I 

115TH CONGRESS 

1ST SESSION H. R. 476 

To amend title 38, United States Code, to clarify the emergency hospital 

care furnished by the Secretary of Veterans Affairs to certain veterans. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 12, 2017 

Mr. NEWHOUSE (for himself, Mr. GOHMERT, Mr. HENSARLING, Mr. JONES, 

Mr. MARSHALL, Mr. OLSON, Mrs. RADEWAGEN, and Mr. YOUNG of Iowa) 

introduced the following bill; which was referred to the Committee on 

Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to clarify the emergency hospital care furnished by the Secretary of Veterans Affairs to certain veterans. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Veterans Emergency 

5 Treatment Act’’ or the ‘‘VET Act’’. 


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1 SEC. 2. CLARIFICATION OF EMERGENCY HOSPITAL CARE 

2 FURNISHED BY THE SECRETARY OF VET3 ERANS AFFAIRS TO CERTAIN VETERANS. 

4 (a) IN GENERAL.—Chapter 17 of title 38, United 

5 States Code, is amended by inserting after section 1730A 

6 the following new section: 

7 ‘‘§ 1730B. Examination and treatment for emergency 

8 medical conditions and women in labor 

9 ‘‘(a) MEDICAL SCREENING EXAMINATIONS.—In car10 rying out this chapter, if any enrolled veteran requests, 

11 or a request is made on behalf of the veteran, for examina12 tion or treatment for a medical condition, regardless of 

13 whether such condition is service-connected, at a hospital 

14 emergency department of a medical facility of the Depart15 ment, the Secretary shall ensure that the veteran is pro16 vided an appropriate medical screening examination within 

17 the capability of the emergency department, including an18 cillary services routinely available to the emergency de19 partment, to determine whether an emergency medical 

20 condition exists. 

21 ‘‘(b) NECESSARY STABILIZING TREATMENT FOR

22 EMERGENCY MEDICAL CONDITIONS AND LABOR.—(1) If 

23 an enrolled veteran comes to a medical facility of the De24 partment and the Secretary determines that the veteran 

25 has an emergency medical condition, the Secretary shall 

26 provide either— 


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1 ‘‘(A) such further medical examination and 

2 such treatment as may be required to stabilize the 

3 medical condition; or 

4 ‘‘(B) for the transfer of the veteran to another 

5 medical facility of the Department or a non-Depart6 ment facility in accordance with subsection (c). 

7 ‘‘(2) The Secretary is deemed to meet the require8 ment of paragraph (1)(A) with respect to an enrolled vet9 eran if the Secretary offers the veteran the further medical 

10 examination and treatment described in such paragraph 

11 and informs the veteran (or an individual acting on behalf 

12 of the veteran) of the risks and benefits to the veteran 

13 of such examination and treatment, but the veteran (or 

14 individual) refuses to consent to the examination and 

15 treatment. The Secretary shall take all reasonable steps 

16 to secure the written informed consent of such veteran (or 

17 individual) to refuse such examination and treatment. 

18 ‘‘(3) The Secretary is deemed to meet the require19 ment of paragraph (1) with respect to an enrolled veteran 

20 if the Secretary offers to transfer the individual to another 

21 medical facility in accordance with subsection (c) of this 

22 section and informs the veteran (or an individual acting 

23 on behalf of the veteran) of the risks and benefits to the 

24 veteran of such transfer, but the veteran (or individual) 

25 refuses to consent to the transfer. The hospital shall take 


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1 all reasonable steps to secure the written informed consent 

2 of such veteran (or individual) to refuse such transfer. 

3 ‘‘(c) RESTRICTION OF TRANSFERS UNTIL VETERAN

4 STABILIZED.—(1) If an enrolled veteran at a medical fa5 cility of the Department has an emergency medical condi6 tion that has not been stabilized, the Secretary may not 

7 transfer the veteran to another medical facility of the De8 partment or a non-Department facility unless— 

9 ‘‘(A)(i) the veteran (or a legally responsible in10 dividual acting on behalf of the veteran), after being 

11 informed of the obligation of the Secretary under 

12 this section and of the risk of transfer, requests in 

13 writing a transfer to another medical facility; 

14 ‘‘(ii) a physician has signed a certification (in15 cluding a summary of the risks and benefits) that, 

16 based upon the information available at the time of 

17 transfer, the medical benefits reasonably expected 

18 from the provision of appropriate medical treatment 

19 at another medical facility outweigh the increased 

20 risks to the veteran and, in the case of labor, to the 

21 unborn child from effecting the transfer; or 

22 ‘‘(iii) if a physician is not physically present in 

23 the emergency department at the time a veteran is 

24 transferred, a qualified medical person (as defined 

25 by the Secretary in regulations) has signed a certifiVerDate Sep 11 2014 23:06 Jan 25, 2017 Jkt 069200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H476.IH H476

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1 cation described in clause (ii) after a physician, in 

2 consultation with the person, has made the deter3 mination described in such clause, and subsequently 

4 countersigns the certification; and 

5 ‘‘(B) the transfer is an appropriate transfer as 

6 described in paragraph (2). 

