[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 476 Introduced in House (IH)]

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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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Emergency Treatment Act'' 
or the ``VET Act''.

SEC. 2. CLARIFICATION OF EMERGENCY HOSPITAL CARE FURNISHED BY THE 
              SECRETARY OF VETERANS AFFAIRS TO CERTAIN VETERANS.

    (a) In General.--Chapter 17 of title 38, United States Code, is 
amended by inserting after section 1730A the following new section:
``Sec. 1730B. Examination and treatment for emergency medical 
              conditions and women in labor
    ``(a) Medical Screening Examinations.--In carrying out this 
chapter, if any enrolled veteran requests, or a request is made on 
behalf of the veteran, for examination or treatment for a medical 
condition, regardless of whether such condition is service-connected, 
at a hospital emergency department of a medical facility of the 
Department, the Secretary shall ensure that the veteran is provided an 
appropriate medical screening examination within the capability of the 
emergency department, including ancillary services routinely available 
to the emergency department, to determine whether an emergency medical 
condition exists.
    ``(b) Necessary Stabilizing Treatment for Emergency Medical 
Conditions and Labor.--(1) If an enrolled veteran comes to a medical 
facility of the Department and the Secretary determines that the 
veteran has an emergency medical condition, the Secretary shall provide 
either--
            ``(A) such further medical examination and such treatment 
        as may be required to stabilize the medical condition; or
            ``(B) for the transfer of the veteran to another medical 
        facility of the Department or a non-Department facility in 
        accordance with subsection (c).
    ``(2) The Secretary is deemed to meet the requirement of paragraph 
(1)(A) with respect to an enrolled veteran if the Secretary offers the 
veteran the further medical examination and treatment described in such 
paragraph and informs the veteran (or an individual acting on behalf of 
the veteran) of the risks and benefits to the veteran of such 
examination and treatment, but the veteran (or individual) refuses to 
consent to the examination and treatment. The Secretary shall take all 
reasonable steps to secure the written informed consent of such veteran 
(or individual) to refuse such examination and treatment.
    ``(3) The Secretary is deemed to meet the requirement of paragraph 
(1) with respect to an enrolled veteran if the Secretary offers to 
transfer the individual to another medical facility in accordance with 
subsection (c) of this section and informs the veteran (or an 
individual acting on behalf of the veteran) of the risks and benefits 
to the veteran of such transfer, but the veteran (or individual) 
refuses to consent to the transfer. The hospital shall take all 
reasonable steps to secure the written informed consent of such veteran 
(or individual) to refuse such transfer.
    ``(c) Restriction of Transfers Until Veteran Stabilized.--(1) If an 
enrolled veteran at a medical facility of the Department has an 
emergency medical condition that has not been stabilized, the Secretary 
may not transfer the veteran to another medical facility of the 
Department or a non-Department facility unless--
            ``(A)(i) the veteran (or a legally responsible individual 
        acting on behalf of the veteran), after being informed of the 
        obligation of the Secretary under this section and of the risk 
        of transfer, requests in writing a transfer to another medical 
        facility;
            ``(ii) a physician has signed a certification (including a 
        summary of the risks and benefits) that, based upon the 
        information available at the time of transfer, the medical 
        benefits reasonably expected from the provision of appropriate 
        medical treatment at another medical facility outweigh the 
        increased risks to the veteran and, in the case of labor, to 
        the unborn child from effecting the transfer; or
            ``(iii) if a physician is not physically present in the 
        emergency department at the time a veteran is transferred, a 
        qualified medical person (as defined by the Secretary in 
        regulations) has signed a certification described in clause 
        (ii) after a physician, in consultation with the person, has 
        made the determination described in such clause, and 
        subsequently countersigns the certification; and
            ``(B) the transfer is an appropriate transfer as described 
        in paragraph (2).
    ``(2) An appropriate transfer to a medical facility is a transfer--
            ``(A) in which the transferring medical facility provides 
        the medical treatment within the capacity of the facility that 
        minimizes the risks to the health of the enrolled veteran and, 
        in the case of a woman in labor, the health of the unborn 
        child;
            ``(B) in which the receiving facility--
                    ``(i) has available space and qualified personnel 
                for the treatment of the veteran; and
                    ``(ii) has agreed to accept transfer of the veteran 
                and to provide appropriate medical treatment;
            ``(C) in which the transferring facility sends to the 
        receiving facility all medical records (or copies thereof), 
        related to the emergency condition for which the veteran has 
        presented, available at the time of the transfer, including 
        records related to the emergency medical condition of the 
        veteran, observations of signs or symptoms, preliminary 
        diagnosis, treatment provided, results of any tests and the 
        informed written consent or certification (or copy thereof) 
