I
104TH CONGRESS
2D SESSION
H. R. 3118
To amend title 38, United States Code, to reform eligibility for health care
provided by the Department of Veterans Affairs.
IN THE HOUSE OF REPRESENTATIVES
MARCH 20, 1996
Mr. STUMP (for himself, Mr. MONTGOMERY, Mr. HUTCHINSON, and Mr. ED-
WARDS) introduced the following bill; which was referred to the Commit-
tee on Veterans’ Affairs
A BILL
To amend title 38, United States Code, to reform eligibility
for health care provided by the Department of Veterans
Affairs.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNIT-
ED STATES CODE.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Veterans’ Health Care Eligibility Reform Act of 1996’’.
(b) REFERENCES
TO TITLE 38, UNITED STATES
CODE.—Except as otherwise expressly provided, whenever
in this Act an amendment or repeal is expressed in terms
of an amendment to, or repeal of, a section or other provi-
sion, the reference shall be considered to be made to a
section or other provision of title 38, United States Code.
SEC. 2. HOSPITAL CARE AND MEDICAL SERVICES.
(a) ELIGIBILITY
FOR CARE.—Section 1710(a) is
amended by striking out paragraphs (1) and (2) and in-
serting the following:
‘‘(a)(1) The Secretary shall, to the extent and in the
amount provided in advance in appropriations Acts for
these purposes, provide hospital care and medical services,
and may provide nursing home care, which the Secretary
determines is needed to any veteran—
‘‘(A) with a compensable service-connected dis-
ability;
‘‘(B) whose discharge or release from active
military, naval, or air service was for a compensable
disability that was incurred or aggravated in the line
of duty;
‘‘(C) who is in receipt of, or who, but for a sus-
pension pursuant to section 1151 of this title (or
both a suspension and the receipt of retired pay),
would be entitled to disability compensation, but
only to the extent that such veteran’s continuing eli-
gibility for such care is provided for in the judgment
or settlement provided for in such section;
‘‘(D) who is a former prisoner of war;
‘‘(E) of the Mexican border period or of World
War I;
‘‘(F) who was exposed to a toxic substance, ra-
diation, or environmental hazard, as provided in sub-
section (e); and
‘‘(G) who is unable to defray the expenses of
necessary care as determined under section 1722(a)
of this title.
‘‘(2) In the case of a veteran who is not described
in paragraph (1), the Secretary may, to the extent re-
sources and facilities are available and subject to the pro-
visions of subsection (f), furnish hospital care, medical
services, and nursing home care which the Secretary deter-
mines is needed.’’.
(b) 
CONFORMING
AMENDMENTS.—(1) 
Section
1710(e) is amended—
(A) in paragraph (1), by striking out ‘‘hospital
care and nursing home care’’ in subparagraphs (A),
(B), and (C) and inserting in lieu thereof ‘‘hospital
care, medical services, and nursing home care’’;
(B) in paragraph (2), by inserting ‘‘and medical
services’’ after ‘‘Hospital and nursing home care’’;
and
(C) by striking out ‘‘subsection (a)(1)(G) of
this section’’ each place it appears and inserting in
lieu thereof ‘‘subsection (a)(1)(F)’’.
(2) Chapter 17 is amended—
(A) by redesignating subsection (g) of section
1710 as subsection (h); and
(B) by transferring subsection (f) of section
1712 to section 1710 so as to appear after sub-
section (f), redesignating such subsection as sub-
section (g), and amending such subsection by strik-
ing out ‘‘section 1710(a)(2) of this title’’ in para-
graph (1) and inserting in lieu thereof ‘‘subsection
(a)(2) of this section’’.
(3) Section 1712 is amended—
(A) by striking out subsections (a) and (i); and
(B) by redesignating subsections (b), (c), (d),
(h) and (j), as subsections (a), (b), (c), (d), and (e),
respectively.
SEC. 3. PROSTHETICS.
(a) 
ELIGIBILITY
FOR
PROSTHETICS.—Section
1701(6)(A)(i) is amended—
(1) by striking out ‘‘(in the case of a person
otherwise receiving care or services under this chap-
ter)’’ and ‘‘(except under the conditions described in
section 1712(a)(5)(A) of this title),’’;
(2) by inserting ‘‘(in the case of a person other-
wise receiving care or services under this chapter)’’
before ‘‘wheelchairs,’’; and
(3) by inserting ‘‘except that the Secretary may
not furnish sensori-neural aids other than in accord-
ance with guidelines which the Secretary shall pre-
scribe,’’ after ‘‘reasonable and necessary,’’.
(b) REGULATIONS.—Not later than 30 days after the
date of the enactment of this Act, the Secretary of Veter-
ans Affairs shall prescribe the guidelines required by the
amendments made by subsection (a) and shall furnish a
copy of those guidelines to the Committees on Veterans’
Affairs of the Senate and House of Representatives.
SEC. 4. MANAGEMENT OF HEALTH CARE.
(a) IN GENERAL.—(1) Chapter 17 is amended by in-
serting after section 1704 the following new sections:
‘‘§ 1705. Management of health care: patient enroll-
ment system
‘‘(a) In managing the provision of hospital care and
medical services under section 1710(a)(1) of this title, the
Secretary, in accordance with regulations the Secretary
shall prescribe, shall establish and operate a system of an-
nual patient enrollment. The Secretary shall manage the
enrollment of veterans in accordance with the following
priorities, in the order listed:
‘‘(1) Veterans with service-connected disabilities
rated 30 percent or greater.
