
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document affected by Public Law 107-135 Section 208(e)(4)]
[Document affected by Public Law 107-135 Section 209(b)]
[CITE: 38USC1729]

 
                      TITLE 38--VETERANS' BENEFITS
 
                        PART II--GENERAL BENEFITS
 
    CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE
 
   SUBCHAPTER III--MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND 
           NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS
 
Sec. 1729. Recovery by the United States of the cost of certain 
        care and services
        
    (a)(1) Subject to the provisions of this section, in any case in 
which a veteran is furnished care or services under this chapter for a 
non-service-connected disability described in paragraph (2) of this 
subsection, the United States has the right to recover or collect 
reasonable charges for such care or services (as determined by the 
Secretary) from a third party to the extent that the veteran (or the 
provider of the care or services) would be eligible to receive payment 
for such care or services from such third party if the care or services 
had not been furnished by a department or agency of the United States.
    (2) Paragraph (1) of this subsection applies to a non-service-
connected disability--
        (A) that is incurred incident to the veteran's employment and 
    that is covered under a workers' compensation law or plan that 
    provides for payment for the cost of health care and services 
    provided to the veteran by reason of the disability;
        (B) that is incurred as the result of a motor vehicle accident 
    to which applies a State law that requires the owners or operators 
    of motor vehicles registered in that State to have in force 
    automobile accident reparations insurance;
        (C) that is incurred as the result of a crime of personal 
    violence that occurred in a State, or a political subdivision of a 
    State, in which a person injured as the result of such a crime is 
    entitled to receive health care and services at such State's or 
    subdivision's expense for personal injuries suffered as the result 
    of such crime;
        (D) that is incurred by a veteran--
            (i) who does not have a service-connected disability; and
            (ii) who is entitled to care (or payment of the expenses of 
        care) under a health-plan contract; or

        (E) for which care and services are furnished before October 1, 
    2002, under this chapter to a veteran who--
            (i) has a service-connected disability; and
            (ii) is entitled to care (or payment of the expenses of 
        care) under a health-plan contract.

    (3) In the case of a health-plan contract that contains a 
requirement for payment of a deductible or copayment by the veteran--
        (A) the veteran's not having paid such deductible or copayment 
    with respect to care or services furnished under this chapter shall 
    not preclude recovery or collection under this section; and
        (B) the amount that the United States may collect or recover 
    under this section shall be reduced by the appropriate deductible or 
    copayment amount, or both.

    (b)(1) As to the right provided in subsection (a) of this section, 
the United States shall be subrogated to any right or claim that the 
veteran (or the veteran's personal representative, successor, 
dependents, or survivors) may have against a third party.
    (2)(A) In order to enforce any right or claim to which the United 
States is subrogated under paragraph (1) of this subsection, the United 
States may intervene or join in any action or proceeding brought by the 
veteran (or the veteran's personal representative, successor, 
dependents, or survivors) against a third party.
    (B) The United States may institute and prosecute legal proceedings 
against the third party if--
        (i) an action or proceeding described in subparagraph (A) of 
    this paragraph is not begun within 180 days after the first day on 
    which care or services for which recovery is sought are furnished to 
    the veteran by the Secretary under this chapter;
        (ii) the United States has sent written notice by certified mail 
    to the veteran at the veteran's last-known address (or to the 
    veteran's personal representative or successor) of the intention of 
    the United States to institute such legal proceedings; and
        (iii) a period of 60 days has passed following the mailing of 
    such notice.

