
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 23, 2000]
[Document affected by Public Law 106-419 Section 404(b)(2)]
[Document affected by Public Law 106-419 Section 404(b)(2)]
[CITE: 38USC8153]

 
                      TITLE 38--VETERANS' BENEFITS
 
            PART VI--ACQUISITION AND DISPOSITION OF PROPERTY
 
   CHAPTER 81--ACQUISITION AND OPERATION OF HOSPITAL AND DOMICILIARY 
FACILITIES; PROCUREMENT AND SUPPLY; ENHANCED-USE LEASES OF REAL PROPERTY
 
SUBCHAPTER IV--SHARING OF MEDICAL FACILITIES, EQUIPMENT, AND INFORMATION
 
Sec. 8153. Sharing of health-care resources

    (a)(1) To secure health-care resources which otherwise might not be 
feasibly available, or to effectively utilize certain other health-care 
resources, the Secretary may, when the Secretary determines it to be in 
the best interest of the prevailing standards of the Department medical 
care program, make arrangements, by contract or other form of agreement 
for the mutual use, or exchange of use, of health-care resources between 
Department health-care facilities and any health-care provider, or other 
entity or individual.
    (2) The Secretary may enter into a contract or other agreement under 
paragraph (1) if such resources are not, or would not be, used to their 
maximum effective capacity.
    (3)(A) If the health-care resource required is a commercial service, 
the use of medical equipment or space, or research, and is to be 
acquired from an institution affiliated with the Department in 
accordance with section 7302 of this title, including medical practice 
groups and other entities associated with affiliated institutions, blood 
banks, organ banks, or research centers, the Secretary may make 
arrangements for acquisition of the resource without regard to any law 
or regulation (including any Executive order, circular, or other 
administrative policy) that would otherwise require the use of 
competitive procedures for acquiring the resource.
    (B)(i) If the health-care resource required is a commercial service 
or the use of medical equipment or space, and is not to be acquired from 
an entity described in subparagraph (A), any procurement of the resource 
may be conducted without regard to any law or regulation that would 
otherwise require the use of competitive procedures for procuring the 
resource, but only if the procurement is conducted in accordance with 
the simplified procedures prescribed pursuant to clause (ii).
    (ii) The Secretary, in consultation with the Administrator for 
Federal Procurement Policy, may prescribe simplified procedures for the 
procurement of health-care resources under this subparagraph. The 
Secretary shall publish such procedures for public comment in accordance 
with section 22 of the Office of Federal Procurement Policy Act (41 
U.S.C. 418b). Such procedures shall permit all responsible sources, as 
appropriate, to submit a bid, proposal, or quotation (as appropriate) 
for the resources to be procured and provide for the consideration by 
the Department of bids, proposals, or quotations so submitted.
    (iii) Pending publication of the procedures under clause (ii), the 
Secretary shall (except as provided under subparagraph (A)) procure 
health-care resources referred to in clause (i) in accordance with all 
procurement laws and regulations.
    (C) Any procurement of health-care resources other than those 
covered by subparagraph (A) or (B) shall be conducted in accordance with 
all procurement laws and regulations.
    (D) For any procurement to be conducted on a sole source basis other 
than a procurement covered by subparagraph (A), a written justification 
shall be prepared that includes the information and is approved at the 
levels prescribed in section 303(f) of the Federal Property and 
Administrative Services Act of 1949 (41 U.S.C. 253(f)).
    (E) As used in this paragraph, the term ``commercial service'' means 
a service that is offered and sold competitively in the commercial 
marketplace, is performed under standard commercial terms and 
conditions, and is procured using firm-fixed price contracts.
    (b) Arrangements entered into under this section shall provide for 
payment to the Department in accordance with procedures that provide 
appropriate flexibility to negotiate payment which is in the best 
interest of the Government. Any proceeds to the Government received 
therefrom shall be credited to the applicable Department medical 
appropriation and to funds that have been allotted to the facility that 
furnished the resource involved.
    (c) Eligibility for hospital care and medical services furnished any 
veteran pursuant to this section shall be subject to the same terms as 
though provided in a Department health care facility, and provisions of 
this title applicable to persons receiving hospital care or medical 
services in a Department health care facility shall apply to veterans 
treated under this section.
    (d) When a Department health care facility provides hospital care or 
medical services, pursuant to a contract or agreement authorized by this 
section, to an individual who is not eligible for such care or services 
under chapter 17 of this title and who is entitled to hospital or 
medical insurance benefits under title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.), such benefits shall be paid, notwithstanding 
any condition, limitation, or other provision in that title which would 
otherwise preclude such payment to such facility for such care or 
services or, if the contract or agreement so provides, to the community 
health care facility which is a party to the contract or agreement.
    (e) The Secretary may make an arrangement that authorizes the 
furnishing of services by the Secretary under this section to 
individuals who are not veterans only if the Secretary determines--
        (1) that veterans will receive priority under such an 
    arrangement; and
        (2) that such an arrangement--
            (A) is necessary to maintain an acceptable level and quality 
        of service to veterans at that facility; or
            (B) will result in the improvement of services to eligible 
        veterans at that facility.

