IIB 

114TH CONGRESS 

2D SESSION H. R. 3216 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 27, 2016 

Received; read twice and referred to the Committee on Veterans’ Affairs 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE. 

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

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

4 SEC. 2. CLARIFICATION OF EMERGENCY HOSPITAL CARE 

5 FURNISHED BY THE SECRETARY OF VET6 ERANS AFFAIRS TO CERTAIN VETERANS. 

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

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

9 the following new section: 

10 ‘‘§ 1730B. Examination and treatment for emergency 

11 medical conditions and women in labor 

12 ‘‘(a) MEDICAL SCREENING EXAMINATIONS.—In car13 rying out this chapter, if any enrolled veteran requests, 

14 or a request is made on behalf of the veteran, for examina15 tion or treatment for a medical condition, regardless of 

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

17 emergency department of a medical facility of the Depart18 ment, the Secretary shall ensure that the veteran is pro19 vided an appropriate medical screening examination within 

20 the capability of the emergency department, including an21 cillary services routinely available to the emergency de22 partment, to determine whether an emergency medical 

23 condition exists. 

24 ‘‘(b) NECESSARY STABILIZING TREATMENT FOR

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

26 an enrolled veteran comes to a medical facility of the DeVerDate Sep 11 2014 22:28 Sep 27, 2016 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3216.RFS H3216

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1 partment and the Secretary determines that the veteran 

2 has an emergency medical condition, the Secretary shall 

3 provide either— 

4 ‘‘(A) such further medical examination and 

5 such treatment as may be required to stabilize the 

6 medical condition; or 

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

8 medical facility of the Department or a non-Depart9 ment facility in accordance with subsection (c). 

10 ‘‘(2) The Secretary is deemed to meet the require11 ment of paragraph (1)(A) with respect to an enrolled vet12 eran if the Secretary offers the veteran the further medical 

13 examination and treatment described in such paragraph 

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

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

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

17 individual) refuses to consent to the examination and 

18 treatment. The Secretary shall take all reasonable steps 

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

20 individual) to refuse such examination and treatment. 

21 ‘‘(3) The Secretary is deemed to meet the require22 ment of paragraph (1) with respect to an enrolled veteran 

23 if the Secretary offers to transfer the individual to another 

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

25 section and informs the veteran (or an individual acting 


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

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

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

4 all reasonable steps to secure the written informed consent 

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

6 ‘‘(c) RESTRICTION OF TRANSFERS UNTIL VETERAN

7 STABILIZED.—(1) If an enrolled veteran at a medical fa8 cility of the Department has an emergency medical condi9 tion that has not been stabilized, the Secretary may not 

10 transfer the veteran to another medical facility of the De11 partment or a non-Department facility unless— 

12 ‘‘(A)(i) the veteran (or a legally responsible in13 dividual acting on behalf of the veteran), after being 

14 informed of the obligation of the Secretary under 

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

16 writing a transfer to another medical facility; 

17 ‘‘(ii) a physician has signed a certification (in18 cluding a summary of the risks and benefits) that, 

19 based upon the information available at the time of 

20 transfer, the medical benefits reasonably expected 

21 from the provision of appropriate medical treatment 

22 at another medical facility outweigh the increased 

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

24 unborn child from effecting the transfer; or 


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

2 the emergency department at the time a veteran is 

3 transferred, a qualified medical person (as defined 

4 by the Secretary in regulations) has signed a certifi5 cation described in clause (ii) after a physician, in 

6 consultation with the person, has made the deter7 mination described in such clause, and subsequently 

8 countersigns the certification; and 

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

10 described in paragraph (2). 