‘‘(2) Veterans who are former prisoners of war
and veterans with service connected disabilities rated
10 percent or 20 percent.
‘‘(3) Veterans who are in receipt of increased
pension based on a need of regular aid and attend-
ance or by reason of being permanently housebound
and other veterans who are catastrophically disabled.
‘‘(4) Veterans not covered by paragraphs (1)
through (3) who are unable to defray the expenses
of necessary care as determined under section
1722(a) of this title.
‘‘(5) All other veterans eligible for hospital care,
medical services, and nursing home care under sec-
tion 1710(a)(1) of this title.
‘‘(b) In the design of an enrollment system under
subsection (a), the Secretary—
‘‘(1) shall ensure that the system will be man-
aged in a manner to ensure that the provision of
care to enrollees is timely and acceptable in quality;
‘‘(2) may establish additional priorities within
each priority group specified in subsection (a), as
the Secretary determines necessary; and
‘‘(3) may provide for exceptions to the specified
priorities where dictated by compelling medical rea-
sons.
‘‘§ 1706. Management of health care: other require-
ments
‘‘(a) In managing the provision of hospital care and
medical services under section 1710(a) of this title, the
Secretary shall, to the extent feasible, design, establish
and manage health care programs in such a manner as
to promote cost-effective delivery of health care services
in the most clinically appropriate setting.
‘‘(b) In managing the provision of hospital care and
medical services under section 1710(a) of this title, the
Secretary—
‘‘(1) may contract for hospital care and medical
services when Department facilities are not capable
of furnishing such care and services economically,
and
‘‘(2) shall make such rules and regulations re-
garding acquisition procedures or policies as the Sec-
retary considers appropriate to provide such needed
care and services.
‘‘(c) In managing the provision of hospital care and
medical services under section 1710(a) of this title, the
Secretary shall ensure that the Department maintains its
capacity to provide for the specialized treatment and reha-
bilitative needs of disabled veterans described in section
1710(a) of this title (including veterans with spinal cord
dysfunction, blindness, amputations, and mental illness)
within distinct programs or facilities of the Department
that are dedicated to the specialized needs of those veter-
ans in a manner that (1) affords those veterans reasonable
access to care and services for those specialized needs, and
(2) ensures that overall capacity of the Department to pro-
vide such services is not reduced below the capacity of the
Department, nationwide, to provide those services, as of
the date of the enactment of this section.
‘‘(d) In managing the provision of hospital care and
medical services under section 1710(a) of this title, the
Secretary shall ensure that any veteran with a service-con-
nected disability is provided all benefits under this chapter
for which that veteran was eligible before the date of the
enactment of this section.’’.
(2) The table of sections at the beginning of chapter
17 is amended by inserting after the item relating to sec-
tion 1704 the following new items:
‘‘1705. Management of health care: patient enrollment system.
‘‘1706. Management of health care: other requirements.’’.
(b) 
CONFORMING
AMENDMENTS
TO
SECTION
1703.—(1) Section 1703 is amended—
(A) by striking out subsections (a) and (b); and
(B) in subsection (c) by—
(i) striking out ‘‘(c)’’, and
(ii) striking out ‘‘this section, sections’’
and inserting in lieu thereof ‘‘sections 1710,’’.
(2)(A) The heading of such section is amended to
read as follows:
‘‘§ 1703. Annual report on furnishing of care and
services by contract’’.
(B) The item relating to such section in the table of
sections at the beginning of chapter 17 is amended to read
as follows:
‘‘1703. Annual report on furnishing of care and services by contract.’’.
SEC. 5. IMPROVED EFFICIENCY IN HEALTH CARE RE-
SOURCE MANAGEMENT.
(a) REPEAL OF SUNSET PROVISION.—Section 204 of
the Veterans Health Care Act of 1992 (Public Law 102–
585; 106 Stat. 4950) is repealed.
(b) COST RECOVERY.—Title II of such Act is further
amended by adding at the end the following new section:
‘‘SEC. 207. AUTHORITY TO BILL HEALTH-PLAN CONTRACTS.
‘‘(a) RIGHT TO RECOVER.—In the case of a primary
beneficiary (as described in section 201(2)(B)) who has
coverage under a health-plan contract, as defined in sec-
tion 1729(i)(1)(A) of title 38, United States Code, and
who is furnished care or services by a Department medical
facility pursuant to this title, the United States shall have
the right to recover or collect charges for such care or
services from such health-plan contract to the extent that
the beneficiary (or the provider of the care or services)
would be eligible to receive payment for such care or serv-
ices from such health-plan contract if the care or services
had not been furnished by a department or agency of the
United States. Any funds received from such health-plan
contract shall be credited to funds that have been allotted
to the facility that furnished the care or services.
‘‘(b) ENFORCEMENT.—The right of the United
States to recover under such a beneficiary’s health-plan
contract shall be enforceable in the same manner as that
provided by subsections (a)(3), (b), (c)(1), (d), (f), (h),
and (i) of section 1729 of title 38, United States Code.’’.
SEC. 6. SHARING AGREEMENTS FOR HEALTH CARE RE-
SOURCES.
(a) REPEAL OF SECTION 8151.—(1) Subchapter IV
of chapter 81 is amended—
(A) by striking out section 8151; and
(B) by redesignating sections 8152, 8153,
8154, 8155, 8156, 8157, and 8158 as sections 8151,
8152, 8153, 8154, 8155, 8156, and 8157, respec-
tively.
(2) The table of sections at the beginning of such
chapter is amended—