    (f) Any amount received by the Secretary from a non-Federal entity 
as payment for services provided by the Secretary during a prior fiscal 
year under an agreement entered into under this section may be obligated 
by the Secretary during the fiscal year in which the Secretary receives 
the payment.
    (g) The Secretary shall submit to the Congress not more than 60 days 
after the end of each fiscal year a report on the activities carried out 
under this section. Each report shall include--
        (1) an appraisal of the effectiveness of the activities 
    authorized in this section and the degree of cooperation from other 
    sources, financial and otherwise; and
        (2) recommendations for the improvement or more effective 
    administration of such activities.

(Added Pub. L. 89-785, title II, Sec. 203, Nov. 7, 1966, 80 Stat. 1374, 
Sec. 5053; amended Pub. L. 91-496, Sec. 4, Oct. 22, 1970, 84 Stat. 1092; 
Pub. L. 93-82, title III, Sec. 303, Aug. 2, 1973, 87 Stat. 195; Pub. L. 
94-581, title I, Sec. 115(a)(1), title II, Secs. 206(c), 210(e)(11), 
Oct. 21, 1976, 90 Stat. 2852, 2859, 2865; Pub. L. 96-151, title III, 
Sec. 304, Dec. 20, 1979, 93 Stat. 1096; Pub. L. 97-295, Sec. 4(95)(A), 
Oct. 12, 1982, 96 Stat. 1313; Pub. L. 98-160, title VII, Sec. 702(20), 
Nov. 21, 1983, 97 Stat. 1010; Pub. L. 99-576, title II, Sec. 231(c)(1), 
Oct. 28, 1986, 100 Stat. 3264; Pub. L. 101-366, title II, Sec. 202(b), 
Aug. 15, 1990, 104 Stat. 438; renumbered Sec. 8153, Pub. L. 102-40, 
title IV, Sec. 402(b)(1), May 7, 1991, 105 Stat. 238; Pub. L. 102-54, 
Sec. 14(f)(9), June 13, 1991, 105 Stat. 288; Pub. L. 102-83, 
Sec. 4(a)(3), (4), (b)(1), (2)(D), (E), Aug. 6, 1991, 105 Stat. 404, 
405; Pub. L. 103-210, Sec. 3(c), Dec. 20, 1993, 107 Stat. 2498; Pub. L. 
104-262, title III, Sec. 301(c), (d)(1), Oct. 9, 1996, 110 Stat. 3191, 
3193; Pub. L. 105-114, title IV, Sec. 402(d), (e), Nov. 21, 1997, 111 
Stat. 2294.)