7 ‘‘(2) An appropriate transfer to a medical facility is 

8 a transfer— 

9 ‘‘(A) in which the transferring medical facility 

10 provides the medical treatment within the capacity 

11 of the facility that minimizes the risks to the health 

12 of the enrolled veteran and, in the case of a woman 

13 in labor, the health of the unborn child; 

14 ‘‘(B) in which the receiving facility— 

15 ‘‘(i) has available space and qualified per16 sonnel for the treatment of the veteran; and 

17 ‘‘(ii) has agreed to accept transfer of the 

18 veteran and to provide appropriate medical 

19 treatment; 

20 ‘‘(C) in which the transferring facility sends to 

21 the receiving facility all medical records (or copies 

22 thereof), related to the emergency condition for 

23 which the veteran has presented, available at the 

24 time of the transfer, including records related to the 

25 emergency medical condition of the veteran, observaVerDate Sep 11 2014 23:06 Jan 25, 2017 Jkt 069200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H476.IH H476

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1 tions of signs or symptoms, preliminary diagnosis, 

2 treatment provided, results of any tests and the in3 formed written consent or certification (or copy 

4 thereof) provided under paragraph (1)(A), and the 

5 name and address of any on-call physician (de6 scribed in subsection (d)(1)(C) of this section) who 

7 has refused or failed to appear within a reasonable 

8 time to provide necessary stabilizing treatment; 

9 ‘‘(D) in which the transfer is effected through 

10 qualified personnel and transportation equipment, as 

11 required including the use of necessary and medi12 cally appropriate life support measures during the 

13 transfer; and 

14 ‘‘(E) that meets such other requirements as the 

15 Secretary may find necessary in the interest of the 

16 health and safety of veterans transferred. 

17 ‘‘(d) CHARGES.—(1) Nothing in this section may be 

18 construed to affect any charges that the Secretary may 

19 collect from a veteran or third party. 

20 ‘‘(2) The Secretary shall treat any care provided by 

21 a non-Department facility pursuant to this section as care 

22 otherwise provided by a non-Department facility pursuant 

23 to this chapter for purposes of paying such non-Depart24 ment facility for such care. 


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1 ‘‘(e) NONDISCRIMINATION.—A medical facility of the 

2 Department or a non-Department facility, as the case may 

3 be, that has specialized capabilities or facilities (such as 

4 burn units, shock-trauma units, neonatal intensive care 

5 units, or (with respect to rural areas) regional referral 

6 centers as identified by the Secretary in regulation) shall 

7 not refuse to accept an appropriate transfer of an enrolled 

8 veteran who requires such specialized capabilities or facili9 ties if the facility has the capacity to treat the veteran. 

10 ‘‘(f) NO DELAY IN EXAMINATION OR TREATMENT.— 

11 A medical facility of the Department or a non-Department 

12 facility, as the case may be, may not delay provision of 

13 an appropriate medical screening examination required 

14 under subsection (a) or further medical examination and 

15 treatment required under subsection (b) of this section in 

16 order to inquire about the method of payment or insurance 

17 status of an enrolled veteran. 

18 ‘‘(g) WHISTLEBLOWER PROTECTIONS.—The Sec19 retary may not take adverse action against an employee 

20 of the Department because the employee refuses to au21 thorize the transfer of an enrolled veteran with an emer22 gency medical condition that has not been stabilized or 

23 because the employee reports a violation of a requirement 

24 of this section. 

25 ‘‘(h) DEFINITIONS.—In this section: 


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1 ‘‘(1) The term ‘emergency medical condition’ 

2 means— 

3 ‘‘(A) a medical condition manifesting itself 

4 by acute symptoms of sufficient severity (in5 cluding severe pain) such that the absence of 

6 immediate medical attention could reasonably 

7 be expected to result in— 

8 ‘‘(i) placing the health of the enrolled 

9 veteran (or, with respect to an enrolled vet10 eran who is a pregnant woman, the health 

11 of the woman or her unborn child) in seri12 ous jeopardy; 

13 ‘‘(ii) serious impairment to bodily 

14 functions; or 

15 ‘‘(iii) serious dysfunction of any bodily 

16 organ or part; or 

17 ‘‘(B) with respect to an enrolled veteran 

18 who is a pregnant woman having contractions— 

19 ‘‘(i) that there is inadequate time to 

20 effect a safe transfer to another hospital 

21 before delivery; or 

22 ‘‘(ii) that transfer may pose a threat 

23 to the health or safety of the woman or the 

24 unborn child. 


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1 ‘‘(2) The term ‘enrolled veteran’ means a vet2 eran who is enrolled in the health care system estab3 lished under section 1705(a) of this title. 

4 ‘‘(3) The term ‘to stabilize’ means, with respect 

5 to an emergency medical condition described in 

6 paragraph (1)(A), to provide such medical treatment 

7 of the condition as may be necessary to assure, with8 in reasonable medical probability, that no material 

9 deterioration of the condition is likely to result from 

10 or occur during the transfer of the enrolled veteran 

11 from a facility, or, with respect to an emergency 

12 medical condition described in paragraph (1)(B), to 

13 deliver (including the placenta). 

14 ‘‘(4) The term ‘stabilized’ means, with respect 

15 to an emergency medical condition described in 

16 paragraph (1)(A), that no material deterioration of 

17 the condition is likely, within reasonable medical 

18 probability, to result from or occur during the trans19 fer of the individual from a facility, or, with respect 

20 to an emergency medical condition described in 

21 paragraph (1)(B), that the woman has delivered (in22 cluding the placenta). 

23 ‘‘(5) The term ‘transfer’ means the movement 

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1 ment at the direction of any individual employed by 

2 (or affiliated or associated, directly or indirectly, 

3 with) the Department, but does not include such a 

4 movement of an individual who— 

5 ‘‘(A) has been declared dead; or 

6 ‘‘(B) leaves the facility without the permis7 sion of any such person.’’. 

8 (b) CLERICAL AMENDMENT.—The table of sections 

9 of such chapter is amended by inserting after the item 

10 relating to section 1730A the following new item: 

‘‘1730B. Examination and treatment for emergency medical conditions and 

women in labor.’’. 

Æ 


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