A hospital must provide inpatient hospital services to individuals
who have health coverage provided by either the Civilian Health and
Medical Program of the Uniformed Services (CHAMPUS) or the Civilian
Health and Medical Program of the Veterans Administration (CHAMPVA),
subject to limitations provided by regulations that require the
hospital to collect the beneficiary's cost-share and accept payment
from the CHAMPUS/CHAMPVA programs as payment in full.
A hospital must provide inpatient hospital services to military
veterans (subject to the limitations provided in 38 CFR 17.50 ff.) and
accept payment from the Department of Veterans Affairs as payment in
full.
These revisions implement sections 9121 and 9122 of the
Consolidated Omnibus Budget Reconciliation Act of 1985 (as amended by
section 4009 of the Omnibus Budget Reconciliation Act of 1987), section
233 of the Veteran's Benefit Improvement and Health Care Authorization
Act of 1986, sections 9305(b)(1) and 9307 of the Omnibus Budget
Reconciliation Act of 1986, sections 6003(g)(3)(D)(xiv), 6018 and 6211
of the Omnibus Budget Reconciliation Act of 1989, and sections 4008(b),
4027(a), and 4027(k)(3) of the Omnibus Budget Reconciliation Act of
1990.
CHAMPUS and CHAMPVA on the basis of their JCAHO-approved
status or may be deemed authorized providers based on their Medicare-
approved status. The benefits to the DoD of requiring the providers to
be paid either under a DRG-based payment system or based on reasonable
cost are lost, however, if the hospitals can selectively participate in
the CHAMPUS and CHAMPVA programs.
Section 233 of the Veterans' Benefit Improvement and Health-Care
Authorization Act of 1986 (Pub. L. 99-576) was enacted on October 28,
1986. It added a new paragraph (L) to section 1866 (a)(1) of the Act.
It requires hospitals that participate in Medicare to be participating
providers under 38 U.S.C. 603, in accordance with the admissions
practices, and payment methodology and amounts, prescribed under joint
regulations issued to implement this section by the Secretary of HHS
and the Administrator of the VA. This provision applies to services
furnished to veterans admitted on or after July 1, 1987.
--In which the receiving facility has available space and qualified
personnel for the treatment of the individual and has agreed to accept
the transfer and to provide appropriate medical treatment;
--In which the transferring hospital sends to the receiving facility
all appropriate medical records (or copies) available at the time of
transfer that are related to the emergency condition for which the
individual has presented including records related to the individual's
emergency medical condition, observation of signs or symptoms,
preliminary diagnosis, treatment provided, results of any tests and
informal written consent or certification (or copies), and the name and
address of any on-call physician who has refused or failed to appear
within a reasonable time to provide necessary stabilizing treatment;
--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
Each physician who is responsible for the examination,
treatment or transfer of an individual (including a physician who is
on-call for the care of such individual) is also subject to a civil
money penalty of not more than $25,000 for each violation ($50,000 for
violations on or after December 22, 1987), including--
+ The signing of transfer certifications if the physician knew or
should have known that the benefits of transfer did not outweigh the
risks, and
+ Misrepresenting an individual's condition or other information,
including a hospital's obligations under this section.
Of refusing Heart Medication of a Veteran
--
President of The United States
Guy Ralph Perea Sr President of The United States
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