    (C) A proceeding under subparagraph (B) of this paragraph may not be 
brought after the end of the six-year period beginning on the last day 
on which the care or services for which recovery is sought are 
furnished.
    (c)(1) The Secretary may compromise, settle, or waive any claim 
which the United States has under this section.
    (2)(A) The Secretary, after consultation with the Comptroller 
General of the United States, shall prescribe regulations for the 
purpose of determining reasonable charges for care or services under 
subsection (a)(1) of this section. Any determination of such charges 
shall be made in accordance with such regulations.
    (B) Such regulations shall provide that reasonable charges for care 
or services sought to be recovered or collected from a third-party 
liable under a health-plan contract may not exceed the amount that such 
third party demonstrates to the satisfaction of the Secretary it would 
pay for the care or services if provided by facilities (other than 
facilities of departments or agencies of the United States) in the same 
geographic area.
    (C) Not later than 45 days after the date on which the Secretary 
prescribes such regulations (or any amendment to such regulations), the 
Comptroller General shall submit to the Committees on Veterans' Affairs 
of the Senate and the House of Representatives the Comptroller General's 
comments on and recommendations regarding such regulations (or 
amendment).
    (d) Any contract or agreement into which the Secretary enters with a 
person under section 3718 of title 31 for collection services to recover 
indebtedness owed the United States under this section shall provide, 
with respect to such services, that such person is subject to sections 
5701 and 7332 of this title.
    (e) A veteran eligible for care or services under this chapter--
        (1) may not be denied such care or services by reason of this 
    section; and
        (2) may not be required by reason of this section to make any 
    copayment or deductible payment in order to receive such care.

    (f) No law of any State or of any political subdivision of a State, 
and no provision of any contract or other agreement, shall operate to 
prevent recovery or collection by the United States under this section 
or with respect to care or services furnished under section 1711(b) of 
this title.
    [(g) Repealed. Pub. L. 105-33, title VIII, Sec. 8023(b)(4), Aug. 5, 
1997, 111 Stat. 667.]
    (h)(1) Subject to paragraph (3) of this subsection, the Secretary 
shall make available medical records of a veteran described in paragraph 
(2) of this subsection for inspection and review by representatives of 
the third party concerned for the sole purposes of permitting the third 
party to verify--
        (A) that the care or services for which recovery or collection 
    is sought were furnished to the veteran; and
        (B) that the provision of such care or services to the veteran 
    meets criteria generally applicable under the health-plan contract 
    involved.

    (2) A veteran described in this paragraph is a veteran who is a 
beneficiary of a health-plan contract under which recovery or collection 
is sought under this section from the third party concerned for the cost 
of the care or services furnished to the veteran.
    (3) Records shall be made available under this subsection under such 
conditions to protect the confidentiality of such records as the 
Secretary shall prescribe in regulations.
    (i) For purposes of this section--
        (1)(A) The term ``health-plan contract'' means an insurance 
    policy or contract, medical or hospital service agreement, 
    membership or subscription contract, or similar arrangement, under 
    which health services for individuals are provided or the expenses 
    of such services are paid.
        (B) Such term does not include--
            (i) an insurance program described in section 1811 of the 
        Social Security Act (42 U.S.C. 1395c) or established by section 
        1831 of such Act (42 U.S.C. 1395j);
            (ii) a State plan for medical assistance approved under 
        title XIX of such Act (42 U.S.C. 1396 et seq.);
            (iii) a workers' compensation law or plan described in 
        subparagraph (A) of subsection (a)(2) of this section; or
            (iv) a program, plan, or policy under a law described in 
        subparagraph (B) or (C) of such subsection.

        (2) The term ``payment'' includes reimbursement and 
    indemnification.
        (3) The term ``third party'' means--
            (A) a State or political subdivision of a State;
            (B) an employer or an employer's insurance carrier;
            (C) an automobile accident reparations insurance carrier; or
            (D) a person obligated to provide, or to pay the expenses 
        of, health services under a health-plan contract.

(Added Pub. L. 97-72, title I, Sec. 106(a)(1), Nov. 3, 1981, 95 Stat. 
1050, Sec. 629; amended Pub. L. 99-272, title XIX, Sec. 19013(a), Apr. 
7, 1986, 100 Stat. 382; Pub. L. 100-322, title II, Sec. 202, May 20, 
1988, 102 Stat. 509; Pub. L. 101-508, title VIII, Sec. 8011(a)-(c), Nov. 
5, 1990, 104 Stat. 1388-344; Pub. L. 102-40, title IV, Sec. 402(d)(1), 
May 7, 1991, 105 Stat. 239; renumbered Sec. 1729 and amended Pub. L. 
102-83, Secs. 4(b)(1), (2)(E), 5(a), (c)(1), Aug. 6, 1991, 105 Stat. 
404-406; Pub. L. 102-568, title VI, Sec. 604, Oct. 29, 1992, 106 Stat. 
4343; Pub. L. 103-66, title XII, Sec. 12003, Aug. 10, 1993, 107 Stat. 
414; Pub. L. 104-262, title I, Sec. 101(d)(10), Oct. 9, 1996, 110 Stat. 
3180; Pub. L. 105-33, title VIII, Secs. 8022, 8023(b)(4), (d), Aug. 5, 
1997, 111 Stat. 665, 667.)