                       References in Text

    The Social Security Act, referred to in subsec. (d), is act Aug. 14, 
1935, ch. 531, 49 Stat. 620, as amended. Title XVIII of the Social 
Security Act is classified generally to subchapter XVIII (Sec. 1395 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)(3)(A). Pub. L. 105-114, Sec. 402(d), inserted 
``(including any Executive order, circular, or other administrative 
policy)'' after ``law or regulation''.
    Subsec. (a)(3)(B)(ii). Pub. L. 105-114, Sec. 402(e), which directed 
insertion of ``, as appropriate,'' after ``all responsible sources'' in 
second sentence, was executed by making the insertion after ``all 
responsible sources'' in third sentence, to reflect the probable intent 
of Congress.
    1996--Pub. L. 104-262, Sec. 301(d)(1), substituted ``Sharing of 
health-care resources'' for ``Specialized medical resources'' in section 
catchline.
    Subsec. (a)(1). Pub. L. 104-262, Sec. 301(c)(1)(A), substituted 
``health-care resources'' for ``certain specialized medical resources'', 
``other health-care resources'' for ``other medical resources'', and 
``of health-care resources between Department health-care facilities and 
any health-care provider, or other entity or individual'' for ``of--
        ``(A) specialized medical resources between Department health-
    care facilities and other health-care facilities (including organ 
    banks, blood banks, or similar institutions), research centers, or 
    medical schools; and
        ``(B) health-care resources between Department health-care 
    facilities and State home facilities recognized under section 
    1742(a) of this title''.
    Subsec. (a)(2). Pub. L. 104-262, Sec. 301(c)(1)(B), substituted ``if 
such resources are not, or would not be,'' for ``only if (A) such an 
agreement will obviate the need for a similar resource to be provided in 
a Department health care facility, or (B) the Department resources which 
are the subject of the agreement and which have been justified on the 
basis of veterans' care are not''.
    Subsec. (a)(3). Pub. L. 104-262, Sec. 301(c)(1)(C), added par. (3).
    Subsec. (b). Pub. L. 104-262, Sec. 301(c)(2), substituted ``payment 
to the Department in accordance with procedures that provide appropriate 
flexibility to negotiate payment which is in the best interest of the 
Government.'' for ``reciprocal reimbursement based on a methodology that 
provides appropriate flexibility to the heads of the facilities 
concerned to establish an appropriate reimbursement rate after taking 
into account local conditions and needs and the actual costs to the 
providing facility of the resource involved.''
    Subsec. (d). Pub. L. 104-262, Sec. 301(c)(3), substituted ``preclude 
such payment to such facility for such care or services'' for ``preclude 
such payment, in accordance with--
        ``(1) rates prescribed by the Secretary of Health and Human 
    Services, after consultation with the Secretary, and
        ``(2) procedures jointly prescribed by the two Secretaries to 
    assure reasonable quality of care and services and efficient and 
    economical utilization of resources,
to such facility therefor''.
    Subsecs. (e) to (g). Pub. L. 104-262, Sec. 301(c)(4), added subsecs. 
(e) and (f) and redesignated former subsec. (e) as (g).
    1993--Subsec. (a). Pub. L. 103-210 designated existing provisions as 
par. (1) and substituted ``other form of agreement for the mutual use, 
or exchange of use, of--'' along with subpars. (A) and (B) and par. (2), 
for ``other form of agreement, as set forth in clauses (1) and (2) 
below, between Department health-care facilities and other health-care 
facilities (including organ banks, blood banks, or similar 
institutions), research centers, or medical schools:
        ``(1) for the mutual use, or exchange of use, of specialized 
    medical resources when such an agreement will obviate the need for a 
    similar resource to be provided in a Department health care 
    facility; or
        ``(2) for the mutual use, or exchange of use, of specialized 
    medical resources in a Department health care facility, which have 
    been justified on the basis of veterans' care, but which are not 
    utilized to their maximum effective capacity.''
    1991--Pub. L. 102-40 renumbered section 5053 of this title as this 
section.
    Subsec. (a). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted 
``Secretary'' for ``Administrator'' in two places in introductory 
provisions.
    Pub. L. 102-83, Sec. 4(a)(3), (4), substituted ``Department'' for 
``Veterans' Administration'' wherever appearing.
    Subsec. (b). Pub. L. 102-83, Sec. 4(a)(3), (4), substituted 
``Department'' for ``Veterans' Administration''.
    Subsec. (c). Pub. L. 102-83, Sec. 4(a)(3), (4), substituted 
``Department'' for ``Veterans' Administration'' in two places.
    Pub. L. 102-54 amended subsec. (c) as in effect immediately before 
the enactment of Pub. L. 102-40 by substituting ``under this section'' 
for ``hereunder''.
    Subsec. (d). Pub. L. 102-83, Sec. 4(a)(3), (4), substituted 
``Department'' for ``Veterans' Administration'' in introductory 
provisions.
    Subsec. (d)(1). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted 
``Secretary'' for ``Administrator''.
    Subsec. (d)(2). Pub. L. 102-83, Sec. 4(b)(2)(D), substituted ``the 
two Secretaries'' for ``the Secretary and the Administrator''.
    Subsec. (e). Pub. L. 102-83, Sec. 4(b)(1), (2)(E), substituted 
``Secretary'' for ``Administrator'' in introductory provisions.
    1990--Subsec. (a). Pub. L. 101-366, Sec. 202(b)(1), substituted 
``health-care facilities and other health-care facilities (including 
organ banks, blood banks, or similar institutions), research centers, or 
medical schools'' for ``hospitals and other hospitals (or other medical 
installations having hospital facilities or organ banks, blood banks, or 
similar institutions) or medical schools or clinics in the medical 
community'' and struck out at end ``The Administrator may determine the 
geographical limitations of a medical community as used in this 
section.''
    Subsec. (b). Pub. L. 101-366, Sec. 202(b)(2), substituted in first 
sentence ``a methodology that provides appropriate flexibility to the 
heads of the facilities concerned to establish an appropriate 
reimbursement rate after taking into account local conditions and needs 
and the actual costs to the providing facility of the resource 
involved.'' for ``a charge which covers the full cost of services 
rendered, supplies used, and including normal depreciation and 
amortization costs of equipment.'' and inserted before period at end of 
second sentence ``and to funds that have been allotted to the facility 
that furnished the resource involved''.
    1986--Subsec. (e). Pub. L. 99-576 added subsec. (e).
    1983--Subsec. (d). Pub. L. 98-160 substituted ``title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.)'' for ``subchapter XVIII of 
chapter 7 of title 42''.
    1982--Subsec. (d)(1). Pub. L. 97-295 substituted ``Health and Human 
Services'' for ``Health, Education, and Welfare''.
    1979--Subsec. (a). Pub. L. 96-151 inserted provisions relating to 
applicability to organ banks, blood banks, or similar institutions.
    1976--Subsec. (a). Pub. L. 94-581, Secs. 206(c), 210(e)(11), 
substituted ``when the Administrator determines'' for ``when he 
determines'' and ``clauses'' for ``paragraphs'' in provisions preceding 
cl. (1), and inserted ``health care'' after ``Veterans' Administration'' 
in cls. (1) and (2).
    Subsec. (c). Pub. L. 94-581, Sec. 206(c)(2), inserted ``health 
care'' after ``Veterans' Administration'' in two places.
    Subsec. (d). Pub. L. 94-581, Sec. 115(a)(1), inserted subsec. (d).
    1973--Subsec. (a). Pub. L. 93-82 struck out ``or medical schools'' 
from parenthetical and inserted ``or medical schools or clinics'' after 
parenthetical.
    1970--Subsec. (a)(1). Pub. L. 91-496 substituted ``for the mutual 
use, or exchange of use,'' for ``for the exchange of use''.


