MEDICAL CARE 

* * * * * * * 

Subchapter III—Miscellaneous Provisions Relating to Hospital and Nursing Home Care and Medical Treatment of 

Veterans 

* * * * * * * 

§ 1725. Reimbursement for emergency treatment 

(a) GENERAL AUTHORITY.—

(1) Subject to subsections (c) and (d), the Secretary ømay reimburse¿ shall reimburse a veteran described in subsection (b) 

for the reasonable value of emergency treatment furnished the 

veteran in a non-Department facility. 

* * * * * * * 

(f) DEFINITIONS.—For purposes of this section: 

(1) The term ‘‘emergency treatment’’ means medical care or 

services furnished, in the judgment of the Secretary—

(A) when Department or other Federal facilities are not 

feasibly available and an attempt to use them beforehand 

would not be reasonable; 

(B) when such care or services are rendered 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; and 

ø(C) until such time as the veteran can be transferred 

safely to a Department facility or other Federal facility.¿ 

(C) until—

(i) such time as the veteran can be transferred safely 

to a Department facility or other Federal facility and 

such facility is capable of accepting such transfer; or 

(ii) such time as a Department facility or other Federal facility accepts such transfer if—

(I) at the time the veteran could have been transferred safely to a Department facility or other Federal facility, no Department facility or other Federal facility agreed to accept such transfer; and 

(II) the non-Department facility in which such 

medical care or services was furnished made and 

documented reasonable attempts to transfer the 

veteran to a Department facility or other Federal 

facility. 

* * * * * * * 

§ 1728. Reimbursement of certain medical expenses 

ø(a) The Secretary may, under such regulations as the Secretary 

shall prescribe, reimburse veterans entitled to hospital care or 


wwoods2 on PRODPC68 with REPORTS
10 

medical services under this chapter for the reasonable value of 

such care or services (including travel and incidental expenses 

under the terms and conditions set forth in section 111 of this 

title), for which such veterans have made payment, from sources 

other than the Department, where— ø(1) such care or services were rendered in a medical emergency of such nature that delay would have been hazardous to 

life or health; 

ø(2) such care or services were rendered to a veteran in need 

thereof 

ø(A) for an adjudicated service-connected disability, 

ø(B) for a non-service-connected disability associated 

with and held to be aggravating a service-connected disability, 

ø(C) for any disability of a veteran who has a total disability permanent in nature from a service-connected disability, or 

ø(D) for any illness, injury, or dental condition in the 

case of a veteran who 

ø(i) is a participant in a vocational rehabilitation 

program (as defined in section 3101 (9) of this title), 

and 

ø(ii) is medically determined to have been in need of 

care or treatment to make possible such veteran’s entrance into a course of training, or prevent interruption of a course of training, or hasten the return to a 

course of training which was interrupted because of 

such illness, injury, or dental condition; and 

ø(3) Department or other Federal facilities were not feasibly 

available, and an attempt to use them beforehand would not 

have been reasonable, sound, wise, or practical.¿ 

(a) The Secretary shall, under such regulations as the Secretary 

prescribes, reimburse veterans eligible for hospital care or medical 

services under this chapter for the customary and usual charges of 

emergency treatment (including travel and incidental expenses 

under the terms and conditions set forth in section 111 of this title) 

for which such veterans have made payment, from sources other 

than the Department, where such emergency treatment was rendered to such veterans in need thereof for any of the following: 

(1) An adjudicated service-connected disability. 

(2) A non-service-connected disability associated with and 

held to be aggravating a service-connected disability. 

(3) Any disability of a veteran if the veteran has a total disability permanent in nature from a service-connected disability. 

(4) Any illness, injury, or dental condition of a veteran who—

(A) is a participant in a vocational rehabilitation program (as defined in section 3101(9) of this title); and 

(B) is medically determined to have been in need of care 

or treatment to make possible the veteran’s entrance into a 

course of training, or prevent interruption of a course of 

training, or hasten the return to a course of training which 

was interrupted because of such illness, injury, or dental 

condition. 

(b) In any case where reimbursement would be in order under 

subsection (a) of this section, the Secretary may, in lieu of reimVerDate Aug 31 2005 21:02 Feb 26, 2008 Jkt 069010 PO 00000 Frm 00010 Fmt 6659 Sfmt 6602 E:\HR\OC\SR263.XXX SR263

wwoods2 on PRODPC68 with REPORTS
11 

bursing such veteran, make payment of the reasonable value of 

øcare or services¿ emergency treatment directly— (1) to the hospital or other health facility furnishing the 

øcare or services¿ emergency treatment; or 

(2) to the person or organization making such expenditure on 

behalf of such veteran. 

(c) In this section, the term ‘emergency treatment’ has the meaning 

given such term in section 1725(f)(1) of this title. 

* * * * * * * 

Æ 


wwoods2 on PRODPC68 with REPORTS