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

12 a transfer— 

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

14 provides the medical treatment within the capacity 

15 of the facility that minimizes the risks to the health 

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

17 in labor, the health of the unborn child; 

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

19 ‘‘(i) has available space and qualified per20 sonnel for the treatment of the veteran; and 

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

22 veteran and to provide appropriate medical 

23 treatment; 

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

25 the receiving facility all medical records (or copies 


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1 thereof), related to the emergency condition for 

2 which the veteran has presented, available at the 

3 time of the transfer, including records related to the 

4 emergency medical condition of the veteran, observa5 tions of signs or symptoms, preliminary diagnosis, 

6 treatment provided, results of any tests and the in7 formed written consent or certification (or copy 

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

9 name and address of any on-call physician (de10 scribed in subsection (d)(1)(C) of this section) who 

11 has refused or failed to appear within a reasonable 

12 time to provide necessary stabilizing treatment; 

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

14 qualified personnel and transportation equipment, as 

15 required including the use of necessary and medi16 cally appropriate life support measures during the 

17 transfer; and 

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

19 Secretary may find necessary in the interest of the 

20 health and safety of veterans transferred. 

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

22 construed to affect any charges that the Secretary may 

23 collect from a veteran or third party. 

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

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


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1 otherwise provided by a non-Department facility pursuant 

2 to this chapter for purposes of paying such non-Depart3 ment facility for such care. 

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

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

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

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

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

9 centers as identified by the Secretary in regulation) shall 

10 not refuse to accept an appropriate transfer of an enrolled 

11 veteran who requires such specialized capabilities or facili12 ties if the facility has the capacity to treat the veteran. 

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

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

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

16 an appropriate medical screening examination required 

17 under subsection (a) or further medical examination and 

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

19 order to inquire about the method of payment or insurance 

20 status of an enrolled veteran. 

21 ‘‘(g) WHISTLEBLOWER PROTECTIONS.—The Sec22 retary may not take adverse action against an employee 

23 of the Department because the employee refuses to au24 thorize the transfer of an enrolled veteran with an emer25 gency medical condition that has not been stabilized or 


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1 because the employee reports a violation of a requirement 

2 of this section. 

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

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

5 means— 

6 ‘‘(A) a medical condition manifesting itself 

7 by acute symptoms of sufficient severity (in8 cluding severe pain) such that the absence of 

9 immediate medical attention could reasonably 

10 be expected to result in— 

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

12 veteran (or, with respect to an enrolled vet13 eran who is a pregnant woman, the health 

14 of the woman or her unborn child) in seri15 ous jeopardy; 

16 ‘‘(ii) serious impairment to bodily 

17 functions; or 

18 ‘‘(iii) serious dysfunction of any bodily 

19 organ or part; or 

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

21 who is a pregnant woman having contractions— 

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

23 effect a safe transfer to another hospital 

24 before delivery; or 


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

2 to the health or safety of the woman or the 

3 unborn child. 

4 ‘‘(2) The term ‘enrolled veteran’ means a vet5 eran who is enrolled in the health care system estab6 lished under section 1705(a) of this title. 

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

8 to an emergency medical condition described in 

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

10 of the condition as may be necessary to assure, with11 in reasonable medical probability, that no material 

12 deterioration of the condition is likely to result from 

13 or occur during the transfer of the enrolled veteran 

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

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

16 deliver (including the placenta). 

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

18 to an emergency medical condition described in 

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

20 the condition is likely, within reasonable medical 

21 probability, to result from or occur during the trans22 fer of the individual from a facility, or, with respect 

23 to an emergency medical condition described in 

24 paragraph (1)(B), that the woman has delivered (in25 cluding the placenta). 


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

2 (including the discharge) of an enrolled veteran out3 side the facilities of a medical facility of the Depart4 ment at the direction of any individual employed by 

5 (or affiliated or associated, directly or indirectly, 

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

7 movement of an individual who— 

8 ‘‘(A) has been declared dead; or 

9 ‘‘(B) leaves the facility without the permis10 sion of any such person.’’. 

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

12 of such chapter is amended by inserting after the item 

13 relating to section 1730A the following new item: 

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

women in labor.’’. 

Passed the House of Representatives September 26, 

2016. 

Attest: KAREN L. HAAS, 

Clerk. 


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