                    Effective Date of 1976 Amendment

    Amendment by Pub. L. 94-581 effective Oct. 21, 1976, see section 211 
of Pub. L. 94-581, set out as a note under section 111 of this title.


                    Effective Date of 1973 Amendment

    Amendment by Pub. L. 93-82 effective Sept. 1, 1973, see section 501 
of Pub. L. 93-82, set out as a note under section 1701 of this title.


Report to Congress on Rates and Procedures Covering Payment of Benefits 
 for Care or Services Provided in Veterans' Administration Health Care 
 Facilities to Individuals Not Eligible for Veterans' Hospital, Nursing 
                   Home, Domiciliary, or Medical Care

    Section 115(c) of Pub. L. 94-581 provided that at such time as the 
rates and procedures described in subsec. (d) of this section were 
prescribed, the Secretary of Health, Education, and Welfare [now 
Secretary of Health and Human Services], in consultation with the 
Administrator of Veterans' Affairs, was to submit to the Committee on 
Ways and Means and the Committee on Veterans' Affairs of the House of 
Representatives and to the Committee on Finance and the Committee on 
Veterans' Affairs of the Senate a full report describing such rates and 
procedures.

                  Section Referred to in Other Sections

    This section is referred to in sections 712, 8107, 8157, 8158 of 
this title.