        provided under paragraph (1)(A), and the name and address of 
        any on-call physician (described in subsection (d)(1)(C) of 
        this section) who has refused or failed to appear within a 
        reasonable time to provide necessary stabilizing treatment;
            ``(D) in which the transfer is effected through qualified 
        personnel and transportation equipment, as required including 
        the use of necessary and medically appropriate life support 
        measures during the transfer; and
            ``(E) that meets such other requirements as the Secretary 
        may find necessary in the interest of the health and safety of 
        veterans transferred.
    ``(d) Charges.--(1) Nothing in this section may be construed to 
affect any charges that the Secretary may collect from a veteran or 
third party.
    ``(2) The Secretary shall treat any care provided by a non-
Department facility pursuant to this section as care otherwise provided 
by a non-Department facility pursuant to this chapter for purposes of 
paying such non-Department facility for such care.
    ``(e) Nondiscrimination.--A medical facility of the Department or a 
non-Department facility, as the case may be, that has specialized 
capabilities or facilities (such as burn units, shock-trauma units, 
neonatal intensive care units, or (with respect to rural areas) 
regional referral centers as identified by the Secretary in regulation) 
shall not refuse to accept an appropriate transfer of an enrolled 
veteran who requires such specialized capabilities or facilities if the 
facility has the capacity to treat the veteran.
    ``(f) No Delay in Examination or Treatment.--A medical facility of 
the Department or a non-Department facility, as the case may be, may 
not delay provision of an appropriate medical screening examination 
required under subsection (a) or further medical examination and 
treatment required under subsection (b) of this section in order to 
inquire about the method of payment or insurance status of an enrolled 
veteran.
    ``(g) Whistleblower Protections.--The Secretary may not take 
adverse action against an employee of the Department because the 
employee refuses to authorize the transfer of an enrolled veteran with 
an emergency medical condition that has not been stabilized or because 
the employee reports a violation of a requirement of this section.
    ``(h) Definitions.--In this section:
            ``(1) The term `emergency medical condition' means--
                    ``(A) a medical condition manifesting itself by 
                acute symptoms of sufficient severity (including severe 
                pain) such that the absence of immediate medical 
                attention could reasonably be expected to result in--
                            ``(i) placing the health of the enrolled 
                        veteran (or, with respect to an enrolled 
                        veteran who is a pregnant woman, the health of 
                        the woman or her unborn child) in serious 
                        jeopardy;
                            ``(ii) serious impairment to bodily 
                        functions; or
                            ``(iii) serious dysfunction of any bodily 
                        organ or part; or
                    ``(B) with respect to an enrolled veteran who is a 
                pregnant woman having contractions--
                            ``(i) that there is inadequate time to 
                        effect a safe transfer to another hospital 
                        before delivery; or
                            ``(ii) that transfer may pose a threat to 
                        the health or safety of the woman or the unborn 
                        child.
            ``(2) The term `enrolled veteran' means a veteran who is 
        enrolled in the health care system established under section 
        1705(a) of this title.
            ``(3) The term `to stabilize' means, with respect to an 
        emergency medical condition described in paragraph (1)(A), to 
        provide such medical treatment of the condition as may be 
        necessary to assure, within reasonable medical probability, 
        that no material deterioration of the condition is likely to 
        result from or occur during the transfer of the enrolled 
        veteran from a facility, or, with respect to an emergency 
        medical condition described in paragraph (1)(B), to deliver 
        (including the placenta).
            ``(4) The term `stabilized' means, with respect to an 
        emergency medical condition described in paragraph (1)(A), that 
        no material deterioration of the condition is likely, within 
        reasonable medical probability, to result from or occur during 
        the transfer of the individual from a facility, or, with 
        respect to an emergency medical condition described in 
        paragraph (1)(B), that the woman has delivered (including the 
        placenta).
            ``(5) The term `transfer' means the movement (including the 
        discharge) of an enrolled veteran outside the facilities of a 
        medical facility of the Department at the direction of any 
        individual employed by (or affiliated or associated, directly 
        or indirectly, with) the Department, but does not include such 
        a movement of an individual who--
                    ``(A) has been declared dead; or
                    ``(B) leaves the facility without the permission of 
                any such person.''.
    (b) Clerical Amendment.--The table of sections of such chapter is 
amended by inserting after the item relating to section 1730A the 
following new item:

``1730B. Examination and treatment for emergency medical conditions and 
                            women in labor.''.
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