                       References in Text

    The Social Security Act, referred to in subsec. (i)(1)(B)(ii), is 
act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XIX of the 
Social Security Act is classified generally to subchapter XIX (Sec. 1396 
et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For 
complete classification of this Act to the Code, see section 1305 of 
Title 42 and Tables.


                               Amendments

    1997--Subsec. (a)(1). Pub. L. 105-33, Sec. 8023(d)(1), substituted 
``reasonable charges for'' for ``the reasonable cost of''.
    Subsec. (a)(2)(E). Pub. L. 105-33, Sec. 8022, substituted ``October 
1, 2002'' for ``October 1, 1998''.
    Subsec. (c)(2)(A). Pub. L. 105-33, Sec. 8023(d)(2), substituted 
``reasonable charges for'' for ``the reasonable cost of'' and ``such 
charges'' for ``such cost''.
    Subsec. (c)(2)(B). Pub. L. 105-33, Sec. 8023(d)(2)(A), substituted 
``reasonable charges for'' for ``the reasonable cost of''.
    Subsec. (g). Pub. L. 105-33, Sec. 8023(b)(4), struck out subsec. (g) 
which established in the Treasury a fund known as the Department of 
Veterans Affairs Medical-Care Cost Recovery Fund and provided for 
deposits to and payments from the Fund.
    1996--Subsec. (g)(3)(A). Pub. L. 104-262 substituted ``under 
subsection (f) or (g) of section 1710 of this title for hospital care, 
medical services, or nursing home care'' for ``under section 1710(f) of 
this title for hospital care or nursing home care, under section 1712(f) 
of this title for medical services,''.
    1993--Subsec. (a)(2)(E). Pub. L. 103-66 substituted ``October 1, 
1998'' for ``August 1, 1994''.
    1992--Subsec. (a)(2)(E). Pub. L. 102-568 substituted ``August 1, 
1994'' for ``October 1, 1993''.
    1991--Pub. L. 102-83, Sec. 5(a), renumbered section 629 of this 
title as this section.
    Subsecs. (a) to (c). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), 
substituted ``Secretary'' for ``Administrator'' wherever appearing.
    Subsec. (d). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted 
``Secretary'' for ``Administrator''.
    Pub. L. 102-40 substituted ``5701'' for ``3301'' and ``7332'' for 
``4132''.
    Subsec. (f). Pub. L. 102-83, Sec. 5(c)(1), substituted ``1711(b)'' 
for ``611(b)''.
    Subsec. (g)(3)(A). Pub. L. 102-83, Sec. 5(c)(1), substituted 
``1710(f)'' for ``610(f)'', ``1712(f)'' for ``612(f)'', and ``1722A'' 
for ``622A'' in introductory provisions.
    Subsec. (h)(1), (3). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), 
substituted ``Secretary'' for ``Administrator''.
    1990--Subsec. (a)(2)(E). Pub. L. 101-508, Sec. 8011(a), added 
subpar. (E).
    Subsec. (c)(2)(B). Pub. L. 101-508, Sec. 8011(b), substituted ``if 
provided by'' for ``in accordance with the prevailing rates at which the 
third party makes payments under comparable health-plan contracts 
with''.
    Subsec. (g). Pub. L. 101-508, Sec. 8011(c), amended subsec. (g) 
generally. Prior to amendment, subsec. (g) read as follows: ``Amounts 
collected or recovered on behalf of the United States under this section 
shall be deposited into the Treasury as miscellaneous receipts.''
    1988--Subsec. (b)(2)(C). Pub. L. 100-322 added subpar. (C).
    1986--Pub. L. 99-272 amended section generally, inserting authority 
to recover from a third party under a health-plan contract the 
reasonable costs of a non-service-connected disability, to require the 
Administrator to prescribe regulations to govern determination of 
reasonable costs, to authorize the compromise, settlement or waiver of 
claims, and to provide for the deposit of money collected under this 
section in the Treasury.


                    Effective Date of 1997 Amendment

    Amendment by section 8023(b)(4) of Pub. L. 105-33 effective Oct. 1, 
1997, and amendment by section 8023(d) of Pub. L. 105-33 effective Aug. 
5, 1997, see section 8023(g) of Pub. L. 105-33, set out as a note under 
section 712 of this title.


                    Effective Date of 1990 Amendment

    Section 8011(e) of Pub. L. 101-508 provided that: ``The amendments 
made by this section [amending this section] shall take effect as of 
October 1, 1990.''


                    Effective Date of 1986 Amendment

    Section 19013(b) of Pub. L. 99-272 provided that:
    ``(1) Except as provided in paragraph (2), section 629 [now 1729] of 
title 38, United States Code, as amended by subsection (a), shall apply 
to care and services provided on or after the date of the enactment of 
this Act [Apr. 7, 1986].
    ``(2)(A) Such section shall not apply so as to nullify any provision 
of a health-plan contract (as defined in subsection (i) of such section) 
that--
        ``(i) was entered into before the date of the enactment of this 
    Act; and
        ``(ii) is not modified or renewed on or after such date.
    ``(B) In the case of a health-plan contract (as so defined) that was 
entered into before such date and which is modified or renewed on or 
after such date, the amendment made by subsection (a) [amending this 
section] shall apply--
        ``(i) with respect to such plan as of the day after the date 
    that it is so modified or renewed; and
        ``(ii) with respect to care and services provided after such 
    date of modification or renewal.
    ``(3) For purposes of paragraph (2), the term `modified' includes 
any change in premium or coverage.''


                             Effective Date

    Section 106(b) of Pub. L. 97-72 provided that: ``Section 629 [now 
1729] of title 38, United States Code, as added by subsection (a), shall 
apply with respect to care and services furnished under chapter 17 of 
title 38, United States Code, on or after the date of the enactment of 
this Act [Nov. 3, 1981].''


   Disposition of Funds in and Termination of Department of Veterans 
                 Affairs Medical-Care Cost Recovery Fund

    Section 8023(c) of Pub. L. 105-33 provided that: ``The amount of the 
unobligated balance remaining in the Department of Veterans Affairs 
Medical-Care Cost Recovery Fund (established pursuant to section 
1729(g)(1) of title 38, United States Code) at the close of June 30, 
1997, shall be deposited, not later than December 31, 1997, in the 
Treasury as miscellaneous receipts, and the Department of Veterans 
Affairs Medical-Care Cost Recovery Fund shall be terminated when the 
deposit is made.''


              Transfers to Medical-Care Cost Recovery Fund

    Section 8011(d) of Pub. L. 101-508, as amended by Pub. L. 102-83, 
Sec. 5(c)(2), Aug. 6, 1991, 105 Stat. 406, provided that the Secretary 
of the Treasury was to transfer $25,000,000 from the Department of 
Veterans Affairs Loan Guaranty Revolving Fund to the Department of 
Veterans Affairs Medical-Care Cost Recovery Fund and that the amount so 
transferred was to be available until the end of Sept. 30, 1991, for the 
support of the equivalent of 800 full-time employees and other expenses 
described in former subsec. (g)(3) of this section, and provided that 
the first $25,000,000 recovered or collected by the Department of 
Veterans Affairs during fiscal year 1991 as a result of third-party 
medical recovery activities was to be credited to the Department of 
Veterans Affairs Loan Guaranty Revolving Fund.


               Reports on Implementation of 1986 Amendment

    Section 19013(c) of Pub. L. 99-272 directed Administrator of 
Veterans' Affairs, not later than six months after Apr. 7, 1986, to 
submit to Committees on Veterans' Affairs of Senate and House of 
Representatives a report on the process for and results of 
implementation of this section, as amended by subsection (a), such 
report to show costs of administration (and a detailed breakdown of such 
costs) and the amount of receipts and collections under this section, 
and not later than Feb. 1, 1988, to submit to such Committees a report 
updating the information in the report previously submitted and 
providing information on the process and results of such implementation 
through at least the end of fiscal year 1987.

                  Section Referred to in Other Sections

    This section is referred to in sections 1725, 1729A of this title.
